The Many Faces of Adult Acne
The varied causes of Acne may surprise you, it is not all about hormones.
Acne is a symptom that causes much distress for sufferers and can impact quality of life as frustration, embarrassment, anxiety and even depression can set in when struggling with the onset of adult acne. It can come as a surprise when in our teen years our skin may have been clear (or reasonably clear) but then appeared in force in late teens or 20’s, possibly even later. Often our hormones are blamed as ‘flares’ may occur around menstrual cycles. However a deeper understanding of acne can demonstrate that the acne is a response to deeper imbalances at the gut level, which may only be exacerbated by changing hormonal levels. In essence I like to consider and explain to my clients that acne is a symptom of imbalance. Yes, acne vulgaris is considered a condition, but in reality it is a condition that has occurred due to other factors or conditions in the body, and the acne lesions are in response to these imbalances.
Causes of Acne
In fact you may be surprised that by the mid-20s only approximately 3% of acne cases are primarily hormonal acne. Of course in clinic I still consider hormonal acne, and it is predominantly the acne associated with PCOS with a typical jaw line dominant cystic acne that occurs. However, for many others acne will be across wider areas of the face and spreading down to arms and back.
It is these other ‘types’ of acne that broader clinic case taking is required so that your story can be learned as we peel back the layers.
Considerations for your acne drivers include:
Stress. Chronic and acute stress will cause elevation in the stress hormone cortisol which will in turn drive inflammation and excess sebum production. Signs that stress is your main driver is that your acne may clear when you have finished exams, completed a big project at work, or your acne clears when on holidays.
Post-Pill Acne. There may be a flare of acne after ceasing hormonal contraceptives as liver and gut function is affected by the contraceptives.
Gut Related Acne. This is probably the most prominent acne causative factor when looking at adult acne. Especially when the acne has not occured until later in life. It can be difficult to understand why the acne has turned up some years later than expected, but is often due to underlying chronic gut conditions that have been seen youth. Symptoms such as bloating, IBS, food sensitivities are all signs of gut disturbance.
Gut dysbiosis (microbiome overgrowths and imbalance), gut pathogens including parasites, Helicobacter pylori infection, Small Intestinal Bacterial Overgrowth (SIBO), food sensitivities are all conditions that can cause leaky gut, activating immune system and inflammation - and acne.
Environment Toxins. Exposure to mould, mycotoxins, heavy metals or environmental allergens can cause liver detoxification pathway ‘overload’
Of course there is a lot of cross-over of the drivers for acne and your acne could be a combination of factors.
After an understanding of you and your life influencing factors, when the acne started, flares, your digestion, menstrual cycle, stress and inflammatory signs we will determine possible testing to assist in determining your unique treatments.
This may start with:
undergo microbiome stool testing to find underlying gut microbiome pathogens and overgrowths
Assessment of nutrient deficiencies
Hormonal testing if indicated
Treatments and Clearing Acne
Your overall health and skin health are intricately related, hence why someone may appear to be ‘glowing’ when their health is in their prime - their digestion, liver detoxification, menstrual cycle, stress and inflammation are all working symbiotically and in harmony.
Therefore when looking to treat and heal acne it is both an inside-out and an outside-in approach.
Treatment may include:
A whole food diet, is of course central to healing, and is not just during your acne treatment, but your everyday diet should be undertaken and considered as your ultimate ‘health pill’.
Your skin is also your barrier between the outside world and your inside world. The skin has it’s own microbiome. When the skin layer is compromised inflammation can result and will exacerbate or trigger acne.
Herbal medicine to support liver function and detoxification, ensuring bowel function with no constipation or diarrhoea are first steps towards healing your acne.
Healing your acne is healing your health. This won’t be a quick fix for an acne free life, but will require a wholistic approach. Healing the digestive tract, your liver function, your stress response, toxin detoxification, and whole food diet that supports your needs and digestion are all the steps towards healing. Listen to your body, remember acne is a symptom of other imbalances.
Naturopathic Clinic
As a university trained naturopath with a clinical practice - meaning I see clients in clinic consultations for their health concerns - I look at a client's entire health picture.
Please reach out for further guidance and naturopathic treatment that can assist and guide you back to wellness.
See me in naturopathic clinic or at the apothecary for nutrient and herbal medicine to support the nervous system, gut health, hormonal health, stress, detoxification and methylation pathways.
