Adult Acne: why it happens and what do about it

Adult acne, cystic acne, plain old white and black heads, whatever you suffer from they can all be life interrupters. Acne can affect your self-esteem, self-worth and change how you show up in the world. And if you have cystic acne, the type with cysts and deep red inflammation it can be painful too.

I’ve suffered with acne my whole life to some degree or another. As a teen, into my early 20’s and postpartum. I had big break outs on my face, chest and back. Adult acne interrupted my life. It dictated clothes I would wear or not and it was a heavy weight of embarrassment I carried around.

Although my health journey wasn’t spear headed to have clear smooth skin, it has always been a driving force. Today my skin isn’t perfect but it is generally clear and it continues to be a tool I use to evaluate my health. We all have our own wellness indicator, a tool to use to check in on how we’re doing, a reminder that we are or aren’t not living from a place of balance. For some it’s bad menstrual cramps, joint pain, insomnia, depression, headaches, maybe a mix of things, for me it’s acne.

I know if I have too many drinks, stop taking my supplements for too long or eat food that I react to, my skin will let me know!

Are you listening to your body?

Your body is constantly giving you feedback. The problem is we aren’t taught to listen and interpret the signs. We are taught to deal with it and move on. The good news is, after years of guessing and trying a little of everything I have found a skin protocol that works for me and my clients.

Getting to the root cause of adult acne, not just forcing it away with birth control (which just hides it until you get off the pill again), putting intense creams or cleaners on is the true way to clear up your skin once and for all.

What is acne?

Acne occurs when your hair follicle gets plugged with oil and dead skin cells. In a healthy follicle sebum, an oily substance that lubricates and keeps the skin healthy is produced and released. However, when there is a blocked pore from dead skin cells or bacteria it prevents the release of the sebum. A pimple forms when the oil continues to build.

Adult acne is more likely to be connected to a hormone imbalance and inflammation. Whereas teen acne is more likely to be connected to overactive sebum production.

Similarly to the gut, the skin has its own microbiome of bacteria milling about. When there is a rise in problematic flora on the skin acne may arise. This can occur from excess oil, poor diet and excess inflammation. Acne is an inflammatory skin condition.

If you have any skin issues such as acne, rosacea, eczema or psoriasis these are all a direct reflection of an internal imbalance. It’s not just a topical, external imbalance, these issues are a mirroring of what is going on inside the body.

Why does acne happen?

Adult acne is a multifaceted issue, there are many players involved. However, the main areas to consider for skin health are the gut, immune system, liver, bowels and hormones. It is so much more than not washing your face properly, although what you choose to put on your body influences more than just your skin.

The gut and skin

The gut is always the starting point because if it’s out of imbalance the effects will be felt throughout the body. With 70 – 80% of the immune system living in the gut, you want the gut thriving because immune health is essential for glowing skin.

Eating processed foods, stress, antibiotics, herbicides and synthetic chemicals all harm your gut and your skin will tell you. Furthermore, the contraceptive pill, often prescribed to women to ‘treat’ acne is a massive gut disruptor. The pill acts as a low grade antibiotic, killing the good bacteria and creating an imbalance in the gut microbiome. Once you get off the pill your acne is likely to come back 10 fold because you didn’t treat the problem, you temporarily covered it up.

Gut health is linked to your digestion, hormones, inflammation, the liver, immune system and bowels. And when you can appreciate the connectedness of the body you can start to unravel your own story to rewrite a new outcome.

Food triggers and your skin

In addition to supporting the immune system the gut is a key player in food and environmental allergies and sensitivities.

Personally, I have foods that when I eat them I break out within 24-48 hours, I call them my trigger foods. My main trigger is dairy. I was in denial for a very long time that dairy could be a major factor in my acne. It never gave me digestive distress, no bloat, gas or diarrhea so how could it be a problem? But when I finally decided to go all in on my healing journey, I noticed the correlation between eating dairy and when I would get breakouts. I found HUGE relief by cutting out dairy.

This may not be the case for you, dairy may not be an issue although I highly suggest you give dairy a break if you do suffer from acne. Dairy naturally contains the hormones from the animal (cow usually). If your hormones are already imbalanced adding more is only going to exacerbate the issue.

You may have a different trigger food or none at all but, I hope my story opens your eyes to how food reactions can appear in many different forms.

The liver and your skin

The liver does over 500 jobs daily, it’s a workhorse. If you add in toxic makeup and cleansers, processed food, suppressed emotions, medications, pollutants, synthetic vitamins, dehydration, household cleaners and pesticides your liver has a difficult time keeping up with the demand.

The liver is one of the main elimination organs, along with the kidneys, bowels, lungs and skin. If the liver is overburdened the body will do everything in its capacity to remove toxins such as pushing it out of the skin. The skin can both take things in, such as cortisone cream and excrete, as seen with acne.

This is why using natural products free of BHA and BHT, synthetic fragrance, phthalates, parabens, sulfates and other toxic chemicals helps reduce the load for the liver. It is a huge step in supporting and rewriting your health story. Check out the Environmental Work Group for more information on product choices.

Your body is brilliant and can withstand so much pressure and toxins but every body has a tipping point. Eventually your body won’t be able to withstand the burden and you will feel it through acne, joint aches, poor concentration, bad breath, PMS and other hormonal imbalances.

As terrible as acne can be, it is your body’s way of saying ‘we aren’t doing so hot right now’; it’s an opportunity to ‘see’ inside and make a change.

The bowels and the skin

The bowels are another key area to consider when you’re experiencing skin issues. If you aren’t pooping every single day you are retoxing (coffee poops don’t count, you need to be able to poop on your own).

The liver and gut work so hard to neutralize and package up toxins and wastes in the body. If you aren’t eliminating them you are reabsorbing. Yeup, if you aren’t detoxing them out you are retoxing creating inflammation and free radical damage. Imagine how the liver feels about that!

Now you may be thinking, ‘oh don’t you worry I poo everyday’ but I’m talking about the right type of poop. Not too liquidy or dry, no undigested food, not too frequently or too sticky. These are all signs of an unhappy gut and improper elimination aka retoxing.

If you tend more towards the constipated side or have sticky poops read about seed cycling here to get your poops back on track.

Hormones and your skin

Excess testosterone can be a major contributing factor to acne. It ramps up sebum production. This may be the case for you if your breakouts happen mostly around ovulation or day 14ish of your menstrual cycle. Furthermore, if you have dark hair on your chin and chest, thinning hair on your head, oily skin and your anger is always high you may have high testosterone.

Excess estrogen may be a culprit for our acne too. If your breakouts mainly happen right before your period, experience PMS, swollen and tender breasts and gain 5 lbs a week before your bleeding phase you may have excess estrogen.

Confused about what your hormones are doing? Don’t guess and get your hormones tested with the DUTCH test.

Acne mapping

Furthermore, the location of acne can give insight to your adult acne. Acne can be found on your face to your neck, back, glutes, chest and arms, basically anywhere.

Jawline and mouth: hormonal pattern – androgens mainly testosterone and its metabolites, stress, repressed emotions

Cheeks: congestions – gut and respiration, dirty phone and pillow case

Forehead: liver congestion, digestion, constipation,  hormones, stress, dehydration

In between brows: liver congestion, gallbladder, allergy, diet

Temples: respiratory congestion, digestion, poor circulation, gallbladder, diets too high in fat and processed foods, alcohol 

Neck: lymphatic system

Nose: liver congestion, digestion, constipation,  diet, hormones, stress, heart

All over the face: low grade systemic inflammation

Ears: kidneys 

Chest, back and glutes: androgens, waiting too long to shower after sweating, staying in your workout clothes all day, not dry brushing or exfoliating, not cleaning clothes or sheets enough, hair products, too tight of clothing,

By no means is the location of your acne a diagnostic tool. However, it may give you insight into what area of your body needs TLC to get to the bottom of your adult acne.

What won’t help get to the root cause of your adult acne

With so much information out there it’s easy to get confused in what will help and what will hinder. Firstly, we will cover what wont’ help to heal your adult acne.

The contraceptive pill will not help you get to the root cause of your adult acne. It will temporarily band-aid the problem but once you come off again be prepared for its reemergence.

Neglecting the gut and liver. Eating too much processed and high sugar foods, (over the counter) drugs, suppressing your emotions, alcohol, using toxic cleaners, makeup and body products are all going to further damage and burden the liver and gut. This will work exactly against you.

Antibacterial face cleansers or over washing your face strips the skin of its natural protection and imbalances the skin microbiome.

Stress is often overlooked and under-appreciated when looking to clean up your acne. Chronic stress will undermine your liver, reproductive hormones and gut flora.

Detoxing too soon. Learning how to clear your skin can bring excitement and exuberance but going too hard too fast isn’t the answer. If your liver cannot keep up with the demand you can get detox reactions such as breakouts, headaches and irritability. Work slowly to build a healthy relationship with your body for lasting results.

Action steps for adult acne

If you have adult acne these 10 general guidelines will aid you in getting relief.

  1. Eat 20 grams fiber/day to feed the good bacteria and bulk up your poops. You need to be having full easy poops at least daily, but no more than 3/day.
  2. Drink a minimum of 8 cups but aim for 12 cups of clean water a day. Starting your day with 1-2 cups of lemon water upon rising gets the ball rolling.
  3. Remove any trigger foods. Dairy and gluten are common trigger foods. A food journal can be helpful in identifying any triggers.
  4. Support the gut. Removing a trigger is the first step. Then you start building up the gut again with fermented foods (unless you have SIBO) and eating a variety of fruits and veggies. Supplements such as collagen and L-glutamine are great at rebuilding the intestinal lining.
  5. Eat liver loving foods – cruciferous veggies such as kale, broccoli, cauliflower, arugula and brussel sprouts daily, as well as beets, citrus, green apples, turmeric, chamomile and dark leafy greens
  6. Limit coffee and alcohol intake. Matcha, yerba mate or dandelion root are great coffee replacements.
  7. Focus on anti-inflammatory foods such as dark coloured berries, veggies, beans, fresh and dried herbs, whole grains, cold water fatty fish, organic or wild meats, healthy fats – coconut, avocado oil, EVOO, ghee, sesame seed oil, nuts, seeds, avocado, olives and free run or local eggs.
  8. External – only apply makeup, cleansers, lotions and soap that support a healthy skin microbiome and liver. Dry brush to help exfoliate your skin and support immune health.
  9. Sweat, get the pores cleared. Don’t forget to wash your body, sheets and clothes regularly to keep that skin fresh.
  10. Stress management – you can be doing all of the above but if your stress is chronically high your body will let you know. Reduce stress where possible and use coping mechanisms such as journaling, therapy, talking with a friend and doing what brings you joy to help balance what you can’t control.

Hormonal support

In addition to have a solid foundation to health adding supplements can help propel you forward in your healing journey.

Testosterone imbalance: saw palmetto, nettles, reishi mushroom, vitex, zinc

Estrogen imbalance: DIM, I3C, magnesium, methylated B vitamins, turmeric, sulforaphane

Always talk with your doctor before starting any new supplements.

What’s next?

You start! Wherever you are in your journey you start by applying one of the guidelines until it is a habit. Adding more veggies is a great place to start. The more colour and variety of food you eat increases your phytonutrient intake (think antioxidant, glowing skin and anti-aging), better fuller poops and you’re feeding the good bacteria. Then you add in another and another until you’ve slowly made a strong foundation for health and clear skin.

Stay committed, you are building your healthiest body moving forward, it takes time. It took time to get unwell and it takes time to undo the damage too. 

This is what has worked for me and my clients, but this may not work for you! If you need a more detailed and accountable plan of action, I am available to work one on one with you.

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