• DrSwae

Let Them Eat Cake- Hold the Milk



Today was my oldest's (Wyatt's) birthday. Birthdays are special. They give us the opportunity to celebrate and remember. It is also his cousin's birthday, so we doubly cherish it.


It was just our family for this birthday, but that's the way I love it, more or less. I think Wyatt was okay with it too. Every time I looked over he seemed to be having a great day.



I remember the day he was born like it was yesterday. It was, in my memory, the first beautiful Vermont spring day, and we went on a long walk on the waterfront before I went into labor.


We went out a little too far and then had a long ride and he was almost born in the car! He still likes to push things off to the last minute and then race like mad to get them done. He was born that way.


We had a beautiful celebration with his brothers, me, Scott and of course his best bud, Radar. And though it was cold and rainy this morning, the clouds parted for a good while during the day, and it was almost warm. The day had a good energy.



Everett tried to be on his best behavior and even made big brother a colorful picture present of his own volition, which just melted my heart.



Also, Wyatt and his cousin are both animal lovers, and they share that bond, among others. So it was so nice to see our first frog, who I am sure came to greet us in honor of our boys.


Funny though, he probably regretted the decision, having spent endless time trying to wriggle out of the brothers' grasps.



Later, I made an orange vanilla cake, which was just this cake tweaked a bit to reflect more of a birthday cake feel and really emphasize the sweet and tangy citrus and vanilla.


It turned into more of a trifle when we put blueberry compote over the top, and it was delicious.



And now, after staring at the boys while they sleep (and sitting with Wyatt while he works on his hurdy gurdy), I am tired.


Sometimes skin needs a rest, just like its wearer. We scrub it, rinse it, dry it, exfoliate it, cover it in questionable creams and then apply products that we probably shouldn't.


Now is the BEST time to give it a rest. I mean, it's not as though we are going anywhere.



If we don't give it a rest, sometimes it fights back. Often in the form of acne.




Acne is basically a condition of our hair follicle that happens because of really four things.

1. The hair follicle gets plugged- the fancy term is "follicular hyperkeratinization"

2. Bacteria inside our hair follicle overgrow- P. acnes aka C. acnes is the culprit

3. Excess oil/sebum- often due to HORMONES

4. Inflammation- let the facts speak for themselves.


We treat it by thinking of those four factors, and attacking it from those fronts. Some people have more of one part than another, and we can tailor treatment.


Right now, since we are home, we can allow our pores to air out so to speak, and take some time off of using thick products that clog them.


There is so much to cover on acne. I used to talk about it endlessly to residents and medical students, and if you're interested, you can check out more info on it here.


Suffice it to say, treating acne is a billion dollar industry.


But while we are at home not really seeing anyone outside of our FaceTime and Zoom calls, there is one HUGE thing we can do for our acne (and our skin in general) that works way better than many of our medications.


Wait for it...


Change our diet.


Start by eliminating dairy.



Now remember I live in Vermont where dairy is sacrosanct. Dairy farmers are the foundation of our state (along with alternative energy, world class breweries, maple syrup). Did you know how famous Vermont is for its cheese? And pastural landscapes! Dairy defines the state, in many ways.



But dairy has its downsides, especially on the skin. The biggest offenders are skim milk, followed by other percentages of milk and yogurt. Cheese is borderline, so it's not as pressing to give it up (you're welcome).


It seems that for many people there is a dose dependent risk for acne with dairy. Meaning essentially the more you drink, the more acne you may develop.


It's thought that this happens because of the following two main factors:

1. Milk contains hormones including estrogens, progesterone and testosterone precursors.

2. Milk contains insulin-like growth factor which pressures the pores, resulting in acne.


Dairy is inflammatory, plain and simple.


Both hormones and the insulin-like growth factor tend to lead to a breakout that has the hallmark of inflammation. With it, we see red, sometimes sore spots on the face, neck and upper back as well as blackheads and whiteheads.


Sometimes people end up on medications by mouth to calm down the inflammation we see on their skin. These medications work on the hair follicle and they work to block hormones. But they can be risky and they are not for everybody.


But by eliminating dairy, we eliminate the need to block added hormones and we don't have to have the same pressing concerns about inflammation. It just melts away over time on its own, when the driving force is gone.


So if you drink milk and you have acne, put your glass down. There are so many great milk alternatives these days. Or better yet, try this.


Your skin will thank you.



We ended the night with another bonfire, cut a little short by rain, but so pleasant while we were out. This photo was from last night, because I couldn't hold the phone, the baby, the skewer and wipe my happy tears at the same time. But you get my drift.


Hope you're well. Classes resume tomorrow. The bell (on the microwave) rings at 8:10.


xo, Dr. Swae


(photo credits: oranges-Wix, acne- American Academy Dermatology, cows- VT Agency of Agriculture, Farm barn- Shelburne Farms)

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