This article looks into the 6 internal causes of acne in adult women and the natural ways to treat them.
As I say time and time again, acne isn’t just something that happens out of the blue. It’s a symptom of a deeper imbalance within the body… and pimples are your body’s way of crying out for help. Unfortunately, in today’s world, it’s so much easier to just go on the hunt for a new spot zapping lotion or facial treatment instead of working with your body and finding out the real root cause of your acne and other symptoms because trust me, spots might be the only thing that’s really bothering you right now but I’ll bet that your breakouts are also accompanied by other symptoms such as fatigue, period pains, weight gain, sugar cravings, constipation, tender breasts and emotional hypersensitivity – all major signs that something is up!
Sure, you can get acne breakouts from using coconut oil as a moisturiser, picking at your skin or wearing foundation everyday that contains pore-clogging ingredients, hell – you can even get acne breakouts from not changing your pillow case as often as you should! However, if you’ve been suffering from acne for what seems like forever, then it’s possible that the problem isn’t down to external factors and you could be dealing with an underlying health condition that needs to be addressed before you can clear your skin for good.
Sadly, many women who have been suffering from chronic acne for a long time give up hope and commit to what many doctors dermatologists believe to be ‘the magic pill”. Accutane. Unfortunately, while many people will have clear skin for months, even years after Accutane, it never solves the root cause of acne so your acne can come back. The only way to completely clear your skin and reach a place where you know your acne will never come back is to listen to your body and start a healing journey that will improve more than just your skin.
6 internal causes of acne in adult women
These 6 internal causes of acne in women is by no means the full list. There are other medical conditions and daily habits that have been known to contribute to acne breakouts but these 5 are by far the most common causes of acne.
The reasons why acne occurs in women is due to increased production of specific hormones (specifically insulin, testosterone, IGF-1 and DHT). In the case of excess testosterone, it is converted in a more potent androgen called DHT by an enzyme called 5-alpha-reductase. It’s actually DHT, not testosterone, which causes our oil glands to go into overdrive and paves the way for an acne breakout. Similarly, if the body has too much insulin floating around then the production of Insulin Growth Factor – 1 (IGF-1) is ramped up, which also causes your oil glands to go crazy and intensifies the conversion of testosterone to acne-causing DHT in the skin.
Once those oil glands are working overtime and producing a tonne of excess oil – you’re going to run into big problems acne-wise. All that excess oil oxidises and results in a condition known as hyperkeratinisation – a build up of dead skin cells – which leads to clogged pores and congestion. These clogged pores the create a perfect breeding ground for a bacterial overgrowth, which finally results in inflammation and a killer breakout.
To cut a long story short, excess androgens and insulin spell disaster for your skin.
There are often other hormonal imbalances that accompany excess androgens such as imbalanced progesterone, oestrogen and cortisol that can add to your ever growing list of frustrating symptoms but excess androgens and/or insulin will be main reason behind your acne breakouts.
internal causes of acne #1: insulin resistance
As I mentioned before, too much of the hormone insulin can wreck havoc on your skin just as much as popular acne villains; androgens. Not only does too much insulin cause excess levels of IGF-1 which leads to increased sebum production but it also makes the skin extra sensitive to androgens which will further increase sebum production, hyperkeratinisation, blocked pores and inflammation.
Insulin is a hormone produced in the pancreas and helps keep our glucose and blood sugar levels in check. Glucose is pretty damn important as it’s our body’s key source of energy and without it, we wouldn’t be able to function properly. While some glucose is essential, the problem occurs when we have too much glucose and our body fails to respond normally to the insulin so the pancreas continues to release more and more insulin, causing a buildup of sugar in the blood. When our blood sugar levels are continuously raised for long periods of time, the body’s cells will eventually stop responding to insulin altogether.
Early stages of insulin resistance can result in acne and other symptoms such as fatigue, apple shaped body and high blood pressure but if left untreated, insulin resistance can lead to more complicated issues such as PCOS, diabetes and heart disease.
how to treat insulin related acne:
Poor diet and a stagnant lifestyle are the main causes of insulin resistance. Eating high amounts of refined carbohydrates and sugary snacks cause the pancreas to dump a load of insulin and IGF-1 to help maintain balanced blood sugar. However, we know now that insulin and IGF-1 cause major problems for our skin so it’s easy to see how poor diet choices can lead to chronic acne breakouts over time. Another factor that needs to be considered is the OCP. Researchers in Finland found that oral contraceptives may worsen insulin sensitivity so if you’ve recently come off the pill then resolving insulin resistance is something you should definitely consider in your own personal treatment plan.
The best way to correct insulin resistance is to eat a minimally processed, low carb/high fat diet, exercise regularly and consider supplements such as Magnesium Glycinate, Myo-Inositol/D-Chiro-Inositol, Lipoic Acid, Chromium, Berberine and Cinnamon. These supplements are great for reversing insulin resistance and have even shown to be more effective than popular insulin sensitising drug Metformin. You may be able to treat insulin resistance through diet and exercise alone, but if you read my article on my Hair Mineral Analysis Test you’ll know that despite being active and eating a near perfect diet for over two years – I was still seriously insulin resistant!
internal causes of acne #2: coming off the pill
If you’ve read my post on why the pill can cause acne then you’ll know that the synthetic forms of hormones found in birth control can contribute to depression and insulin resistance – and that’s before you’ve come off the pill!
Coming off the pill, after years of taking it, will result in your body being pretty low on progesterone. Low progesterone in relation to oestrogen causes acne by increasing androgens. This is because low progesterone increases insulin output which leads to excess androgens and eventually acne.
For more information on progesterone and acne, please visit these posts:
- Why low progesterone is causing your acne and killer PMS
- How to naturally increase progesterone for acne free skin
Not only will you be low on progesterone, but coming off the pill also sends your oil glands into overdrive and increases androgen production. The pill suppresses sebum production – which is why it’s often commonly prescribed by GP’s for acne patients. The problem is, as soon as you come off the pill your oil glands fight back and start over producing sebum, leaving your skin shiny, greasy and at major risk of breaking out.
how to treat post pill acne?
If you had clear skin and regular periods before going on the pill, then chances are that any breakouts you get in the months coming off the pill will calm down within 12 months. However cutting out sugar and dairy and supplements such as Zinc (regulates hormones and improves insulin function), DIM (blocks androgen hormones and detoxes excess oestrogen) and Berberine (boosts gut health, reduces androgens and improves insulin sensitivity) are great options for saving your skin from post pill acne and for best results, should be implemented 1-2 months before you come off the pill.
If you originally went on the pill to help with acne or period problems, then you need to address the true underlying cause of your acne FIRST as your symptoms existed prior to your time on the contraceptive pill. While DIM, Zinc and Berberine could be beneficial to your acne healing – you may also need to work on other areas of your health to see major improvements (gut function/stress/insulin resistance).
For the full blog post on how to avoid post pill acne, visit this post here.
internal causes of acne #3: stress
There are so many causes of stress, including social pressure, work deadlines, relationships, bereavement and even personal appearance. Feeling anxious and rubbish about your skin is just as toxic to your wellbeing as being stressed out about a work deadline… yet we often fail to recognise this type of stress as a potential acne trigger. Working on your stress levels is often the most difficult factor we have to overcome when healing our acne but it’s ESSENTIAL. You can do everything else right, but if you’re chronically stress then you’ll never be able to clear your skin.
High stress levels can cause our adrenal glands to start dipping into our progesterone stores (also knows as the “progesterone steal”) to make cortisol and adrenaline. This can mean less progesterone is available to support our menstrual cycle and affects the balance of progesterone to oestrogen. As we learnt in the previous point, low progesterone can make us more prone to acne, PMS and other hormone-related symptoms by increasing insulin output, causing excess androgens and intensifying the conversion of testosterone to acne-causing DHT.
how to treat stress induced acne?
Working on stress management will ultimately be your key to clearer skin, but it’s so much easier said than done right!? Exercise is a great way to destress but only if you love it and it makes you happy! I spent years trying out different types of exercise including Bikram yoga, weights, going to the gym, jogging, spinning, yoga and none of them inspired me enough to stick at it regularly 2-3 times a week! It wasn’t till I started dancing that I realised you can love working out! I now dance 2/3 time a week whether it’s a Zumba class, home dance workout or just a long walk and can’t imagine ever forcing myself to go back to the gym. Supplements that can help reduce the impact that stress has on our body include vitamin C and adaptogen herbs such as Ashwadanga, Rhodiola and Ginseng, but I recommend only reaching for the supplements once you tried all other areas of stress management.
internal causes of acne #4: PCOS
Polycystic Ovarian Syndrome is a condition where you are unable to ovulate regularly – it’s NOT just about having ovarian cysts (read this great post from Lara Briden here). If you’re not ovulating properly then you’ll be deficient in important hormones such as estradiol and progesterone which will lead to high levels of androgens.
If you suffer from PCOS, whether you’ve been officially or unofficially diagnosed, then it’s these high levels of androgens that are causing your acne, facial hair and male pattern baldness as well as weight gain, hellish periods and all of the other battles you face every day. To make matters worse, everything you try fails you, right? I’ve been there too, I’ve tried every single diet, hundreds of topical treatments and spent a fortune on various supplements over the years. I know how totally soul destroying it can be to feel like you’ve exhausted every single option yet you’re still plagued with acne, weight gain and hairy bits! Thankfully, there are plenty of natural ways to improve PCOS symptoms and clear your skin, you’ve just got dig a little deeper to discover them.
how to treat PCOS related acne:
All PCOS symptoms, including acne, can be effectively treated with diet, lifestyle and supplement changes. In terms of your diet, it’s important that you stick to a anti-inflammatory diet that’s rich in colourful whole foods but the first thing you must do is understand WHY you are not ovulating. Is it insulin resistance (the most common type of PCOS)? Stress? The contraceptive pill?
Whatever the underlying problem is for you, you can improve your symptoms using the treatment information provided for insulin resistance, stress and coming off the pill (above). Once you have the root cause under control, you’ll be able to reestablish regular ovulation and your skin and other symptoms will improve.
internal causes of acne #5: gut dysfunction
All disease begins in the gut. – Hippocrates
Hippocrates made this statement over 2,000 years ago, but it’s only been recently that we’ve began to understand just how accurate this may be. It’s now widely believed that an unhealthy gut contributes to a wide range of problems including diabetes, obesity, rheumatoid arthritis, depression, chronic fatigue syndrome and skin disorders.
Long before probiotics became fashionable, in a time when there was no such thing as a fridge-freezer, our ancestors would preserve food by fermentation – these fermented foods would be full of good bacteria that would keep our inner eco-system strong and healthy. However, with the advent of modern food science, we rely heavily on alternative preserving methods such as freezing, pasteurising and canning – meaning that are bodies are no longer receiving a regular supply of beneficial bacteria to keep our digestive system balanced.
antibiotics are particularly harmful to our gut and our skin. Studies have shown that antibiotics cause a devastating effect on our gut flora – what’s most worrying is that this change in our guts can’t be reversed without intervention i.e with fermented foods and/or probiotics.
On top of this, there are other factors that cause even further problems to our gut flora. Factors such as the contraceptive pill, high sugar/processed diet, stress, lack of sleep, medication/antibiotics, poor digestion, food allergies/intolerances all disrupt the bacteria population so our internal eco system becomes out of balance. This lack of good bacteria in our gut can damage the gut wall and cause gut permeability (i.e. “leaky gut syndrome”) where toxins leak out and cause inflammation which affects not only your digestion and the gut itself, but also other organs and tissues – such as your skin!
If your acne breakouts flare up every few days (not once a month around your period) and inflamed, red and takes forever to heal, it’s a sign you may have chronic inflammation and your gut health needs to be addressed.
how to treat gut related acne?
The first step to treat gut relate acne is to promote a healthy gut by avoiding all the thing listed above that can destroy gut flora and damage the intestinal barrier. Other important steps to heal your gut include a good quality probiotic (I recommend Prescript Assist, Epigenetic International, Garden of Life and Symprove), Betaine HCL and Berberine. Betaine HCL helps increase stomach acid to help you digest food better and Berberine helps acne and gut issues directly by improving intestinal permeability, reducing inflammation, reducing testosterone in women, improving insulin sensitivity and is also a natural antibiotic. Berberine is a potent herb so it’s important to pulse your dose – I like to take it for 1 month then break for a week, then take for a month then break for a week etc.
internal causes of acne #6: hypothyroidism
Hypothyroidism is thought to be one of the main problems behind adult acne in women. Why? Your thyroid is the boss of your endocrine system, so if it’s not functioning properly it will have a huge effect on your entire wellbeing. Your endocrine (hormone) system is responsible for practically everything including metabolism, growth, repair and reproduction so it’s vital that the thyroid is given the attention it needs.
Many factors can cause an underactive thyroid including a diet lacking in protein, over exercising, excessive stress and extreme dieting. In a world where social pressure is at an all time high, it’s so easy to fall into these obsessive habits, especially when we’re so so desperate for clear skin and we’ve read somewhere that diet/workout ‘X’ has promised miraculous results…
if your constipation doesn’t improve from healing your gut, it may be that you’re struggling with an underachieve thyroid.
There is a huge long list of symptoms other than acne that can occur from a low functioning thyroid such as depression, insulin resistance, PMS, low libido, constipation, difficulty losing weight and of course, acne! You can see a huge list of all the low thyroid symptoms here.
Luckily there are some pretty easy ways to tell whether hypothyroidism is something you should be concerned about. The easiest way is to start tracking your basal body temperature (more info here) and if your temperature is consistently below 36.6°C (98.6°F), then it’s highly possible that you’re dealing with an underactive thyroid. Other ways to check your thyroid function is by a hair mineral analysis test, your heart rate (a slow heart rate is linked with hypothyroidism) and of course a blood test – however blood tests are notoriously inaccurate as many doctors fail to recognise an underactive thyroid as they don’t run a full thyroid blood test and just test for TSH (Thyroid Stimulating Hormone). Read more about why blood tests don’t show the full thyroid picture here.
if your average waking temperature is consistently below 36.6°C (98.6°F), you may have hypothyroidism.
So why exactly does an underactive thyroid cause acne? When thyroid hormones are deficient, the body is unable to convert cholesterol to key sex hormone progesterone and adrenal hormones pregnenolone and DHEA. As we know from the stress section of this article, low progesterone can make us more prone to acne by increasing insulin output, causing excess androgens and intensifying the conversion of testosterone to acne-causing DHT. An underactive thyroid also increases internal inflammation and for as long as you’re struggling with internal inflammation, you’ll never be free from acne.
how to treat Hypothyroidism related acne?
Hypothyroidism is a really complex condition so there’s not one single treatment that will work. Depending on the severity of your hypothyroidism there are many natural treatments that don’t require full thyroid hormone replacement therapy that can support your thyroid and reduce your symptoms. Underactive thyroid has been linked with Magnesium, Iodine, Selenium or Iron deficiencies so these all need to be addressed. Taking a daily 300mg dose of Magnesium Glycerinate can help support the thyroid and grass-fed liver pills and Brazil nuts are a great high potency food source of thyroid supporting nutrients such as selenium, iron and vitamin A. Another way to improve thyroid function is to reduce your intake of fluoride, found in green/black tea, processed meat, toothpaste, mouthwash and in our water supply. Fluoride has been shown in studies to deplete our levels of iodine and iodine is essential for thyroid health (more info here) so reducing your fluoride intake could have a positive impact on your thyroid health. I recently read an incredible book that looks deeper into the link between fluoride and acne so if it’s a topic that’s sparked some interest I definitely recommend you read it!
As you can see, there are many different treatments or different internal causes of acne. That’s why it’s really important that you understand why your acne flared up in the first place. Without understanding what the internal cause of acne is, you’ll never be able to fully heal your skin naturally.
Do you have any questions regarding the internal causes of acne in adult women? Let me know your questions in the comments below!
Peace, Love & Clear Skin