Acne is among the most prevalent diseases worldwide. Affecting 9.4% globally. And the most common skin condition in the United States, affecting up to 50 million Americans annually. Acne is often seen at some point in puberty, but for some acne continues into adulthood and some do not develop it until they are adults. Genetics play a role as inherited genes can predispose a person to develop acne. However, your genes are only about a third of the puzzle. Your genetics can load the gun, but it’s gut health, lifestyle and diet that pulls the trigger.
Acne is an inflammatory condition and gut health may play a role in its development. Low levels of stomach acid are often associated with acne. A higher gastric pH (alkaline) enables bacteria from the colon to grow in the small intestine. This can cause gut dysbiosis (imbalance of good-to-bad ratio of bacteria), malabsorption of nutrients, and small intestinal bacterial overgrowth (SIBO). Stress, imbalanced hormones and diets high in sugar and dairy also play a role in acne.
Nutrient malabsorption may play a role in acne when bacterial overgrowth competes with the host for nutrients and impairs absorption of nutrients. Malabsorption of
micronutrients such as folate, chromium, selenium, omega-3 fatty acids, and zinc is associated with the development of acne.
The production of bacterial toxic metabolites resulting from SIBO can increase gut permeability, leading to systemic inflammation and has an association with acne.
Stress hormones produced by the adrenal glands can cause a decrease in gastric acid production and slows bowel transit time. It increases blood sugar levels and temporarily suppresses the immune system making the body more susceptible to bacterial and yeast overgrowth.
Androgen hormones control the sebaceous (oil) gland secretion and worsen the development of abnormal keratinization by the follicle. This causes blockage of the gland that becomes enlarged and inflamed. C. Acnes bacteria can then grow in the pilosebaceous unit. Conditions such as Poly Cystic Ovarian Syndrome is a condition associated with increased androgen hormone production in women with resulting acne. Many women with PCOS also have insulin resistance that leads to high blood sugar levels.
Diets high in refined sugars, processed carbohydrates, and high saturated fats have been shown to increase acne lesions. Gluten, a sticky protein naturally found in wheat can also play a role in some individuals. When gluten is ingested, it signals the body to release Zonulin. Zonulin is a protein naturally produced in the body that modulates the permeability of the tight junctions between the cells of the wall of the digestive tract. Gluten effectively induces leaky gut temporarily every time it is ingested.
Treating acne is complex and requires identifying the root cause to heal. A good place to start is a diet with plenty of vegetables and low glycemic fruits while avoiding dairy and refined sugars. Add supplements that can replace nutrient deficiencies and use clean skin care that promotes an acidic skin pH and has antibacterial and/or anti-inflammatory properties. Specialized testing can be completed by your integrative practitioner to determine if you have nutrient deficiencies, gut dysbiosis, SIBO or hormone imbalance. Procedures such as chemical peels, comedone extraction, and Blue LED light can also be used to help control acne. For acne scarring, microneedling has been an effective way to improve the scars with minimal downtime and can be used with added topical serums or PRP (Platelet Rich Plasma).