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Root Causes of Acne and what you can do about it


For many people, acne is a sign of underlying inflammation or issues with the immune system. The most known causes for acne include diet, stress, hormone imbalance, poor sleep, infections and allergies.  Some of the lesser-known causes of acne include gut bacteria, skin bacteria, and digestion.

Anyone who has acne has probably said they would try anything to get rid of it. You would do anything to cover it or hide it.

Does that sound familiar to you?

Read below to find out the root causes of acne and what you can do to manage it.

The customary treatment for acne is either antibiotics or applying topical products. A better approach is addressing the root causes; acne is active with increased levels of inflammation, more sebum (oil) production and a build-up of skin cells. This can lead to inflammatory acne (cysts, papules, and pustules) as well as whiteheads and blackheads which can get infected. Physicians may prescribe drugs like Accutane which can have serious side effects such as birth defects and DNA damage. Furthermore, antibiotics over a long period of time can damage the microbiome and destroy beneficial gut bacteria.

Hormonal Acne: The Facts

Hormone imbalance is a major factor when it comes to acne. During adolescence, estrogen and testosterone flood the body for the first time causing teenage breakouts. Cyclical breakouts are also common in teenage girls during the menstrual cycle when estrogen fluctuates. Estrogen and testosterone are not the only hormones that affect the skin; insulin can aggravate acne by stimulating oil glands. When we eat the pancreas produces insulin. More is produced when we eat foods high in sugar and refined carbohydrates. Insulin levels in the bloodstream increase when we consume a lot of high-glycemic foods.

Insulin stimulates oil production. Insulin-like growth factor (IGF-1) has a stimulatory effect on oil glands and also leads to elevations in testosterone and androstenedione, which in turn can stimulate oil production. Whey-protein shakes boasting high amounts of IGF-1 can contribute to acne, therefore protein shakes from rice, hemp or pea proteins are suitable as alternatives.
When insulin rises, the stress hormone cortisol will also rise. Cortisol directly stimulates the sebum glands and causes acne. A diet high in saturated fats causes high cortisol and inflammation. Additionally, stress and lack of sleep will both cause high cortisol resulting in more acne. A cross-sectional study of 144 sixth-year female medical students showed that stress severity strongly correlated with an increase in acne severity. 

What has my gut got to do with my face?

Gut health is another root cause contributing to acne; toxins in the body are eliminated through the skin, digestive, and urinary system. If the digestive system is not running smoothly, toxins leave through an alternative route, such as the skin. Many factors can damage gut health, including food sensitivities, dysbiosis, regular exposure to inflammatory foods and lack of digestive enzymes. This can lead to leaky gut, poor nutrient absorption, and inflammation. A study conducted on adolescents with acne found an increased prevalence of halitosis (bad breath), GERD (heartburn), bloating, and constipation in the participants. 

Underlying infections in the gut, like Candida, can cause inflammation and acne. Beneficial bacteria in the gut play a role in keeping the immune system strong, when the immune system is weakened, it allows the bad microbes to take over and impact the skin. Beneficial bacteria in the gut remove toxins and excess hormones from the body which may help acne.

Long-term use of antibiotics can also disrupt the delicate balance of bacteria on and below the skin surface. In a review of the literature about the gut-brain- skin connection in acne, findings suggest gut microbes and the integrity of the gut lining are contributing factors in the acne development process. 

Why is diet so important for clear skin?

A Western diet usually consists of high-calorie intake (carbohydrates, fats, and meat intake, as well as dairy protein). This increases androgen (male) hormone secretion and over stimulates the sebaceous glands. A diet high in Omega 6  increases the likelihood of acne outbreaks in contrast to one high in Omega 3, which decreases inflammation. According to a cross-sectional study comparing diets between adults with and without acne, participants with acne consume a diet with more carbohydrates and sugar. Dairy consumption causes acne, as dairy contains anabolic steroids that promote the increased production of androgens and the subsequent development of acne. 

Acne is best tackled from the inside out. Topical treatments and antibiotics may work short-term, however, it is vital to healing the internal ecosystem for long term results.

How can I improve my diet?

Focusing on food is the best place to start. An anti-inflammatory and low glycemic diet will fight inflammation and keep your blood sugar stable. Foods that are high-phytonutrient vegetables (broccoli, rocket, kale), dark leafy greens, vegetables of different parts of the colour spectrum, healthy proteins like pastured meats, wild-caught fish, and eggs, healthy fats (avocados and olive oil), and low-glycemic fruit like berries should be consumed. Avoid dairy – it is highly inflammatory and can aggravate the lining of the gut, it also increases insulin levels, yoghurt is easier to digest and does not increase insulin levels as much as milk. Also, consider eliminating gluten from the diet, as it is known to increase levels of zonulin (protein regulating the permeability of the gut lining). Maximise micronutrients like Vitamins B, C and E, omega-3 fatty acids, zinc and probiotics can help clear the skin.

Boost detoxification pathways; eating cruciferous vegetables (broccoli, cauliflower, cabbage, kale and bok choy) is one way of supporting liver function. Additionally, regular exercise and making use of other sweat therapies boost sweat. Keeping hydrated and a high-fiber diet will ensure bladder and bowel movement.

Remember, what you put inside your body shows on the outside. A healthy skin on the outside starts with a healthier you on the inside!

If this resonates with you then…

If you want to discuss dietary changes for your skin, take advantage of our 15-minute sessions with a Nutritionist or Functional Medicine Practitioner. Each session is designed to give you the support you need throughout your journey to optimal health. 

This article was written by our team of specialist therapists at Perfect Balance Clinic. If you would like more specific advice about how our team can help you with this condition or symptoms you may be having, please complete the contact form below and one of the team will get back to you shortly.

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