The Root Causes of Your Acne (and Solutions!)
Most of the population have suffered with acne breakouts at some point in their lives, often during puberty, but increasingly many people are struggling with acne into their adulthood.
Do you wake up each day and dread looking in the mirror as you know you will have gotten a fresh batch of pimples overnight?
Are you constantly stressing in your day to day life, trying to figure out whether it's your breakfast choices or workout causing your acne?
Do you try to hide your face in embarrassment when people are talking to you, because you don't want them to judge you?
Acne and skin conditions often don't occur alone. Some of the related conditions and symptoms include irritable bowel syndrome and digestive issues, anxiety, depression, hormone imbalances including PMS and food intolerances. This is a big indicator that our external symptoms aren't just due to us not using topical acne products, but instead an internal imbalance involving many bodily systems.
I have struggled with acne myself for several years which was driven, at some point, by all of the factors I am going to share with you today. I have spent tons of money on the miracle serum or superfood to cure my skin, to no avail. It was only when I really started to take a holistic approach to my whole life and self care that I started to make progress.
I want to help YOU do the same and finally be able to figure out which of these root causes if affecting your skin, so that you can take action!
So here are the main causes and solutions for acne breakouts:
Blood sugar imbalances
In my opinion, this is the main issue that is contributing to acne. Have you ever binged on chocolate and sweets, then woke up 2 days later with a huge, angry spot right in the centre of your forehead? That spike, (and subsequent crash), in blood sugar stresses our body and causes our adrenal glands to pump out cortisol and our pancreas to produce a ton of insulin. Both of which, can increase inflammation and sebum production...the precursors to spotty skin. "But I eat a really healthy diet with no sweets or processed food?!" I hear you say. We can all tolerate different amounts of sugar and carbohydrates in our diet and when we exceed an excess for our individual tolerance, we can react. Remember, all carbohydrates turn to glucose (sugar) once consumed, so all those banana smoothie bowls, date laden energy balls and sweet potato fries, although natural foods, may be negatively affecting your blood sugar levels, and contributing to your acne.
I would recommend you first get your fasting blood glucose and HbA1C tested to see what your blood levels are initially. Then I would clean up the diet, eliminating all refined sugars and processed foods if you haven't already. Another recommendation I give to all my clients is to ensure you consume a source of high quality protein, healthy fats and fibre at each meal. This will help to stabilise blood sugar levels preventing those inflammatory spikes and crashes. Swap your high glycaemic load (GL) carbohydrates such as bananas, dried fruits and natural sweeteners like maple syrup for smaller portions of starchy carbs like carrots, parsnips, pumpkin and beetroot. Resistance training e.g lifting weights can also improve the way our body uses glucose, therefore incorporating this into your workout routine a few times per week may also help.
Ahh hormones...don't you just love them?! Acne, especially around the mouth and jawline in women (but not always!) can be a of hormone imbalances. If you haven't been tested already and you are a female suffering with unexplained acne I would ask your doctor to investigate PCOS being a possible causative factor. Polycystic Ovarian Syndrome (PCOS) is the number one endocrine disorder in females and can cause horrible symptoms such as cystic acne, hair loss on the head, hair growth on the face and body, irregular or absent periods and weight gain, due to an elevation male hormones such as testosterone and DHEA. Oestrogen dominance or a progesterone deficiency can also lead to skin inflammation, so I would recommend working with a practitioner who can run lab work to check these things for you.
Fortunately, a lot of hormonal imbalances can be positively affected by addressing the first recommendation, balancing your blood sugar. High insulin and blood sugar levels can drive our ovaries and adrenals to produce excess androgens (male hormones) and cortisol. Some other things to avoid for hormone imbalances include non organic meat and dairy products and hormone mimickers, known as xeno-oestrogens, which are found in plastic. You could also look into seed cycling as a way to naturally balance hormones too! Stress management which will be mentioned shortly will also help to balance your hormones as stress interferes with your blood sugar levels and hormone production.
When your body is struggling to eliminate toxins through your bowels, urine and sweat, it will try to get rid of them through your skin, which is your largest organ in the body. Addressing constipation, liver health and hydration levels are all crucial steps if you want to treat any skin conditions. They are so important, but often overlooked. Working on your gut health and addressing any dysbiosis that may be present can also support detoxification and takes a stressful load off your liver. Avoiding toxins found in non-organic food, car exhaust fumes, conventional skincare and chemical laden cleaning products will also lower your toxic burden and cuts your liver some slack!
Increasing your fibre intake will help the bowels to work more efficiently and alleviate constipation. Healthy fats from sources such as avocado, nuts, seeds and olive oil can also keep things running smoothly and provides you with some of the nutrients needed for liver detoxification, such as magnesium! High quality proteins including wild oily fish, organic meat, offal, quinoa and eggs should be consumed daily as the liver needs amino acids to complete phase 2 of liver detoxification, which helps to assist toxins out of the body. Cruciferous vegetables such as broccoli, cauliflower, cabbage, kale and brussel spouts contain compounds called indole-3-carbinol (I3C) and diindolylmethane (DIM) which support liver detoxification and the excretion of oestrogen metabolites. Remember that if its green, its probably going to be good for you. (Not including Skittles)
Now, I'm not talking about food allergies here. You would obviously know about it if you had an allergy as it can cause swelling, rashes and even anaphylaxis! An intolerance, on the other hand, can be behind minor symptoms such as headaches, joint pain, IBS and you guessed it...ACNE. These can appear up to 4 days after eating the food so it can be tricky to identify the culprits. An easy way to overcome this is to do a 30 elimination diet that cuts out the most common offenders which are gluten, dairy, corn, soy, eggs, refined sugar, caffeine, alcohol and chocolate. After the 30 days, you can slowly start reintroducing 1 new food per week, watching for symptoms to return and keeping a food journal. Personally I would leave gluten and dairy reintroduction until last (if at all!), due to the high association with skin problems and inflammation.
Doing an elimination diet is much more accurate than expensive food intolerance testing so I always recommend it to clients. If your struggling for meal inspo I would check out the Whole30 for their recipes and books. Having several food intolerances is also a huge sign that you may be suffering from intestinal permeability aka 'leaky gut'. Hippocrates, the father of modern medicine, famously said "All disease begins in the gut" and it's scary but true! More and more research is coming out about the gut-skin connection so its worth investigating further with testing if you have made the foundational changes, with little improvements.
All chronic health conditions are inflammatory in nature. Inflammation is good (to a point) until it becomes constant and then starts to harm the body. Stress, blood sugar imbalances, poor diets, gut problems and toxicity can all create inflammation but thankfully we have the power to address this through the food we eat and how we live our lives. Our omega fatty acid ratio is very important in determining our inflammation levels too. Omega 3 is anti-inflammatory and is found in foods such as oily fish, walnuts, flax, chia and hemp seeds. Omega 6 is pro-inflammatory and is found mainly in poor quality meat and dairy and vegetable oils like sunflower, canola, corn and soybean (common in processed foods and used in restaurants). Therefore focusing on healthy, fats will help to create more of an anti-inflammatory internal environment.
Most of the recommendations I'm sharing today will start to help lower the inflammatory response, however, if you continue to deal with skin issues or symptoms such as joint pain, headaches and fatigue I would strongly recommend working with a practitioner who can order some functional lab testing to help dig a little deeper to the root causes of your inflammation. These may include gut testing (SIBO breath test and stool test) to identify inflammatory markers, pathogens and absorption levels and also blood tests like C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR). Our immune system is located mainly in the gut so we need to take care of our digestive system to make sure we keep inflammation in check. Adding anti-inflammatory foods such as oily fish, nuts/seeds, herbs and spices and a rainbow of vegetables is a great idea for health overall, not just acne.
Incorrect skin care
I'm guilty of spending quite a bit of money on skincare that claims to 'brighten' or 'cleanse' my face and make me glow like Jessica Alba. I have previously spoken about avoiding toxins in order to clear up acne, and unfortunately conventional skincare products are some of the most toxic exposures we face due to minimal regulations in the beauty industry. We are lucky to have more natural, organic brands available here in the UK than we've had previously, but you may have to order online or visit a health store. Using products that are too harsh and drying can actually worsen acne by causing your skin to product MORE oil so say goodbye to your chemical laden cleansers. The more simplistic your skincare routine, the better, in my opinion.
Some of my favourite brands here in the UK include Dr Hauschka, Green People, Tropic, Neal's Yard Remedies, and MooGoo. Yes, its probably going to be more expensive than your £1.99 moisturiser from the high street store, but it's going to be better for your body and skin. I recommend gentle exfoliation 1-2 times per week using a natural product or homemade scrub made with brown sugar. Using steam rooms/saunas a few times per week if you have access can also be a great way to improve detoxification and unclog pores. Don't forget the obvious personal hygiene factors too. Regularly change your pillow cases, wash makeup brushes and wipe your phone, as bacteria can transfer onto your skin. Although its hard, i'd recommend wearing LESS makeup when you have active breakouts or know you are acne prone, to allow your skin to breathe! Also don't be afraid of using oils on your face if you have oily skin and acne. Jojoba, grapeseed and argan oils can help to moisturise the skin without clogging pores. Coconut oil, although it's good to consume internally, may actually worsen acne due to its comedogenic (pore clogging) properties! So keep it in the kitchen, not the bathroom.
I bet you are sick of hearing about stress management, but there is a reason why it is mentioned so often...it's just so important! Stress is inevitable, so we need to learn how to respond and manage this stress in order to stay healthy. Our stress hormones, cortisol and adrenaline, work mainly by raising our blood sugar so that we have a surge of energy to run from danger and remember the strong link between blood sugar management and acne. Stress creates inflammation in the body and can affect our immune system so that our bodies can't 'turn off' the inflammatory process or repair tissues effectively. Our modern day stressors are no longer escaping predators and famine, instead they are constant and chronic low grade stressors such as traffic, finances, overworking, poor diets and exposure to environmental toxins.
I wrote a blog post recently sharing my top tips for managing stress, you can check it out here. Journalling, emotional freedom technique (EFT), yoga, meditation, nature, painting, dancing and spending time with family and friends have all been shown to reduce cortisol and improve our feeling of well-being. When struggling with acne, you probably wake up every day and head straight for the mirror to assess your skin and spend your day feeling self conscious if you aren't hidden behind a face full of makeup. That in itself is stressful! Spend less time staring in the magnifying mirrors, when you catch a glimpse of yourself think of a compliment ("My hair looks amazing today!") and unfollow the social media accounts that make you feel bad about yourself. The majority of them don't look like their pictures in person anyway!
Nutrient deficiencies (and excesses!)
The skin, like other organs, needs a variety of nutrients in order to look and feel good. Deficiencies (or insufficiency) in nutrients such as vitamin A, zinc, B vitamins, sulphur and omega 3 fatty acids have all been linked to acne and poor skin health. The process of repair and renewal of skin cells is an energy intensive process and therefore requires the presence co-factors and building blocks. Now before you run out and start buying all the supplements available at your local heath store, its important to know that some nutrients can actually cause breakouts if you take more than your body needs. Biotin (often hailed as the miracle treatment for healthy hair, skin and nails), vitamin B12 and omega 6 fatty acids can trigger breakouts in susceptible individuals. So be cautious when taking supplements and work with a knowledgeable practitioner who can guide you through the process.
I always recommend focusing on food first. This way we can get a balanced ratio of nutrients found in their whole food form, which our body prefers. You can also do blood tests to check your individual nutrient deficiencies or requirements and therefore choose specific supplements that your body needs. Consuming 7-10 portions of fruit and vegetables (mainly veg!) per day will be a great starting place. Make these plants different types and colours to ensure you are getting a wide variety of vitamins and minerals. I love recommending high quality organ meats, such as liver, to clients with acne and skin conditions as they contain almost all of the nutrients needed for clear skin. Chicken livers are my personal favourite, but you can sneak them into other meals such as bolognese or homemade burgers if your not a fan of the taste.
As you can see, acne is often a multi factorial issue. I know this from personal experience! Because of this I always recommend that acne sufferers work alongside a qualified practitioner with experience treating skin conditions, as self treating can be very stressful.
Instead of reading hundreds of blog posts and articles, spending money on the latest acne busting skincare and eliminating more and more foods from your diet, a skilled practitioner can put you on an effective protocol, saving time, effort and stress!
It may feel overwhelming to you, but the confidence you gain when you have clear skin (as vain as that sounds) is worth the investment.
You may finally join those gym classes you have been putting off because you didn't want to go bare faced.
You might feel ready to start dating again and find your soul mate.
Or you may feel confident enough to now have your photograph taken and join in the group shot with your friends.