Acne

Root Cause Approach To Acne

To get to the bottom of any skin problem, acne included, you’ve got to consider an inside out approach because a skin problem is usually never just a skin problem.

While you’re working through that, there are several effective strategies you can try to manage acne externally, and many depend on where the acne appears. Here's how to start identifying and narrowing down potential external triggers.

Outside in approach:

Breakouts in the same place might be caused by:

• Touching your face, like having your hand on your chin while working

• Touching your phone to your face

• Certain makeup and skincare products

• Picking pimples

chin and jawline acne might be caused by:

• Hormone imbalances and even normal female hormone fluctuations

• Stress

• Teething and drooling in babies

• Dietary sugar and dairy

cheek Acne might be due to:

• Touching your phone to your face

• Resting your cheek/face in your hand

• Bacteria on your pillowcase

• Certain makeup and skincare products

• Stress

For acne on the forehead, you might consider:

• Hair products, including shampoo and conditioners (ingredients like SLS [sodium lauryl sulfate/sodium laureth sulfate] and coconut oil)

• Fungal involvement (the same fungus that causes cradle cap, seborrheic dermatitis, and dandruff)

• Diet

• Stress

Acne around the mouth might be due to:

• Toothpaste that contains SLS

• Teething and drooling in babies

natural, Topical options to try:

1. Apple cider vinegar (antibacterial and antifungal) - Mix 1 part ACV and 3 parts water (for sensitive skin add more water); wash skin, then use a cotton ball to apply it on affected areas; after 20 seconds, rise and pat dry. You can try this up to a couple of times each day. ACV can burn skin, so make sure to use small amounts and dilute it appropriately for your needs.

2. Honey and Cinnamon Mask (antioxidants and antibacterial) - Mix 2 tablespoons honey and 1 teaspoon cinnamon into a paste; wash skin, apply the mixture and leave it on for up to 15 minutes; rinse and pat dry.

3. Tea Tree Oil (antibacterial and antifungal) - Mix 1 part tea tree oil with 9 parts water; apply to affected areas with a cotton ball. You can repeat this up to 2 times daily. Tea tree oil can burn skin, t’s very strong and can burn skin, so make sure to use small amounts and dilute it appropriately for your needs.

4. Green Tea (antioxidant and antibacterial) - Steep green tea in boiling water for 3–4 minutes; let it cool; apply the tea to clean skin with a cotton ball, or pour it into a spray bottle to spray it on. Let it dry, rinse and pat dry.

5. Witch Hazel (antibacterial) - Wash skin; apply with a cotton ball. You can repeat this 1–2 times per day, as needed.

6. Moisturize With Aloe Vera (antiinflammatory, contains salicylic acid and sulfur, both helpful with acne) - Wash skin; apply aloe gel. You can repeat this during the day as needed. Get a product that’s pure aloe, without added ingredients.

7. You can try jojoba oil for cleansing and moisturizing.

8. Exfoliate regularly to remove dead skin cells, which can clog pores (making acne worse). You can make your own scrub by mixing equal parts sugar or salt and coconut oil. Scrub gently, rinse and pat dry. You can try this daily, and less often if your skin is sensitive.

   • Coconut is a potent antibacterial and antifungal, which makes it helpful for some skin problems and not others.

     • Acne, seb derm, and cradle cap - YES

     • Eczema, psoriasis, and other skin rashes that involve “leaky skin” - NO

Baby acne:

Baby acne can show up right after birth, or a few weeks after. It usually clears up on its own. In the meantime, strategies that can help are:

1. Keep the face clean and moisturized.

2. Soak a cotton ball in breastmilk and dab it on the affected area.

3. Dilute apple cider vinegar in water and use a cotton ball to dab it on the affected area. ACV can burn sensitive skin, so make sure to dilute it, and use it cautiously.

4. Dip a cotton ball in coconut oil and apply to the affected area.

5. Use a cotton ball to dab alcohol-free, diluted witch hazel to the affected area.

6. Gently exfoliate.

Inside Out approach:

Gut Health and Acne

The gut-skin connection plays a key role as a root cause of acne. Imbalances in the gut microbiome, like dysbiosis or leaky gut, can trigger systemic inflammation that makes acne worse. Getting a comprehensive digestive stool test done (GI Map) helps to identify the imbalances that need to be resolved, and helps determine what supplements will work best for doing that.

Avoiding foods that can irritate the gut and cause inflammation, like gluten, dairy, excess added sugar, and processed junk foods can help.

Hormonal Imbalances

Acne is often linked to hormone fluctuations, especially androgens (like testosterone) that can increase oil (sebum) production and clog pores. There is hormone testing available to help identify imbalances. Balancing hormones naturally is essential in treating acne, especially for women with menstrual or stress-related breakouts.

Inflammation and Detoxification

Chronic inflammation can worsen acne by over-activating the immune system and leading to clogged pores and infection. Systemic inflammation like this can be lowered by supporting detoxification pathways the right way, and using supplements to help if needed.

Also, foods high in antioxidants, like berries and leafy greens, help fight oxidative stress that can worsen acne.

Great places to start to make sure detox pathways work appropriately are with diet, avoiding constipation, and making sure enough water is getting in (your child should be drinking at least one 8oz glass of water per year of age, and before age 1/once they start eating solids they can have sips of water).

Nutrition and diet

Foods high in sugar, dairy, and refined carbohydrates increase insulin levels and trigger inflammation, which can lead to acne flares. Instead, eat more nutrient-rich, whole foods like fruits, vegetables, healthy fats (such as omega-3s), and lean proteins. This not only helps with acne but also supports the body’s natural healing processes in general.

Stress Management

Stress is a major contributor to hormonal imbalances and inflammation, which can make acne worse. Lowering stress can help regulate cortisol levels, lower inflammation, and help the skin heal.

Supplements

Certain supplements can help support healthy skin and reduce acne. Get guidance to know what will work best for your case. There is no one size fits all approach.

Reference

Rupa Health. (2023). Functional medicine protocol for treatment of acne. Rupa Health. Retrieved from https://www.rupahealth.com/post/functional-medicine-protocol-for-treatment-of-acne. Accessed October 11, 2024.

Chemical Food Triggers Behind Your Skin Rash Flares

Photo credit: Skinterrupt

I had the honor of being interviewed by Jennifer Fugo, Clinical Nutritionist, Founder of Gluten Free School, the Healthy Skin Show, and Skinterrupt for her Podcast, The Healthy Skin Show.

During our interview, we discussed:

Identifying natural chemical triggers found in many healthy foods that may be behind your skin flares...

Why this happens, and...

What you can do about it.

Here's a hint...

It's NOT about removing all these foods from your diet.

In fact, elimination diets and restrictive diets over time cause even more health problems and worsening of your symptoms, including your skin rashes.

Here's the deal...

“It’s well known that the source of many skin problems lies in the gut."

In the episode you'll learn:

• How impaired gut health impacts the skin’s health in a myriad of ways

• The differences between food allergies, intolerances, and sensitivities

• Some common chemical triggers you might want to watch out for in what you eat

• Simple steps you can take to see if you have a food sensitivity

MTHFR And Methylation, How Your Skin Is Affected, And What You Can Do About It

Photo credit: Tatiana

MTHFR what?

MTHFR is an acronym for an enzyme called methylenetetrahydrofolate reductase. This enzyme is involved in methylation reactions, which act like a switch turning genes on and off. Methylation is essential for biochemical processes, including those important for healthy skin, like:

• Processing amino acids to make proteins

• Using antioxidants

• Detoxification

• Breaking down histamine

The problem with MTHFR

If you have an MTHFR genetic mutation, methylation pathways may be adversely affected, which can cause problems like:

• Inability to convert folic acid (synthetic B9) to folate, the active form needed for these reactions.

• Glutathione (your body's master antioxidant) production can be impaired. Lower antioxidants increase inflammation (a driver for rashes like eczema). Glutathione plays an important role in liver detoxification too.

• Methylation breaks down Histamine!

  • Your body makes histamine. It’s necessary for brain health and digestive health, and it’s released by immune cells when they are triggered.

  • Histamine is found naturally in many healthy foods.

  • Histamine is made by bacteria, like those in the gut, and histamine-producing bacteria are found in probiotic supplements.

  • That’s a lot of histamine! If methylation is impaired, it can interfere with how your child’s body processes it. If their body can’t, the excess can increase itching, rash flares, allergy-like, and many other symptoms.

What you can do about mTHFR

• Avoid folic acid in food (it’s added to processed foods) and in supplements, so read labels. Ingesting folic acid with MTHFR can increase homocysteine, which increases inflammation (again a driver of rashes like eczema).

• You can test for MTHFR through functional labs and your conventional doctor (request it). There are a lot of different genetic mutations that can exist with MTHFR, but the two that are considered most problematic are C677T and A1298C (AKA 677 and 1298). Remember, just because there’s a gene for something doesn’t mean it’s expressed. Only when it’s expressed does it result in symptoms.

• Supplement with the active form of vitamins B9 (methlyfolate), B12 (methylcobalamin, adenosylcobalamin, hydroxycobalamin), and B6 (pyridoxine-5-phosphate/P5P).

• Eat foods naturally rich in these nutrients like salmon, oysters, mussels, leafy greens, beef, organ meats, legumes, and eggs.

Rosacea

Root cause approach to Rosacea

Rosacea is an inflammatory skin problem that shows up as redness, flushing, flaking and dryness, visible blood vessels, and acne-like pustules on the face. The face might look “ruddy” or sunburned. Rosacea can affect the eyes, too, and cause tearing, light sensitivity, eye redness, and blurred vision.

Flare-ups can be triggered by internal and external factors including gut health, genetics, immune system dysfunction, diet, environmental triggers, and emotional stress.

Conventional treatments for rosacea typically include antibiotics, and various topical interventions to help control symptoms. A root cause approach looks deeper, and ties together the variety of possible triggers for your unique case with underlying problems that are causing it, and that are making it worse.

The Gut-Skin Connection

Research has established a strong link between gut health and skin conditions, including rosacea. Imbalances in the gut microbiome, and gastrointestinal conditions including H. pylori, low stomach acid, Small Intestinal Bacterial Overgrowth (SIBO) or leaky gut syndrome, Crohn’s disease, ulcerative colitis, candida overgrowth, and irritable bowel syndrome (IBS) are often found in people who have rosacea. These imbalances can increase inflammation throughout the body, which makes skin symptoms worse.

Testing for gut problems is critical. Good places to start are with a comprehensive stool test (GI Map - use code R-AFIT to order) to identify microbial imbalances, and a breath test for SIBO (Trio-Smart/IMO (Glucose) - Gemelli Biotech Lab Kit - use code R-AFIT to order).

Diet changes

Certain foods are known to trigger rosacea flares, avoiding them can help manage symptoms. Common triggers are spicy foods, chocolate, citrus, cinnamon, alcohol, hot beverages, caffeine, and high histamine foods (like tomatoes, avocado, aged cheese, dried fruit, cured meats, smoked fish, vinegar, spinach, cashews, peanuts, walnuts, eggplant, and fermented foods). Inflammatory foods (refined sugars, processed junk foods, gluten, white flour, processed vegetable oils, and artificial sweeteners) can be triggering, too. Focus on an antiinflammatory diet, and foods high in:

• Omega-3 fatty acids (found in fish and flaxseed) to help reduce systemic inflammation.

• Antioxidant-rich fruits and vegetables to support skin health.

• Fiber to promote gut health and reduce inflammatory reactions in the body.

Topical and Natural Therapies

There are some natural, gentle options you can use on the skin to soothe without harsh side effects:

• Green tea extract: Rich in anti-inflammatory polyphenols, green tea has been shown to reduce redness and irritation.

• Colloidal oatmeal: Often used to calm sensitive skin and reduce inflammation.

• Niacinamide: A form of vitamin B3 that helps strengthen the skin barrier and reduce redness.

Stress Management

Stress is a major trigger for rosacea flares, and emotional or physical stress can make the condition worse. Managing stress is a critical, and regular exercise and adequate sleep are important, too!

Environmental and Lifestyle Changes

Environmental triggers including extreme temperatures, wind, ultra violet exposure, and even irritating skincare products can make rosacea worse. Avoid harsh cleansers and switch to gentle, fragrance-free products, use sunscreen daily to protect, and protect the skin from extreme weather with scarves or hats.

A Comprehensive Approach

Supporting the body’s natural healing processes while addressing the root causes of inflammation and immune dysfunction can help solve the problem, and provide long-term relief.

These natural strategies can make a big difference when dealing with rosacea, but if things get tough, don’t hesitate to get professional support!

Clinical Pearls:

Your skin is your largest organ. It protects your body, makes vitamin D, is important for detoxification, and much more.

Your gut microbiome is your second largest organ, and gut dysfunction can cause skin problems.

Reference

Rupa Health. (2023). Integrative Dermatology Approach to Rosacea. Rupa Health. Retrieved from https://www.rupahealth.com/post/integrative-dermatology-approach-to-rosacea. Accessed October 11, 2024.

Addressing Psoriasis

Photo credit: Breakingpic

Psoriasis

Psoriasis is an autoimmune condition that targets the skin, and plaques that result commonly show up on the elbows, knees, or scalp, but the plaques can show up anywhere on the body.

Normally your body produces new skin cells and sheds old ones every 28-30 days.

With psoriasis, your immune system is in overdrive, causing skin inflammation and skin cell turnover to occur faster than normal.

Instead of taking 28-30 days for skin cells to turnover, new cells are pushed to the surface in 3-4 days.

Because your body can’t shed the old dead cells as fast as new ones are being produced, they pile up and form thick, red, itchy, flaky, scaly patches called plaques, which may burn and sting.

The exact cause of psoriasis is unknown. There are various factors involved, however, and when they occur together, they result in autoimmunity and, for some people, the symptoms of psoriasis. 

There is scientific evidence that psoriasis is associated with differences in the gut microbiome when compared to the microbiomes of healthy individuals without psoriasis.

These differences can negatively impact the immune system by triggering specific, inflammatory immune responses.

These identified gut microbiome / immune system interactions suggest that by addressing gut microbiome imbalances, you can effectively address and manage psoriasis.

There is also long-standing scientific evidence that leaky gut plays a role.

What can you do?

There are a variety of nutrient needs common with skin conditions like psoriasis, including omega 3 fish oils, zinc, vitamin B2, niacin, vitamin A, vitamin C, and vitamin D. Eating foods rich in these nutrients, and others that are important for skin health, is paramount for healthy skin.

Think food first! If you want to supplement, test don’t guess! All nutrients work together in the body. Supplementing with individual nutrients can push others out of balance and cause additional problems.

Because psoriasis is associated with leaky gut, avoiding foods that contribute to gut hyperpermeability can help, including:

• Gluten

• Alcohol

• Nightshades (tomatoes, white potatoes, peppers [spicy, bell, etc.]), eggplant)

• Food additives

  • Sugar

  • Salt

  • Emulsifiers (found in processed baked goods, dairy, mayonnaise, sauces, ice cream, margarine, and convenience foods)

  • Organic solvents (used to produce edible oils like soy oil and are found as additives like stabilizers, preservatives, and flavorings)

  • Microbial transglutaminase (used in baked goods and conventionally raised/produced meat, fish and dairy for texture, appearance, hardness, preservability, and elasticity)

  • Nanoparticles (used to improve taste, color, uniformity and texture of foods, used in food packaging, or to kill bacteria)

Your skin is a detox organ, and adequate detoxification is important for healthy skin.

Toxin buildup that can’t be excreted via regular routes (liver to the bowels) can make its way out through the skin, causing flares. 

This can happen when phase 1 liver detox is pushed too hard, when phase 2 isn’t working as well as it should, and when there are gut problems.

In particular, it’s essential to have a bowel movement 1-3 times every day. If you’re not, addressing constipation is critical!

Diet plays a role in detox too, and there are a variety of nutrients necessary for supporting your body's detox pathways. Including foods in your diet rich in these nutrients is a good first step to improving detox function.

The skin has its own microbiome that needs to be addressed, and the skin microbiome also plays a role in the pathogenesis of psoriasis. There are various topical options to help support your skin microbiome and some that you should avoid.

Exercise, getting enough sleep, and stress management are examples of lifestyle factors that play a major role in your skin and overall health.