Anti-Wrinkle Nutrition

What might help is the soothing South African herbal tea honeybush (Cyclopia). After it protected the skin of “nude” (hairless) mice from UV damage, honeybush water extracts were tested in a randomized, placebo-controlled, double-blind study. And instead of looking for a placebo tea that looked and tasted the same, the honeybush tea was dried, ground, and put into capsules, which were then compared with identical-looking placebo capsules. Therefore, it’s not clear how much tea was actually used, but after twelve weeks it reduced the depth of crow’s-feet wrinkles by about 28 percent more than placebo.

The second anti-wrinkle drink is a surprise: hot cocoa. Two hours after a drink with about two and a half teaspoons of natural cocoa powder, participants’ skin had significantly better blood flow. If you drink that every day for six weeks, redness drops by 15 percent at the same UV dose, and after twelve weeks by as much as 25 percent. Skin thickness, density, and hydration increased compared with placebo, a cocoa powder from which most of the flavanols had been removed. Wrinkle severity didn’t change in twelve weeks, but in a 24-week study, skin elasticity and wrinkle depth improved significantly—from less than a teaspoon of cocoa powder that was part of the daily diet.

“Wrinkles should merely indicate where smiles have been.” —Mark Twain

Wrinkles show up where fracture lines form in aging skin, comparable to the cracks in leather gloves. Over time, the furrows of daily facial expressions carve themselves in as permanent little lines. In see.nf/wrinkleformation, I discuss the role of Botox, “anti-wrinkle” pillows and adhesive strips, genetics, and even the light from smartphone screens. Children can, of course, make faces as much as they want because their skin hasn’t been irreparably damaged yet. So, to avoid wrinkles, you have to prevent the underlying structural damage—for example, by not smoking and always protecting yourself from the sun.

Anti-Wrinkle Nutrition

If you already have wrinkles, can you tackle them with diet? Those who eat mainly meat and processed junk tend to have more wrinkles, but if you mostly reach for fruit—or fruit, vegetables, and nuts—you develop significantly fewer wrinkles. The foods associated with more or fewer wrinkles are discussed in see.nf/antiwrinkle, along with the intervention data on almonds, flax, soy, and mangos—yes, yes, yes, and no.

Since there are only a few intervention studies, the recommendations can be trusted only to a limited extent, but the best approximations were summarized in 2020 in the dermatology review “The Anti-Wrinkle Diet.” The defenses consist of foods high in antioxidants (see the chapter on oxidation), anti-inflammatory foods (see the chapter on inflammation), foods that counter glycation (see the chapter on glycation), high-fiber foods for the microbiome, foods like broccoli that support DNA repair, and foods that (at least in vitro) block collagen- and elastin-eating enzymes, such as garlic, turmeric, and ginger. In other words, the most promising anti-wrinkle diet is based on whole plant foods.

Vegan Weak Spots

Now, you might think a plant-based diet would be ideal for preventing or reversing skin aging, but some studies found a few potential weak spots. For example, in a study of UV light therapy for psoriasis, vegans’ skin became inflamed more easily than that of other patients. In light therapy, a combination of photosensitizing medications and a UV lamp or laser light is typically used. After eight weeks of treatment, significantly more vegans (42 percent) than vegetarians (17 percent) or omnivores (10 percent) had severe skin redness as a side effect. Why? Because the vegans were already loaded with furocoumarins, photosensitizing compounds that naturally occur in certain fruits and vegetables such as parsley, parsnips, celery, and citrus fruits. The vegans in the study reported eating about 600 grams of parsley a week (that’s six cups of parsley in seven days!). They also ate five kilos of citrus fruit each week, including one kilo of lemons, and pounds of parsnips and celery. It’s great that they ate so many healthy, fresh foods, but all that furocoumarin really can make the skin burn more easily in the sun.

A light-therapy study aimed this time at destroying precancerous skin lesions likewise found increased skin inflammation and a longer healing time in vegan participants. In omnivores, it took an average of ten days for the wound to close, which is considered normal. In vegans, however, complete wound healing took more than twice as long, namely 22 days. Healing also dragged on in vegans after laser tattoo removal, and their outcome was worse (average healing time 23 days); in omnivores, healing averaged 19 days; the same thing happened with ablative (resurfacing) laser skin rejuvenation. That could be due, first, to greater skin damage from the light treatment because vegans eat more photosensitizers, but second, vegans also appear to have delayed wound healing independent of light.

Postoperative scars after an excision of skin cancer did not heal as well in vegans as in omnivores. A reduced collagen production was suspected as the reason. Collagen is not only the main component of skin in general, but also the most important connective tissue and is directly involved in wound healing. Impaired collagen production could also explain why cosmetic fillers last longer in omnivores, since the mechanical stress from filler injections stimulates collagen production, and why microfocused ultrasound treatments of the skin work better. With strongly focused ultrasound, loose skin is treated with temperatures up to 60 degrees to trigger a process that also forms new collagen. The researchers suspected that the skin improvements with this treatment were less pronounced in vegans because they produced less collagen.

Does a plant-based diet actually lead to lower collagen production? Apparently, yes. In vegetarians it is about 10 percent lower. The question is why. In each of the studies mentioned in which vitamin B12 levels were measured, vegan subjects had a deficiency (on average < 200 pg/ml), and studies in both humans and animals showed that B12 is important for collagen synthesis, and for wound healing. Homocysteine, a toxic byproduct of B12 deficiency, inhibits collagen cross-linking, which gives connective tissue mechanical integrity. Therefore, anyone who eats predominantly plant-based should absolutely include a permanent, reliable vitamin B12 source in their diet.

Another possible factor is protein, which you need more of during wound healing. For pressure ulcers, for example, the recommended protein intake increases from 0.8 grams per day per kilo of body weight to 1.25 to 1.5. That explains why most of a dozen studies on protein supplementation for pressure ulcers found that the ulcers regressed more with supplementation. On average, vegans consume 1.0 grams of protein per kilo of body weight and therefore have enough for daily needs, but omnivores average about 1.3 grams, meaning they already have the extra protein that can be helpful for wound healing. So while vegans are recovering from their tattoo removal, I recommend more legumes.