What's Poppin'?: Navigating Acne In Adulthood
Acne is an expected characteristic during our teenage years, as a result of hormonal changes. For some it is worse than others, but we hope that our skin magically becomes glowing and clear skin once we leave those turbulent years behind us.
Unfortunately, that does not always happen, and it can be debilitating for some. Your skin is the first thing you present to the world, and although this is a superficial thought, it can greatly affect our confidence. Oral birth control, topical creams such as benzoyl peroxide, low-dose antibiotic use and Accutane are some of the most common treatments that are offered. While these options can provide relief, they can be short-term and can have some undesirable side effects. To help long-term, let's ask, "why do I have acne?" in order to target the treatment accordingly.
1. Hormone Imbalance: This could be an entire article in itself, so forgive my simplistic description. In puberty our hormones begin to fluctuate; our androgens (male hormones) are typically the hormones responsible for sebum production and as the ratio of androgens to estrogens change, so does our skin. Even if testosterone levels are normal, sex-hormone binding globulin (SHBG) levels can be low resulting in more available testosterone. In adulthood, acne is more common in women than in men and one of the many reasons can be due to PCOS (Polycystic Ovarian Syndrome).
2. Food Sensitivity: The most common aggravating food for acne is dairy which has been documented in conventional dermatological medical journals. However, any food sensitivity can manifest itself as acne. Even if birth control has helped acne in the past and there is an identified hormonal component, there can also be food involvement.
3. Stress: Studies clearly demonstrate the correlation of perceived stress and acne exacerbation. This means regardless of physiological processes, people’s perception of their stress affects acne flare-ups. Psychological stress (such as exams) can slow wound healing by 40%!
4. Topical Regime/Hygiene: Of course keeping your face clean is important, but people with chronic acne tend to have the best facial hygiene because they have tried everything to help reduce its severity. Propionibacterium is the organism that is the culprit of acne vulgaris, but the propagation of this bacteria can be affected by the 3 factors listed above.
What Can You Do?
Clean up your diet: Doing an elimination diet serves two purposes: it helps to identify any food triggers that cause acne flare-ups and it decreases inflammation (acne is an inflammatory process). Decreasing refined sugar intake, dairy consumption and increasing fruit and vegetable intake (don’t forget water!) are the biggest ways to reduce overall inflammation.
Support your liver: The liver processes our hormones, so if the liver isn’t functioning optimally, neither are our hormones. This is the first step in addressing a hormonal imbalance, which can be done through botanicals, acupuncture and supplementation.
De-stress: Identifying stress triggers is the first step, however there are small things you can do in your day such as meditation and deep breathing (I love the Calm App), setting aside time for YOU, getting adrenal support, getting enough sleep and seeking therapy or counselling if the stress is significant (although, I am a big fan of everyone seeking psychological support!).
Optimize natural topical skin care: Washing pillow cases often, cleaning make-up brushes and phones are some small ways to reduce the microbial load. Tea tree is a well-known botanical that targets acne topically (caution with the use of the essential oil alone as it can burn the skin). Homemade oatmeal, honey and coconut oil masks are hydrating, soothing and anti-microbial.
This list is not exhaustive and each person is completely different in how they respond to their environment and treatments. See a Naturopathic Doctor or visit the Robert Schad Naturopathic Clinic to find out more about what you can do for your skin and overall health!
Cunliffe, W. J. "Acne, hormones, and treatment." British medical journal (Clinical research ed.) 285.6346 (1982): 912.
Di Landro, Anna, et al. "Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults." Journal of the American Academy of Dermatology 67.6 (2012): 1129-1135.
Melnik, Bodo C. "Evidence for acne-promoting effects of milk and other insulinotropic dairy products." Milk and Milk Products in Human Nutrition. Vol. 67. Karger Publishers, 2011. 131-145.
Chiu, Annie, Susan Y. Chon, and Alexa B. Kimball. "The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress." Archives of dermatology 139.7 (2003): 897-900.
Bhate, K., and H. C. Williams. "Epidemiology of acne vulgaris." British Journal of Dermatology 168.3 (2013): 474-485.