Hormonal Acne

Breakouts – ugh! Pimples always have a way of popping up at the most inopportune times, but those that appear monthly with our cycle can be the most frustrating of all. We know they are coming, they visit every month, but we just can’t seem to get them under control. Well, I’m here to tell you don’t give up hope. The battle against hormonal acne takes a multi-faceted assault.  Just as what goes ON your skin matters, what you put IN your body is paramount in the health of your skin, and I’ve got a list of the foods you need as defense in your skin care army.

Before we take dive into my clear skin eats, let’s take a quick look at what’s happening inside your body to cause these hormonal breakouts.

When we think of hormones (especially those that cause breakouts) we tend to think of female sex hormones like estrogen and progesterone. However, our body has a multitude of hormones that regulate everything from your monthly cycle to blood sugar regulation, from hunger and metabolism to bone health. Balancing your hormones can be a tricky thing. Think of each hormone in your body as an instrument in an orchestra. When all those instruments are tuned and playing in concert with each other you hear a beautiful symphony. However, when just one instrument is out of tune or playing out of synch with the rest it can ruin that performance. Your hormones play the symphony of your health. When one hormone is not in synch it impacts all the rest, making it difficult to identify the root cause.

Keeping the symphony in mind, we’ll do a quick break down of the big players in your breakouts. For most, the biggest culprit in hormonal breakouts is testosterone. We tend to think of testosterone as one of the male hormones, but ladies, we too produce it and need it. When testosterone levels are too high, it can increase the production of sebum, the oily, waxy substance our skin produces. This excess sebum gets trapped in the pores, with bacteria, causing infection. I often see high testosterone levels and acne in women suffering from PCOS (polycystic ovarian syndrome).

Testosterone plays a duet with another hormone…. insulin – not one we usually think of when it comes to skin health. But insulin and insulin resistance have been linked to higher testosterone levels. Regulating blood sugar to keep insulin levels stable will be a big help in reducing acne breakouts.

Of course, our female femme fatale, estrogen has her part to play in our hormonal acne un-symphony. Estrogen tends to help prevent acne by suppressing sebum overproduction. During our menstrual cycle, estrogen is high in the first 14 days, helping your body prepare for ovulation, but around the 14-day mark it drops, and progesterone and testosterone production increase. This drop in estrogen accompanied by a rise in progesterone and testosterone can contribute to hormonal breakouts.

Now that we’ve got our hormones 101 down, let’s get to the good stuff. Food! The foods we eat have a direct link to the health of our skin. First, we’ll start with my recommendation of foods to limit, and then we’ll dive into those you want to focus on to combat hormonal acne with diet.

SUGAR AND REFINED CARBOHYDRATES

Now that we know the relationship between blood sugar, insulin, and testosterone, it should come as no surprise that sugar falls on my limit list. Refined carbohydrates such as pasta, white bread, white rice, crackers, cookies and cakes should be limited as well, as they tend to raise blood sugar levels and circulating insulin. Substitute your rice and pasta with starchy veggies such as sweet potatoes, root veggies and winter squash (think butternut and acorn).  They are my favorite ways to get carbohydrates without sending your blood sugar levels skyrocketing. To further keep your blood sugar in check, always eat your carbohydrate-rich foods as part of a balanced meal. This means adding some fat, protein and a non-starchy veggie to round out the perfect plate!

Also, it should be noted that acne is an inflammatory condition and sugar is a key player in your body’s inflammatory response.

DAIRY

Studies have demonstrated that there is an association, albeit weak, between frequent dairy intake and acne. Many people tend to have an intolerance to dairy, and food intolerances lead to inflammation. Removing the trigger can help quell this inflammatory response. Dairy also may be a source of hormones produced from cows which could contribute to our own hormonal imbalance. Lastly, dairy is high in the saturated fat palmitic acid, which has been shown to be a culprit in acne production.

SATURATED FATS

We already mentioned palmitic acid, a type of saturated fat in dairy that can contribute to acne, but other saturated fat may also play a role. Limit your saturated fat intake by eating less meat and poultry (consume grass-fed and pasture raised when you do – it has a healthier fatty acid ratio) and instead, and focus fish and seafood, and plant-based sources of protein.

GLUTEN

While there is limited well-conducted research on the role of gluten and acne, I have seen gluten sensitivity show up in a wide array of symptoms including skin irritation and acne. If limiting sugar, refined carbs, dairy, and saturated fats don’t seem to help, a gluten-free trial may be a worthwhile next step.

SKIN SUPERHERO’S

Here’s my five food as medicine favorites to help combat hormonal acne with diet.

OMEGA-3 FATTY ACIDS

Omega-3 fatty acids get their claim to fame for their role in heart health, but that’s just the tip of the iceberg for these essential fatty acids. These fatty acids play a pivotal role in your body’s immune response and are powerful inflammation fighters. As I mentioned before, acne is an inflammatory condition, so anything that will help counterbalance that gets a gold star in my book. Choose fatty fish (wild caught salmon, mackerel, anchovies, sardines and herring), walnuts, chia seeds and flax seeds.

ZINC

This micronutrient has a big impact on skin health, and emerging research is showing it may be an alternative to traditional harsher pharmaceutical treatments for acne.  Pumpkin seeds, chickpeas, cashews, spinach, chicken, and meat are the top sources of dietary zinc.

PROBIOTICS

While we know that certain bacteria can contribute to acne development, good bacteria (probiotics) can help prevent acne, by preventing the overgrowth of that bad bacteria. Fermented foods such as kimchi, sauerkraut, kombucha, kefir, and yogurt (if not sensitive to dairy) should be part of your daily diet.

GREEN TEA

Green tea is one of my favorite beverages for so many reasons. It’s packed with antioxidants that help protect the skin from free radical damage and helps regulate the inflammatory response. But in the case of hormonal acne, it’s got a secondary mechanism of action! Green tea may play a role in androgenic (testosterone) hormone activity, further aiding in controlling those hormonal breakouts.

SELENIUM

Selenium is another micronutrient with a mega role in skin health. Selenium is a potent antioxidant and studies show it may play a role in PCOS and hormonal related acne. Just two little brazil nuts a day gives you 100% of the RDA.

I always recommend starting with a food first approach. Nourishing your skin with a well-balanced, plant-focused diet that incorporates clean proteins and healthy fats sets the foundation for clear skin and healthy hormonal balance.

REFERENCES: COMBAT HORMONAL ACNE WITH DIET

Bowe, W. P., & Logan, A. C. (2011). Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathogens3, 1. https://doi.org/10.1186/1757-4749-3-1

Burris, J., Rietkerk, W., & Woolf, K. (2013). Acne: The Role of Medical Nutrition Therapy. Journal of the Academy of Nutrition and Dietetics113(3), 416–430. https://doi.org/10.1016/j.jand.2012.11.016

Cates, T. (2017). Clean Skin From Within: The Spa Doctor’s 2-Week Program to Glowing, Naturally Youthful Skin. Beverly, MA: Fair Winds Press.

Cervantes Jessica, Eber Ariel E., Perper Marina, Nascimento Vanessa M., Nouri Keyvan, & Keri Jonette E. (2017). The role of zinc in the treatment of acne: A review of the literature. Dermatologic Therapy31(1), e12576. https://doi.org/10.1111/dth.12576

Corbould, A. (2008). Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome? Diabetes/Metabolism Research and Reviews24(7), 520–532. https://doi.org/10.1002/dmrr.872

Drayer, L. (2008). The Beauty Diet: Looking Great has Never Been So Delicious. New York, NY: McGraw-Hill Education.

Holmang, A., Svedberg, J., Jennische, E., & Bjorntorp, P. (1990). Effects of testosterone on muscle insulin sensitivity and morphology in female rats. American Journal of Physiology-Endocrinology and Metabolism259(4), E555–E560. https://doi.org/10.1152/ajpendo.1990.259.4.E555

Hormonal factors key to understanding acne in women. (2012). Retrieved from https://www.aad.org/media/news-releases/hormonal-factors-key-to-understanding-acne-in-women

Ju, Q., Tao, T., Hu, T., Karadağ, A. S., Al-Khuzaei, S., & Chen, W. (2017). Sex hormones and acne. Clinics in Dermatology35(2), 130–137. https://doi.org/10.1016/j.clindermatol.2016.10.004

Katiyar, S. K., Ahmad, N., & Mukhtar, H. (2000). Green Tea and Skin. Archives of Dermatology136(8), 989–994. https://doi.org/10.1001/archderm.136.8.989

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