10 Reasons You Still Have Acne
I had porcelain skin throughout my school years, whilst my peers had to deal with acne breakouts.
I honestly thought that I was one of the lucky (yet totally annoying) people who would always have clear skin, despite what they ate or did.
Sadly, that all changed when I was 18, and I think my body made up for the previous years when I didn't have a single zit.
And they weren't just blackheads or tiny spots that would go within a few days, these were deep cysts which hurt to touch and wouldn't come to a head for weeks.
Over the years I tried topical creams, too many supplements to even list, birth control pills, diet changes and herbal medicines, however I only experienced temporary improvements or even worse skin with these things.
Looking back, there was always something that I was missing.
The times when my diet was the 'cleanest' and most nutritious, my stress levels were through the roof.
When I addressed the infections and overgrowths in my gut, I wasn't also supporting my liver detoxification pathways.
For some people, their acne totally clears up just by ditching junk food and eating more vegetables, but that is not the case for others, myself included.
Acne is complex and multifactorial, meaning that there are often multiple imbalances within the body that need addressing.
Remember, the whole body is connected.
Despite what your dermatologist may have told you, acne isn't just a skin problem, it is often a whole body problem.
Here are 10 possible reasons that you are still dealing with adult acne...
#1 You haven't addressed gut health
There have been many studies connecting acne to digestive issues such as small intestinal bacterial overgrowth (SIBO) and low stomach acid (hypochlorhydria). (source)
Poor gut health is probably one of the biggest causes of acne I see in clinical practice. You don't necessarily have to display digestive symptoms to have an imbalance, despite what you may think.
It is very important to test, not guess, especially when it comes to gut health, as you need to know exactly what is going on, in order to select the correct treatment options.
I use functional lab testing using the GI MAP or SIBO breath test to help rule out issues like bacterial overgrowth, parasitic infections, low digestive enzyme production, low beneficial flora and yeast overgrowth.
#2 Your hormones are 'out of whack'
We all produce around 50 different hormones, however the most common imbalances I see contributing to acne are high insulin and/or androgens (common in women with PCOS), elevated oestrogen and/or low progesterone levels, low thyroid (hypothyroidism) and elevated cortisol (stress hormone).
Hormones affect pretty much everything from our appetite, skin quality and mood, to our energy levels, sex drive and fertility.
I recommend a combination of conventional blood testing and functional lab testing. I personally use the DUTCH Test to assess sex and adrenal hormones and a full thyroid panel, including antibodies.
#3 Your blood sugar isn't stable
Elevated blood glucose levels often go hand in hand with high insulin levels, both of which are common acne triggers. When blood sugar levels are spiking and crashing due to factors such as stress, poor diet or imbalanced meals, this can create inflammation and stimulates the body to produce stress hormones like cortisol and adrenaline.
These hormones can up-regulate sebum production in the skin and promote inflammation, which are the precursors to clogged pores and acne breakouts.
I recommend cutting out all sources of refined carbohydrates and sugars whilst increasing your intake of high quality protein, healthy fats and fibre. Limit snacking too as this can keep blood glucose and insulin levels elevated.
#4 You have nutrient deficiencies
Our skin has a high requirements for nutrients. If we eat a poor diet, or have a limited selection of foods we choose from on a daily basis, we are putting ourselves at risk of nutrient deficiencies.
The major nutrients needed for skin health include vitamin A, C, D, E, B complex, zinc, amino acids, omega 3 fatty acids and sulphur. Aim to increase foods rich in these nutrients including wild caught oily fish, dark leafy greens, organic berries, organ meats, grass fed beef, ginger, turmeric, cruciferous vegetables and avocados.
Certain medications can also deplete nutrients, such as the birth control pill, NSAIDS, stomach acid blockers and metformin. You may need to supplement some of these nutrients, however I highly recommend working with a practitioner who has access to practitioner grade brands and can check for drug/nutrient interactions.
Excessive intake of biotin, B12, omega 6 and iodine can actually WORSEN acne in susceptible people *
#5 You're too stressed
Stress exacerbates a lot of the other factors including blood sugar levels, gut health, hormonal imbalances, nutrient levels and detoxification. Cortisol, our main stress hormone, can up-regulate sebum production and inflammation within the skin. Plus it can cause our adrenal glands to produce more androgenic (male) hormones such as testosterone, DHEA and DHEA-S, all of which can cause and/or worsen acne.
Remember though, stress isn't just phycological. Even though you may not feel mentally stressed by your job, finances or relationships (definitely address these if you are), your body may be stressed out for other reasons including dehydration, lack of sleep and over exercising.
Stressing about your acne or other health issues, may actually be making the situation worse.
As hard as it may seem, try to reframe your mindset about your current situation. Keep a gratitude journal, visualise yourself with clear skin, try not to spend hours in front of the mirror picking yourself apart. Read this post for more of my favourite ways to destress and reduce cortisol.
#6 Your liver needs some love
Our liver is responsible for so many functions within the body, the main one being detoxification. When we are being exposed to too many toxins (both internally and externally produced), our liver can struggle to keep up with the high demands.
It has a high requirement for nutrients (google search nutrients for liver detoxification to see for yourself!), therefore we need to make sure we are first avoiding our exposure to toxins, but also flooding our body with the nutrients which are used as cofactors. These include magnesium, zinc, b vitamins, vitamin C, amino acids, antioxidants and sulphur - all of which are also needed for healthy, glowing skin (Coincidence? I think not)
Alcohol, drugs, smoking, medications, stress, environmental chemicals, heavy metals, trans fat, high intake of fructose and refined sugar can all lead to a sluggish and overburdened liver. When our liver cannot keep up or the other elimination organs aren’t functioning well (eg colon and constipation, kidneys and dehydration), these toxins are pushed through the skin, resulting in skin rashes, hives and acne.
Certain foods and herbs such as dandelion root, turmeric, ginger, garlic, eggs, artichoke, beetroot, bitter greens and milk thistle are all liver supportive.
#7 You are eating foods you're sensitive to
When we consume foods that don’t work well for our body, this promotes inflammation and intestinal hyper-permeability (aka leaky gut). As I have already discussed, the health of our gut has a massive impact on our skin. I recommend that everyone with acne eliminates dairy, gluten, alcohol, refined sugar and corn to begin with, as these are the biggest triggers, however you may need to take this further and remove other common sensitivities like soy, eggs and chocolate.
For me personally, high histamine foods like citrus, avocados and bone broth were my biggest acne triggers (you can read more about this here), however this is definitely not the case for everybody.
It is normal to be sensitive to one or two foods, however if you are reacting to multiple, seemingly ‘random’ things, then this is actually a sign of poor gut health. Once you address things like dysbiosis, parasitic infections, low stomach acid and intestinal permeability (aka ‘leaky gut’) and work on improving gut health, you will likely be able to reintroduce many of these foods.
I’m not a fan of food intolerance testing as I find them to be inaccurate and really expensive. I prefer to recommend a short term food elimination diet like Paleo or Whole 30, as your body will give you feedback whether a food is working for you or not, upon reintroduction. Make sure you do the elimination and reintroduction processes carefully though, otherwise your efforts may go to waste (give this article a read)
#8 You are using the wrong products
I certainly made the mistake of over exfoliating, cleansing, drying and picking my skin, which made my skin a whole lot worse. Your skin is an organ that both absorbs and excretes substances, therefore it is important to ask yourself, “would I care for my heart or liver in this way”?
If you are still using conventional skincare and beauty products, you need to stop asap! These products are likely filled with tons of chemicals and endocrine disrupters (hormone mimicking substances). You do not want ingredients such as parabens, SLS or phthalates on your skin, as what we rub on our body can directly absorb into our bloodstream.
Stick with simple, natural ingredients such as facial oils, manuka honey, yogurt, oats and rose water. Try to go make-up free as often as possible to let your skin breathe, however when you do, make sure you choose green beauty, organic brands which offer effective products that are free from harmful ingredients.
#9 You are being exposed to environmental toxins
Along with chemicals and endocrine disrupters hiding in your skincare products, there can also be a ton hiding in your kitchen, living room and work place. Plastic, in particular, should be avoided at all costs (even the BPA free products!) Stop microwaving or heating your food in plastic tupperware containers, storing your food in cling film and drinking from a plastic water bottle. Not only is this harmful for your health, but it is also the environment.
Go organic as much as possible! Non-organic food is sprayed with pesticides, which can have detrimental effects on our hormones, immune system and gut health. Think about it, if they are able to kill off bugs and insects, they can definitely affect our microscopic gut bacteria. If you consume animal products, please go for the highest quality you can afford (ideally organic, at least free range). Organic meat tends to be higher in nutrients and contains less inflammatory compounds such as omega 6 fatty acids.
Use non toxic cleaning products and consider investing in a water filter. My favourite is the Berkey, as it eliminates harmful particles, but doesn’t remove minerals like other systems can. Obviously, it’s not expected that you change all these things overnight, however make the slow transition over to a ‘greener’ lifestyle.
#10 You have poor hygiene habits
This factor is often overlooked, but it is easy to solve. Don’t forget about regularly washing your pillow cases, bed sheets, hair brushes, makeup brushes, towels and face cloths. Oil, dirt and bacteria can easily build up and spread to your face, potentially leading to breakouts.
I commonly see acne on the outer cheeks relating to holding a dirty phone against your ear. When was the last time you cleaned your iPhone?! Get an antibacterial wipe and clean that thing every week if possible.
Make sure you are washing your face after working out or sweating too. There’s no need to go crazy with soaps and cleansers, just a quick rinse will do. If you are dealing with back acne, you may not be washing your body well after your gym workout. Avoid leaving sweaty clothes on for too long afterwards.
Although this list may seem overwhelming, I urge you to see it as motivational and inspiring.
Acne is a condition that isn't life threatening and it is certainly something that can be overcome, when we provide the body with the right environment and building blocks.
That is not to diminish the seriousness of acne, trust me, I know how much it can affect self esteem and confidence, (from personal experience).
I highly recommend working with a skilled practitioner through this, as it can be very stressful trying to figure this out on your own.Not to mention, you will probably spend a ton of time and money trying different products, supplements and treatments.