Skin concerns can be complicated, mainly because there are a variety of imbalances which can contribute to skin problems, such as an under-performing liver, gut dysbiosis, hormonal imbalances, and often can be a combination of these causes.
It’s not unusual for women to experience acne or skin flare-ups in line with their menstrual cycle. Premenstrual acne is very common, and can affect women of any age. Hormonal acne is due to hormone fluctuations, such as an increase in the relative level of testosterone to oestrogen. Higher levels of testosterone stimulate the sebaceous glands which can then go on to cause skin flare ups. Going on the contraceptive pill, or coming off the pill can therefore be triggers as the hormones fluctuate substantially.
Hormonal imbalances can be tricky to identify, as there are often a number of imbalances and even possibly underlying dysfunctions which reflect in symptoms of the skin. For example, androgen excess (which is often caused by PCOS or just insulin resistance), androgen excess caused by stress and overworked adrenals, and androgen sensitivity which can be triggered by the pill or chronic inflammation.
For these type of hormonal imbalances, the goal is to reduce the androgen production so that you are preventing the conversion of testosterone to DHT (dihydrotestosterone), which is what causes the acne. DHT is produced when free testosterone increases in the blood (which may be triggered by stress, PCOS, insulin resistance, or other hormone ratio fluctuations).
So how do we reduce androgens?
Firstly, women are extremely sensitive to androgens. Even just a small increase can set off a skin breakout.
Minimise/remove sugar and starchy foods
To reduce androgen levels you must minimise your intake of sugar and starchy foods which spike insulin levels. Refined sugars, processed foods, breads, cakes, biscuits, pastas, chips, sweets all need to be removed from the diet, and replaced with healthier food choices and low glyceamic wholefood carbohydrates. This is key.
DIM is a compound found in cruciferous vegetables (broccoli, cauliflower, kale, brussel sprouts) which boosts liver function and aids in hormone metabolism. This helps to keeps balanced ratios between oestrogen, progesterone, and clears excess androgens.
Peony and/or Licorice herbal medicines
Both peony and licorice have hormonal balancing effects, particularly when used together. Peony reduces testosterone production, and licorice contains phytoestrogens to block androgen receptors.
Spearmint tea has an anti-androgen effect by inhibiting testosterone. It also aids the restoration of follicular development in ovarian tissue, which makes this tea particular good for PCOS sufferers.
Reishi mushrooms assist in lowering androgens by lowering the enzyme 5-alpha reductase, which is needed for the conversion of testosterone to DHT. Reishi also supports good health in a number of ways, including boosting liver detoxification, which is also needed to clear skin.
Studies have shown that zinc deficiency is high among those who suffer from skin conditions such as acne. Zinc is a wonderful mineral for healing of the skin, promoting the regeneration of healthy skin, and hormone balance. Zinc is needed for healthy ovarian function (as well as cell division, cell growth, wound healing, increasing progesterone, and for the breakdown of carbohydrates). Progesterone is a natural androgen blocker, and sometimes an imbalance between progesterone and oestrogen is enough to flare skin breakouts (such as pre-menstrual flare ups).
Zinc is toxic in high doses, and should not be taken without first determining if your levels are adequate.
Why boosting liver function is important
The liver is the largest internal organ, and its job is to filter blood from the digestive system before it travels around the body. Your liver is responsible for detoxification, removing toxins from the blood and processing nutrients. The liver helps the body to clean out excess hormones, so by looking after your liver, you can help to improve the elimination of excess hormones to keep the balance right.
Load up on the following liver-friendly foods:
ONIONS. Rich in allicin, onions support the body’s natural detoxification process.
GARLIC. Garlic is rich in allicin and selenium which are natural detoxifiers, and also reduces oxidative stress in the liver.
BROCCOLI. Broccoli is a great source of phytonutrients, and helps with detoxification along with many other cruciferous vegetables such as cauliflower, bok choy and brussels sprouts.
GREEN TEA. Green tea is high in antioxidants, and has been found to support the liver, improving enzyme levels and reducing oxidative stress.
WILD CAUGHT FISH. Salmon and other fatty fish such as sardines, tuna, mackerel, are great sources of Omega-3 fatty acids. Studies have shown that these fatty acids can help regulate enzyme levels, fight inflammation, improve insulin resistance and brain health.
General tips and healthy skin habits
Stop touching your face
Every time you touch your face, you’re transmitting whatever is on your hands directly onto your skin as well as moving bacteria around your face from your breakout which could cause further breakouts.
Drink enough water
Maintaining hydration is essential for healthy skin, and you should aim for 30mL per kilo of body weight. Most people aren’t drinking enough water, so this change alone can often assist in creating an immediate improvement.
Exercising enough to sweat is great to get the lymph moving around the body and flush out toxins. Always be sure to wash your face/shower as soon as you can after a workout to avoid having the sweat and toxins clog up the skin.
Change your pillow case
Always ensure you remove all makeup before going to bed, and if you have a breakout, change your pillow case daily. You spend many hours each night with your face on your pillow and if you have bacteria on your face, you are just transferring it again to your face the following night on the same pillow. Bacteria will build up on pillowcases over time, through hair, skin, sweat, environment and makeup.
Be Mindful That Stress Impacts Your Skin
Everyone encounters stress at some point, but it’s important to have some tools to manage it as effectively as possible. The first step is to identify the cause of the stress. Once you know that, you can determine if it’s something you can avoid or minimise. Elevated stress hormones over the medium or long term can lead to many health conditions such as anxiety, depression, adrenal fatigue, insomnia, weight gain and decreased fertility.
In order to help regulate your levels of adrenaline and cortisol, remember these key tips:
Focus on sleep
Stress impacts sleep, however sleep is so important for the production of hormones. Without good sleep, your hormones won’t balance, and your skin can’t heal.
Balance your diet
A balanced diet full of whole foods, low in sugar and starchy foods, and high in fibre and antioxidants, healthy fats, and clean proteins will assist in regulating stress hormones and detoxifying excess.
Meditation helps to lower cortisol levels and maintain a healthy outlook on life. It keeps our stress hormones down and keeps us calm and chilled.
For help in understanding the reason behind your skin problems, speak to your naturopath who will organise a full health history, arrange any necessary testing, and devise a tailored treatment plan based specifically on your underlying cause.
Yvette is a qualified Melbourne-based Naturopath and Nutritionist, MINDD Practitioner, member of the Naturopaths and Herbalists Association of Australia, and Complementary Medicine Association. Yvette specialises in the treatment of conditions commonly affecting women and children, with a key interest in children’s digestive and neurological conditions, as well as women’s hormonal concerns, digestive issues, fatigue, anxiety, and skin concerns. Yvette consults in South Yarra, Melbourne, as well as Australia-wide via skype/zoom/phone.
The Naturopathic Co. Melbourne Naturopath 2020