To Heal Your Acne, Start With Your Gut
Hormones seem to cop all the blame for skin conditions, especially acne. But what if I told you that there’s another major player that, in my clinical experience, is the root cause of acne in more than 90% of cases?
It turns out, it’s no coincidence that I see poor gut health causing or exacerbating acne in so many of my clients. In fact, there’s an abundance of research on this topic - aptly named the gut-skin axis.
Let’s dive in to what this means, why you should care, and what you can do to get things running smoothly.
How happy is your microbiome?
The bugs that inhabit your gut influence the skin in several ways. For better or worse, they influence:
Inflammation
Oxidative stress
Blood sugar levels
Lipid levels in the skin (helping it to look and feel plump and hydrated - or not)
If pathogenic microbes take hold in the gut, they can produce toxic metabolites and compete for nutrients, leaving you depleted. An unhappy microbiome can also play a part in constipation (either as the cause or effect), which interferes with phase III detoxification - the physical removal of waste (including conjugated hormones) from your body. A major way your body does this is through the bowels. If this process isn’t working optimally (you should be having a well-formed bowel movement at least once daily), hormones get ‘recycled’ and can worsen acne.
If constipation is caused by a diet low in fruits and vegetables - which act as 'food' for your gut microbes - this complicates the picture even further. Just like you couldn’t power yourself with gasoline, beneficial gut microbes can’t thrive without the right fuel!
How stress, depression and anxiety affect your skin
As if there isn’t enough going on, a third player in the gut-skin connection exists: the gut impacts the skin, and the brain impacts the gut.
Depression, anxiety or prolonged periods of stress can reduce transit time through the intestines, reduce stomach acid, encourage the overgrowth of bacteria, increase intestinal permeability, cause inflammation and generally disrupt the gut microbiome (this is what’s really going on for those who have received the flimsy diagnosis of IBS). Alterations to the gut microbiome can further disrupt mood, creating a vicious cycle. Two protective species, lactobacilli and bifidobacteria, have been found in studies to be particularly affected by stress, a picture which I certainly see reflected in the microbiome test results of my acne clients.
Disrupted mood (or clinical depression) can alter gut transit time (the time it takes food to pass through the digestive system), resulting in chronic constipation, which is strongly associated with significant changes to the intestinal microflora. This picture can ultimately lead to acne through the mechanisms discussed above.
Should I take probiotics for my acne?
Although clinicians have long suspected that lactobacillus-containing products had the capacity to treat acne by modulating inflammatory processes occurring along the gut-brain-skin axis, it was not until 1961 that the first formal research in this area was published. Even this early research found that an impressive 80% of the 300 acne patients in the trial experienced clinical improvement in their symptoms. Patients with inflammatory acne were more likely to see these benefits.
The bacterium Cutibacterium acnes on the skin is also established to play a role in acne, and some people with acne may benefit from topical probiotics to reduce the impact of C. acnes without wiping out populations of beneficial bacteria.
How working with a naturopath can help
When someone comes to me for help with acne, the first order of business is ascertaining why they have acne in the first place. I refer almost all clients for blood tests, and may refer for functional tests (which provide a deeper level of insight) if relevant. Considering the information I shared above, you can probably guess that tests looking at the gut microbiome are (usually) my first port of call.
Microbiome testing gives us the inside scoop on what’s really happening inside your gut, and why you might have acne. All clients also undergo a comprehensive health assessment during their initial consultation, which helps me to make meaning of your symptoms and test results, so that we can develop a treatment plan that drives results.
ABOUT THE AUTHOR
Gemma is a women’s health naturopath and nutritionist in Auckland, New Zealand. She works with women from all walks of life throughout New Zealand and Australia and has a special interest in acne, infertility and women’s health. She is a mother to 4-year-old Laura and an avid (perhaps slightly obsessive) cook. In her spare time, you’ll find her rummaging through her cookbook collection, hitting up local restaurants or pottering in the veggie garden