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The Best Supplements For Your Acne & Rosacea!

Along with the idea of how important nutrition is for our skin and acne, there are several key supplements that can help keep your skin looking clear. A combination of vitamins and natural supplements can help to maintain healthy skin and nails. It is important to remember that supplements can take 8-12 weeks before significant changes are noted in our skin…so be patient and do not give up. In my office I consult patients on diet, supplements, skin care and will also prescribe topical and oral therapies as adjuncts to treatment, but I first make a note to stress the importance of diet and supplements.

I will go over which supplements work best, and how to pick which ones for your skin. Rosacea and acne have a lot of overlap when it comes to oral supplements. For hormonal acne, I have a few recommendations that are specific for women.If you have a health condition or are taking medications always speak with your doctor before starting a new supplement.

Vitamin A

This power vitamin, works on much more than just vision, it is integral to our immune function, and plays a powerful role in skin, hair and nails. In fact the treatment known as Accutane, is essentially a synthetic form of vitamin A, so it would make sense that supplementation with vitamin A would be of benefit to your skin. (However, if already taking Accutane, do not take vitamin A supplements). A daily dose of 5.000 I.U. in an oil capsule, in the retinol form I find is most beneficial.  Take with a fatty meal such as dinner.

Niacinamide (Vitamin B3)

This vitamin has a potent anti-inflamatory effect on the skin, in addition to its importance in maintaining the barrier function of our skin. Niacinamide is particularly helpful for both acne and rosacea. The recommended dosage is 500-800mg twice daily. Unlike Niacin, Niacinamide should not cause redness or flushing of the skin.

Zinc

There are many studies that have shown the benefit of taking daily zinc in the reduction of acne and rosacea. Zinc is essential to the proper function of our skin, and can be found in many foods such as pumpkin seeds, oysters and beef. Zinc picolinate or chelated zinc may have better absorption and effect than zinc gluconate. The general  recommended dose is 50mg per day. This will not only help rosacea and acne but will probably prevent or ease the common cold. Make sure to take zinc with food to prevent stomach upset.

Borage Oil & Evening Primrose Oil

If you have never heard of either of these oils, they are widely used for the treatment of menopausal symptoms, PMS, and work great for the hormonal component of acne. These oils are derived from plants, and are high in anti-inflammatory fatty acids, and are precursors to the production of our own hormones, this can help to stabilize imbalances.  Many patients swear by this for their acne, and I am often recommending this for hormonal acne. Often hormonal acne will be noted in the beard distribution, along the jawline, lower cheeks and upper neck area, but can also include the chest and back.

Probiotics

Our gut flora and digestive tracts have a strong impact on acne and rosacea as well. It may sound like a lot of supplements, but maintaining a healthy gut should not be overlooked for its importance. A natural way to increase your intake of good bacteria is to eat fermented foods such as sauerkraut and kimchi (these are non-dairy recommendations).

Spearmint Tea

No kidding. Studies have shown that 1 cup twice daily reduced hormonal acne and even facial hair in women. With a mild mint flavor, this tea is very pleasant, to sweeten it try a teaspoon of raw honey (also so good for you).

Green Tea

The powerful green tea polyphenols found in this tea work well for your overall health, and are wonderful anti-oxidants that can help brighten your complexion and reduce both acne and rosacea flares.

Are you eating right for your Acne?

Have you tried every over the counter/prescription for acne, and still can’t seem to stop those pimples from appearing every other day? You are definitely not alone, and this is something I deal with in my office every day. It is unrealistic to believe that all acne will improve with just topical creams and cleansers. This particularly rings true for those of you out there who have hormonal acne….a high number of you indeed. I will go over my general recommendations that can dramatically improve acne naturally!

It is essential to recognize the importance of what we are putting into our bodies every day. I find that especially for acne, in order to get consistent results and eliminate flare-ups the proper diet is key. There are several food groups that contribute in particular to acne, and what I suggest has also been confirmed through dermatologic research in patterns of acne and dietary triggers.

DAIRY

Skip the cow products. Trust me. They are loaded with hormones, even if you buy organic. Think about it, this is meant for a baby cow to become a big cow rapidly. The “Western” ideology that dairy is essential to your health and bone growth is false. The calcium in milk can easily be replaced with eating dark leafy vegetables, in fact some of the largest populations on the planet do not include dairy in their diet….and they are all doing very well.  I have many patients who notice that they get flare ups after having a dairy splurge.

To avoid dairy, that means no milk, cheese, ice cream, butter, and products that have butter in them…so read labels. A wonderful milk replacement is Almond Milk (try Califia, it is terrific).

REFINED CARBOHYDRATES

This is the tough one to talk about.  Many people will say….What?!  No bread?!  How dare you?  And, I wish that this wasn’t the case, but all the research shows such strong correlations with acne and the glycemic index. This means…try to avoid sweets, white bread, white rice, pastas, etc. Certainly in moderation whole grains can be well tolerated, such as brown rice and bread. However, these should not be the main star of your meal.  Avoid the bread basket when you go out to eat, either keep the towel over the bread or even ask them to not bring bread to the table. I will often have them hold the toast when ordering an omelet if I am out.

Anecdotally, I also have seen that a gluten free diet can help clear the skin for many patients. It will take 8 weeks with any change in your diet or skin care regimen to notice a change, so I suggest you give it a real try if you think this might help you.

Tips For What To Eat

Breakfast

The American breakfast has to be the most carb driven out there. Skip the cereal, pancakes, English muffins….opt for eggs, a veggie omelet, or quinoa (made oatmeal style is so yummy and nutritious for breakfast). Eggs are good for you! They had a bad reputation for many years, but we now know that they have always been good. The oldest woman alive that just turned 117, eats 2 eggs a day (she eats them raw, and I am definitely not suggesting that you do!). Eggs are loaded with good proteins, Vitamin A and D.

Snacks

Try snacking on a handful of nuts, or a Kind Bar. Bring Apple slices and almond butter for dipping. Try a berry smoothie, this will be filled with skin friendly antioxidants.

Lunch

Skip the sandwich, instead opt for a salad, or a protein (such as salmon or chicken) with vegetables. If you must have a sandwich get a whole wheat wrap, but it is still better to avoid the extra carbohydrates when possible. Have some fruit with your meal.

Dinner

Eat a healthy fish such as Salmon that is rich in Omegas. Eat meats that are grass fed, these meats actually produce Omega fatty acids that are beneficial to your health and skin. Eat plenty of vegetables. Keep your carbs to a small amount, imagine a handful of brown rice, that is not a lot. Use olive oil and coconut oil in your cooking, not only are they good for your skin but using oils in your food will help keep you feeling full longer, so you will not have to snack.

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                                                                                         Fraxel 2 Sessions

Every day I treat people for acne and acne scarring.  Luckily there very effective treatment options available to improve the appearanceof acne scars. There are also some treatment myths that need to be cleared up.

1. The first thing I always address with my patients is whether they are still breaking out, if you are still getting acne lesions, you first need to get control of the acne. Otherwise, new scars will be developing, and money and effort will be wasted to treat scars without doing anything to prevent new scars. I make a point to make this clear to my patients, because I believe it is important in order for the outcome to be the best possible.

2. The top 3 treatments I believe work the best for acne scarring are the Fraxel (a fractionated resurfacing laser), the pixel (which is a CO2 laser), and microneedling. The Fraxel will take 3-5 treatments, but has a relatively quick recovery, it creates “micro” perforations in the skin with spared healthy skin in between these areas, so the skin heals quickly. Patients will have redness after a treatment, similar to a sunburn, but this resolves usually over 3-7 days, and makeup may be worn. The CO2 laser which is often used together with an Erbium Yag laser, is similar to the Fraxel but is slightly more invasive, with most patients only needing 1-2 treatments. This laser treatment does require a recovery period of 7-10 days, with frequent application of ointments to the face until completely healed. Microneedling pens are gaining popularity for acne scarring. They are mechanized tool with fine needles which are used over the areas of scarring, creating perforations mechanically. The outcome is very similar to results seen with fractional lasers, with less redness and shorter “down time”, this may be a better option for darker skin types than a laser – offers a reduced risk of post treatment hyperpigmentation.

3. A lot of people ask me what kind of creams should they purchase. The ingredient that is most helpful in the treatment of scarring is retinoic acid or retinol. Retinoic acid comes in many different formulations from the generic tretinoin, to well-known brands such as Retin A, Renova, Tazorac or Atralin. Retinoic acid/Retinol containing creams can help stimulate new collagen production. Used in a pea size amount in the evening, these creams are usually very tolerable. It is a useful medication to treat the acne and acne scarring together.

4. Get a dermroller. If you haven’t heard of a dermroller, imagine a roller with numerous fine needles, this is used to roll over the surface of scars to create small perforations similar to the lasers. These small injuries to the skin heal with new collagen in the areas treated. Out of curiosity, I myself purchased a dermroller, and I cringed in anticipation of pain prior to using it on my cheek…I was surprised that it actually tickled/felt like mild scratching. The needles come in different lengths, I would recommend starting out with a shorter needle, the 1mm, and working up to a longer one. Topical numbing creams are usedfor the longer needle rollers, and the depth of treatment is controlled by the amount of pressure being used when you press down on the rollers. If the roller is used 1-2 times per week, over the course of several months the texture of the skin and scarring can be greatly improved.

5. Chemical peels were historically among the first treatments available for scar treatments, but now with advances in technology I generally don’t recommend them in my practice for the treatment of scarring. The reason for this is that in order for a chemical peel to be useful in the appearance of deep acne scarring the peel has to be very strong. A strong peel, such that would be necessary for deep acne scarring should only be used in a very fair skin type, otherwise this can be very risky for skin discoloration and scarring. Because of their limitations of use for lighter skin types, it becomes prohibitive to other patients. It can take many peels in order to see results, meanwhile only several laser treatments would have been necessary to achieve better results for the same price. That being said, I do use chemical peels routinely with great results: for discoloration/hyperpigmentation and dull complexions.

6. Time! Time has a role in the treatment of scars, a new scar will often have a red appearance to it. And this can take time to improve. There is a delayed healing process that occurs after a scar treatment has been administered. It can take 3 to 6 months to see the full effect of a treatment, this is because there is a slow tissue remodeling process which occurs with new collagen and elastin being produced in the areas treated. This is why good photographs are so important! Often patients even forget how their skin looked prior to starting their treatments, and are very encouraged when they see how much they have improved.

7. Filling pitted acne scars with fillers. Injectibles, such as Restylane (a hyaluronic acid based filler) or Artefill (human collagen based semi-permanent filler) can be used to fill select pitted and boxcar acne scars. The advantage is that the results are instant, without the long wait for tissue remodeling.The drawback is that it is usually not permanent, will not address the textural component of the scarring or skin tone.

If you are interested in what would work best for your skin see your Dermatologist for the best fit for your needs. Scarring does not need to be newer in order to be amenable to treatment, the oldest of scars can still be improved!

Dr. Kally Papantoniou, MD, FAAD

Board Certified Dermatologist: Cosmetic & Medical

Advanced Dermatology Laser & Cosmetic Surgery

Mount Sinai Dermatology Clinical Instructor

Who hasn’t had a pimple emergency at one point in their life, if you are lucky and haven’t had to deal with this…then that is just unfair, but maybe take some notes for your friends and family!

 First treat the pimple, then camouflage it. 

 Treat the Pimple

• Ice it: Wrap an ice cube in a soft cloth and apply gently to the affected area for 20-30 seconds, rest for a minute and apply again. Cold reduces blood flow to the area and may reduce swelling and inflammation. Don’t press hard and don’t leave the ice on too long or you may irritate the skin.
• Apply an over-the-counter acne preparation that contains benzoyl peroxide or salicylic acid which kill the bacteria that cause pimples. These creams and lotions also help shed layers of dead cells, leaving skin fresher and rejuvenated. A 2.5% concentration of benzoyl peroxide is sufficient and is less irritating than stronger formulations. Overusing acne preparations will irritate the skin; follow directions precisely.
• Apply an over-the-counter hydrocortisone cream that contains 1% hydrocortisone. This medication provides pain relief, and can help to reduce swelling and redness in the area of the pimple. This should not be used every day, or for acne prevention, if used all over the face every day it can actually promote acne.

Camouflage the Pimple

• Eye drops that are formulated to reduce redness in the eyes can also be effective in reducing the redness and irritation of acne. (Tetrahydrozoline hydrochloride is the ingredient to look for.) Apply to the area with a cotton swab. Or combine with cold by soaking the cotton swab with eye drop solution, freezing for an hour or so, then applying to the pimple.
• Conceal the blemish with a heavy-duty cosmetic concealer. Consider blending two shades to avoid using one that’s either too light or too dark, which will accentuate the pimple. Blend carefully into the surrounding area.

What NOT To Do

• Don’t pick, pop, squeeze or scratch an inflamed pimple. It will take longer to heal, will be more likely to leave a scar and will be harder to camouflage. Try to keep your hands away from your face entirely.
• Don’t use aspirin, toothpaste or other home remedies that aren’t formulated for the skin. They may actually trigger acne or cause irritation.
• Don’t expect a facial, chemical peel or other spa treatment to provide a quick fix. While they may ultimately have beneficial effects, in the short term they are likely to leave the skin red and irritated. 
• Don’t overuse astringents, if used appropriately this can help the skin to contract and may shrink the pimple while also reducing the size of your pores. Pharmaceutical astringents that contain benzoyl peroxide or salicylic acid also fight pimple-causing bacteria. Natural astringents include: witch hazel (choose one without alcohol); lemon juice (dilute lemon juice with water and dab with a cotton swab over the area); and green tea (steep a tea bag in hot water, drain and apply directly).
• Don’t apply undiluted tea tree oil, an antibacterial essential oil with anti-inflammatory properties, if used directly this may be irritating to the skin. There hasn’t been much research on its effectiveness but it’s safe to use in diluted form. Dilute with coconut oil or argan oil and dab it on with a cotton swab.

General skin care advice won’t help in an emergency but good skin hygiene will help you avoid those emergencies, In a true pimple emergency call your dermatologist and see if you can be seen that same day, a dermatologist can inject the pimple with low potency cortisone which dramatically helps to resolve the break-out. For prevention, start by washing your face twice a day with a gentle facial cleanser; follow with moisturizer. Pat your face dry with a soft towel; don’t rub. Drink plenty of water. Exercise regularly and shower after exercising to remove excess perspiration from your skin. You can’t completely prevent your skin from acting up but you can reduce the likelihood of it happening at an inopportune moment and be prepared if it does.