A Functional Medicine Guide to Healing Acne

6 Steps You Can Take Now to Start Improving Your Acne

Acne…those annoying breakouts that no one wants to wake up to in the morning.

And while it’s not fair that many adults struggle with acne, it’s, unfortunately, a reality.

Adult acne can affect your mental and physical health, but the good news is you no longer need to struggle with adult acne.

With help from a functional medicine practitioner, you can get to the root cause of your acne and break the breakout cycle.

What is acne?

Acne is a skin condition that occurs when sebum (the oil produced by your skin’s glands), dead skin cells, or skin bacteria clog your pores. (1) When this occurs, an inflammatory reaction in the skin is triggered, resulting in pimples, redness, or irritation.

Getting the occasional pimple is relatively common, but acne is more severe and longer lasting. Acne vulgaris is the most common type of acne and commonly presents as whiteheads, blackheads, and redness in the t-zone. (2)

Some adults may also experience acne conglobata, commonly known as cystic acne. (3) Cystic acne is accompanied by large, raised bumps under the skin that likely never turn into pimples.

What is hormonal acne?

Hormonal acne continues into adulthood and develops when hormonal changes increase sebum production. (4)

Who does acne affect?

Acne is one of the most common skin conditions affecting nearly 80% of the U.S. population. (5, 6) Even though acne can affect both men and women, research indicates that women between the ages of 25-44 struggle the most with hormonal acne. This is likely partly due to fluctuating hormones during pregnancy and then again during menopause. (7)

How can you tell if you have hormonal acne?

If one or more of these characteristics sound familiar, you may be dealing with hormonal acne.

Your acne is primarily along your chin and jawline.
You break out consistently every month.
Your breakouts increase when you are stressed.
You experience cystic acne.

Underlying Causes of Adult Acne

Hormonal Imbalance

If you experience cyclical acne, meaning your acne is worse before, during, or after your period, your acne is likely related to a hormone imbalance. As many as 57% of women who report having acne experience flares related to their cycle. (8)

Common hormonal imbalance issues include:

Estrogen Dominance. Estrogen dominance occurs when estrogen levels are in excess relative to progesterone. (9) Women who experience estrogen dominance premenstrually commonly experience acne before or during their period.
Androgen Excess. Androgen excess occurs when the hormones testosterone and DHEA become elevated. Elevated testosterone can lead to increased production of sebum premenstrually, contributing to acne before your period. (10) One of the most common causes of elevated androgens is Polycystic Ovary Syndrome (PCOS).

Poor Liver Function

The liver performs hundreds of vital functions, including detoxifying the blood, metabolizing fats and proteins, and excreting hormones. When the liver is overloaded with filtering out chemicals and toxins, it struggles to clear out hormones leading to hormonal imbalances and skin issues like acne.

Gut Health and Food Sensitivities

Many inflammatory skin conditions are linked to gut health and food sensitivities. While it’s unlikely that these are the only causes of acne, gut health and food sensitivities like dairy, gluten, eggs, corn, or soy can be contributing factors.

Stress

Stress triggers our brain to release corticotropin-releasing hormone (CRH), which tells the adrenals to release cortisol. CRH binds with our skin cells, promoting sebum production, leading to an increase in acne. Several studies have found a direct connection between increased psychological or physical stress with acne production. (11)

Nutrient Deficiencies

Nutrients found in vitamin A, vitamin D, omega-3, and zinc are essential for skin regeneration, inflammation management, and helping to maintain skin elasticity. A deficiency in one or all of these nutrients can promote the development of acne. (12)

Functional vs. Conventional Treatments for Acne

If you struggle with acne, you’ve likely tried several conventional approaches for treating acne, like topical creams, prescription medications, facials, laser treatments, or chemical peels. Unfortunately, most conventional acne treatments only address the symptom, not the cause.

Conventional acne treatments can include

Topical Creams. Creams containing Dapsone, Benzoyl Peroxide (BPO), Clindamycin, or Adapalene can help calm inflammation, fight bacteria, remove dead skin cells, and fight pimple development.

Hormonal Birth Control. Many women are prescribed birth control pills to help regulate their hormones and address cyclical acne. Many women using birth control pills to treat acne are only masking a problem that returns once they stop taking the pill. Read more on the adverse effects of hormonal birth control here.

Antibiotics. Prescription antibiotics help treat cystic acne by clearing up underlying bacteria. Long-term use of an antibiotic can lead to resistance. In addition, antibiotics target all bacteria, which can significantly impact your gut health.

Retin-A or Accutane. Medically known as Isotretinoin, this topical gel, cream, or liquid derived from Vitamin A increases the rate of skin cell production and helps eliminate blackheads while improving the look of fine lines and wrinkles. (14) Isotretinoin decreases inflammation, reduces the build-up of dead skin cells, and decreases sebum production. The FDA considers Isotretinoin a potentially dangerous drug with side effects like long-term vision impairment, gastrointestinal disorders, and potential birth defects should you become pregnant while on this medication. (13)

Spironolactone. Spironolactone reduces the production of androgens (testosterone) which can lower hormonal acne flare-ups. It can also lead to decreased kidney function, muscle weakness, irregular heart rate, and lack of energy.

Functional medicine aims to identify and treat the root cause of acne, focusing on natural remedies such as:

Balancing Hormones. Through advanced hormone testing, we can assess hormone imbalances that can play a critical role in the development of acne. With this data, we can make the necessary dietary and lifestyle changes to rebalance your hormone levels.
Supplements. Depending on your type of acne and underlying concerns, certain supplements can help improve the appearance and occurrence of acne. The following supplements may be beneficial depending on the results of your lab data:
- NAC. N-acetyl cysteine (NAC) is a powerful antioxidant that promotes cellular health while fending off oxidative stress and reducing acne. (15)
- DIM. DIM is a compound found in cruciferous vegetables that helps metabolize excess estrogen.
- Omega-3s. Omega-3 fatty acids are rich in anti-inflammatory properties and hormone-regulating benefits that can help reduce acne.
- Probiotics. Probiotics help improve the gut microbiome by restoring a healthy balance of bacteria.
- Ashwagandha. Ashwagandha is an adaptogen known for helping manage stress and anxiety, which can help reduce acne caused by chronic stress.
- Magnesium. Magnesium is another chronic stress-busting mineral. As a bonus, magnesium can also help balance hormones and blood sugar and lower inflammation.
Food Sensitivity Testing. Inflammation from our diet can play a significant role in acne. Food sensitivity testing can help identify foods that may be especially inflammatory for you and help us devise a plan to eliminate those foods.

Gut Health Analysis. An increasing number of studies have linked good skin with a healthy gut through what has become known as the gut-skin axis. (16) While gut health symptoms can vary widely, the skin is often a good indicator of what’s going on inside the gut, and stool or breath testing can help us analyze the health of your gut.

6 Steps You Can Take Today to Begin Combating Acne

Now that you have a deeper understanding of acne, its root causes, and natural approaches to healing, here are 6 steps you can take today to begin combating your acne.

1. Reduce Toxin Exposure

One of the simplest ways to improve your acne is by reducing your overall toxin exposure and improving your liver function. Start at home by looking for harmful chemicals in your cleaning and skincare products. Check out the Environmental Working Group’s Skin Deep database for more information.

2. Reduce Stress

Building your resilience to stress takes time, but working to reduce and manage your stress can be beneficial for your entire body. Try incorporating meditation, regular movement, and improved sleep habits into your day to help reduce stress.

3. Take a Break from Alcohol

Alcohol can increase inflammation, decrease the liver’s ability to process toxins, and impact your mood. Taking a break from alcohol can give all of your body systems a chance to reset.

4. Support a Healthy Gut

Start by focusing on a diet that supports a healthy gut. Avoid problematic foods like paturized dairy, gluten, convential eggs, corn, or soy. And instead, incorporate a variety of fruits, vegetables, and protein while minimizing processed foods and refined sugars.

5. Find Regular Movement

Regular movement for your body can benefit you in so many ways. Find a way to move your body every day that gets you sweating. This will help encourage detoxification in your skin and help reduce stress.

6. Hydrate

Focus on staying hydrated to encourage your body’s detoxification processes. Try drinking half your weight in ounces each day in water.

When to consult with a functional medicine practitioner?

Everyone’s acne journey looks very different! For some, it might be a few breakouts around their cycle. For others, acne is a life-long struggle.

If you have been dealing with any of the following acne-related concerns, it may be time to consult with a functional medicine practitioner:

Severe lesions
Several acne breakouts that cover large areas of your skin
Acne scarring
Pigmentation
Low self-esteem from acne

Functional medicine aims to treat acne by identifying and treating the root cause so you can ditch acne and achieve optimal health.

At Denver Holistic Medicine, we understand that you want to see your acne resolved sooner than later. We combine light therapy, microneedling, acupuncture, and functional medicine to facilitate changes and enhance results.

Denver Sports and Holistic Medicine offers in-person and telemedicine consultations. To get started, request a free consultation today.

Resources

1 PubMed

2. National Library of Medicine

3. National Library of Medicine

4. PubMed

5. PubMed

6. PubMed

7. PubMed

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9. PubMed

10. PubMed