Hormonal acne- is this why your skin is breaking out?

If you’re still battling with acne breakouts long after your turbulent teenage years are behind you, this article is written for you.

Acne is an inflammatory skin condition where the pore is blocked either by too much oil, too much dead skin cells or too much bacteria (P.Acne bacteria).There are internal and external factors that can worsen this problem. This is what i have observed in my practice for over 15 years as an Integrative Aesthetic and Hormone Doctor.

5 reasons why your skin is still breaking out and what you can do about it.

1.You have gut issues leading to internal inflammation

The gut contributes to 70% immunity and protects against the external environment. The mucosal lining of the gut has tight junctions which separates friend from foe. It also is in charge of digesting, absorbing, metabolising, assimilation and detoxification.

Microbial imbalance

A damaged and depleted gut micro-biome is one of the most common causes of internal inflammation. This is when microbial environment in the gut is out of balance either too much bad bacteria or not enough good bacteria.

Gut Fungus or Parasites

There may also be an overgrowth of fungus/parasites or viruses. This can lead to inefficient absorption of nutrients required for skin health, inefficient detoxification, food sensitivity and heightened immune response leading to leaky gut, migraines and even IBS.

This is commonly seen in women on long term oral antibiotics use, high stress levels or using an oral contraceptive. Eating inflammatory foods and lack of fibre or food variety can also contribute to low nutrient absorption levels.

Leaky gut syndrome

Inflammatory foods e.g. sugar, dairy, gluten and highly processed food can cause leaky gut syndrome – a condition where microscopic holes develop in the wall of your intestines, allowing molecules to pass through and create an inflammatory response in your body.

When our liver and large intestine is not working well, our skin steps up and tries to eliminate the toxins, resulting in skin inflammation and acne.

Symptoms associated with gut issues.

Some clues where you may have gut issues:-.

• Feeling bloated, nauseous
• Stomach cramps
• Diarrhoea/ constipation
• Cravings
• Feeling tired
• May be intolerant or sensitive to food
• Suffer from skin rashes.

The Solution: Reduce inflammatory foods

To speed up healing, reduce or eliminate inflammatory foods from your diet as best as you can. Try cutting it out completely for 3 weeks, then if you still crave it afterwards, introduce it one by one 3 days apart, noticing the effects on your skin.

Adding turmeric, garlic and ginger to your food is a good way to reduce inflammation as they have anti inflammatory properties. How you eat is also important – don’t rush your meals, chew your food and eat with good company.

2. You have a sugar balancing problem

After we eat food, sugar gets digested into glucose, amino acids and fatty acids. Glucose enters the blood stream and causes a spike in blood glucose. Our clever body then releases insulin, a hormone from the pancreas, to balance the blood sugar level, moving the glucose from the blood stream to other parts of the body to be used or stored.

Blood sugar spikes

Problems arise when we eat specific foods or the order we eat them that causes massive blood sugar spikes, or there’s too many spikes throughout the day. Big sugar spikes converts Testosterone to DHT (5x more potent) increasing sebum production in the skin.

More insulin is released to balance the sugar levels but this will in turn stimulate testosterone production leading to more sebum production which can block the pores and cause adult female acne.

Insulin Resistance

When there is too much sugar about for a long period of time, the insulin can become resistant and it doesn’t do its job properly. This leads to sugar being stored in fat, liver and cells. This results in gaining weight, a congested liver and cell glycation resulting in inflammation and premature ageing.

Symptoms associated with sugar imbalance

Some clues where you may have a problem regulating your blood sugar levels:-

• Bad sugar cravings.
• Energy crashes.
• Needing an afternoon caffeine pick me up
• Never feeling satisfied after eating.
• Feeling irritable and “hangry” when you skip meals.
• Excessive hair on your face, weight gain and irregular periods.

The Solution: Get better at regulating your blood sugar levels

Eat a healthy, balanced meal cutting down on processed sugar. Don’t skip meals and make sure you don’t go hungry. Have healthy snacks on the side to keep you going through the day. Cinnamon and Chromium picolinate supplement can help to improve insulin sensitivity.

3. You're not managing stress in a healthy way

When we are stressed, there is a rise in cortisol hormone which is normal. When there is a chronic consistently high cortisol level this can increase wear and tear and increase inflammation. It can also poke “holes” in the skin.

High cortisol levels

Indirectly, high cortisol affects sleep, digestion, motivation, patience, concentration, moods, joy and energy levels. It affects the normal production, detoxification and balance of other hormones which can all affect skin.

This can include stress that we are aware of and stress that we are not e.g. internal inflammation, emotional stress, mental worries and even spiritual misalignment. There is growing research to show how the brain and skin is connected, the skin often referred as the third brain.

Symptoms associated with high cortisol

Some clues high cortisol may be hijacking your system:-

• Feeling wired but tired
• Brain Fog
• Painful Periods
• Worsening PMS
• Uncontrollable skin picking
• Food cravings
• Difficulty sleeping
• Feel very uncomfortable slowing down
• Wild mood swings

The Solution: Work on reducing stress

There are many ways to manage stress. The key is awareness and learning to slow down, removing and reducing sources of stress where possible and cultivating routines that supports your mental health and overall wellbeing.

Learning to say no, practicing discernment, protecting our energy, holding healthy boundaries and taking care of your emotional house are all important skills to get good at as you grow wiser in age because no one else will do it for you.

4. Your liver is congested

Our liver is an important organ for detoxification, especially for environmental toxins, chemicals and even excess hormones. A well-functioning liver also boosts absorption of all vitamins and minerals, preventing deficiencies in the first place.

Sub optimal liver detoxification

Alcohol, nutrient deficiency, the birth control pill, stress, insulin resistance – all can cause liver congestion. When detoxification is suboptimal, we can get hormonal imbalances. When hormone levels aren't balanced this can lead to weight gain, skin sensitivity, adult acne and worsening PMS.

Symptoms associated with liver congestion

Some clues you may have a sluggish liver:-

• Brain fog
• Fatigue
• Elevated cholesterol
• Allergies and skin rashes
• Nausea
• Water retention
• Yellowish skin
• Red dots appearing and broken veins in your upper body
• White coating on your tongue and bad breath
• Easily bruised

The Solution: Cut down on alcohol. Manage stress. Optimise nutrient intake. Balance sugars.

Take more foods that cleanses the liver naturally – garlic, grapefruit, beets and carrots, green tea, leafy green vegetables, avocados, olive oil, lemons and limes, turmeric, broccoli, cauliflower, artichoke and brussels sprouts.

5. Your hormones are out of balance

Hormones are chemical messengers that allow different parts of the body to talk to each other. Nicely, most of the time but sometimes miscommunication can happen or worst, totally ignoring each other.

Hormonal changes or an imbalance can lead to the sebaceous glands increasing oil production, inflammation and big cystic acne. Hormonal imbalance is usually a byproduct of other things e.g. stress, inflammation, drugs or environmental toxins.

Symptoms associated with hormonal imbalance

Common symptoms of hormonal imbalance include

• Painful, heavier periods
• Irregular menstrual cycle
• PMS
• Sugar cravings
• Weight gain
• Facial flushing
• Excessive facial hair or hair loss on the head

Perimenopause and hormonal changes

During Perimenopause the ovaries slow down in releasing eggs so hormones don’t follow the predictable monthly pattern and fluctuate (sometimes wildly). During this time, women not only FEEL a difference in themselves but also SEE a difference in their skin.

Perimenopause generally comes in 2 phases

Phase 1 - Early Perimenopause

Progesterone starts to drop first. This is a skin and mood calmer, helping you sleep better and control cravings. When progesterone is low, skin can get oilier, it breaks out, becomes more sensitive and flushed.

Oestrogen then becomes more dominant in the equilibrium, resulting in water retention, puffiness and increased pigmentation.

Phase 2 - Late Perimenopause

This occurs in later years when Oestrogen starts to fall too. Oestrogen keeps us sharp, feminine, calm and on the ball. It also protects our bones, heart, gut and brain.

For the skin, it controls skin hydration and collagen production. Skin becomes dry, itchy, sensitive. Dryness from loss of water from the thin epidermis, loss of oil which protects the skin. It thins so it becomes more translucent and we lose the glow.

Vessels become more fragile so we bruise easier and can have broken veins. The skin barrier becomes impaired, increasing reactivity to external triggers and slow to heal.

The Solution: Balance the body, seek medical advice.

As you’re addressing points 1-4 above, it will help reduce the wild hormonal fluctuations and better equip you to take better care of yourself as you go through this normal transition in a woman’s life. Supplements and possible hormonal therapies ( HRT) may help if indicated following a medical consultation.

Growing old might sound scary but my aim is to educate you on what goes on with your hormones and skin so you can choose how to change it if you wish to.

About Dr Terry Loong, Integrative Aesthetic Hormone Doctor

Dr Terry Loong (or Dr Terry as most of her patients call her) is a qualified doctor for more than 18 years, having graduated from King’s College London in 2002. She first trained as a surgeon before specialising in Aesthetic Medicine in 2007. She started out her career, inspired by her late mother who suffered from hormonal acne and acne scars which led to her first book “The Hormonal Acne Solution”.

When Dr Terry was 30 years old, she was diagnosed with early stage cervical cancer which led her down the path of nutrition, lifestyle medicine and hormonal balance. Her philosophy as an Integrative Aesthetic and Hormone Doctor is to help her patients look and feel their best, with each passing year, naturally and holistically.

Through her personal experience and working with patients through the decades, Dr Terry  specialises in hormonal acne, aesthetic treatments and hormonal balance (particularly. perimenopause and menopause). Having grown up in Malaysia and trained in UK and USA, she combines Eastern philosophy with Western technology and science. To learn more or arrange a consultation visit Dr Terry's website or find her on Instagram.