How To Holistically Heal Acne

Acne is a prevalent skin condition characterised by the development of pimples, blackheads, whiteheads, and various types of skin lesions. It typically arises when hair follicles become obstructed by a combination of excess oil and dead skin cells. While acne most commonly affects the face, it can also emerge on the neck, back, shoulders, upper arms, buttocks, thighs, scalp, and, in some instances, the chest and abdominal area. The underlying causes and treatment approaches for acne can vary depending on factors such as location, severity, genetics, hormones, stress, diet, and lifestyle.

To delve deeper into the factors contributing to acne, we must first consider excessive skin sebum production, follicular hyperkeratinisation and the role of bacteria:

Excess sebum production, an oily substance that naturally lubricates the skin, can intermingle with dead skin cells, obstructing hair follicles and laying the foundation for acne. This seborrhoea condition is influenced by a complex interplay of genetic, hormonal, stress, diet, environmental, and lifestyle factors.

Follicular hyperkeratinisation

Acne often begins with a process called "follicular hyperkeratinisation," where the keratinocytes within hair follicles (pores) become abnormally sticky and accumulate around the hair shaft. This can lead to the formation of a plug or comedome, which can be either open (blackhead) or closed (whitehead). The overproduction and abnormal behaviour of keratinocytes contribute to this process.

Bacteria, particularly Propionibacterium acnes (P. acnes), which normally resides on the skin, can proliferate rapidly within clogged hair follicles, leading to inflammation and acne formation. P. acnes typically resides in hair follicles and sebaceous glands and, under typical circumstances, poses no issues. However, certain conditions, such as follicle blockages, can prompt rapid multiplication, resulting in inflammation and the development of acne. Additionally, some studies suggest that Staphylococcus bacteria may also contribute to acne, especially in severe or treatment-resistant cases.

Now, let's delve into the underlying causes and influencing factors contributing to acne:

• Genetics: Your genetics play a significant role in determining your skin type, including sebum production. If you have a family history of oily skin or acne-prone skin, you may be genetically predisposed to produce more sebum.

• Stress: Chronic stress can trigger the release of hormones like cortisol, which can stimulate sebum production. Additionally, stress can weaken the body's immune response, making it more susceptible to skin issues, including excess sebum production.

  • Cortisol and Increased Sebum Production: Stress triggers the body's "fight or flight" response, leading to the release of hormones like cortisol. While cortisol is essential for dealing with immediate stressors, prolonged or chronic stress can result in continuously elevated cortisol levels. Cortisol, in turn, can stimulate the sebaceous glands to produce more sebum (skin oil). The excess oil can mix with dead skin cells and other debris, potentially clogging pores and contributing to acne formation. This increased sebum production is a common feature of stress-related acne.

  • Weakened Immune System: Chronic stress can weaken the immune system's response, making it less effective at combating acne-causing bacteria - Propionibacterium acnes (P. acnes) on the skin. When the immune system is compromised due to stress, it may have difficulty controlling the growth of P. acnes, allowing it to multiply more freely within clogged hair follicles and contributing to inflammation.

  • Gut Bacteria Imbalance: Stress can disrupt the balance of gut bacteria, leading to a condition known as dysbiosis. The gut and skin are closely connected, and imbalances in gut bacteria can contribute to systemic inflammation. Dysbiosis can also lead to intestinal permeability, commonly referred to as "leaky gut." When the gut lining becomes more permeable, toxins and harmful substances can enter the bloodstream, triggering inflammation throughout the body, including the skin. This inflammation can exacerbate existing acne or promote its development.

  • Unhealthy Eating Habits: Individuals experiencing stress may turn to unhealthy eating habits as a coping mechanism. Stress eating often involves consuming sugary, high-carbohydrate, and processed foods, which can contribute to insulin spikes and increased sebum production. Moreover, such eating habits may result in nutrient deficiencies that affect skin health, further worsening acne.

  • Sleep Disturbances: Chronic stress can interfere with sleep patterns, leading to inadequate or disrupted sleep. Sleep is crucial for overall skin health, as it is during this time that the skin undergoes repair and regeneration. Sleep deprivation can hinder these natural processes, potentially delaying the healing of acne lesions and increasing the risk of scarring.

• Weather & Humidity: Environmental factors, such as hot and humid weather, can increase sebum production. High humidity can make the skin feel greasier and contribute to clogged pores.

• Cosmetics & Skincare Products: Certain cosmetics and skincare products, especially those with heavy or occlusive ingredients, can contribute to excess sebum production by blocking pores and trapping sebum. It's essential to choose non-comedogenic, natural products that are less likely to clog pores.

• Over washing or Harsh Cleansing: Paradoxically, excessive washing or using harsh cleansers can strip the skin of its natural oils, prompting the sebaceous glands to produce even more sebum in response. It's important to strike a balance by using a gentle cleanser appropriate for your skin type.

• Medications: Some medications, such as certain steroids and hormonal treatments, can affect sebum production. It's important to discuss potential side effects with your healthcare provider if you suspect medication is contributing to oily skin.

• Intestinal Toxaemia & Constipation: Intestinal toxaemia, often stemming from constipation, can contribute to acne development. When the body fails to efficiently digest and eliminate food, it can lead to the fermentation of undigested food in the gut, releasing toxins that may be absorbed into the bloodstream, potentially causing various health issues, including acne. Additionally, constipation hinders the proper elimination of waste products and toxins, leading to their buildup in the body, triggering inflammation, and potentially worsening acne. Furthermore, constipation can disrupt gut bacteria balance, resulting in an overgrowth of harmful bacteria, which can further contribute to acne by promoting inflammation and compromising the immune system. Constipation may also lead to an elevated copper-zinc ratio in the body, promoting inflammation and tissue damage, ultimately leading to acne breakouts.

• Dehydration:

• Increased Toxin Accumulation : Inadequate hydration can lead to the accumulation of toxins and waste products in the body. These substances can circulate in the bloodstream and potentially trigger inflammation. Inflammation, in turn, can exacerbate existing acne lesions and promote the formation of new ones.

• Skin Dryness and Breakouts: Dehydration can result in dry and flaky skin. While it might seem counterintuitive, dry skin can actually contribute to acne development. When the skin is excessively dry, it may compensate by producing more sebum (oil) to combat the dryness. This excess sebum can mix with dead skin cells and lead to clogged pores, setting the stage for acne.

• Compromised Skin Barrier: Dehydration can weaken the skin's natural barrier function, making it more vulnerable to external factors that can exacerbate acne. Without a robust barrier, irritants, allergens, and bacteria have an easier time penetrating the skin and causing inflammation.

• Hormones: Hormones play a pivotal role in regulating various bodily functions, including the health of your skin. Androgens, a group of hormones found in both males and females, have a significant impact on the sebaceous (oil) glands in your skin. When hormonal imbalances occur, they can lead to an overproduction of sebum, setting the stage for acne to develop. Here's a more detailed look at how hormones, particularly androgens, contribute to acne:

  • Androgens and Sebum Production: Androgens, which include hormones like testosterone, dihydrotestosterone (DHT), and dehydroepiandrosterone (DHEA), are known to stimulate the sebaceous glands found in your skin. These glands are responsible for producing sebum, an oily substance that helps lubricate your skin and keep it hydrated. Under normal circumstances, sebum is beneficial and necessary for maintaining healthy skin, as it prevents dryness and promotes skin flexibility. However, when androgens, especially testosterone, become imbalanced or elevated, they can trigger these sebaceous glands to produce more sebum than the skin needs.

  • Testosterone in Acne Development: Among androgens, testosterone is a key player in acne development, particularly in males but also in females to a lesser extent. Elevated levels of testosterone can stimulate the sebaceous glands to produce excessive sebum. This excess sebum, when mixed with dead skin cells and other debris, can lead to the formation of clogged pores and hair follicles. The trapped sebum provides an ideal environment for the proliferation of acne-causing bacteria, including Propionibacterium acnes (P. acnes). As P. acnes multiplies within these clogged follicles, it releases substances that trigger an immune response. The resulting inflammation can manifest as redness, swelling, and tenderness, which are characteristic of acne lesions. In more severe cases, inflammation can extend deeper into the skin, leading to the formation of larger, painful acne lesions such as nodules and cysts. Additionally, the increased production of keratin, a protein that forms the outer layer of the skin, can contribute to the clogging of pores and the development of acne comedones (whiteheads and blackheads).

  • Progesterone and Oestrogen in Acne Development: While testosterone is a primary driver of sebum production, hormones like progesterone and oestrogen also influence acne development, especially in females. Progesterone and oestrogen work in harmony within the menstrual cycle, helping to maintain balance. Low progesterone levels relative to oestrogen, as seen in some women with premenstrual syndrome (PMS), can lead to hormonal imbalances that contribute to acne breakouts. Progesterone plays a role in regulating the menstrual cycle and can help balance oestrogen's effects on the skin. When progesterone levels are insufficient, oestrogen dominance can occur, potentially increasing the risk of acne.

  • Hormonal Fluctuations and Acne Development: Hormonal fluctuations are a common trigger for acne development, and they often occur during various life stages:

    • Puberty: Adolescents typically experience a surge in androgens during puberty. This surge leads to an increase in sebum production, making the skin oilier and more prone to acne breakouts. The resulting clogged pores can serve as fertile ground for the proliferation of acne-causing bacteria.

    • Menstruation: Menstrual cycles in females involve fluctuations in hormones, including oestrogen and progesterone. Just before menstruation, there's often a drop in oestrogen levels relative to progesterone, which can increase sebum production. This hormonal shift may contribute to premenstrual acne flare-ups in some individuals.

    • Pregnancy: Hormonal changes during pregnancy can also influence sebum production, leading to changes in skin texture and increased susceptibility to acne.

    • Post-pill acne , which can occur after discontinuing hormonal birth control, is a common concern. The main causes of post-pill acne are twofold:

      • Rebound Sebum Production: Some hormonal birth control methods significantly reduce the production of skin oils (sebum) to levels typically seen in childhood. This unnatural situation prompts your skin to produce more sebum when you stop the pill. This increased sebum production can persist for several months after discontinuation.

      • Temporary Androgen Surge: When you discontinue birth control, your ovaries become active again. This transition may lead to a temporary surge in androgens, which are male hormones. This hormonal shift can sometimes be mistaken for polycystic ovary syndrome (PCOS).

• Nutritional Deficiencies: Nutritional deficiencies can play a role in the development and severity of acne. Various essential nutrients are necessary for maintaining healthy skin and regulating processes like sebum production, inflammation, and immune function. Here's a closer look at how different nutritional deficiencies can contribute to acne:

• Chromium Deficiency: Chromium is a trace mineral that plays a role in regulating insulin, a hormone that controls blood sugar levels. A deficiency in chromium can lead to insulin resistance, where the body's cells do not respond effectively to insulin. This can result in elevated insulin levels, which, in turn, stimulate androgen production. Increased androgens can lead to higher sebum (oil) production in the skin, potentially clogging pores and contributing to acne.

• Deficiencies in Fat-Soluble Vitamins (A, D, and E): Fat-soluble vitamins are essential for skin health and overall well-being.

  • Vitamin A: Vitamin A is crucial for skin cell development and repair. It helps regulate sebum production and supports the shedding of dead skin cells. A deficiency in vitamin A can lead to the accumulation of dead skin cells and an increased risk of clogged pores.

  • Vitamin D : Vitamin D plays a role in modulating the immune system and reducing inflammation. Inadequate vitamin D levels may contribute to inflammation and worsen existing acne lesions.

  • Vitamin E : Vitamin E is an antioxidant that helps protect skin cells from oxidative damage. A deficiency in vitamin E may make the skin more susceptible to inflammation and free radical damage, potentially worsening acne.

  • Essential Fatty Acid Deficiency: Essential fatty acids, such as omega-3 fatty acids, are important for skin health and maintaining the skin's moisture barrier. Deficiencies in these fatty acids can result in dry skin, which may exacerbate acne. Dry skin can lead to increased dead skin cell accumulation and potentially clogged pores.

• Zinc Deficiency : Zinc is an essential mineral for immune function and skin health. It is involved in wound healing and helps regulate inflammation. A deficiency in zinc can disrupt immune system balance, making it more challenging for the body to combat acne-causing bacteria. Zinc also plays a role in regulating sebum production, so a deficiency may contribute to excess oiliness. Zinc is necessary for the absorption and utilisation of vitamin A in the body. Without adequate zinc, the body may struggle to convert vitamin A into its active form, which is essential for its biological functions.

• Vitamin B6 Deficiency: Vitamin B6, also known as pyridoxine, is important for hormonal balance. It helps regulate hormone levels, including androgens. A deficiency in vitamin B6 can lead to hormonal imbalances associated with acne, potentially contributing to breakouts.

Diet & Acne

Let's explore the impact of sugar, dairy, and vegetable oils as contributing factors to acne.

Sugar and Acne Development

A dietary pattern characterised by the frequent consumption of sugar, refined carbohydrates, and processed foods such as condiments, sauces, jams, cordials, soft drinks, sweet treats such as milk chocolate & desserts can significantly increase the risk of developing acne. This type of diet can have several detrimental effects on skin health:

• Insulin Production: Insulin is a hormone produced by the pancreas in response to elevated blood sugar levels, primarily after eating. Its main role is to regulate blood sugar by facilitating the uptake of glucose into cells, where it can be used for energy or stored for later use.

• IGF-1 Production: IGF-1 is a hormone produced primarily in the liver in response to growth hormone (GH) stimulation. It plays a key role in cell growth and development, particularly during childhood and adolescence. IGF-1 also has various effects on tissues and cells throughout the body.

• Insulin and IGF-1 Interaction: Insulin can stimulate the liver to produce IGF-1, particularly when there are elevated levels of insulin in the bloodstream. This is more likely to occur in conditions like hyperinsulinemia, where there is an excess of insulin.

• Sebum Overproduction: Increased sebum production, driven by elevated insulin and IGF-1, can result in clogged pores. As sebum accumulates within the hair follicles, it provides an ideal environment for the development of acne.

• Keratinocyte Multiplication: IGF-1 not only promotes sebum production but also triggers the multiplication of skin cells known as keratinocytes. This process is closely linked to the development of acne lesions. The accelerated growth of keratinocytes can further contribute to clogged pores and the formation of acne.

• Inflammation: High sugar intake and frequent consumption of processed foods can induce inflammation within the body. This inflammation is closely associated with the development and exacerbation of acne. Chronic inflammation can worsen existing acne lesions and promote the formation of new ones.

• Bacterial Dysbiosis: Sugar consumption can contribute to acne by fueling bacterial dysbiosis in the gut. When we consume excessive sugar, it provides a readily available energy source for certain harmful bacteria in our digestive system. This disruption in the balance of gut bacteria can lead to inflammation and trigger skin issues, including acne.

• Nutrient Deficiencies: A diet high in added sugars may displace nutrient-dense foods, leading to potential deficiencies in various vitamins and minerals, including those important for skin health and immune function.

Vegetable Oils & Acne

Vegetable oils, particularly those high in omega-6 fatty acids, can contribute to acne development in some individuals. Here's how vegetable oils may play a role in acne. Vegetable oils, such as corn oil, canola oil, rapeseed oil, sunflower oil, cottonseed oil, soybean oil, and safflower oil, are rich in omega-6 fatty acids. These oils are found in processed foods and used for frying when you eat out or get take away. While omega-6 fatty acids are essential for the body, an excessive intake of them, especially in relation to omega-3 fatty acids, can lead to an imbalance in the omega-6 to omega-3 ratio. This imbalance can promote inflammation in the body, and inflammation is a key factor in the development and exacerbation of acne.

• Omega-6 fatty acids are precursors to pro-inflammatory signaling molecules called eicosanoids. When there is an overabundance of omega-6 fatty acids, the body can produce more pro-inflammatory eicosanoids. These molecules can trigger and exacerbate inflammatory responses, including those associated with acne. Where as omega-3 fatty acids have anti-inflammatory properties especially through a decrease in IGF-1 level.

• Insulin Sensitivity: Excessive omega-6 fatty acids in the diet can lead to insulin resistance and reduced insulin sensitivity. This can result in elevated insulin levels in the body, which is associated with increased sebum (oil) production in the skin. Higher sebum production can contribute to clogged pores and acne development.

• Cell Membrane Function: The type of fats you consume can affect the composition of cell membranes throughout your body, including your skin. A diet high in omega-6 fatty acids can influence the properties of cell membranes, potentially making them more prone to inflammation and less effective at maintaining healthy skin.

Dairy & Acne

Dairy products, particularly milk, have been a topic of interest and research in relation to acne development. Here are some key points regarding the potential link between dairy and acne.

• Insulin-like growth factor 1 (IGF-1) and Growth Hormone: One proposed mechanism behind the association between dairy and acne is the presence of hormones in milk. Cow's milk, even when labeled as hormone-free, can contain naturally occurring hormones, such as insulin-like growth factor 1 (IGF-1) and growth hormone. These hormones can stimulate the sebaceous glands in the skin to produce more sebum (oil), potentially leading to clogged pores and acne. IGF-1 is found in higher concentrations in dairy products, particularly whey protein. Elevated IGF-1 levels have been linked to increased sebum production, skin cell proliferation, and inflammation—all of which are factors contributing to acne development.

• Lactose and Insulin: The lactose (milk sugar) content of dairy products can lead to insulin spikes in some individuals. Elevated insulin levels can stimulate the sebaceous glands to produce more sebum, potentially contributing to acne.

• Androgens : Dairy consumption may influence androgen hormone levels in some individuals. Androgens, including testosterone, can stimulate sebum production and contribute to acne. Some studies suggest that certain components of dairy products, like whey protein, may affect androgen levels.

• Inflammation: Dairy products can also contribute to inflammation in the body due to their potential to trigger an immune response. Inflammation is closely linked to acne development and can worsen existing acne lesions.

Book a Naturopathic Consultation for Acne Support

If your acne is persistent, chronic, or long-standing, it's time to look beyond the surface. Let’s work together to uncover the underlying causes and contributing factors - whether hormonal imbalances, digestive disturbances, inflammatory triggers, or stress-related patterns. A naturopathic consultation offers a more comprehensive and personalised approach tailored to your unique needs. This may include dietary guidance, lifestyle support, and natural therapies to help restore internal balance and promote clearer, healthier skin from within.