How does bulimia affect the skin?
Bulimia can have several side effects on the integumentary system, or the internal system that regulates skin, hair, and nails, including:1
- Brittle and dry hair and nails
- Infections around the nails and cuticles
- Discoloration of the extremities from poor circulation
- Russell’s sign (calluses on the knuckles from repeated induced vomiting)
- Abnormally dry skin and membranes
- Slow wound healing
- Fine body hair (lanugo)
That's because the eating disorder behaviors associated with BN, including self-induced vomiting and other maladaptive coping mechanisms, can trigger hormonal changes, weight loss, and other issues that impact the skin.
Bulimia and acne
The frequent vomiting often associated with BN can result in dehydration and excessive dryness of the skin. This, in turn, can lead to acne development.
After 2-4 weeks of this type of malnutrition-driven dehydration, the skin will start to produce less surface lipids, and sebum, or oil, production can decrease by as much as 40%.2
And while acne is often associated with skin that is too oily, dry skin can also lead to this skin condition, in several ways:
- By causing an excess of dead skin cells, which clogs the pores
- By making pores more likely to break open, allowing acne-causing bacteria to penetrate deeply into the skin
- By triggering the production of excess sebum, or oil
Certain vitamin and mineral deficiencies are also common among people who have acne, including deficiencies in zinc and vitamins A and E and some forms of vitamin D.4,7
While all are essential for bodily functions—and vitamin A and E, particularly, are full of helpful antioxidants—the connection between the levels of these minerals and the propensity to develop acne are unclear. Though, researchers recommend diets rich in these vitamins and nutrients to help combat skin issues. (3)
Treatment for bulimia acne
When dealing with any kind of issue connected to eating disorders, treatment of the underlying eating disorder is often the best way to resolve the problem. This includes skin issues connected to bulimia nervosa.2
Recovery from BN is often a long journey, and not always one that occurs in a straight line. Some patients experience additional acne breakouts, even after starting treatment, and need clinical dermatology to help clear things up.
But, in general, there are ways someone can help heal stressed, acne-prone skin during the recovery process.
Skin care tips
Acne isn't the only skin condition that can cause serious damage. But there are steps you can take to help pamper and maintain the body's largest organ.
Never skip sunscreen
Some of the active ingredients in acne treatments, such as benzoyl peroxide and salicylic acid, can make skin more sensitive to the sun. So it’s important to apply sunscreen with at least SPF 30 every day.4 Sunscreen will also help reduce inflammation and pigmentation marks left behind by acne.
Repair the skin barrier
Be kind to your skin. If it’s dry and dehydrated, you will irritate it further with abrasive scrubs, exfoliants, cleansers, or harsh astringents. These can all strip the skin of its natural moisture.
Other things you can do to repair the skin barrier include:
- Avoiding scrubbing the skin
- Applying products with your fingertips
- Using gentle, alcohol-free products to avoid further drying out the skin
- Washing and rinsing with lukewarm water
- Applying a light non-comedogenic moisturizer after cleansing
- Choosing products with soothing and hydrating ingredients, such as hyaluronic acid, niacinamide, and ceramides
- Drinking plenty of water to stay hydrated
The best option for overcoming bulimia nervosa, and any of the skin problems it may cause, is a comprehensive treatment plan. With a multidisciplinary team of professionals, you can find help with all aspects of this eating disorder.