On this website we’ve talked a lot in the past about how chemical contaminants in food and cosmetics and tap water are secretly causing acne. There’s no doubt that heavy metals like arsenic and supposedly healthy additives like fluoride are adding a lot to the problems behind the global acne pandemic.
In my eBook Annihilate Your Acne we spend a whole chapter exposing each of the specific contaminant groups you need to avoid…
…but we haven’t discussed the naturally occurring plant toxins yet, namely the many species of mycotoxins.
Mycotoxins are in short, toxic chemicals manufactured by mould growing on contaminated foods. In nature there are three groups of life – animals, plants, and fungi, In turn, there are three groups of fungi and they are mushrooms, bacteria and mould.
Mould and bacteria are locked in a never-ending war for dominance with each other, and one of the key weapons of moulds in this war are mycotoxins. They have the power to kill bacteria, and hence, many common medicines are derived from mycotoxins; penicillin is a chemical derived from the Penicillium mould family. Hence, mycotoxins have kept millions of humans free from bacterial infection…
…but there’s a menacing dark side: other mycotoxins have the ability to destroy your health. Examples of deadly mycotoxins include aflatoxin, ochratoxins, T2 toxins, fumonisins, zearalenones (which have potent estrogenic activity), and deoxynivalenols. Mycotoxins can kill humans when eaten or breathed in excess. For instance, chronic respiratory and health disorders among residents of old and disused buildings are often related to mould overgrowth in those buildings.
Why do these chemicals matter to us? The single biggest source of mycotoxins are foods contaminated with the moulds that produce them – and such foods are everywhere. Poor quality coffee, chocolate, beer, wine, nuts, and beans may all contain mycotoxins. They contaminate cocoa beans during the earliest stages of fermentation and sun drying, and end up in commonly eaten chocolate bars. The same is true for coffee beans and the resultant coffee, and countless other foods.
Nearly 100% of acne patients have mycotoxins in their bodies. At high levels, mycotoxins can be just as bad for the health conditions behind acne as heavy metals like mercury and arsenic.
Consider the two most famous mycotoxins:
Ochratoxin A – a chemical found in green coffee, cocoa products, nuts, dried fruits, and meat. Predominantly generated by the aspergillus and Penicillium strains of mould. This mycotoxin is most notorious for accumulating in the kidneys and causing kidney failure, in humans, rats, birds, and many animals. Ochratoxin A is linked to liver disease in rats and has weak cancer causing powers elsewhere. Ochratoxin A also has a high affinity for the brain and once there it may gradually contribute towards Alzheimer’s disease.
Aflatoxin B1 – considered to be the most potent carcinogen (cancer causing substance) on earth. Aflatoxins are a wide group of mycotoxins which are generally deadly. Aflatoxin B1 is classified as a group 1A carcinogen by the International Agency for Research on Cancer (the worst of the worst).
They first gave it this classification after noticing how Asians and Africans who ate food contaminated with the mycotoxin developed far higher rates of liver cancer. Aflatoxin B1 is also suspected to cause Reye’s disease, a viral infection that causes often permanent brain and liver damage.
The World Organisation is seriously worried about aflatoxins; in 2007 they issued a statement saying that reducing global exposure to aflatoxins is an “important public health goal”. Aflatoxin contamination is rampant in animal feeds too. Aflatoxin B is found in cocoa, coffee, nuts and most notoriously peanuts.
It also has the ability to permeate human skin. Aflatoxin B is manufactured by two main species of mould – aspergillus parasitic and aspergillus flavus, although there are others involved.
Those are the two big beasts of the mycotoxin world, but there are many others which damage human health. Further to the above, the WHO is increasingly concerned about mycotoxins in food. It began in 1991 when the WHO Expert Committee on Food Additives discussed aflatoxin B for the first time and gave it a tolerable weekly intake of 100ng per kg of bodyweight.
By 1997, the WHO committee concluded that aflatoxins should be treated as carcinogenic food additives and kept as low as reasonably possible. In 2002, the WHO Food Additive Committee discussed for the first time how this aflatoxin contamination was rampant in common foodstuffs.
Finally in 2007, reducing mycotoxins in food and animal feed across the world became an official plank of World Health Organisation strategy. 100 countries around the world encompassing 85% of the world’s human population regulate the quantities of mycotoxins in foods, with the EU having the tightest regulations.
It doesn’t end with official health bodies; consumers are increasing concerned. For example, coffee lovers everywhere are ditching their cheaply made, poor quality bean derived, instant coffees, and spending extra money on top quality beans.
Many notice that headaches, fatigue and joint pain from such coffees, and mycotoxin sensitivity is to blame. The famous Bulletproof Coffee, the coffee recipe which involves liberal quantities of butter, owes a great portion of its appeal to being totally mycotoxin free.
There’s little doubt that mycotoxins can be a menace for your health, in high quantities. Among more dedicated health and fitness fanatics in paleo and primal type movements, there’s a lot of argument right now over whether mycotoxins are sufficient reason to abandon coffee and chocolate completely.
But are aflatoxins, ochratoxins, other mycotoxins and all the foods that contain them really contributing to your acne, or indeed any worsening of health?
Mycotoxins crank up your inflammation levels
Anyone with a mycotoxin sensitivity will know the classic symptoms – joint pain, total disruption of mental concentration, fatigue. Those are also some classic signs of chronic inflammation, the worst disease behind acne.
- This study examined two substances and their effects on human cells: the mycotoxin thrichothecene and the mould which produces it, s.chartarum. S.chartarum is a key villain behind indoor mould contamination in old, dilapidated buildings. The scientists found that purified thrichothecene mycotoxin strongly enhanced the release of the pro inflammatory, pro acne chemicals interleukin 1-beta and interleukin 8. Three other mycotoxins, roridin A, verrucarin A, and T-2 toxin, did the same. In one study, acne patients were found to have much higher interleukin 8 levels in their skin than patients without acne.
- This study analysed another thrichothecene mycotoxin (one of the more heavily studied and dangerous groups) called Fusarenon-x. Scientists weren’t testing its effects on inflammation; they were simply using it as a tool to induce inflammation in animals to then test other treatments for the inflammation, like aspirin and hydrocortisone. Clearly, some mycotoxins are well established to cause inflammation.
- Here we have a study specifically examining ochratoxin A’s effects on inflammation. The scientists were trying to determine exactly how ochratoxin A damages the kidneys so badly. They investigated several parameters including collagen output and inflammatory biomarkers. There’s not much detail in the abstract of the study, except that ochratoxin A substantially increased markers of inflammation. Specifically, they measured the activity of NF-KappaB, which is a master molecule that controls the release of many different pro inflammatory chemicals behind acne.
- Scientists in this 2012 study examined the effect of ochratoxin A on inflammation in human nasal cells. Exposure to ochratoxin A lead to a big increase in both interleukin-6 and inteleukin-8, two classic inflammatory chemicals behind acne. The scientists concluded: “Our data show that the ubiquitous mycotoxin OTA has a strong pro-inflammatory effect on NEC resulting in the release of IL-6 and IL-8. Mycotoxins may promote inflammation in nasal mucosa”.
- Here is yet another study showing that ochratoxin A leads to inflammation. This time scientists found that OTA specifically increased NF-KappaB activity, and also another master inflammatory messenger behind acne called COX-2. They concluded that “these results confirm the pro inflammatory effect of ochratoxin A by itself”.
- Next we have a study conducted on aflatoxin B. After treatment of cells with AFB1 for 72 hours, the pro-inflammatory and pro acne chemical IL-6 increased substantially. Meanwhile, an anti-inflammatory chemical called interleukin 10 was decreased.
- Scientists analysed aflatoxin B1 again in this study from 2014. AFB1 was tested for its effects on both oxidative stress and inflammation. The scientists commented that “Concordantly, the liver from the AFB1-treated rats showed over expression of pro-inflammatory cytokines”. TNF-a, IL-6, and IL-8 all shot upwards. The conclusion: “These findings…provide evidence for activation of oxidative stress-pro-inflammatory pathway during hepatocarcinogenesis induced by AFB1 toxicity”.
- Aflatoxin was again examined for its effects on inflammation in this study. This time the scientists found that stimulation of cells with ATB resulted in higher interleukin-6 and interleukin-1 levels. “We concluded that AFB1effects on the immune system can be either stimulatory or suppressive dependent on a critical exposure window of dose and time”. In other words, mycotoxins often increase immune system activity.
There’s great evidence that the two most common mycotoxins, aflatoxin B1 and ochratoxin A, can increase bodily inflammation noticeably.
How does that affect acne? Well, reducing inflammation is the single most important strategy an acne patient can follow. Without inflammation, your pore never swells up, reddens, and becomes acne.
Basically, the cycle begins when your pores get blocked and when p.acnes bacteria overgrows and thrives in them. With a normal immune system, p.acnes is efficiently wiped out. But when you have chronic inflammation, the immune response to p.acnes is an all-out assault, and the collateral damage causes acne. You won’t cure acne unless you deal with this over the top production of pro-inflammatory chemicals, of which there are many different types.
We can’t be sure exactly how mycotoxins cause chronic inflammation, but given how toxic and carcinogenic they are, in the kidneys, the liver, the brain, or wherever, it’s likely that your immune system treats them as a direct threat and increases its activity to destroy them.
Mycotoxins are linked to oxidative stress
Tackling these free radicals uses up a wide variety of bodily antioxidants – vitamin E, vitamin C, vitamin A, glutathione, superoxide dismutase. All antioxidants are critical for preventing blocked pores and acne, as they keep the sebum (oil) on your face intact against external pollutants.
Furthermore, many antioxidants like vitamin C and A have other acne-clearing powers. Vitamin C lowers stress hormones behind acne and vitamin A decreases your sebaceous gland activity.
Higher oxidative stress = more free radicals and less antioxidants. That’s a scenario which is vital to avoid for all acne patients, but it seems that mycotoxins are a chief villain behind it:
- This recent study from 2015 fed aflatoxin B1 to rats for several weeks and analysed their markers of oxidative stress afterwards. At the end, the rats had significantly elevated levels of blood free radicals along with a big decrease in one of the body’s main acne antioxidants, superoxide dismutase. Clearly, antioxidants were being depleted by having to deal with the increased free radicals from AFB1.
- This review analysed many of the side effects of aflatoxin B1 consumption and concluded that “the oxidative stress caused by AFB1 may be one of the underlining mechanisms for AFB1-induced cell injury and DNA, protein and lipid damages”.
- Next there’s this interesting study which found that exposing cells to ochratoxin A led to a big increase in reactive oxygen species (free radicals). Furthermore, there was massive depletion glutathione levels; glutathione is the main antioxidant which your body manufactures itself, as opposed to being obtained through your diet. Acne patients are notoriously deficient in glutathione. The scientists also found that supplementing with n-acetyl-cysteine, a supplement used for increasing glutathione production, prevented the increase in oxidative stress from ochratoxin A.
- This study found similar results. 6 male rats were fed ochratoxin A and/or lycopene (the most powerful antioxidant in tomato) for 14 days. OTA substantially increased oxidative stress in the rats’ kidneys. Furthermore, there was a 44% reduction in glutathione levels. That’s an enormous reduction in acne clearing antioxidants. Adding lycopene to the supplement protected against the oxidative stress from OTA.
- Another study on rats performed back in 2007 by the Institute for Medical Research and Occupational Health in Croatia found that ochratoxin A increased almost all parameters of oxidative stress. There was a substantial increase in serum malondialdehyde, an important lipid peroxide (free radical formed from fat tissues). Another mycotoxin, fumonisin B-1, also increased oxidative stress when combined with OTA.
- This study from way back in 1988 specifically examined the effect of ochratoxin A on lipid peroxides, free radicals formed from fat soluble compounds in the body. Feeding OTA to rats substantially increased their blood levels of lipid peroxides, an especially bad free radical for acne. The scientists commented that increasing lipid peroxides could be a mechanism behind the high toxicity of OTA in other areas of health.
- This 1996 study found that OTA led to free radical generation when added to cells.
- Instead of ochratoxin A itself, this 1999 study found that by-products produced during the digestion of OTA led to free radical generation.
The evidence that mycotoxins can increase the oxidative stress behind acne is extremely strong. There’s at least ten other studies which I didn’t include here.
As we discussed earlier, both ochratoxins and aflatoxins have strong links to cancer. Scientists were once confused to observe that mycotoxins aren’t directly genotoxic (toxic and cancerous to genes) but the generally accepted belief now is that mycotoxins cause cancer partially through oxidative stress. They believe that it’s the increase in free radicals which is mutating cells and genes across the kidneys and body.
As you can see in the studies above, mycotoxins are especially potent at increasing lipid peroxides. That’s especially bad for acne because vitamin E and vitamin A are the main scavenger of lipid peroxides, both of which are the two most important acne vitamins.
Are mycotoxins a real culprit behind acne?
It’s clear that mycotoxins have the power to cause acne. What’s not clear is whether eating them in concentrations obtained from a normal diet with normal intakes of coffee, chocolate, beans and nuts will actually be enough to cause acne or poor health.
Firstly, levels of mycotoxins in even the most contaminated foods are well below safe limits. For example, one European study found that the total exposure to ochratoxin A among Spanish people from foods was just 3% of the level deemed safe by the European Food Safety Authority.
Meanwhile, another study on Europeans found that drinking 4 cups of coffee per day contributed just 2% of the daily exposure limit for ochratoxin A set by the World Health Organisation.
That coffee wasn’t top notch quality; it was the type any caffeine loving worker might enjoy at the local coffee house. It’s a similar story for dried fruits, chocolate, and nuts. One study found that nearly 100% of humans tested had mycotoxins in their blood.
The truth is that mycotoxins are unavoidable, but they’re generally in such low levels that they’re totally safe for acne and health. Mycotoxins are only a problem in serious cases of contamination, e.g., dirt cheap coffee, chocolate sourced from corrupt cocoa farms with dodgy practises. There are no studies I know of suggesting harm from low levels of mycotoxins.
Now when it comes to clearing acne, I don’t recommend blindly following the advice of health bodies like the FDA when they insist that a particular pesticide, chemical, or heavy metal is perfectly safe at low levels. Look at the case of the acne causing menace BPA; they insisted that small amounts in baby’s milk bottles were safe for years. Then reality hit home when said children grew up with far lower IQ scores.
Furthermore, it’s often not low levels of one chemical that does the damage, but the cumulative effect of many chemicals found in food, cosmetics or tap water. Remember those rules for clearing acne.
That said, low levels of mycotoxins appear to be completely safe for acne. You evolved your detoxification systems for a reason. If you couldn’t eat any foods with low levels of natural toxins without getting acne you wouldn’t be eating anything.
Almost all plants have natural defensive toxins. Potatoes have glycoalkaloids, tomatoes have tomatine, and sweet potatoes have oxalates. Yet those foods are still healthy because your detoxification system is working. The same is true for mycotoxins.
Secondly, many foods with mycotoxins are also packed with acne nutrients that counteract the acne-causing harm.
In this study scientists fed rats some ochratoxin A and also fed one group of rats OTA combined with vitamin E, vitamin A, and vitamin C. The nutrients totally negated the oxidative stress and harm from OTA. Likewise, this study found that catechin antioxidants from tea blunted the harm from mycotoxins.
Because mycotoxins act against acne largely through oxidative stress, getting the above nutrients plus other antioxidants can make your acne basically immune to them.
Coffee, for example, is the second most common offender for mould contamination but is also the single biggest of antioxidants for the average American. Chocolate polyphenols (a class of antioxidant) were specifically found in this study to defend against mycotoxins excellently.
Antioxidants more generally were found to protect in this study, lycopene in tomatoes can protect against glutathione depletion from mycotoxins (study), as can antioxidants from the liquorice plant (study).
As long as your food is packed with other acne antioxidants and acne nutrients, it’s hard to see how mycotoxins could do anything. All the menacing studies above used isolated mycotoxins, not foods containing them.
This illustrates a rule you should always remember when improving your health or acne: always judge a food by its whole rather than a single isolated compound.
The lowdown on mycotoxin contaminated foods
There’s been massive volume of scientific research on mycotoxins in the last decade. Scientists have investigated all the classic foods and you can read the results in the acne friendly guide below. Generally I don’t advise acne patients to worry about mycotoxins BUT it is smart for clearing acne to avoid the rare foods which are seriously contaminated:
Coffee – coffee is most notoriously contaminated with ochratoxin A and fusarium mycotoxins. Coffee beans growing at low altitude, humid locations are more likely to endure mould overgrowth. However, the two studies discussed earlier speak for themselves. Drinking coffee on a regular basis contributes only a fraction of the mycotoxin intake safe for acne patients. Look at these studies:
- In this study, 20 of 60 samples of green coffee beans from Brazil contained Ochratoxin A at low levels.
- This study found that just 8 of 30 roast coffees contained Ochratoxin A, and far higher contamination was observed in chilies.
- Out of 40 coffee brews from commercially available coffee beans analysed, only 18 contained Ochratoxin A (study).
Contamination is not rampant and even when mycotoxins are present, the levels are far too low to cause acne. Coffee’s antioxidants protect against mycotoxin acne damage, as do several other acne friendly compounds like kahweol and cafestol.
Furthermore, coffee farmers have been well aware of the mycotoxin problem for years. Coffee is actually assigned a quality score which is partially based on mycotoxin count. Contaminated beans are either discarded or sold for dirt cheap, totally unprofitable prices. Hence, farmers use many techniques to keep them for proliferating, like wet processing, which was shown in this study to reduce mycotoxin levels substantially.
Roasting coffee beans reduces the mycotoxin levels by between 42-55% according to this study. This study found that roasting coffee beans for between 2.5 and 10 minutes reduced the mycotoxin count by 69-93%. Remember that roasting does not kill mycotoxins themselves but it destroys the moulds that produce them.
There’s perhaps only one type of coffee where mycotoxins become a serious problem and they are instant, decaffeinated brands. Instant coffee is typically made from the cheapest, lowest quality beans, beans which are cheap precisely due to being assigned a poor quality score due to mycotoxins. Decaffeinated coffee is also made from cheap discarded beans which are relegated to “decaf duty”.
Furthermore, caffeine has strong antifungal effects; it’s found in coffee beans as a natural antibiotic to keep the plant free from moulds and disease. Removing the caffeine removes many defences against mycotoxins.
If you want an acne friendly decaffeinated coffee, then simply buy a more expensive brand. Price does not indicate quality alone but it helps a lot. Buy a younger coffee as well; on older beans the mould has much longer to take over.
Cocoa – raw cocoa beans are often mishandled like coffee beans. Some beans always get contaminated with mycotoxins, but this can spread to other beans if the infected ones aren’t discarded and separated quickly enough.
All standard chocolate products have to be fermented first, both to reduce toxins like lectins and to produce the right balance of natural compounds to provide the chocolatey flavour we all know and love.
The problem is that this introduces moisture levels of around 40-50%, the perfect breeding ground for moulds. The most prominent strain on cocoa beans is aspergillus flavus. Compared with coffee, cocoa is more known for contamination with aflatoxin B1 and also cyclopiazonic acid (CPA). Apparently, 64.1% of a.flavus moulds produce aflatoxins and 34.2% produce CPA. A.tamarii is another common cocoa mould which produces CPA.
Next, cocoa beans are sundried to bring the beans down to 6-7% moisture. Usually, this takes a week, but in damp and cloudy weather conditions it can take up to four weeks. Mycotoxins have a low tolerance for dryness, so the longer the sun-drying takes to succeed, the greater the opportunity for the moulds to multiply.
Furthermore, cocoa beans are often dried on wooden platforms, which are a source of the mycotoxin producing fungi inoculum. Some producers sun dry cocoa in very thin layers, which also aids mould multiplication by increasing the oxygen levels and destroying anti-fungal acids in cocoa like acetic acid.
Basically, there is a lot of opportunity for cocoa beans to get infected. The mycotoxins do end up in the chocolate you eat. But like with coffee, levels are far too low to cause acne. A study found that 50% of cocoa bean samples contained ochratoxin A after sun drying, but levels were very low. In fact, that’s a high outlier as almost all studies on cocoa products find that less than 20% contain any mycotoxins.
Like coffee, roasting cocoa beans decreased the mycotoxin levels by 24-40% in one study and by 17% in another. One study from 2002 found that cocoa products contribute just 5% of total European ochratoxin exposure.
Furthermore, another important part of cocoa processing is the winnowing to remove the cocoa bean shell (the testa). In finished cocoa nibs and cocoa bean products, a maximum of just 1-1.5% testa residue is allowed. The good news is that many fungal strains concentrate in the testa and especially ochratoxin A. Mechanical shelling apparently removes 48% of the OTA and hand shelling removes between 50 and 100%.
What’s the best cocoa product then? Almost all are safe, but mycotoxin regulations are stricter in Europe compared to the USA, so chocolate brands like Lindt are very clean. Raw chocolate is likely to contain more mycotoxins as it isn’t roasted but is still fermented (contrary to popular belief). Mycotoxin contamination in cocoa also varies according to country of origin, with the Ivory Coast and Nigerian cocoa beans generally having the highest counts…
…but even in those circumstances, top quality dark chocolate (85% plus is best) will almost certainly not contain enough mycotoxins to cause acne. Cocoa powder is among the best sources of acne antioxidants in the world, and in the study above cocoa polyphenols were specifically found to reduce the harm from mycotoxins.
Peanuts – your acne strategy is here is very simple. Buy organic peanuts which are absolutely fresh. Peanuts are some of the worst foods for aflatoxin contamination, if improperly handled. Like cocoa or coffee, they are generally free from moulds when produced by reputable farms. The exact same applies to peanut butter.
Wine and beer – a known source of mycotoxins but for acne patients an insignificant one. In this study, 30 beers and 30 wines were analysed but only 5 and 2 samples contained mycotoxins respectively, and the levels were low.
If you’re a chocoholic or a proud coffee addict then you can rest easy. Mycotoxins are nothing to worry about for acne as long as you avoid really down-market products.
There’s only one other possible problem and that’s if you’re hypersensitive. Sensitivity to mycotoxins does exist and while the symptoms can be almost anything (including acne), the classic ones are fatigue, a dry mouth, inability to think properly, chronic pain, and digestive discomfort. These can occur shortly after consumption of suspicious foods or can plague you constantly and only vanish when you cease regular consumption.
The good news is that we humans have been eating moulds in foods for millions of years and are mostly adapted to processing them. Your odds of being sensitive are slim.
There’s one final strategy to defend against acne from mycotoxins and that is to build up your bodily defences. By eating more fruits and vegetables, mycotoxins will make nary a dent in your antioxidant stocks. The same applies if you declare all-out war on chronic inflammation elsewhere by eating more zinc, sleeping well, eating garlic and so on.
Ochratoxin A might deplete glutathione and cause acne, but if you get more selenium you’ll have higher glutathione levels than the average acne patient anyway.
Thanks for reading!