Ugh, adult acne. It’s the worst. Having acne as a teen seems like a rite of passage. It’s “normal” due to growth and hormones at this stage of our lives, but it starts feeling more embarrassing and challenging when we’re still having acne breakouts in our adult years. Isn’t acne one of those things we were supposed to grow out of?
If you’re a sufferer of adult acne, know that you aren’t as alone as you may feel. In fact, it’s actually on the rise with 55% of 20-40 year olds having low grade persistent acne (1).
Personally, I really thought my breakout days were behind me…until 3 years ago. I just turned 30 and my skin seemed to take that as a signal to give me the worst acne I’d ever experienced. At first I blamed it on stress…but even as I tried to reduce stressors, nothing seemed to help.
That’s when I started looking internally – a “gut feeling” maybe? 😛
The connection between gut and skin health
Did you also know that our skin health can be a window into our gut health? Improvement to skin is often noted as one of the many benefits of repairing gut health!
Here are some of the ways acne and gut health are related:
- Gut dysbiosis and leaky gut linked to acne and skin inflammation. (2)
- Hypochlorhydria or low stomach acid is common in those with acne.
- H. pylori infections found in 88% of individuals with severe acne vulgaris. (3)
- The gut-skin axis is governed by diet and acts bidirectionally.
- Probiotic supplementation found beneficial for acne relief.
As someone who had struggled with acne, getting a breakout here or there was just life. I’d just apply some topical treatments, drink more water and things usually cleared themselves up. However, when my acne took a turn for the worse and my tried and true methods weren’t working, I decided it was time to dive deeper. Lo and behold, my GI Map Stool Test found H.pylori infections, low stomach acid, gut dysbiosis, leaky gut, and a parasite! 😱
Before testing, I attributed my acne and bloating to increased stress, but that ended up only being part of the problem. After going through my personalized diet, lifestyle, and supplement protocol, my skin has been clearer and smoother! Repairing my gut and rebalancing my gut microbiome helped eliminate my acne – allowing me to feel even more confident in my skin. 🥰
The proof is in the pudding…or in this case, the pictures! ⬇️
How do Hormones Fit into This?
Hormonal acne can be caused by excess androgens or a hormone imbalance. Androgen hormones increase the sebaceous glands’ secretion of sebum, an oily substance. The gut microbiome is a major regulator of androgen metabolism in the intestinal tract (4).
Poor gut microbiome can increase estrogen levels and lead to increased hormone imbalances. Your liver usually binds up excess estrogen during detoxification so that it can be eliminated, but unfriendly gut bacteria produce an enzyme, called beta-glucuronidase, that frees this bound estrogen that was being deported. This process releases estrogen to be reabsorbed and thrown back into our circulation leading to excessive estrogen that could impact estrogen-related disorders, like fibrocystic breast, endometriosis, or more. While this process may not create problems overnight, it has a snowballing effect on body chemistry. The longer it goes on, the greater its influence.
If you know you have hormonal acne, you can start by improving hormonal balance naturally. Making some adjustments to your diet could also be the first step in your healing journey…
What to Eat
- Focus on balanced meals with healthy fats, protein & fiber. Research studies have observed imbalances of the gut and skin microbiomes, known as dysbiosis, in a number of common skin conditions, including acne. There is also an association between inflammation and acne (5). So if we’re constantly consuming or bombarding our bodies with inflammation whether through stress or nutrition, it can play a role in acne development. By eating balanced meals and lifestyle practices that support healthy hormones and gut, we can positively impact our skin.
- Eating fermented foods daily diversifies your gut microbiome. Fermented foods are probiotics that may decrease gut associated inflammatory signaling, which contributes to inflammation, insulin resistance, blood sugar regulatory problems, poor immunity and other metabolic imbalances. Fermented foods, like sauerkraut, miso, kimchi, yogurt, kefir and many more contain beneficial bacteria – probiotics.
- Get 25-35 g fiber per day. Prebiotics, a type of fiber, act as food for bacteria to support growth of good gut bacteria. When prebiotics are fermented by our gut bacteria, the by-products form anti-inflammatory compounds, called short-chain fatty acids (SCFAs), that are vital for skin health, metabolic health, brain health and immune health.
- Consider Akkermansia probiotics* to support gut lining and reduce leaky gut. Akkermansia muciniphila is a keystone strain in our gut microbiome that’s critical for improving gut health, strengthening gut lining, and reducing gut permeability.
What To Avoid
- Avoid inflammatory foods, such as processed foods, fried foods, refined carbohydrates and a Western diet. Western diets are typically high in overly processed foods and refined carbohydrates, which may lead to inflammation. Inflammation can lead to acne and skin breakouts, so following an anti-inflammatory diet may be beneficial.
- Reduce sugar/refined carb intake. Consuming refined carbs, like white rice, white bread, baked goods, sweets or sweetened beverages, are typically foods that are high on the glycemic index (GI). High GI foods raise the blood sugar more quickly compared to low GI foods. Research suggests that foods that raise blood sugar levels and cause a greater insulin response that make acne worse (6). This rise in blood sugar can also stimulate the secretion of androgens, which when elevated may contribute to acne.
- Switch to natural, low-tox makeup and skincare products. Check the EWG Skindeep to search your favorite products to see how it measures up with toxin load. Skin care products could have harmful substances like fragrance, parabens and other endocrine disruptors that can lead to inflammation and imbalanced hormones.
- Check your tap water. Visit the EWG Tap Water Database to find out exactly what’s in your water. Did you know there could be contaminants, like PFAS, lead, or chlorine, that can negatively impact your skin health if you’re using it to wash your face? Consider buying filters for your sink, drinking water, or the whole house to reduce unwanted toxins and improve skin health.
How Testing Can Help
- Check your hormone health. The DUTCH hormone test is not the usual blood hormone tests – analyzing not just your estrogen, but estrogen metabolites to get more details on your levels and how your using and processing your hormones. Testing can be key for adult acne treatment.
- Check your gut health. I utilize GI MAP stool testing to analyze gut microbiome balance, check for parasites, H. pylori, bacterial pathogens, opportunistic bacteria, beta-glucaronidase, leaky gut and so much more. Once we’ve evaluated your gut health, we can form personalized meal plans and supplement protocols to reduce inflammation and improve skin and gut health.
- Food journaling or nutrition tracking could be beneficial in determining foods that might increase inflammatory response leading to increased acne breakouts. When journaling or tracking, make note of when acne breakouts flare and look back at the days before. You might find a pattern and it’ll help you limit those reactive foods. Or end the guessing games and get straight answers to food triggers with food sensitivity testing. Food sensitivity testing tests your blood against specific foods, dyes, and additives to see the level of inflammatory reaction you have to those foods.
Looking to renew your skin by uncovering the root cause of your adult acne? Schedule a call today to see how using a functional approach can lead to long-lasting acne relief! 💪
References:
(1) Rocha MA, Bagatin E. Adult-onset acne: prevalence, impact, and management challenges. Clin Cosmet Investig Dermatol. 2018 Feb 1;11:59-69. doi: 10.2147/CCID.S137794. PMID: 29440921; PMCID: PMC5798558.
(2) Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathog. 2011 Jan 31;3(1):1. doi: 10.1186/1757-4749-3-1. PMID: 21281494; PMCID: PMC3038963.
(3) Effat Khodaeiani, Monireh Halimi and Amir Hagigi, 2014. Severe Acne Vulgaris is Associated with Helicobacter pylori Infection: First Report in the Literature. Journal of Medical Sciences, 14: 92-96.
(4) Colldén, H., Landin, A., Wallenius, V., Elebring, E., Fändriks, L., Nilsson, M. E., … & Ohlsson, C. (2019). The gut microbiota is a major regulator of androgen metabolism in intestinal contents. American Journal of Physiology-Endocrinology and Metabolism, 317(6), E1182-E1192.
(5) Tanghetti EA. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol. 2013 Sep;6(9):27-35. PMID: 24062871; PMCID: PMC3780801.
(6) Burris J, Rietkerk W, Shikany JM, Woolf K. Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne. J Acad Nutr Diet. 2017 Sep;117(9):1375-1383. doi: 10.1016/j.jand.2017.03.024. Epub 2017 Jun 9. PMID: 28606553.
*Affiliation Disclaimer. Please note that I am an affiliate for some of the products mentioned on this page. If you click my affiliate link or use a code and make a purchase, I may earn a percentage of the sale.
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Paulina Lee is a functional and integrative dietitian, who specializes in gut health and IBS. She works with women looking for long-term relief from IBS so they can get back to what's important to them - their life, work, and relationships.