Acne affects primarily adolescents, but also affects adults, and for some can be a condition that follows them into their 50s. In fact, acne will affect 80-85% of people to some degree, at some point in their lives1.
Medical treatment of acne typically involves Antibiotics, Roaccutane, and for females, the Hormonal Contraceptive Pill.
Unfortunately, these treatments come with significant side effects, and are often not effective.
As someone who personally struggled with acne throughout my teens and early 20s, and had tried all of the aforementioned medical treatments without success, I can honestly say that a naturopathic and holistic approach to acne management is the best treatment strategy.
What Causes Acne?
The simple answer is hormones and genetics. A hormonal imbalance leads to the production of excess androgens. Androgen excess increases the skin’s production of sebum, and triggers abnormal keratinisation. What occurs as a result is blockage of the skin’s pores, and pimples.
The sensitivity to androgen excess in the skin may be influenced by the genetics, explaining why some are susceptible to acne during periods of hormonal imbalance, while others are not2.
In inflammatory acne (think multiple red, sore pimples), the hormonal imbalance occurs simultaneously with an imbalance of the skin’s microbiome. This microbial imbalance on the skin may be directly due to the hormonal imbalance (as excess sebum production favours the proliferation pro-inflammatory bacteria such as Propionibacterium acnes), or may be a reflection of another imbalanced microbiome in the body, i.e., the gut3. P.acne hydrolyses the excessively produced sebum into pro-inflammatory fatty acids, creating a cycle of more pimples, and more inflammation1.
Complications - More Than Skin Deep!
The complications of acne can be psychological and physical. Acne can lead to depression, anxiety and reduced self-esteem4. Unfortunately, the added stress caused by the psychological impact of the acne can lead to an increase in acne severity.
Physically, acne lesions can result in scarring. When acne becomes chronic and inflamed, it is important to seek help sooner rather than later, to minimise the risk of scarring. Naturopathic treatment will focus on clearing the acne, but also supporting skin healing and collagen synthesis.
Holistic Acne Treatment
Effective treatment of acne requires an individualised and holistic approach. Every acne patient may present with a set of unique triggers, which will best respond to a personalised dietary, nutritional, herbal and/or topical protocol.
A key feature of holistic acne management is to support hormone metabolism, and/or hormone modulation. Hormone metabolism occurs in the liver, and hormones are then excreted via the gut and kidneys. Therefore, it is important that all of these organs are functioning optimally.
Hormones can be modulated both directly and indirectly. Direct hormone modulation using herbal medicine can be saved for adult acne patients, who are no longer experiencing the normal hormonal ups and downs of puberty.
Indirectly, the best method to modulate hormones is to normalise insulin levels. Elevated insulin sees increases of insulin like growth factor and androgens. Elevations of these hormones can cause abnormal keratinisation and excess sebum production, thereby acne.
Stable insulin levels require stable blood sugar levels, which is achieved by eating a varied, high fibre, low GI diet, and exercising regularly. In some cases, acne patients may need additional nutritional and/or herbal support to keep blood sugar and insulin levels within normal ranges.
Optimal immune system function is essential for maintaining an anti-inflammatory microbial balance in the skin. We can support the immune system by consuming a diet rich in Zinc, Vitamin C, Vitamin A and Selenium, as well as maintaining an adequate Vitamin D status.
Importantly, the gut is host to most of our body’s immune cells, and plays a huge role in the regulation of the entire immune system5. So, the gut microbiome is as important as the skin microbiome in acne management.
Reducing inflammation by following an anti-inflammatory diet, and if necessary, supplementing with herbal and/or nutritional anti-inflammatories, supports skin healing and reduces the risk of acne scarring.
Stress can wreak havoc on hormones, gut function, the immune system, and therefore acne6. In some cases, stress management may be the most important tool in acne management. Stress can be managed using lifestyle medicine, as well herbal and/or nutritional medicine where necessary.
Topical Treatment
Purely trying to treat acne using a topical only approach simply will not work. The aim of a topical protocol should be to support the natural keratinisation processes of the skin, allow the skin’s microbiome to resettle, and possibly use spot treatments during initial phases of the protocol to reduce acne lesions and risk of scarring. The best way to achieve this is to use a minimalistic, natural skin care routine that does not strip the skin’s natural barrier.
Inversely, if you try to rid the skin of all bacteria using harsh chemical cleansers and peels, you create an even more imbalanced environment, where it is more likely that opportunistic bacteria will proliferate and create more and more inflammation.
Naturopathic Acne Solutions
Naturopathy treated my acne after nearly ten years of trying every treatment that conventional medicine had to offer. I only wish I had found it sooner!
In fact, the successful Naturopathic treatment of my acne is what inspired me to study Naturopathy all those years ago. That is why helping adults and adolescents to leave acne behind using Naturopathic medicine is a special area of interest for me as a practitioner.
Book an appointment with me to start your journey to clear-skin wellness.
References
1. Paller A, Mancini A. Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence. 5th ed. Elsevier; 2016.
2. Hechtman L. Clinical Naturopathic Medicine. Elsevier; 2020.
3. Pessemier B de, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut–skin axis: Current knowledge of the interrelationship between microbial dysbiosis and skin conditions. Microorganisms. 2021;9(2):1-33. doi:10.3390/microorganisms9020353
4. Uhlenhake E, Yentzer BA, Feldman SR. Acne vulgaris and depression: A retrospective examination. Journal of Cosmetic Dermatology. 2010;9(1):59-63. doi:10.1111/j.1473-2165.2010.00478.x
5. Yoo JY, Groer M, Dutra SVO, Sarkar A, McSkimming DI. Gut microbiota and immune system interactions. Microorganisms. 2020;8(10):1-22. doi:10.3390/microorganisms8101587
6. Zari S, Alrahmani D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clinical, Cosmetic and Investigational Dermatology. 2017;10:503-506. doi:10.2147/CCID.S14849