Gluten and Acne

(Last Updated On: August 29, 2018)

Does gluten cause acne or make the condition worse?

When you’re trying to figure out how to best get acne under control, and topical treatments aren’t working, it’s only natural that you begin to wonder if your acne is caused by something you’re eating.

Even though official dietary advice still emphasizes eating plenty of healthy whole grains, it’s clear that grains themselves and the gluten that some grains contain are heavily implicated in many of the diseases and disorders that are so prevalent today.

And while acne appears to be a surface problem caused by blocked pores and bacteria, its roots go much deeper. The food that you eat and the effect that it has on your body are intricately linked to the development of acne, and in some cases, gluten can make the problem much worse.

Gluten – What Is It?

Gluten is a protein naturally found in some grains, namely wheat, barley, rye, and spelt.

If you’re eating bread, cakes, pastries, pasta, pizza, noodles, pancakes, and similar gain based (tasty, addictive) foodstuffs, you’re putting a lot of gluten into your body.

Gluten is also found in around 90% of processed foods, either because the food contains grains, or because the isolated protein has been added.

Gluten is a sticky protein which makes it an ideal ingredient in processed foods because it helps to hold other ingredients together.

Its sticky property is also put to good use in cosmetics, shampoo and toothpaste, among other things.

Avoiding gluten isn’t as easy as simply avoiding grains, and many times even when you’re trying hard to avoid gluten, you can ingest it without realizing because gluten isn’t usually listed on ingredient labels as gluten (scroll down for a list).

Gluten Allergy & Celiac Disease

Gluten allergy (affecting less than 1% of the population) causes celiac disease. This is an autoimmune disorder that over time destroys the villi in the small intestine. Villi are responsible for absorbing nutrients.

Celiac disease also results in undigested proteins passing into the bloodstream through holes in the gut wall. These proteins trigger an inflammatory immune system response.

Celiac disease is caused by genetic factors which trigger the abnormal response to gluten in affected individuals.

Symptoms of Gluten Allergy

Symptoms vary, and the symptoms in children are usually different to those in adults.

In children, digestive complaints are the biggest symptom – constipation, diarrhea, stomach ache, gas, bloating, nausea and vomiting.

Adults can also experience digestive problems but are more likely to suffer symptoms that can include fatigue, depression, anxiety, mood swings, joint pain, headaches, menstrual irregularities, osteoporosis, anemia, sores in the mouth, tingling hands and feet, and a number of skin disorders.

Gluten allergy is fairly straightforward to diagnose using a blood test to detect the presence of gluten antibodies and an endoscopic biopsy of the small intestine to examine the villi.

Gluten sensitivity, on the other hand, is difficult to diagnose, and it’s thought to be far more widespread in the population that gluten allergy.

Gluten Sensitivity

Some estimates put the incidence of gluten sensitivity in the population as high as 30%. And most people will never make the connection between their health problems and a troublesome protein in their diet.

Gluten sensitivity is a subclinical form of gluten intolerance. It doesn’t cause the same destruction of the villi, but it does lead to the formation of tiny holes in the intestinal wall which allow undigested proteins into the bloodstream. This gut permeability is not as extensive in those with gluten sensitivity as it is in those with celiac disease, but an immune response is triggered all the same.

The impaired intestinal wall also affects nutrient absorption.

Symptoms of Gluten Sensitivity

  • Fatigue
  • Brain fog
  • Headache
  • Gas
  • Bloating
  • Abdominal Pain
  • Skin disorders

How Does Gluten Affect Acne?

How Does Gluten Affect Acne

If you have an allergy or sensitivity to gluten, it may play a role in your acne. But do be aware that acne is a complex disorder and gluten is unlikely to be the only factor at work.

Gluten is linked to acne because of the effect it has on insulin levels in the body, and the effect it has on nutrient absorption. Insulin is a key factor in acne development.

  1. Gluten contains a protein called lectin. Lectins can contribute to a condition known as insulin resistance by locking onto the insulin receptors on cell membranes. Insulin resistance results in very high insulin levels
  2. When your body reacts to gluten, your intestinal lining becomes more permeable. A more permeable gut lining allows undigested protein molecules to access the bloodstream triggering an immune response. This inflammatory immune system response exacerbates insulin resistance.
  3. A damaged gut is unable to properly absorb nutrients, and a lack of certain nutrients (antioxidants) has a direct effect on acne, which we’ll talk about in a little while.

So What is Insulin Resistance?

Insulin is a hormone that transports glucose into the cells. The more carbohydrates (sugar, bread, potatoes, grains etc.) that you eat, the more insulin your body releases to hurry the resulting glucose out of your bloodstream and into your cells.

Your body has to keep your blood glucose level in a very tight range, levels that are too high or too low are very dangerous.

Insulin is made in the pancreas. Beta cells in the pancreas continually monitor glucose levels in the blood, and when they detect an influx of glucose, they tell the pancreas to make more insulin.

But in some cases (often after years of eating a high-carb diet) cells in the body eventually begin to ignore the normal quantity of insulin secreted and they don’t open to allow glucose in.

Beta cells, sensing that blood sugar levels are still too high, tell the pancreas to make more insulin, but the cells still don’t respond, so even more insulin is released. Eventually, when the insulin levels are so high that they can’t ignore it any longer, the cells respond and allow glucose in.

Insulin resistance doesn’t continue forever. Eventually, the pancreas loses the ability to produce the required amount of insulin and type 2 diabetes is the result.

While gluten and its lectins are certainly a factor is insulin resistance, the carbohydrate-rich foods in your diet are more likely to be the main cause of high insulin levels.

Insulin and Acne

Insulin causes the skin to increase sebum production. The more insulin present in your system, the more sebum your skin will make.

Insulin also triggers the production of a testosterone precursor called Dehydroepiandrosterone (DHEA).

Your body (male or female) produces testosterone, and high levels of testosterone are strongly correlated with acne. However, you can have normal levels of testosterone circulating in your bloodstream and still have severe acne. This is because your skin makes its own testosterone and that testosterone won’t show on a blood test.

Enzymes in the skin convert precursor DHEA into testosterone and these enzymes increase their activity in the presence of insulin turning even more DHEA into testosterone.

Testosterone affects the sebaceous glands in your pores – the sebaceous glands are responsible for producing sebum. The more testosterone present, the larger these glands become and the more sebum they produce.

Let’s Recap What We Know So Far

  • Some people can’t tolerate gluten, resulting in either celiac disease (rare) or gluten sensitivity (less rare).
  • The immune system responding to alien proteins in the bloodstream triggers an inflammatory response.
  • This inflammatory response affects insulin sensitivity.
  • Gluten contains a protein called lectin which also affects insulin sensitivity.
  • The biggest factor when it comes to high insulin levels is usually a carbohydrate heavy diet.
  • Increased insulin levels cause the skin to produce sebum.
  • Insulin causes more testosterone precursor to be made and increases the action of the converting enzymes in the skin resulting in high levels of testosterone in the skin.
  • Testosterone makes sebaceous glands in the skin larger and more active, increasing sebum production.
  • Gluten intolerance also prevents proper nutrient absorption in the gut.

But this isn’t the whole story. While the overproduction of sebum triggered by insulin and testosterone will give you oily skin, it won’t give you acne. To understand why acne develops we need to cover a few more points.

Sebum & Acne

According to research, acne sufferers produce 59% more sebum than those with normal skin. And as we’ve already seen, insulin and testosterone trigger the overproduction of sebum.

Sebum itself is made up of various lipids, fatty acids, and wax and cholesterol esters. Two components of sebum feature strongly in the development of acne – a fatty acid called linoleic acid, and a lipid called squalene.

The linoleic acid in sebum helps to ensure that the skin’s pore walls are strong and healthy, but in people with acne, linoleic acid levels are as much as 65% lower than they should be. This deficiency results in weak walls punctured with tiny holes.

Squalene is a (usually) very beneficial component of sebum, and you’ll find that it’s added to many skin care products for that reason, but once squalene becomes damaged, it’s bad news all the way.

Instead of being helpful to skin, squalene becomes highly comedogenic, and actually promotes acne.

Damaged squalene is known as squalene peroxide because it has been altered through oxidation. Researchers have found that the sebum from people with acne contains up to 79% more squalene peroxide than the sebum in normal skin.

When squalene peroxide is present in the pore, it causes keratin production to go into overdrive. Keratin is a protein that binds skin cells together. Too much keratin prevents dead skin cells from naturally exiting the pore via the skins built in exfoliation system.

Instead of exiting the pore one by one, the skin cells clump together and block the pore.

Too much keratin also makes the pore wall brittle.

How Does Squalene Get Damaged in The First Place?

Squalene becomes damaged because of a lack of antioxidants in the skin.

Antioxidants like vitamin C, vitamin E, and vitamin A.

A 2009 study measured antioxidant levels in the skin of acne sufferers and found that levels of vitamin C were 40% lower, levels of vitamin E 45% lower, and levels of vitamin A 33% lower than the levels found in clear skin.

One reason antioxidant levels can be so low is poor diet. If the diet doesn’t contain sufficient amounts of the required nutrients, then it makes sense that they won’t be present in the body to protect against oxidation.

The body also prioritizes need, using nutrients for the most important functions first. Your body will send nutrients to vital systems like your cardiovascular system before it sends them to your skin.

So even if you eat a fairly healthy diet, if you have other health problems, sufficient antioxidant nutrients may not be available for your skin.

And, if you recall from earlier, when a gluten sensitivity or allergy is present, the gut wall is damaged and nutrients aren’t absorbed as well as they should be.

So along with triggering insulin and testosterone overproduction, which results in excess sebum, gluten can also contribute to the nutrient deficiencies which lead to the creation of comedogenic squalene peroxide.

What Happens Next?

All of the sebum trapped inside the pore by the clumped skin cell plug, provides an enormous food source for the normally harmless bacteria living deep inside the pore, allowing them to multiply wildly.

Like all living organisms, bacteria produce wastes and these toxins are excreted into the pore where they cause irritation and inflammation.

When the swollen pore, with its brittle weak walls, can’t hold another drop of bacteria, toxic waste, dead skin cells, or sebum, it bursts, allowing all of the debris from the pore to flow into surrounding tissue.

This triggers a highly inflammatory immune system response resulting in large raised red swellings on the skin – acne, and that inflammation feed into the insulin resistance cycle.

So that’s the link between gluten intolerance and acne. Now it’s time to move on to some solutions.

Is Gluten is Playing a Role in Your Acne?

As mentioned earlier, gluten sensitivity affects around 30% of the population and celiac disease affects less than 1%. While 30% might seem high, it’s important to realize that that figure also shows that 70% don’t have gluten sensitivity.

So, take stock of your overall health and try to determine if you have any other symptoms of gluten intolerance. Acne is unlikely to be the only manifestation of this problem in your body.

If you come to the conclusion that yes, you do have other symptoms of gluten sensitivity, then the next step is to eliminate gluten from your diet and see if your skin improves. If you have symptoms of celiac disease, see your doctor!

You will need to follow a gluten elimination diet for at least one month before you can expect to see any changes.

Gluten Free Eating

Gluten Free Eating

As well as giving your system a rest from the problematic protein gluten, a gluten free diet allows your gut to heal and regain normal function.

The simplest diet to follow is one that eliminates the gluten containing grains (wheat, rye, and barley) and the processed foods that are loaded with gluten.

This basically means eating a paleo style diet of meat, fish, eggs, vegetables, and low-sugar fruits like berries.

The bonus of following a paleo diet is that it’s also low carb, and since too many carbohydrates wreak havoc on insulin, you’ll be able to keep your blood sugar in a healthy range and prevent excess insulin release.

Mark Sisson, creator of leading paleo blog Mark’s Daily Apple, has a great book out called The New Primal Blueprint which covers the philosophy and the science behind this very natural, very healthy, and very satisfying way of eating.

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In the book, you’ll learn why the modern western diet is so dangerous, and you’ll discover the harm that grains do to the body. Most importantly, you’ll find out which foods will safely fuel and heal your body.

There’s nothing faddy about the diet, and there are no meal replacement shakes or bars or anything like that to buy, it’s just nutritious food from your grocery store.

Unlike most diets, the paleo diet isn’t difficult to stick with because you get to eat real food and plenty of it.

While the paleo diet is an obvious choice if you eat meat, it’s not suitable for vegetarians unless you make some modifications. Trying to figure those modifications out by yourself isn’t easy to do, but luckily you can follow the expert advice in It Starts With Food, which is a 30 day boot camp based on vegetarian paleo.

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Other Names For Gluten

When you’re shopping for groceries check labels for the following, not so obvious, forms of gluten.

  • Avena sativa Cyclodextrin
  • Barley including barley flour, barley flakes and pearl barley
  • Breading
  • Brown rice syrup
  • Brewers yeast
  • Bulgur (type of wheat)
  • Caramel color
  • Dextrin
  • Dinkel (type of wheat)
  • Durum (type of wheat)
  • Faro (type of wheat)
  • Fermented grain extract
  • Graham flour
  • Hordeum distichon
  • Hordeum vulgare
  • Hydrolysate
  • Hydrolyzed malt extract
  • Hydrolyzed vegetable protein
  • Hydrolyzed soy protein
  • Hydrolyzed wheat protein
  • Kamut (type of wheat)
  • Malt, malt extract, malt syrup, malt flavoring
  • Maltodextrin
  • Malted milk
  • Malt vinegar
  • Matzo, matzo meal
  • Modified food starch
  • Modified wheat starch
  • Natural flavoring
  • Oats, oat flour, oatmeal, oat bran.*
  • Phytosphingosine extract
  • Rye
  • Secale cereale
  • Seitan (used in many vegetarian dishes)
  • Semolina
  • Spelt
  • Triticale (wheat and rye hybrid)
  • Triticum aestivum (wheat)
  • Triticum Vulgare (wheat)
  • Wheat Bran
  • Wheat flour
  • Wheat germ
  • Wheat starch
  • Yeast extract

*Oats don’t contain gluten, but in the harvesting and refining process, they can become contaminated with gluten because the equipment is also used to process gluten containing grains. To be certain your oat products aren’t a source of gluten in your diet you need to make sure the labels guarantee that the oats are gluten free.

Boost Your Antioxidants Levels

To prevent the squalene in your sebum from oxidizing, you need to boost your antioxidant levels. And the best way to get plenty of vitamin C, vitamin E and vitamin A into your body is with supplements.

It’s important to select good quality supplements.

Vitamin C is usually a straightforward supplement because it’s a simple ascorbic acid molecule. Vitamin A and vitamin E are a little more tricky, however.

The majority of vitamin E on the market is incomplete. Natural vitamin E comprises 4 tocopherols and 4 tocotrienols. And it’s the tocotrienol factions that have the most antioxidant activity. So make sure your vitamin E is complete by choosing a supplement like Now Advanced Gamma E Complex.

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Vitamin A is another supplement where you need to check the label. Most vitamin A supplements use beta carotene which isn’t actually vitamin A. Your body has to convert beta carotene into vitamin A, and it doesn’t do it very well.

The retinol form of vitamin A is ready for your body to use, and the best source of this type of vitamin A is cod liver oil. Cod liver oil is pretty unpleasant to take, but you can get around that by taking capsules which are taste and odor free.

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Because of the intestinal absorption problems that you may have due to gluten, it’s also worth applying vitamin C and vitamin E to your skin directly.

This is quick and easy to do. For vitamin C you simply dissolve a couple of teaspoons of vitamin C powder in a little cold water, then smooth the liquid over your skin.

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To apply vitamin E, break open a capsule and spread the oil over your skin.

Ultimately, there’s no quick fix, miracle cure for acne, but with good antioxidant support and a diet that minimizes insulin release and cuts out gluten, clear skin and better health are definitely within your reach.

 

“This article is due to be re-visited, proofread and updated a maximum of 3 years from its original upload date by Dr. Kimberly Langdon, M.D. All the content and media has been uploaded by Lily Greene our webmaster, who is also is in charge of page design.”

Written by Irina Radosevic MD
Irina graduated from the University of Belgrade, School of Medicine as a Doctor of Medicine (MD) and spent over 3 years working in the Clinical Hospital Center Zvezdara, in the Department of Emergency Medicine. She also undertook a postgraduate in Cardiology from the same University and had previously worked for over a year as a Physician and Nutritionist Dietitian for the Fitness club Green Zone. She eventually left her chaotic but fulfilling job in the ER to pursue her passion of writing, travelling and mountain climbing which has included writing a first aid course for the alpine club of Belgrade. Irina currently works as a VA for PintMedia focusing on medical and travel writing. Feel free to connect with Irina on LinkedIn and FaceBook. Her CV can be seen here.