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Bulimia nervosa (BN) is a mental health disorder, but the condition can also cause a number of physical complications, including with the skin.
Acne and bulimia can be a particularly harmful combination, as many people with this eating disorder already struggle with negative body image. But, with the right kind of care, it’s possible to treat most of these concerns.
Bulimia can have several side effects on the integumentary system, or the internal system that regulates skin, hair, and nails, including:1
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.
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:
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)
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.
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.
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.
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:
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.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
