Is your acne hormonal?

How hormones can cause acne_by hormone expert and London based nutritionist Kay Ali

Photograph by Oliver Johnson.

Recently I’ve had an influx of clients coming to see me about their acne. It must be the time of year, as we gear up for party season. 99% of the time they’ll say the same thing. Something along the lines of… “I’ve battled with acne for years. I’ve tried everything. I’ve even been to see the doctor, dermatologist and nothing has helped. I think it’s my hormones. Help!”

It’s actually a narrative that’s close to my heart as I’ve battled with my own skin for many years. Let me tell you the cold truth, that no one told me. It could be your sex hormones. But then again, it might not. It could be stress hormones, but then again, maybe not. It could be your gut, blood sugar, nutritional deficiencies, toxins and maybe even food intolerances. But then again, it could be all of the above!

Our health is not 2D. We are complex machines (or more accurately, celestial beings), with trillions of biochemical and electrochemical reactions occurring every second of every day of every year of our lives. So much can go wrong! It’s great that we live in a world where information is so accessible and we can search and learn about the possibilities of what could be going on. But don’t be foolish. Dr Google is unregulated, not to mention, understanding your health is not as simple as stumbling across an article on how your sex hormones might be impacting your acne (ironic, I know).

Here me out. Whenever someone comes to see me, it’s important I manage their expectations as social media can often water down the reality of the hard work involved in establishing balance in health.

Your health can feel like a boat out at sea_analogy by hormone specialist and London based nutritionist Kay Ali

Photograph by Zoltan Tasi.

The truth is ill health, such as acne, is much like a boat out at sea with multiple anchors thrown. When you target an underlying imbalance, let’s say your hormones, it’s like pulling in one of those anchors. But if you’ve still got, 3 or 4 that are out (i.e. other imbalances that have not been supported), you still can’t get your boat moving.

Sometimes, your health can feel the same. In other words, your skin won’t clear up despite your efforts. There’s nothing more frustrating. But you have to keep an open mind that there could be multiple factors contributing to your acne (or other health problems). You’ll need to pull all the anchors in, one by one, before you see progress. This is why for many of you that have been to see a dermatologist and you were put on either antibiotics, the contraceptive pill, roaccutane or a topic treatment and it “didn’t work”, it could be that other factors are contributing to your acne that were not supported.

So, what could these anchors be? The most common are:

Food sensitivities

Is dairy and gluten causing your acne_by hormone specialist and London Nutritionist Kay Ali

Photography by Monica Grobowski.

Yes, it’s not an obvious cause, but it’s actually very common. Eating foods that you are sensitive to is a stress on your body. It triggers your immune system, driving inflammation. In turn, this can affect your gut health, which you’ll learn is instrumental for great skin (why else do dermatologists prescribe antibiotics?). But that’s not all, if the inflammation becomes systemic, this can affect hormone communication driving yet another factor that affects your skin. This is why I like to start off with pulling in this anchor first. Dairy and gluten are common culprits, but even eggs and peas can be problematic too. I prefer to test, rather than guess so we can be really accurate.

Nutrient deficiencies

Food is information that our body uses to carry out its function. And it’s the nutrients from the food we eat that ultimately do this; they are our building blocks. Given that there are multiple factors that affect your skin that rely on key nutrients, another good starting point is making sure that your nutrition is up to scratch.

Hormonal imbalances

Yes, it’s true, your hormones can drive acne. High androgens (like testosterone), can increase sebum production and promote acne. The pimples tend to be painful and inflamed around the chin and jaw-line. I often see this in cases of Polycystic Ovary Syndrome, a condition characterized by high androgens.

Poor blood sugar control

How sugar causes acne_by hormone specialist and London nutritionist Kay Ali

Photography by Heather Ford.

When your blood sugar levels are high it raises insulin. Insulin is the hormone that helps carry sugar from the blood and into your cells. But its affects are much bigger than that. It also influences how much testosterone you make, driving hormonal imbalances that contribute to hormonal acne. As if that’s not problematic enough, high blood sugar levels, trigger sugar crashes too. The surge in insulin quickly bring levels back down. This crash triggers stress hormones, which are also part of the acne conundrum.

Chronic stress

Cortisol – your fight or flight hormone, increases the androgens you make too. So, just like poor blood sugar balance, it can exacerbate how your sex hormones affect your skin. But that’s not all. If you’re pumping our too much cortisol due to stress stimulation, it promotes inflammation, suppresses your immune system (which means you don’t ward off infections on the skin very well) and dampens digestion too. The latter means higher risk for bacterial imbalances in the gut – another factor that affects skin health.

Poor gut health

Which brings me to my last common factor; bacterial imbalance in the gut. You might be surprised to learn that our bodies are like a ring donut. That’s to say, even when you put food in your mouth it hasn’t officially entered your body until it’s absorbed through the lining of your gastrointestinal tract. Viewed in this way, our gut is merely an extension of our skin. So it’s not surprising then, that imbalances in the gut has a ripple effect on our skin too. In fact, research has shown that overgrowth of P. Acnes bacteria increases risk of acne. Ensuring a healthy microbiome and happy gut is essential for good skin health.

As you can see there’s a lot that can contribute to your acne. This is why it’s important to keep an open and not develop tunnel vision, focusing on just one possible factor. As there are so many factors at play, I highly recommend working with a practitioner who can help you navigate through this and test any areas of your health that are necessary.