Tune In: How To Treat Acne & Skin Inflammation Holistically

By now, I don't feel I need to school you on how lifestyle choices can worsen acne. For example, the nutrition and acne connection: It's pretty well understood and established that certain food triggers can lead to breakouts for those genetically predisposed to acne. (Think: some kinds of diary, high-glycemic-index foods, and so on.) Stress is another trigger for lots of folks, as it can send the body into an inflammatory state that could lead to blemishes. 

"While genetics do play a role in these conditions, there is also the environment we have to consider. It's like a soda bottle. Our DNA and genetics put soda into the bottle, but the environment shakes it up," says naturopathic doctor Bryant Esquejo, N.D., who specializes in skin conditions like eczema and acne. 

On this episode of Clean Beauty School, he joins me to talk about how lifestyle influences inflammatory skin conditions. "The skin is a visual representation of overall health and wellness. The body is always trying to heal itself and adapt to the environment given the tools it has," he says, noting that if we just give our bodies the right tools, we can achieve clear, bright, glowing skin with a few simple modifications. 

As Esquejo says in the episode, acne, eczema, and other inflammatory skin conditions are on the rise. This is due to a variety of complicated factors, one of which is certain aspects of the Western diet. 

"I believe that Western diets are playing a role," he says, noting that a Western diet is defined as high dietary intake of ultraprocessed products, fats, sucrose, refined grains, and a reduced intake of fiber, fruits, and vegetables. 

"The thing we see with the Western diet is low fiber intake," he emphasizes. He's not wrong: The average American is eating about 16 grams of fiber1 daily, but the dietary recommendations for fiber are far higher. As a baseline, the National Academies2 recommends that women under 50 have at least 25 to 28 grams of fiber per day, while men under 50 should strive for at least 38 grams daily.

"We know Western diets have been found by several researchers to be associated with inflammatory issues like cardiometabolic issues," he goes on to explain. "And interestingly enough, scientists suggest that this could be because of small-scale inflammation caused by gut bacteria and their byproducts called lipopolysaccharides, also known as endotoxins." 

But one of the best ways to support a healthy gut microbiome—and reduce the risk of these inflammation-triggering endotoxins—is through fiber intake. For proof, Esquejo points to a 2021 study that found a relationship between fiber intake and eczema flareups. "They found that as dietary fiber increased-prevalence-eczema decreased." 

A sedentary lifestyle can have profound and harmful effects on your overall health. Sitting too much throughout the day can not only lead to physical conditions, but it can impact mental health, longevity, and even skin. 

"There's some really interesting science that speaks to how exercise modulates the gut microbiome," Esquejo says. "What studies found was that as people increased their exercise, it increased the amount of beneficial bacteria that make short-chain fatty acids. For folks who don't know what short-chain fatty acids are, they're basically gut-derived fats that are anti-inflammatory to the intestinal barrier."

This is exciting in its own right, as improving the gut barrier has a host of long-term benefits for the full body. And this includes the skin.  

There's a reason we've all been taught the importance of vitamin D: Vitamin D is a fat-soluble nutrient that contributes to several of the body's physiological processes. It regulates calcium and phosphorous absorption, helps you maintain good teeth and bone health, and supports the functioning of the immune and nervous systems, among other important responsibilities.

It can also influence skin, it turns out. That's why Esquejo pays attention to vitamin D deficiency in his treatment protocol.  

"There's interesting research around nutrient status and deficiency, so I want to understand if that might be playing a role in their acne," he explains. "For example, I want to know if there's a history of vitamin D deficiency because there was a 2016 article4 that linked vitamin D deficiency to acne. In that study, when vitamin D deficiency was corrected, the severity of acne and subjects improved, which is really cool.”