Acne is estimated to affect 85% percent of Australian children and young adults aged 12 – 24 (but if you’re one of the unlucky ones, like me, you may experience the condition well into adulthood!). Approximately 5% of adolescents will experience severe acne. Regardless of severity, it can be painful, embarrassing, and negatively affect a teen’s self-esteem & hold them back in life. 

Conventional treatments generally focus on treating the topical symptoms of acne or prescription medication, but most have limited long-term effectiveness, are expensive, & many have unwanted side effects. But there are some key processes and things happening inside your teen’s body that’s affecting what’s happening on your teen’s skin. And we can address all of them with your teen’s diet. 

What Does the Inside-Out Approach Mean? 

During puberty, high levels of growth hormone are being produced – this essential for those rapid growth spurts that occur, but what this also does is it inhibits the action of insulin, which creates a state of temporary insulin resistance. 

Insulin drives a sex hormone called androgens, and androgens regulate the sebum or oil in our hair follicle. When our androgens are high, this can increase the oil in the hair follicle and the bacteria that feeds on our oil multiply, causing inflammation and pimples. The more androgens, the more oil the more bacteria, the more pimples. (This is also why some topical oils and moisturisers can cause breakouts!) 

Inside-Out is an approach that takes a holistic look at your teen’s acne, which means we look at what’s happening inside the body – managing those androgens and inflammation, rather than just focusing on the topical symptoms. We know that hormones, microbiome imbalance, dysregulated blood sugars and nutrient deficiencies all come into play when we’re addressing a teen’s acne from the inside out, so when we’re looking to reduce teen acne, we’re looking at dietary changes that will support:

  • healthy hormones 
  • a healthy gut 
  • stable blood sugars 
  • detoxification 
  • inflammation 

Dietary Changes: reduce sugars & eliminate dairy 

One of the biggest changes I usually make to a teen’s diet is to take out the sugars – in the form of table sugar, but also in the form of processed white carbohydrates, and replace them with complex, high-fibre carbohydrates. Unfortunately, when we process a grain down to a white flour, it essentially becomes a simple sugar, and the response in our body is the same. Replacing our white flour products with wholegrain versions does three things: 

  • it supports a healthy microbiome in your teen’s gut 
  • it stabilises their blood sugars 
  • & it supports bowel movements 

Dairy food has also been shown in some studies to exacerbate acne in some people. Dairy with the protein A1 can cause increased levels of insulin, IGF-1 hormone, and the enzyme mTor. These stimulate keratin, inflammation, and sebum – all of which contribute to acne. I generally recommend teen’s remove all forms of dairy (apart from a little butter) for around 6 weeks & assess from there. (A bonus for teen girls who suffer period pain, eliminating dairy may also reduce their period pain!) After 6 weeks, they can try reintroducing dairy, or they may find that switching to A2 works better for them as well. 

I also want to assess your teen’s diet to ensure they’re eating enough protein, especially for breakfast. Eating sufficient protein will help stabilise their blood sugars and protein will help build those hormones that we want to regulate and balance. Protein requirements vary according to each teen’s activity level, muscle mass & growth, but a general rule of thumb is to eat around a palm-sized piece of protein with each mail meal. This may look like 2-3 eggs, 2 lamb chops, 1 fillet of fish, half a block of tofu, 1 cup of yoghurt, 1 chicken thigh. 

Other great foods for supporting hormone production & regulation include:

  • seeds like flax, hemp & pepita 
  • cruciferous vegetables like kale & broccoli 
  • healthy fats like oily fish & avocado 

Micronutrients to Consider 

  • Zinc (found in oysters & seafood, red meat) 
  • Glutamine (found in bone broth, 
  • essential fatty acids (found in oily fish & seafood, nuts & seeds, olive oil) ● Probiotics (found in fermented foods like sauerkraut, yoghurt, kefir & kim chi) ● Vitamin A (found in liver, oily fish, red & orange coloured vegetables) ● Vitamin C (found in kiwi fruit, citrus & all our fruits & vegetables) 

Microbiome Support 

Our gut has an incredibly powerful influence on all aspects of our overall health, including our skin. Science has now been able to identify that there are particular strains of bacteria that can support clearer skin. In clinic, I regularly prescribe a strain-specific probiotic formulated for acne. You will find there are some great over the counter products available at your local health food store or online. 

Including fermented foods everyday is another great way to support the health of your teen’s gut & optimal microbiome. Fermented foods like sauerkraut, kefir & yoghurt all encourage optimal gut microbiome and support a healthy gut-skin axis. 

But our microbiome is a living organism, and like all living things, it needs food to survive. What food does it eat? Fibre. So eating a diet that’s low in processed food and high in high-fibre foods, like wholegrains, vegetables, fruits, nuts & seeds promotes a healthy gut because the fibre provides food for our microbiome. 

Kellie Montgomery is an accredited Nutritionist & author of the eBook “The Inside Out Approach: A Nutritionist’s Guide for Parents”