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The dehydration and malnutrition that can occur in those with bulimia nervosa can do some serious damage to the skin and cause severe acne. (1) Even if bulimia symptoms are under control, the skin issues that remain can still cause deep distress, particularly in a world of touched-up images and unrealistic beauty standards. But most of these issues are treatable.
Bulimia can have several side effects on the integumentary system, that is, the skin, hair, and nails, including: (2)
Frequent vomiting from bulimia can result in dehydration that may lead to an abnormal dryness of the skin. This excessive dryness is caused by a decrease in skin surface lipids, which occurs between 2-4 weeks after consistent nutrient restriction and sees sebum, or oil, production decrease by as much as 40%. (3)
Wait, what? How can less sebum and dry skin result in acne? Dry skin caused by bulimia can contribute to acne in several ways:
Vitamin and mineral deficiencies often seen in people with bulimia may also be linked to the development of acne: (4)
Treatment of the underlying eating disorders often resolves skin issues like bulimia acne. (3)
Recovery from bulimia can be a long journey, and some patients experience additional acne breakouts, once they start treatment. This could be due to the sebaceous glands reactivating in the skin, leading to an overproduction of oil, resulting in blemishes. But there are things that can help heal stressed, acne-prone skin during the recovery process.
It can be tempting to pop, squeeze, or pick your acne, but blemishes will take longer to heal and may result in acne scars. Plus, touching your face frequently can transfer bacteria to your skin, causing new flare-ups. (5) Obsessive-compulsive tendencies often go hand-in-hand with bulimia and can compel repetitive behaviors like this. But the right treatment approach to bulimia can help break accompanying habits and address the underlying causes.
Acne can be successfully treated with topical antibacterials, benzoyl peroxide, or azelaic acid as a single therapy or in a combination. Combination antibacterials, like zinc with erythromycin, are also effective treatments, as they address zinc deficiency often seen in people with eating disorders. (6)
A dermatologist can be a key member of a treatment team for those in bulimia recovery. (7) These specialists can identify the skin problems resulting from your disordered eating behaviors, determine whether your skin barrier is damaged through nutrient deficiencies, and recommend an appropriate course of treatment. This can include topical creams, gels, or lotions, oral medications, or dietary supplements, as well as a skincare regimen.
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. (5) 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 and 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:
We live in a world where filters and photoshopping are the norm. We’re bombarded with images of flawless skin on social media and TV, in movies and magazines. This can be so damaging to self-esteem.
A comprehensive treatment plan with a multidisciplinary team of professionals will help those who struggle with bulimia address all aspects of this eating disorder. At Within Health, we know how hard it can be to ask for help, but it’s the first step toward a healthy relationship with food and your body. And we are here for you, to give you the guidance and support you need every step of the way. Call our team at Within Health to learn about our attuned approach to treatment.
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.
