Skin health requires a multifactorial approach to healing. With acne there are many contributing factors, but to simplify it I’m going to talk about the two main contributing factors to female adult acne:
Hormones& Diet. I’ll be discussing them in two separate categories, but as you see when you read on, Hormones and Diet are NOT mutually exclusive factors, they both influence each other.
Diet is more commonly at the root cause of female adult acne. This is because by the time we’re in our mid 20’s our cycles/hormones *should* be regulated – this is not always the case, especially nowadays when women are commonly on a form of hormonal birth control from the time they’re in their mid-teens until mid 20’s/early 30’s when they come off of the pill. If this is the case for you, your acne may be more rooted in your hormones (to be discussed in the next section), I’ll get back to talking about diet for now.
An important factor to consider when examining diet in the treatment of female adult acne is blood sugar regulation. If blood sugar is poorly regulated (eating too many refined carbohydrates and simple sugars) this will cause spikes in your insulin and then can result in dramatic drops in your blood sugar (hello mood swings, hangry and dizzy). If this blood sugar rollercoaster persists daily, it will impair your overall insulin sensitivity and can result in excess insulin in your system. Excess insulin decreases your livers capacity to produce SHBG (Sex hormone binding globulin), and if there is less SHBG available in your system to bind testosterone, there will be an increase in bioavailable testosterone in circulation that can stimulate the sebaceous glands. If sebaceous glands are over stimulated, this will result in excess oil and sebum production resulting in cystic acne.
Another component I like to consider is gastrointestinal (GI) inflammation. If digestion is not working smoothly (gas, bloating, constipation, loose stools, cramping etc.) then there is already a baseline level of inflammation in the body coming from the GI system. Inflammation from the GI system contributes to systemic levels of inflammation. Acne is already an inflammatory condition, and the body becomes less efficient at healing the skin condition if it’s also battling GI inflammation too. Also, if your digestive system is irritated, you may not be absorbing the foods you are consuming adequately, which could result in a lack of proper nutrients required for healthy skin – specifically vitamins C, A, E, and the minerals Zinc and iron.
Some basic treatment options to get blood sugar under control are:
- Reducing refined sugars and carbohydrates in the diet
- Increase consumption healthy fats and proteins
- Aim to eat 3 meals/day appropriately spaced out to reduce over-secretion of insulin
Some basic treatment options to reduce GI inflammation are:
- Keep track of what you eat and how you feel after to be able to identify any foods that you have trouble digesting and are irritating your GI system
- Sit down and take your time to eat meals properly. This is a way to activate your parasympathetic nervous system which gears you up to eat and digest foods properly
As mentioned earlier, hormones are another factor to consider when addressing acne. If hormones are a contributing factor at the root of your acne breakouts, there are typically other signs of hormone imbalances present (PMS symptoms, irregular cycles, heavy periods, food cravings etc) and the acne breakouts tend to be more cyclical as to when they show up. That means that the breakouts are predictable for when they are going to show up – for example they may occur just prior, or during your period, or a breakout happens midcycle. The cyclical nature of breakouts are a reflection of the ebb and flow of your hormones (estrogen, progesterone and testosterone) throughout your monthly cycle. I previously talked about how insulin – SHBG – testosterone all works together and can influence breakouts, and now I want to talk about estrogen and progesterone.
If estrogen is high relative to progesterone, this can contribute to hormonal breakouts. Some reasons why we may have high estrogen are: a poor diet high in sugar, trans fats and low in protein, lack of exercise, increased central obesity, constipation, stress, use of hormonal birth control. A reason we may have low progesterone in relation to our estrogen is lack of ovulation, inadequate consumption of healthy fats and stress (just to name a few). We get our progesterone from the corpus luteum which is what’s left of the follicle in the ovary after we ovulate, so if ovulation is not occurring, there is no corpus luteum, which means no progesterone to balance out estrogen.
Some basic treatment options to help lower estrogen levels and rebalance hormones are:
- Foods to help clear estrogen from the body: ground flax seeds, pumpkin seeds, broccoli, cauliflower, brussels sprouts, kale
- Support your digestion transit time by staying hydrated and eating a diet rich in vegetables and fibers.
- Vitamins and minerals to consider when balancing hormones: DIM, I3C, B Vitamins
As you can see, diet and hormones are not mutually exclusive causes of acne – and in order to optimize skin health, it’s a good idea to address both of these factors.
This is meant to be an overview of two major factors that affect skin health and acne, and to provide a starting point for looking into your own health. For more a more detailed and individualized treatment plan, please consult with your naturopathic doctor!