"What should I eat?" That is the question I am asked most often by skin patients in my Traditional Chinese Medicine practice. They ask it in a tone of despair and frustration, because they have already been avoiding various foods on the advice of health writers, bloggers, nutritionists and naturopaths, and yet their skin condition persists. Let's try to shed some light on this confusing question, and lay to rest some of the undue expectations that surround it.
The most common misconception is that dietary changes alone can cure inflammatory skin diseases like eczema, psoriasis, acne and rosacea. After treating a great many skin disease sufferers and hearing their stories, I have come to understand this is very much the exception, not the rule. The great effort these patients expend to modify their diet often leads to disappointment.
There is no doubt that abstaining from irritating food and drink can improve a skin condition to some degree. In combination with a targeted therapeutic treatment – the best of which is herbal medicine – dietary changes can ultimately lead to a cure. It is also true that during herbal treatment for the most aggressive and stubborn of these illnesses, a change in diet may be just the thing that tips the balance from failure to success. Let's look at some common dietary advice given to skin patients in a Chinese Medicine clinic. It may be quite different from what is recommended elsewhere, but I believe it to be intuitively reasonable.
Avoid 'Heating' Types of Food and Drink
This is by far the most important and useful dietary modification that you can make if you suffer from any skin disease that is red, hot, burning and itching. Why add fuel to the fire? According to TCM, 'heating' foods are those which cause the body temperature to rise, the capillaries to dilate, and generally increase the warming, yang functions of the body.
Alcohol – We can plainly feel how a glass of red wine warms us up on a cold day, but this effect can be harmful to a person with skin inflammation. Once this is pointed out, people become instantly aware of the connection between alcohol and increased itching. Red wine is the worst culprit, while beer and white wine may be better tolerated. Avoiding alcohol is especially recommended when the skin disease is on the face or head, where heat will naturally rise more rapidly and affect one’s appearance. Rosacea, acne, seborrheic or atopic dermatitis and psoriasis are the most likely to affect the face.
Spices – Hot pepper, black pepper, ginger and garlic are also contraindicated, as are all the "gingerbread house" spices: cinnamon, nutmeg, clove. This means avoiding chai teas, ginger teas, hummus, Thai food and the like. Of all of these, garlic seems to give the worst flare-ups of redness, burning and itch. On the other hand, fresh green herbs, cumin, coriander and anything without a pungent, spicy bite are OK.
Smoking – Cigarette smoking is strongly associated with psoriasis, especially pustular psoriasis of the palms and soles. Quitting will often improve the condition. Teenage acne, as well, is adversely affected by smoking. Teens already have a great deal of naturally occurring 'heat' in their lungs and stomach, as evidenced by their loud voices and voracious appetites – this is a sign of health and vitality during a time of great growth. However, smoking and drinking will push this lung and stomach heat over the upper limit of 'normal,' turning it into the red fire of acne. The fat-, sugar- and calorie-dense diets that teens have in the West also fuel this fire. It may be that the calories that have made kids increasingly tall and strong have also given them acne at rates unseen in more traditional societies.
Avoid Oil, Shellfish, Tropical Fruit
The most controversial recommendation that I make concerns oil supplements. I ask that anyone with very weepy skin disease, most often eczema, reduce consumption of these or avoid them entirely. Patients are often taking these, precisely because they believe them to be anti-inflammatory. This may be true, but all oils are rich, damp and hard to digest. When the skin is oozing and weeping sticky fluids or pus, the last thing needed is a sticky, rich supplement like oil, especially in a high dose. Flax is generally better than fish oil in this regard if the person is not willing to give them up.
Greasy fried foods and bad oils are even worse, and should be avoided. Shellfish and fatty fish like salmon should be avoided for the same reason as oils, not only by weepy skin sufferers, but by anyone whose skin is red or itchy at all.
Tropical fruit may also irritate. Mango, papaya, pineapple are the worst, while banana seems to be OK. It is probably the high sugar content and acidity of these that are responsible. Apples and berries are quite good to eat, since they are cooling and hydrating.
What About Gluten, Sugar and Dairy?
This is where I part ways with standard naturopathic opinion. I believe gluten, sugar and dairy are only a problem for a very small proportion of people with skin disease, and that they do not need to be avoided by the vast majority of sufferers. It may be that avoiding these foods will improve digestion, but rarely will this translate into an improvement of the skin disease. And yet, these are the most common ingredients removed from the diet, often at great cost of effort and planning. My rule of thumb on these items is a digestive check: If a person suffers from chronic bloating, diarrhea, constipation, gas or heartburn, then it may be worthwhile to remove them. If not, I believe they pose no problem, but would recommend staying away from the very fatty, aged or sharp cheeses.
(Editor’s Note: Since gluten, sugar and dairy rank among the top 10 most common food allergens, and contain GMOs, heavy metals and drug residues respectively, Vitality encourages readers to make every effort to find suitable substitutes, readily available in health food stores.)
Good Foods for Healthy Skin
During the active phase of skin inflammation, when the itch is still strong, the skin still very red, and the lesions spreading, the best foods will be cooling, venting and draining. Green tea, mint tea, salad, fruit, and clean, light meals, freshly prepared, are best. White pearled barley and beans are excellent at draining away excess mucus and dampness if the skin is oozy. Mung beans and aduki beans are wonderful at this, and all three of these substances double as "herbs" which are found in many skin prescriptions. When the eyes and face are red and itchy, jasmine, chamomile, mint and crysanthemum teas are very soothing.
During the chronic and follow-up phases when redness has subsided but the skin is dry and flaky, flax seeds, sesame seeds, almonds, pears, lean red meat and pork bone soup are all good blood builders to nourish, hydrate and repair the skin. White pearl barley, or its herbal cousin Job's Tears, can continue to be used at every stage.
Changing one’s diet is not easy, and changing it forever is harder still. For some, a dietary change may bring new problems: tension, stress, guilt, binge eating, excessive self-control, and of course, hunger! These may have a more detrimental impact on our health than the eliminated foods. Listening to your own body is essential. For skin disease sufferers, adjusting the diet a little to avoid heat is a good idea. In combination with a cooling herbal treatment, a change of diet might be just the thing to cure a persistent skin disease.