There are so many internal and external factors that cause or contribute to acne. The list is extensive however there are several common threads I see when treating individuals with acne.
Commonly, females are prescribed the oral contraceptive pill (the pill) to help control their acne. The pill contains synthetic hormones that, when ingested, are released into circulation where they suppress ovulation and revert sebum production to levels like those seen in childhood. This suppression ultimately leads to a reduction in acne and therefore clearer skin.
However, when a female chooses to come off the pill, natural hormone production is no longer suppressed. Often the body, or the ovaries, will overcompensate and begin to produce excess amounts of hormones including androgens, such as testosterone. As a result, sebum production goes into overdrive and you are now producing more sebum than before you went on the pill. We call this ‘post-pill acne’.
In addition, taking the pill contributes to vitamin and mineral deficiencies, gut inflammation and liver congestion. These are all common causative factors of acne which, when combined with excess hormone and sebum levels following cessation of the pill, create the presentation of acne.
The health of our gut and what is happening within it is directly reflected in our skin. Consuming inflammatory foods (gluten, sugar, dairy, caffeine), food intolerances, psychological stress, bacterial overgrowth and medication use can all cause immune reactions within the gut. This leads to inflammation that can become systemic, affecting the entire body including the skin. Often this will worsen the appearance and severity of breakouts – think big, red, cystic breakouts. When this type of acne presents it is important to address gut inflammation. Gut inflammation also impairs the eliminatory capacity of the gut, placing increased pressure on other channels of elimination (skin, liver, lymphatics). This is discussed further below.
Impaired detoxification and elimination
Our body has many primary routes of elimination – the gut, liver, lungs, kidneys and the lymphatics. They are responsible for detoxifying and eliminating substances such as medications, metabolic wastes, toxins, pathogens, inflammatory mediators and excess hormones from the body. Our skin is regarded as a secondary route of elimination.
Often, due to lifestyle and environmental factors, there is increased pressure on the primary routes of elimination, particularly the liver and lymphatics, meaning they cannot adequately detoxify and eliminate those substances from the body. When this is the case, the body tries to reduce the burden on these routes of elimination and will look to the skin as a secondary or ‘back-up’ route. This means that metabolic wastes, toxins, excess hormones etc are excreted through the skin, causing breakouts and acne.
While there is no direct evidence to suggest that certain foods such as chocolate or fried foods cause acne, they definitely do not help. These foods are what we call high GI simple carbohydrates. These carbohydrates are taken up quickly into the bloodstream and used almost instantly for rapid energy production.
In the body, high GI simple carbohydrates trigger the secretion of a compound called insulin-like growth factor 1 (IGF-1). This compound has been shown to increase the production of androgens in the body, contributing to higher circulating levels. Androgens are known to alter skin cell characteristics and increase sebum production in the skin. This leads to clogging of the skin’s pores, which causes inflammation and leads to breakouts and cysts.
A note on dairy: The consumption of dairy products has also been linked to acne because it too triggers the secretion of IGF-1 in the body.
While there are so many more internal and external factors that cause acne, these are just a few commonly seen in clinic. Once the underlying cause of acne has been identified, the appropriate naturopathic treatment can be prescribed. Treating acne requires a holistic approach, compliance and dedication in order to achieve healthy, clear skin with long-lasting results.
Written by Perri Baldwin BHSc
FREE WEBINAR ~ HEALING SKIN FROM WITHIN
Join Perri for this practical and informative session about the pathophysiology of acne, causes and contributing factors, treatment and topical products. Perri will provide loads of valuable information about hormones, gut health and liver function, along with diet and lifestyle, how treatment is prescribed and what it does within the body.
Wednesday 22 April 2020
Online – Zoom
Let’s talk about your liver. You hear naturopaths talking about the liver all the time so why is it so important?
Our liver is one of the hardest working organs in our body. It performs many vital functions including digestion, assimilation and storage for essential nutrients and red blood cells.
Its primary role, however, is the detoxification of our bodies.
You see, every metabolic process that occurs in our body, every minute of every day, creates toxic by-products which the liver makes into less toxic substances and excretes from our body (primarily in our faeces and urine via the bowel and kidneys).
In addition to the internal toxins produced by normal metabolic function, we come into contact with a variety of external toxins every day; everything we breathe, taste and touch has to be processed through our liver.
Let’s think about that for a minute. Toxins are in the air we breathe, the clothes we wear (including what they are washed in and chemicals used in the manufacturing process) which sit on our skin all day and what we sleep on all night.
The food and drink we consume all has to be processed through the liver, as do the toxins in our skin care products (soap, shampoo, conditioner, face wash, toothpaste, mouth wash, moisturisers, make up, shaving cream, deodorant, aftershave and perfume) and our hair care products (dyes, styling products, hairspray). Our furniture and surroundings produce chemicals – think about sitting in the car in traffic, household cleaning products, air fresheners, medications we take, alcohol, nicotine and other drugs and so on and so forth.
The liver clearly has a lotto do. It is busy enough with all the internal metabolic functions and we go and add a whole heap of other elements in there for it to deal with as well. Is it any wonder our poor old liver struggles?
And what does our liver actually do with all this stuff?
Liver detoxification goes through three main phases to turn these fat-soluble compounds (we will call them toxins) into water soluble molecules that can be excreted from the body via one of the five systems of elimination – liver/bowel, blood/lymph, lungs/respiration, skin/perspiration and kidneys.
Phase I– cytochrome P450 pathway
The phase I reactions are the beginning of transforming toxic compounds into non-toxic molecules to be excreted. In other words, the P450 enzymes convert fat-soluble substances into intermediate compounds that have increased water solubility. This provides the body with the ability to process and remove compounds that could change or even damage cellular function.
Things that speedup your phase Iliver pathway include alcohol, caffeine, cigarettes, some medications and illicit drugs.
Things that slowdown your phase I pathway include hormones, medications, heavy metals, environmental chemicals, liver damage and nutrient deficiencies (B6, zinc & magnesium).
After the phase I reactions, the compounds are then broken down into smaller particles and they wait in the intermediate phase before moving on to phase II. This is a bit like a taxi rank full of cabs waiting for rush hour.
Phase II – conjugation
During this phase, the particles proceed to find their pathway out of the body. There are six different phase IIpathways: peptide conjugation (glycine & taurine), methylation, sulphation, glucoronidation, acetylation and glutathione conjugation. Each of these pathways metabolises different compounds and enables them to be excreted from the body.
It is in this phase that things are normally slowed down and our liver has trouble in keeping up with everything. It’s like a packaging plant, where the conveyer belt gets faster and faster and the person at the end packaging up the boxes can’t keep up.
When one or more of these phases of detoxification are impaired in some way, it slows down the whole process, creating a backlog of toxins waiting to be processed.
Here are some common signs that your liver may need a little help:
Indigestion or feeling nauseous or unwell after eating, especially after consuming fatty foods
Altered bowel movements – frequent diarrhoea and or constipation
Feeling of fullness and food not moving after eating
General fatigue and tiredness
Altered mood, feeling a little more grumpy than usual
Itchy skin, rashes, eczema, psoriasis etc
Muscle/joint aches and pains
Insomnia/disrupted sleep, waking between 1–3 am on a regular basis
Abdominal pain/bloating/distension after eating
Excessive sweating, especially the feet
Body odour and/or bad breath
High cholesterol levels.
This is just to name a few! Most people today have some level of liver dysfunction. This is purely due to the foods we consume and the every day exposure the liver has to deal with.
But you can certainly help your liver and one of the best ways to help your liver, and your body in general, is through your food. We all need to eat, right? So why not consume foods that are beneficial to your health and wellbeing and avoid foods that cause problems. Try to incorporate some of these liver-friendly foods into your diet every day.
While it might sound boring, your whole body—especially your liver—loves water. Make sure you get at least two litres of this amazing stuff every day (preferably filtered water that takes out these nasty chemicals we are talking about).
Not the sliced variety in a tin, I’m talking about real, whole, fresh beetroot (including the leaves). These little beauties are great at cleansing and purifying the blood. They contain fibre plus a whole stack of beneficial nutrients your blood and liver will love.
This is part of the cruciferous vegetable family, with other family members including cabbage, kale, bok choy, brussels sprouts and cauliflower. This family of vegetables are high in sulphur—and one of the phase II detox pathways is the sulphation pathway so these vegetables help to improve the flow through this pathway. They also contain lots of other nutrients that generally help to support healthy digestion and liver function.
Garlic and onion
Again, these are sulphur containing foods that stimulate liver detoxification. They are also anti-inflammatory which means they help to slow or reverse inflammation in the body. When your liver is under stress and not keeping up with things, it can become inflamed and that can cause it to slow down even more. They also help to activate liver enzymes which are essential in the detoxification process to help flush out toxins.
Lemon and limes contain high levels of vitamin C which helps the liver turn fat soluble molecules into water soluble compounds so they can be excreted. It is also an antioxidant so is protective for the liver. Drinking lemon or lime juice in warm water before meals can help to stimulate gastric acid production and the flow of bile acids. These help us digest our foods properly so we can absorb the nutrients we need to aid our body to do all the things it needs to do.
Green leafy vegetables
These are our best friend when it comes to liver health! Get as many of these vegetables into your diet every day as you can—there are so many benefits. The darker the colour, the more nutrients they contain. They contain chlorophyll (this is what gives them their green colour) which helps to alkalise the body and suck up toxins, rendering them neutral and unable to cause damage. They are also high in fibre which helps with fat metabolism and the absorption and excretion of toxins (more details below).
This type of vegetables helps to clean the liver and protect it from damage.
Avocados help to produce glutathione which is essential for healthy liver function and is the master antioxidant in the body. It protects the structure of the cells, which helps them to function optimally.
Wow, what can I say here! Amazing! A very powerful antioxidant, turmeric helps to stimulate detoxification and glutathione production. There are some studies that show turmeric helps to regenerate a damaged liver—that’s pretty amazing.
Fibre is your friend. Our liver makes cholesterol as part of its normal function, we need cholesterol and all of our cells and hormones are made of cholesterol. But when the liver is not functioning well and is being harmed by alcohol, medications, sugar, processed foods, chemicals and toxins, it produces more cholesterol as a means of protecting itself. This is where cholesterol can become a problem in the body, as it has nowhere to go so it accumulates in the blood vessels.
In this situation, a high fibre diet can help. Cholesterol is sticky (like chewing gum) and fibre is coarse (like sawdust). What happens when you drop your chewing gum in sawdust? Yes, the dust sticks to the gum. This is what fibre does in the body; it collects the excess cholesterol and helps it find its way out of the body. It also does the same for the fat-soluble toxins. If you put sawdust on an oil spill, the sawdust soaks up the oil and it is easier to clean up; the same happens in the body.
It also acts like a broom through our digestive system, especially the colon. As we know the colon is one of the main exit routes from the body. If the bowel isn’t working well, even if the liver was clearing things out, it can cause a traffic jam in the colon. So it’s vitally important to have healthy bowel function to support the liver in doing its job.
There are also some pretty powerful herbal medicines and nutritional supplements that can be prescribed by your naturopath to assist with optimising liver function. If you suspect you have issues with your liver or would just like to make sure yours is functioning well, seek the advice of a qualified natural health professional—like one of our naturopaths. In the meantime, eat your greens!