Most people think of acne as a “teenage hormonal thing”; that it is a necessary, but evil part of growing up. But, that is not the truth. There are many different causes and a multitude of ways to treat acne. Whether you are 14 or 45, acne can be a huge problem, affecting us on all levels, physically and emotionally. There are so many types of acne, from inflammatory (rosacea) to cystic, to black heads, and in most cases, we need an inside – out approach. A thorough assessment of how your body functions inside and a topical treatment to rebalance the skin on the outside.
Initial Assessment: Your skin can Tell a Story
An initial assessment of the skin gives us clues as to what sort of imbalances we might find in the body. For example, when there is a lot of underlying redness in the skin, we often see an issue with the gastrointestinal (GI) tract. We also look to see if the acne is concentrated in a specific area that tells us where the issue might be. If it is concentrated along the jawline, it is often adult hormonally based acne, whereas acne across the nose and upper cheeks is likely related to issues in the upper digestive tract. The classic T-zone for teenagers is also indicative of hormonal caused acne.
Deep Dive: Identifying the Root Cause of Your Acne
After the initial assessment, Naturopathic Doctors will take an inside-out approach and start to look more deeply into the body to identify the root causes of your acne. When we address these, we remove the susceptibility for acne.
There are 4 common symptoms that will help us determine what is wreaking havoc on your skin:
1. Gastrointestinal Dysfunction: Let’s Talk Poop and Smelly Gas
Our questioning always begins with digestive functioning; how often do you have a bowel movement? Do you burp? Are you ever bloated?? These questions help to narrow down the area of the digestive system that may not be functioning optimally. As Naturopathic Doctors, we often order very specific tests to determine GI functioning. At our clinic we use, GI MAP (https://www.diagnosticsolutionslab.com/tests/gi-map), because it uses DNA analysis of the stool to determine the digestive functions of each level of the bowel. It also tests for bacterial, viral, worm and protozoa parasites as well as determining the healthy bacterial populations. DNA analysis takes out the human error component and increases the sensitivity.
Proper elimination is vital to prevent acne. Our skin is the largest organ of detoxification. If we don’t eliminate our toxins through the bowels and kidneys, we excrete through our skin! So, how often is often enough? We usually suggest a minimum of one bowel movement a day, but ideally 2, and even 3 are fine, as long as the stools are not loose. Yes, naturopathic doctors ask ALL the questions about poop to ensure you are digesting, absorbing and eliminating efficiently! Constipation can commonly be related to a lack of fibre or water, or sometimes due to parasites or hypothyroid. So many possibilities for such a common problem, which is why we spend so much time working through health history to determine the root cause specific to the person.
One of the most common things we see with adult acne is low hydrochloric acid in the stomach, a necessary secretion from the stomach lining to ensure proper protein breakdown in the stomach. Common symptoms include smelly gas after protein rich meals, bloating and bad breathe. Long term low levels will have a significant effect on hair, skin and nails, leaving them brittle and dull. Left untreated, this can result in acne. Thankfully this can be easily rectified.
2. Your Acne may be the Result of a Hormonal Imbalance
Hormonal acne, often appearing in the T-zone (chin, nose, forehead) is often related to a disruption in the intricate balance of hormones (estrogen, progesterone, and testosterone). These fluctuations in hormones might be triggered by menopause, menstruation, polycystic ovarian syndrome (PCOS) or excess androgens. Women who start getting acne in their late 40’s or 50’s might be suffering from menopausal acne, caused by a drop in estrogen or an increase in testosterone. Acne vulgaris, is a hormonal type of acne that is often a result in a rise of the hormone, testosterone. We can often determine the cause by symptoms, but rely on testing such as the CHI or Dutch Test, for accurate assessment. These tests not only test for the 4 most common hormones but all the intermediates so we can help determine if your acne is from improper detoxification of estrogens or genetic dispositions that we can coax to healthier pathways using diet and nutritional supplementation.
3. Nutrient Deficiencies can Cause Acne
Specific nutrient deficiencies are common with acne, and when supplemented, can result in positive results. Some of the more common ones we see are Zinc, Vitamin E, and Vitamin A. We should all actually be getting more than enough Vitamin A in our diets through our fruits and veggies, and should not need to supplement. However, sometimes lack of proper breakdown (hydrochloric acid deficiency) and absorption can result in this deficiency. Zinc is also found ubiquitously in our food; pumpkin seeds, meat, nuts but also happens to be a nutrient that the body uses quickly when under stress. A common visual cue of zinc deficiency are white spots or lines on your finger nails. Vitamin E is found in a lot of seed oils and nuts but can be low in some that are trying to limit fat in their diets.
4. So How does Anxiety Affect my Skin?
Let me tell you about Cortisol! Cortisol is the hormone that is produced in response to stress, and if you are “wired up” all day long, your body is producing a whole lot of it! When your body is producing too much cortisol, it uses up all the pregnenolone to make it, and it doesn’t have enough left over to produce progesterone. Unfortunately pregnenonlone is a finite resource in your body, and a vital building block for essential hormones. When progesterone is low, estrogen appears high in the body, and hormonal acne can present, as well as symptoms such as breast tenderness, PMS, hair loss and mood swings.
Acne Treatment Results from an Inside-Out Approach
Treating acne may seem complicated and impossible, but it is actually one of the most rewarding conditions that I treat as a naturopathic doctor. The causes are many, but are also easily identifiable, and the reward is in seeing the change, as someone starts to glow from the inside-out. As I continue to work with my amazing team at Pur Glo, I am now seeing more and more results, as we work with medical grade skin care to repair damaged skin, decrease inflammation and restore a healthy glow.
Author: Dr. Mary Anne Hembroff ND is the Co-Owner of Pür GLō Natural Skin Rejuvenation Centre in Winnipeg, MB Canada. She is also the co-owner of The Nature Doctors where she is a Naturopathic Doctor.