When I say acne, you probably have a flashback to your teenage years. Remembering what it was like having a giant pimple on your face on picture day or for prom. Or, maybe you think about how much you have struggled with acne as an adult.
Acne is not just a symptom of your adolescence. Approximately 12 percent of women struggle with adult acne. For some women, acne lasts well into their 20s, 30s, and even into their 40s. Some women even experience a recurrence of acne during menopause.
I know, I know, it’s so not fair! As if we aren’t dealing with enough already!
Adult acne is a chronic health concern and can absolutely take a toll on you mentally and physically. I’ve had women share that they avoid in-person meetings, pass on social events, and struggle with feelings of self-consciousness due to acne. The good news is that we there are tools to help us better manage this chronic health concern.
There are options beyond topical and oral medications prescribed by a dermatologist. Getting to the root cause of your acne can help you to look and feel your very best.
So I guess the question is...can we manage and treat acne naturally?
Yes! And I’m a testament to using a holistic approach to healing acne.
My Story
I was one of those lucky teenagers who didn’t struggle with severe acne. In fact, I didn’t have acne until about 10 years ago. At this time, I was super stressed out and my acne would flare up right before my period. I tried everything…and I mean everything! If there was a topical treatment advertised to help with acne, you better believe I bought it. I even tried several oral medications. But, nothing worked.
It felt off. And it was.
My body was becoming dependent on oral medications and topical creams, even though they weren’t working. And on top of that, no one told me all the harm they were causing to my body, especially long term.
I was in naturopathic medical school at the time of this big acne flare. So, of course, I went to see a naturopathic doctor for help. For the first time, a doctor didn’t prescribe me a topical medication. She focused on my liver and gut health, which over time helped to balance my hormones and mostly resolve my acne.
It wasn’t an overnight solution. We identified the main acne triggers (for me, it was and still is stress, dairy, and sugar), and established some foundational practices for my gut, hormones, and skin. Getting to the root of the problem led to a long-lasting change in my acne. The best part is that I stopped putting all those medications on my skin and in my body. And, I said goodbye to major break outs the holistic way!
I still get acne, but it’s much milder than before. I can anticipate the onset. It usually comes on after too much stress, cheese, or sweets. But sometimes eating a few extra sweets is worth a pimple or two. :) Plus, I know that my skin can bounce back in a short amount of time. All because of the foundation I’ve established in my body.
In this blog, I’ll share the hidden and underlying causes of acne that I see in my practice and four areas to focus on to holistically heal your acne.
Underlying Causes of Adult Acne
Treating acne can be complicated. To identify the root cause of your acne, we need to take a step back and look holistically at your body. The underlying cause of acne is rarely skin deep. Oftentimes, adult acne is caused by a combination of hormonal imbalances, sub-optimal liver function, gut dysfunction, stress and genetics. I don’t discuss the role of genetics in this blog, but it is important to note that genetics can play a big role in adult acne. However, addressing the other contributing factors is still helpful for individuals whose genetics predispose them to acne.
When it comes to adult acne, I see four main areas that contribute to acne:
Hormonal Imbalance
If you experience irregular periods, painful periods, or other period problems, and your acne is cyclical (worse before, during, or after your period), your acne is likely related to a hormonal imbalance. Also known as “hormonal acne.” One study found that 57% of women who report having acne, experience flares related to their cycle. Of these women with hormonal acne, 95% of them experienced acne flares before or during their menses.
Hormonal acne flare-ups occur at different times in your cycle based on specific hormones. For example, studies have shown that higher levels of testosterone or DHEA premenstrually can contribute to acne before your period. Also, lower levels of progesterone (in relationship to estrogen) premenstrually can contribute to acne before or during your period. It’s very helpful to know where you are in your cycle when acne occurs and resolves so we can get to the bottom of what’s contributing to your acne. Not sure where you are in your cycle? Read more about tracking and charting your cycle.
The most common cause of elevated androgens (testosterone and DHEA) is Polycystic Ovary Syndrome (PCOS). Women who have PCOS often produce more testosterone premenstrually. It’s believed that elevated testosterone can lead to an increased production of sebum which leads to acne.
It’s important to share your acne symptoms as well as your cycle history with your provider so that appropriate hormone testing can be done. Comprehensive hormone testing can include testosterone, DHEA, estrogens and estrogen metabolites, progesterone, and cortisol.
Suboptimal Liver Function
The liver is the second largest organ in the body. It’s a badass! The liver performs hundreds of vital functions including detoxifying the blood, neutralizing toxins, metabolizing fats and proteins, and excreting hormones.
Yep, that’s right. Hormones! Filtering our hormones is the responsibility of the liver. The liver struggles to clear hormones when it’s overloaded with filtering out chemicals or toxins. This can lead to hormonal imbalances and skin issues.
Chemicals and toxins come from a variety of sources including our water, air, and food. Our first exposure to the world of toxins and chemicals comes from our mother (not to blame her at all!). We pass many of the built-up chemicals in our bodies to our babies in utero and through breast milk. Pesticides/herbicides, heavy metals, growth hormones, and plastics are in our food. Plastics, dangerous fillers, and other chemicals are in our skincare and home products. All of these chemicals get absorbed through the skin or inhalation and cause harm to our bodies.
No matter their source, all chemicals need to get neutralized and shipped out of the body. The liver plays a huge role in this process. The liver doesn't have the resources to do its job when bogged down with chemicals and toxins. When this happens, our body, including our skin, can take a huge hit.
The toxin talk is not to scare or discourage you at all. There is no way to completely avoid chemicals in our environment. Nor should that be the goal. The key is to learn where they are coming from so you can reduce your exposure and improve your liver function.
I see acne (and other skin conditions) arise as a result of an overburdened liver a lot in my practice. Once we start supporting the liver (and gut), we can begin reducing acne and enjoying clearer skin.
Gut Health and Diet
Many inflammatory skin conditions are linked to gut health and diet. While these are unlikely to be the sole cause of acne, diet and gut health can be contributing factors.
For some, it may be as easy as eliminating dairy or other problematic foods such as gluten, eggs, corn, or soy. But, for others, it may be more complicated.
Start by focusing on a diet that supports a healthy gut. Incorporate a large variety of fruits and vegetables, adequate protein, and minimize alcohol, processed foods, and refined sugars.
Since the liver and gut work so closely, when we support a healthy gut we also support a healthy liver.
Stress
Most of us have experienced a breakout from stress. Having acne can also increase stress for women. Especially when it is more than one or two zits. Finding ways to manage your stress can help to break the stress / acne cycle. For tips on building resilience to stress, check out my blog post.
Holistic Support for Acne
As you can see, finding the contributing factors to acne can be complicated and multi-faceted. This goes for treatment of acne as well. A holistic approach to treating acne begins with improving your liver function and balancing your hormones. I like to use herbs and nutrition to make those changes. But there are other things that you can begin doing now to improve your acne.
4 Focus Areas to Holistically Heal Acne
1. Reducing Toxins
One of the easiest ways to begin improving your liver function is by reducing your overall toxin exposure. You can start right at home. Look for harmful chemicals in your cleaning products and skincare. A great resource for checking the quality of your beauty products is the Environmental Working Group’s, Skin Deep database. You may also want to have your water tested or start using a filter. Finally, check out my guide to avoiding common chemicals that affect hormones. And remember, it’s about reducing your overall toxin load and not about completely avoiding all toxins.
2. Nutrition
The key to balanced hormones and great skin is eating lots of veggies and fiber. And avoiding/minimizing alcohol, processed foods, and refined sugars. Load up on your veggies, especially cruciferous veggies (kale, broccoli, brussels sprouts, cauliflower, etc). I recommend starting with 5 servings of veggies each day. Work up to 8 – 10 per day. Consider taking a 30-day break from alcohol and sweets and see what that does for your skin.
3. Herbs, Nutrients, and Vitamins
There are so many wonderful herbal and mineral blends to help regulate hormones and reduce PMS symptoms, including acne. Talk with your provider about herbal blends and nutrients that are best for you and your body.
4. Stress Resilience
Building your resilience to stress takes time but can be beneficial for your entire body. I recommend meditation, regular movement, and sleep to help build resilience to stress. Learn more about building your resilience to stress.
Finally, while this blog focuses on healing acne from the inside, I do have a couple favorite resources for topical treatment and ongoing maintenance of glowing skin (no affiliation, just love ‘em). Acne prone skin does usually require at least some special attention topically. Osmia Organics is a great company founded by an emergency medicine doc who has a love for natural and organic skincare. She has some great products that I use and love and patients have also had success with. And if you’re in the Seattle area, I absolutely adore Paige Gayle with Samatva Skin & Body. Paige is an aesthetician and massage therapist. She is also certified in Vodder Manual Lymphatic Drainage. She is very knowledgeable about treating the skin from the inside out and is very intuitive with her treatments.
Are you ready to say goodbye to acne the holistic way? Schedule a discovery call and let’s figure out how we can best support your skin from the inside out!
References:
1. "Postadolescent acne in females - PubMed." https://pubmed.ncbi.nlm.nih.gov/24280643/. Accessed 14 Dec. 2021.
2. "The association of acne and menstrual symptoms among young ...." 11 Jun. 2020, https://pubmed.ncbi.nlm.nih.gov/32549185/. Accessed 10 Feb. 2022.