Hormonal conditions such as Polycystic Ovarian Syndrome(PCOS) particularly excess testosterone and androgens. Androgen is a type of hormone, the levels of which rise when adolescence begins. Rising androgen levels cause the oil glands under the skin to grow. The enlarged gland produces more sebum. Excessive sebum can break down cellular walls in the pores, causing bacteria to grow.
Post pill acne can happen as a result of a temporary surge in male hormones (androgens) as your ovaries start moving back into action. The withdrawal from sebum suppressing medications like cyproteone (Diane) or drospirenone (Yasmin) can also result in post pill acne.
Stress or Stress Hormones
The relationship between stress and acne breakouts can quickly become a negative cycle. When our bodies feel stress, our adrenal glands respond by producing more of the stress hormone cortisol, as well as small amounts of testosterone. These cause the oil glands in the skin to produce more sebum, which can raise the risk of skin infections and pimples. The appearance of acne can cause further stress and negatively affect self-esteem which causes more stress which then can further exacerbate the problem. More severe acne can also be quite uncomfortable and can lead to scarring. When your body feels stress it will take resources away from non-vital functions like collagen production and cell repair and channel them to the adrenal glands so we can “survive”.
Bacteria & Inflammation
The skin is our largest organ, and one of its main functions is elimination of wastes. If our other elimination systems experience congestion, our body often chooses to detoxify through the skin.
On the skins surface, acne causing bacteria known as Propionibacterium acnes can accumulate in the oil ducts in the skin and cause inflammation leading to breakouts. Just like our gut, our skin has its own microbiome which helps it to be clear of blemishes, breakouts and premature aging. This is also why skin hygiene is really important, particularly when you start to pick and squeeze any spots that are there as it can become concentrated on the face and aggravate acne. Bacteria can spread if you aren’t washing your face correctly/ your hair is touching your face a lot and adding extra oils to the skin/ you are squeezing or popping infected pimples. Changing your pillow slip regularly can also be beneficial.
Eating a wide variety of wholefoods ensures, essential nutrients for skin health include zinc, vitamin C, vitamin A, vitamin E, silica, biotin and essential fatty acids. Food intolerances in your diet like dairy and sugar are often common triggers as they increase the amount of sebum produced on the skin. Cutting out foods high in sugar and dairy often provides a reduction in the severity of acne breakouts. Foods that increase release of histamine can increase mucus production in the body, which potentially be why dairy or sometimes even banana can aggravate acne (this can also have a lot to do with IBS and FODMAPS). Processed foods with lots of foreign chemicals and additives can also aggravate acne as they increase the load for the liver to process.
If there is any inflammation of the mucous membrane in the gut lining, this can also make you more prone to skin breakouts as inflammatory mediators and bacteria from your gut can enter your bloodstream.
Detoxification Pathways & Lymphatic Flow
There are 5 main channels of elimination that we need to pay attention to when looking to clear acne issues. These include the liver, the lymphatic system, the gut, the kidneys and the largest organ the skin.
A major factor in cases of adult acne is our crucial lymphatic system. When lymphatic fluid is congested, it can accumulate beneath the skin and the body is forced to excrete metabolic waste products out through the skin. Unlike the blood, lymphatic fluid doesn’t have a heart to pump it. Movement and exercise is essential as muscles compress on lymphatic vessels, pushing the lymph towards the liver. Drinking plenty of water, avoiding congestive foods like dairy and wheat can be helpful. The livers’ role in removing toxins is also just as crucial and happens through two phase. Phase 1 turns the toxins in your body into less harmful toxins. Phase 2 pairs the toxins up with substances to remove them from your body.
Gut Microbe / Gut Skin Axis
Eating a diet high in processed foods and refined sugars, long term use of antibiotics, stress, candida, leaky gut, can cause poor gut function and negatively impact your skin. The gastrointestinal microbiome forms what is called the Gut-Skin axis, which is a relationship between the good and bad bacteria in your gut and skin conditions. If you have frequent digestive issues like constipation, diarrhoea, bloating, parasites or have frequently been on antibiotics then it is likely your digestive function and microbiome are compromised and need a little help just getting back on track. Regular bowel motions are one of the most important ways the body clears excess hormones and wastes. If you experience constipation then this may be one of the first areas we focus on.
Inflammation is a process in place for our body to protect and heal itself, however if it goes on too long for the wrong reasons, it will start to have detrimental effects. Systemic inflammation will aggravate all skin conditions, not just acne. Managing chronic inflammation often comes back to the gut and stress. The gut-skin axis is relevant because the skin and the gut are the two places in the body where a microbiome of beneficial bacteria exists. This is why identifying any inflammatory food triggers is so important. Stress is a major contributor to inflammation. Cortisol is released during times of stress and increases inflammation, which can contribute to acne. Even if you’re eating all of the right foods, drinking enough water and exercising adequately, if you’re stressed, the skin is likely to suffer.