Can A Dietitian Help With Skin Problems?
December 23, 2022
If you’re reading this, you’ve probably experienced issues with your skin. Skin issues often leave us reaching for expensive creams, oils and even antibiotics to try and get some relief, but have you ever considered heading to a dietitian clinic?
Once you’ve gone through all the standard topical treatments, you may wonder if your diet is causing your skin issues. Perhaps you have stopped eating sugar or gone dairy free to try and help combat your symptoms. While there is mixed evidence for cutting out these foods completely, there may be some truth about how your diet affects your skin.
Our skin is our largest organ. It consists of different layers that work together with our immune system to protect us from the harsh outside environment (1). Our skin cells are constantly being shed and replaced by new cells, a process that requires a rich supply of nutrients such as protein, fats and various vitamins and minerals.
This article will explore the current scientific evidence on diet and skin problems and will show you how an online dietitian in Australia from The PNW Clinic can help you manage these conditions and feel happy, healthy and confident in your skin.
Common skin conditions
Skin conditions are very common in Australia, attributed to nearly 20% of all GP consultations (2). These conditions can vary in symptoms and severity, can be temporary or more permanent, and range from painless to really painful.
The most common skin conditions in Australia are:
The role of genetics
Our genes will play a role in determining if we are more likely to develop one of these skin conditions than another because they are involved in determining our skin type. They can tell us whether we will be more prone to dryness, our skin elasticity and even the size of our pores.
For example, those of us with genes for larger pores will be more prone to developing acne. Genetic mutations in the gene that makes filaggrin (a protein that helps our bodies maintain a healthy protective barrier) have been linked to the development of eczema (3). Mutations in genes that affect the immune system have been implicated in the development of psoriasis.
However, having one of these genetic markers doesn’t mean that you will develop a skin condition. Environmental factors including our diet can also be a trigger.
Acne is the most common skin condition, affecting nearly 90% of people aged between 15-24. It is caused when your hair follicles become clogged with oil, bacteria and dead skin cells. This causes inflammation – swelling, redness, heat and pain within the pore and results in the appearance of whiteheads, blackheads or other types of pimples (4).
Acne most commonly affects teenagers and young adults due to hormonal changes. An increase in androgens (the sex hormones), causes the oil glands on the skin to enlarge and produce more oil, making the pore more prone to blockage.
Other things like air pollution, stress, some medications, fluctuating hormone levels related to the menstrual cycle and even genetics can also cause acne or make acne worse.
Diet and acne
While there are lots of myths out there about diet and acne, the evidence does suggest that eating a diet rich in low glycaemic foods may help to prevent acne and reduce symptoms (5,6). Low glycemic index (low GI) foods include carbohydrate-containing foods that don’t cause a large spike in blood sugar levels soon after eating them. These foods release energy more slowly and help to keep you feeling fuller for longer.
Examples of low GI foods would include:
- Whole wheat pasta and breads,
- Oats and bran cereals,
- Non-starchy vegetables such as broccoli, eggplant, asparagus and spinach.
This doesn’t mean that you need to completely avoid high GI foods. By combining high GI foods such as chocolate, chips or white breads with other foods rich in fibre, protein and healthy fats, you can reduce that instant spike in blood sugar. For example, you could eat a piece of chocolate alongside a small handful of nuts or swap white bread for wholegrain bread and top it with avocado instead of jam.
Going for a walk within an hour after eating higher GI foods can also help to reduce a spike in your blood sugar levels (7).
Currently, the role of dairy in causing acne remains contentious. Studies that show that dairy does affect acne are prone to bias (8). This means that while dairy may trigger acne in some people, it is unlikely to have a big impact on the general population.
If you’re looking to make the switch to plant-based dairy substitutes, keep in mind that not all products are created equal. It’s a good idea to consult with an online dietitian in Australia at The PNW Clinic before you make any swaps. Ideally, you would be choosing products with a good amount of protein that has been fortified with calcium and vitamin B12.
Eczema is an inflammatory skin condition where the skin barrier is disrupted, resulting in dry, red, itchy patches on the skin. This loss of your skin’s protective barrier function makes you more susceptible to infection, dryness and the development of allergies (9).
Eczema usually develops in childhood and is a chronic condition, meaning that once you have it you have it for life. It’s currently not known what causes eczema. It’s thought to develop from a complex interaction between a person’s genes, environment, immune system and skin microbiome (10, 11).
Current treatments for this skin condition include:
- Identifying and avoiding specific triggers that cause your skin to flare up,
- Developing a comprehensive skin-care routine,
- Managing stress,
- Using appropriate topical medication when necessary.
Diet and eczema
Food allergies are commonly associated with eczema. It is important to get these diagnosed by your doctor and allergist. Common food allergens include:
If you don’t have a diagnosed food allergy, there is limited evidence that avoiding these foods will help manage symptoms. In fact, dietary restriction of these foods in people with eczema has been shown to result in deficiencies of key nutrients (12).
Working alongside a dietitian when you have eczema can be helpful to ensure you are eating a nutritionally balanced diet. They also might ask you to keep a food diary so that you can identify any food triggers. For example, one study showed that a diet higher in ‘fast food’ resulted in more severe eczema in children and adolescents (13).
There have been mixed results on the effectiveness of using probiotics for managing eczema. Some studies have shown that supplementation with Lactobacillus or Bifidobacterium-containing probiotics may have some beneficial effects (14). There is also evidence that the supplementation of prenatal and postnatal women with Lactobacillus rhamnoses, may reduce the likelihood of their child developing eczema (15). However, more robust research is needed to confirm this effect.
It’s important to note that probiotic supplements vary in the type and concentration of bacteria. Therefore, it may be more beneficial to eat foods naturally high in probiotics, such as yoghurt, or eat foods containing prebiotics (the food for your gut bacteria). Prebiotics are found in vegetables, fruits and whole grains.
Psoriasis is a chronic skin condition involving the immune system. With this condition your immune system will attack its own skin cells, causing them to multiply too quickly. This results in thick scaly patches that are dry, flaky and painful.
Just like eczema, these symptoms come and go through cycles of flare-ups. What causes them is not completely known (8). Genetics and environmental factors such as diet, lifestyle, the microbiome and stress are thought to play a role. Interestingly, psoriasis is often accompanied by other conditions such as insulin resistance and inflammatory bowel disease (16).
Currently, there is no cure for psoriasis. Despite this, most people experience mild to moderate symptoms that can be managed with creams and ointments.
Diet and psoriasis
Psoriasis is an auto-immune condition. Diets that help to reduce inflammation in the body can be useful in managing this condition.
Eating a Mediterranean diet has shown some benefits in the management of psoriasis (17). This is because the Mediterranean diet is high in anti-inflammatory nutrients like omega-3 fatty acids, monounsaturated fatty acids, fibre and complex carbohydrates. These nutrients come from eating a wide range of fruits and vegetables, as well as extra-virgin olive oil and oily fish.
Some small studies have shown a positive effect of diet supplementation with omega-3 fish oil tablets in reducing the severity of psoriasis, however dietary fish consumption is preferred.
7 Key Nutrients To Optimize Skin Health
Several key nutrients ensure the skin can function properly. Getting enough of these nutrients may help if you are currently suffering from a skin condition.
We usually don’t think about how much protein we are eating unless we are trying to ‘bulk up’ at the gym. However, dietary protein is essential for skin health as it provides the building blocks (known as amino acids) that make up the important structural molecules of our skin – keratin, elastin and collagen.
Foods high in protein include meat, poultry, seafood, eggs, dairy, legumes, nuts, seeds and tofu.
Omega-3’s and -6’s fatty acids
Omega-3 and -6’s are nourishing dietary fats that can help improve the skin’s barrier function and fight inflammation. Some studies have shown that increasing your intake of omega-3 and -6’s can benefit people with acne and psoriasis (19), however, there is little evidence for the benefit of using omega-3 and -6 supplements.
Omega-3s and -6’s can be found in oily fish (salmon, mackerel, tuna and sardines), nuts, seeds and tofu.
There are 8 different B vitamins, all of which are important for skin health. These vitamins can protect against inflammation, improve skin hydration, reduce the appearance of fine lines and wrinkles and boost dull-looking skin.
These are found in a variety of foods including meat, poultry, seafood, dairy, eggs, whole grains, legumes, nuts, seeds, leafy greens, vegemite and fortified foods like breakfast cereals.
Vitamin C is important because it promotes the development of collagen, giving the skin its firm and elastic properties. It also acts as an antioxidant, protecting the skin from UV sun damage (20).
Vitamin C is found in fruit and vegetables such as oranges, lemons, strawberries, kiwi fruit, broccoli, cauliflower, and tomatoes.
Vitamin E is important to the function of our immune system and acts as an antioxidant, protecting our skin from free radicals caused by air pollution, cigarette smoke and UV light from the sun, which can cause photo-ageing (21).
Sources of vitamin E are vegetable oils, green leafy vegetables, nuts, eggs and fortified breakfast cereals.
Selenium has a range of functions within the body. It helps the immune system and reduces inflammation and the occurrence of acne (22). In combination with vitamin E, it helps the skin to heal and works to improve fertility and thyroid function and prevent heart disease.
Dietary sources of selenium include brazil nuts, seafood, meat, cereals and other grains and some vegetables.
Zinc acts to support the production of new skin cells, reducing inflammation within the skin. The best sources of zinc in the diet include meat, seafood, nuts, seeds, legumes, and whole-grain cereals (23).
It is important to note that zinc found in animal products is better absorbed by the body. So, if you are on a vegetarian or vegan diet you need to plan your diet a bit more carefully to ensure you are getting adequate amounts.
Hydration is key!
Keeping hydrated is important for the functioning of your skin. It makes sure the protective outer layer is up to the challenge. Without enough water, our skin will become dry and uneven and fine lines will become more visible.
The Australian Dietary Guideline recommends drinking around 1.5-2 L a day, which is about 8-10 glasses of water (24). Drinking enough water has been shown to be beneficial for individuals who suffer from eczema or psoriasis, reducing the number of flare-ups.
Some tips to stay hydrated include taking a bottle of water with you throughout the day and placing it close by so you remember to drink. If you feel like something a bit different, try a herbal tea. Some, like green tea, have the bonus of antioxidants!
Limit alcohol intake
Drinking alcohol can have the opposite effect of water. It dries your skin out, depleting it of moisture and the nutrients it needs to stay elastic and healthy.
Consuming a lot of alcohol has also been shown to increase your risk of developing psoriasis and the severity of this condition. For people with a family history of psoriasis, it might be beneficial to limit their intake of alcohol.
If you do choose to drink alcohol, stick to the recommended number of standard drinks and pay attention to portion size.
Where do ‘fun foods’ or ‘discretionary foods’ fit in?
Good news for chocolate lovers – there is no strong evidence to show that chocolate causes skin conditions. Dark chocolate contains flavonoids, an antioxidant that may help give skin protection. However, chocolate (particularly milk chocolate) is also quite high in fat and sugar and in large quantities may cause your blood sugar levels to spike.
Overall, aim to eat ‘fun foods’ in moderation and alongside other foods high in fibre, protein or fat.
Eating a balanced diet primarily consisting of whole foods is important for optimal skin health. Many factors can contribute to the development of certain skin conditions, including diet. The good news is that making some small changes to your diet that suit you and your lifestyle can have a huge impact.
If you’re struggling with skin problems and want to adjust your diet the team at our dietitian clinic can help. Book a discovery call with one of our online dietitians at The PNW Clinic.
Article written by: student dietitian Megan Faulks
Reviewed by: PNW Clinic dietitian Megan Boswell