Got acne? If you are well over the age of 20 and have ruled out diet or lifestyle factors, there is a good chance you have hormonal acne. Acne caused by hormone imbalances is often found on your chin and jawline rather than the typical t-zone that we associate with teenagers.
Since I first opened up to you about my battle with acne in March, I’ve seen some promising improvements. I am addressing dietary fat and hormone imbalances, and in this article I’ll share exactly what I did and the steps you can take to begin getting to the root cause of your hormonal acne.
I’ll also share my “before” photo and my “current” photo, what it looks like right now in the process of healing. I’m not calling it an “after” because I’m not done yet! It took a lot of bravery for me to post those pics, so I hope you appreciate it! I share them for those of you who are struggling or have given up all together. I know how debilitating acne can be, and I want you to know that there is hope.
If you are struggling with acne you might be happy to know that I’m going to continue to post about my journey to clear skin in case it proves useful for you. To make sure you don’t miss any articles, sign up for my email newsletter on the sidebar or below this post.
To recap from my last acne post, my long-standing skin problems haven’t healed through the typical holistic advice – clean diet, fit lifestyle, good skincare, you know the drill.
Before you go saying it’s because I’m vegan or it’s because I eat so much fruit, let me tell you a little about my history. I have had acne through all my different diet incarnations over the last 18 years: mainstream meat-eater, dairy-loving vegetarian, whole-foods vegan, high-fat raw, and now low fat raw.
Obviously I’m not a medical professional, but I will share my own experience, what doctors have told me, what I have researched, and where you can find more info (and fact-check me!). If you want a basic holistic overview of some lifestyle elements linked to acne, especially diet, read this book. It’s written by Fran from High on Health, one of my go-to people for real-world acne advice.
It’s no secret that hormone fluctuations are linked to acne. Any teenage boy with pizza-face or woman who’s gotten a zit during her period knows this.
The reason adult hormonal acne is so hard to pinpoint and fix is that our endocrine system is complex with several hormones and different interactions. There are many ways the balance could be off. Go here for a good breakdown of your endocrine system as it relates to acne. If you really want to get into the nitty gritty of natural hormone balance, go here.
Stress elevates cortisol levels, and this can also play an important role and shouldn’t be forgotten. Just learning to manage your stress can positively impact hormonal imbalances.
What My Lab Results Showed
I didn’t mess around with assumptions. I got my blood work done and took the results to a trained professional. This included a full hormone panel as well as a lipid panel (cholesterol, triglycerides, etc.) and some of the major nutrients (Vitamin D, B12, Calcium, etc.).
Testing your Hormone Levels
The main three to test would be progesterone, estrogen, and testosterone. DHEA and cortisol are worth testing also if you can add them on.
I didn’t know this at the time, but a saliva test is actually more beneficial than a blood serum test when looking for imbalances in hormones. The saliva test measures your levels of bioavailable hormones while the blood test looks at all the hormones circulating in your blood regardless of whether they are free and available to cells. (source) You can order these tests online or at a local testing center.
What a Mainstream Gynecologist Says
Since I didn’t know any better, I ordered bloodwork at my routine annual. When my gyno found out that my period is irregular and I have acne, she lumped me into the seemingly catch-all category of Polycystic Ovary Syndrome (after knowing me for all of ten minutes) and wanted to put me on medication. She’s not the first to do that. We also scheduled a pelvic ultrasound to check to see whether I had any cysts (I didn’t).
Now, I’ve been through this diagnosis before, and the holistic doctor I’ve been working with for years says I don’t have PCOS. I’m inclined to trust his word since he has spent hours upon hours with my body and he knows me and my history so well by now. He is also interested in getting to the root of the problem rather than treating symptoms.
The first “option” the gyno gave me for PCOS was to put me back on birth control. I’m pretty sure my few years on the pill several years ago is still a major contributor to my current hormone imbalance. Another option was Metformin, the drug diabetics take to reduce insulin resistance. According to her, there is no cure, and I would be medicated for the rest of my life.
I’d rather figure out what is really wrong, thank you very much. My acne is a cry from my body saying there is something that I need to deal with, and I’m going to listen.
What a Holistic Doctor Says
When I took my lab results to my favorite holistic doctor, Dr. Bob (he’s a Chiropractic Kinesiologist), the first thing he said was I needed to start eating a little more fat. He also said that my hormones were unbalanced, not much of a surprise since it’s something we’ve worked on in the past.
Since adopting a low fat high raw lifestyle 6 months earlier, my fat intake had been about 6-8% total calories on average. It only took about half a year for my HDL cholesterol to drop below normal. For more information, check out my article “Low Fat Diets: How Low is Too Low?“.
Essential fatty acids play an important role in managing inflammation, e.g. the redness of your face. Turns out there was a direct correlation with the elevated inflammation I was seeing in my facial acne. What it taught me is that, yes, you can be too low in fat! A happy medium is worth striving for.
My Current Acne-Battling Program
I am currently taking (and have been for the last few months) a daily liquid DHEA and Pregnenolone supplement.
These are the two “master” hormones that are produced by our adrenal glands. This means that they are the precursors to all hormones (progesterone, estrogren, etc.) and actually convert into whichever hormone the body needs in order to achieve hormonal balance at any one time.
The goal was to give my hormones a little kickstart to get balanced and then hopefully I can remove the supplement and they will then maintain their own balance. Directly applying progesterone cream would be a more aggressive move.
So far, it seems to be working though not there yet. My face is getting clearer every week and (here comes an over-share) where I hadn’t had a period in over a year, I’ve seen some blood and spotting. It’s slow progress, but progress none the less.
I don’t recommend self-diagnosing when it comes to hormones. What I do recommend is finding your own local holistic professional who is willing to help you get to the root cause of your acne and hormone imbalances.
For a month, I took an Omega 3 supplement to get me back up to a healthy level.
I use Ovega-3 which is an algae-based (where the fish get it) source of DHA and EPA. I also made sure to get at least 2 Tbsp nuts or seeds or ¼ avocado each day along with my fruits and veggies. I was skipping this a lot before. (Shame on me.)
It’s worth mentioning another factor that I’ve changed though I’m pretty positive that my skin improvement is due to the hormone work. On my journey to minimalism and beauty product freedom, I’ve recently retired my skincare products and started doing the Oil Cleansing Method. I’ll talk all about that in a future post. Bottom line is that though I think it’s great for my face, I don’t think it’s the main reason I’m seeing results. I’ve made all kinds of skincare changes in my life (including a period of not doing anything) but always with minimal results.
After a month and a half of making sure I got some fat every day, I returned to Dr. Bob, and he said my fat level was back in the normal range. My skin inflammation was down, and it was noticeably clearer. To maintain the healthy fat level, I remain conscious of my fat intake and make sure that hemp seed, ground flax seed, or chia seed are a regular part of my life.
Dr. Bob also put me on molybdenum and aqueous zinc for a month and made sure I was being consistent with my B12 supplementation.
Overall, it seems I’m on the right track. Only time will tell. But after three months, my face is still slowly getting clearer. After 15 years of acne, I can be patient.
Update 07.20.13: I visited Dr. Bob yesterday, and he took me off the DHEA and said my hormones are now balanced. That makes about 4 months on it. I already had a 1-day period this past week, and now I’ll see if my hormones are able to stay balanced on their own.
Update 01.07.15: Read my latest update on how well my skin is doing HERE.
Steps You Can Take to Find the Root Cause of Your Acne
- Remember that acne is a tough nut to crack because it’s very individualized and since it can be the body’s external representation of many different internal issues.
So far my adult acne has been hormonal, but even knowing that, it’s still quite a complex challenge.
- Find a good holistic doctor who will help you get to the root cause.
And help you interpret your lab results. Online advice only goes so far. Since hormonal acne is so individual, you need to work closely with someone.
- Get a saliva/blood serum analysis done to determine hormone levels.
- Take pictures of your face, acne and all, every two weeks to visualize your progress.
Take your photo right when you wake up in the morning before washing or putting on makeup. This is a great way to determine whether the changes you make are working. When I looked at my photos from a month ago, I could tell my face was inflamed then and I can see the improvement I’ve made.
Implement your doctor-approved action plan. And realize that it will take time, but you should know if something is working within the first month (there will be subtle changes to your photos). Don’t be afraid to revisit and tweak your targets with your doctor.