Acne & Rosacea

Like it or not, our skin is our first impression to the world, it is what most people notice first and in part how they judge your appearance. This is what makes conditions like acne, rosacea and facial eczema or dermatitis so socially and psychologically debilitating. Acne has been found to have a moderate to severe impact on quality of life in adolescents especially, leading to low self-esteem, introversion, feeling embarrassed and depression. There have been amazing gains in the bare face movements and makeup free selfies that have taken over social media. Young people especially have begun to help each other accept all faces and skin types as normal and beautify, but there is still a long road ahead.

Our goal is to help you find a balance between skin care and beauty goals and having the confidence to love and accept your skin in all forms.

Why do we get Acne?

Acne is a pretty simple process that involves the steps below:

Excessive production of skin cells at the hair follicle
Blockage of that hair follicle, due to build up of skin cells
Excess sebum (natural skin oils) production
The presence or overgrowth of certain bacteria (Cutibacterium acnes or Propionibacterium acnes)
Inflammation

Genetics determine in large part the predisposition for most of the above causes of acne, but there are many natural and dietary interventions that can keep these acne triggers at bay.

Acne that stars at the onset of puberty is almost certainly your skin unable to react appropriately to the onslaught of hormones. The most common mechanism is increased testosterone production (in both males and females) leads to increased sebum and clogged pores. Adult acne is really a continuation of this process, basically your skin never adjusts and is continually out of balance – there is a large genetic component here, which is the only way to explain why some teen acne disappears quickly and others continue into adulthood.

Adult onset acne, or fluctuations in breakouts throughout your life is often due to changes in your hormones and level of inflammation. The most common causes of these changes are

Chronic stress – dysfunctional cortisol levels, increased inflammation and imbalanced hormones
Gut Health – The skin is a window into the gut! If you have inflammation in your gut from food sensitivities or allergies, imbalanced microbiome, immune based conditions like inflammatory bowel disease or Celiac’s, that is going to predispose your skin to major reactions.
Hormone changes – pregnancies, coming off birth control pills, perimenopause or other disruptions in your normal hormone cycles can feel like a return to puberty for some people, as your skin adjusts all over again to these changing hormone levels.

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Approaches to treatment

As there are typically many contributing causes to acne, eliminate it for good, we have to approach treatment from many angles.

Food Reactions – Both dairy and sugar have been shown to be associated with increased acne, but there may be other food reactions that are specific to you, and causing systemic inflammation. We will evaluate your diet and advise on which foods to eliminate. We may also recommend food sensitivity testing.

Gut Health – Along with food sensitivities, imbalances in the microbiome of your skin often start with the bacterial balance in your gut. We will evaluate and rebalance your gut microbes, possibly recommending probiotics or herbal antimicrobials.

Hormones – Testosterone or Androgens are associated with excess sebum production. If you have very oily skin, and breakouts that happen primarily along the chin, jaw line and back or shoulders – this may be a route cause for you. Androgens levels are in part genetically determined, but they are also stimulated by elevated insulin and blood sugar levels. That means that in these cases, diet changes can play a huge role in controlling acne. We will evaluate how likely hormone imbalance is based on your other symptoms, especially women’s menstrual cycles, but we may also require some testing to make a complete assessment.

Stress – Stress can affect acne in multiple ways. Cortisol levels rise when we are under acute stress, and chronically elevates levels have an impact on our other hormones, like estrogen, progesterone and testosterone. Not only does it have an affect on hormones, but stress also affects your digestive system, creating inflammation which leads to a leaky gut and systemic inflammation.

Supplements & Topical Prescriptions

Once we evaluate the root causes of your acne, we will put together a supplement package that will address your skin health from the inside out.

Your Clear Skin supplement package may include some of the following:

Collagen Building Blocks (for acne scars and aging skin)
- Vitamin A, C, E, Zinc
- Collagen peptides
- Botanicals like Horsetail (silica), Centella asiatica
- Amino acids like proline, glycine, lysine
Hormone Balancing
- Vitamin B6, 9, 12
- Saw Palmeto
- Chaste tree / vitex
- DIM / I3C / Calcium-d-glucarate
Stress Reduction
- Ashwagandha
- Licorice root
- Holy basil

Liver Detox
- Milk thistle, Dandelion
- N-acetyl cystine
- Intravenous glutathione
Anti-Inflammatory
- Fish oils
- Turmeric
- Boswellia
Gut Healing
- Probiotics
- Glutamine

Topical Products

Getting medicine right to the source!

Of course it’s absolutely critical to approach skin from the inside out, but let’s not forget that that topical medications or products can be used to fast track healing and ease breakouts in a pinch. Most conventional topical approaches are antibiotic based creams, or drying agents like benzoyl peroxide, or if you are lucky you might have been prescribed salicylic acid or even a retinol product. For some people, antibiotic creams or even pills work like a charm, but others find they are only effective for a short time, or not at all. This is likely because of bacterial resistance, something that is becoming a great problem with all types of antibiotics.

We can offer you compounded prescription medications that target a variety of your skin concerns. Some examples include:

Spironolactone 5% cream – has been show to reduce the size of cystic acne lesions by 50%
Nicinamide 5-10%
Azelaic acid 10-20%
Salacylic acid 2%
Retinol (Tretinoin 0.025-0.1%)

We will also make some recommendations for your skin care regime that might include the following:

Double cleanse with oil based and Low-pH cleanser
Tone skin with AHA or BHA based toner
Apply serums, treatments or topical prescriptions as needed for individual skin concerns
Moisturize, consider face oils

Rosacea

Rosacea is often confused with acne, as certain subtypes can appear in very much the same way. While it is not acne, it happens to be a condition that we can treat very effectively with Naturopathic Medicine.

Symptoms of Rosacea

Flushing and redness of the face, particularly over the nose and cheeks.
Bumps and pimples over the same area, but NO blackheads or oily skin (this distinguishes from acne)
Often dry and can be scaly or flaking, sometimes burning or stinging
Small visible blood vessels develop and skin may become thick and bumpy over time

The exact causes of Rosacea are unknown, but there are contributions from genetics, your gut and microbiome as well as systemic inflammation and your immune function. There are some lesser-known contributors to Rosacea that might not have been addressed by your medical doctor, these include:

IBS / SIBO – multiple studies (here is just one) have shown a high level of association between patients with bacterial overgrowth and rosacea
Zinc Deficiency – may be associated with Rosacea, and supplementation has been shown to be effective in some trials
H. Pylori infection (Common in GERD / Acid Reflux) – patients went through antibiotic treatment for h.pylori saw a reduction in their rosacea symptoms

Skincare Tips for Rosacea

Gentle cleansers, consider oil cleansing or low-pH cleansers
Choose products that have very simple ingredients and are fragrance free
Use sunscreen everyday, even if it isn’t sunny out
Protect your skin barrier by moisturizing everyday, look for ingredients like ceramides, squalene, centella asiatica, aloe vera, to calm and sooth sensitive skin.

Clear skin, balanced from the inside out

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