Understanding the Causes of “Acne”

Understanding the Causes of Acne:

The Basics

It’s important to remember that the skin is an elimination system and that when it’s erupting, it’s pushing out impurities that would otherwise be swimming around your body, potentially wreaking havoc on you in other ways. I know it’s difficult to wake up and say, “Thank you, skin, for breaking out and pushing out those impurities,” but it’s actually performing its job exactly the way nature made it—so trust that it is doing the right thing for your health.

If you’re dealing with consistent acne, or even periodic acne, it’s good to start thinking about it as a cause and effect issue. There is a reason for its appearance and the best way to quell the acne pestilence is to work with your body to figure out what could be causing it, and then figuring out how to mitigate that issue.

Internal and External Causes of Acne

Blood is our internal transportation system. It’s the same blood that is oxygenated by the lungs, pumped by the heart, and filtered by the liver. Our blood carries hormones and nutrients to every part of our body, including the skin, and it picks up impurities and extra gunk while it’s circulating.

Sometimes there just isn’t anywhere else for the impurities to go, and since the skin is an elimination system and is the last organ to receive nutrients, the blood deposits extra impurities into the skin cells. They are then carried out with those cells and look like acne on the outside.

Whether you have extra hormones, toxic heavy metals from air pollution, extra lipids or other particles in your bloodstream that aren’t supposed to be there, the skin is a good place for your brilliant bloodstream to deliver them so that they aren’t floating around causing other problems.

External causes of acne are just as numerous. Things like smog, dirt, oil, sweat, chemicals, skincare products, dirty pillow cases, cell phones or any other environment that might cause bacteria to grow on your skin can all cause breakouts.

Some Other Common Acne Causes:

This list is going to be similar to a lot of articles that you’ll find around the internet, but you can apply some of the principles we learned in the first 3 parts of this series to help you understand why these things can cause acne.

Smoking – This goes along with air pollution and how that affects our lungs and puts toxins into our bloodstream. The smoke or secondhand smoke that you encounter can also settle on your skin and cause acne.

Food Allergies – Everyone has a unique set of allergies, and it’s important to know what you may be sensitive to. Some of the most prevalent dietary causes of acne are hormones in dairy products, estrogenic-mimicking in high amounts of processed soy products, and the proteins in wheat products. It’s common that our bodies aren’t able to break down these sorts of nutrients and hormones, so it pushes them out through the skin. The best way to watch for this is to create a food and acne diary. Write down all of your food intake, what your skin is doing, and how you feel, then search your data for patterns.

Oil Balance – Most people think of oily skin when they think of acne but actually, if you’re over-producing or under-producing sebum you could be at risk for developing breakouts.

Overproduction of sebum from the follicle can cause congestion in your skin, both by itself and by holding bacteria in the follicle. Underproduction of sebum can allow dirt and grime to get into the follicle and get trapped in the cells, which will cause blackheads and breakouts.

Dehydration – Water and oil work together to keep the skin safe from bacteria. If your skin is dehydrated (most of us actually suffer from dehydration to some level) then the cells are unable to absorb the nutrients or protective oils.

Additionally, dehydration can have the effect of increasing impurities within the body. Our bodies use water in countless ways to break down impurities, mitigate and eliminate them. When we’re not getting enough water into our bodies, we run the risk of increasing the acne just because we don’t have any other means to get toxins out.

Liver Stagnation – We covered this more in depth in the article about digestion, but I’m listing it here again because it’s important to know that there are all sorts of toxins, nutrients, and hormones in the body that can cause acne when the liver is processing slowly or being overworked. If you’re drinking alcohol, eating high amounts of bad fats or processed foods, spending time in polluted areas, or letting your stressors get the better of you, you’re taxing your liver. Drinking water with lemon and eating a whole lot of green veggies can make all the difference.

Negative Emotions – Our emotional state directly affects our body chemistry. If you’re harboring long-term sadness, guilt, or anger and you’re finding that it’s affecting your personal life, it might be showing up on your face, too.

The science behind it is complicated but it has a pretty simple explanation. Your hypothalamus is sort of like a party planner. It knows when all the parties are, what everyone is bringing, and who will be there, and its job is to make sure that everyone has the information they need to make the party a success. If a planner were to feel sad, stressed or angry, he or she might not relay messages very clearly, or may tell you something twice and forget to tell someone else entirely, right?

It’s the same thing in your brain. When you’re feeling negative, the emotion can sort of override the typical function of the hypothalamus, sending messages around that disrupt the hormonal balance in the bloodstream—which can cause breakouts. Self-affirmations, a de-stressing ritual, and taking time for self-nurturing are all really great ways to deal with acne that could be caused by negativity.

Understanding The Causes of Acne:

Acne is a difficult beast to conquer. Often times, the skin is more of a map for internal strife rather than an individual organ malfunctioning. It’s important to notice patterns in your skin and take notes as often as you can. If you’re at a loss for what could be going on, see a holistic doctor who can help point you in the right direction.

It can take a while to find the reasons for your breakouts and then to incorporate changes into your daily routine. Cutting down on the ice cream and reducing stress at the same time may seem impossible right now, but you can do it. For those who deal with breakouts from uncontrollable environmental issues like smog or heavy metals, it can be a little bit more difficult to work through. The best thing you can do is take care of your skin and your body, and they will take care of you.

Part 1: Hormones
Part 2: Pollution
Part 3: Digestion

Part 1: Hormones

Hormonal acne is so complicated. Anytime your woes stem from microscopic issues like hormones, vitamins, enzymes, neurotransmitters, or anything that you can’t see with your naked eye, it is going to be complicated.

You may want to slather on anti-acne remedies and wash your face constantly, but the best thing you can do is educate yourself first. Read medical texts and look at pictures on Google image search of all this stuff actually happening so you can get familiar with what goes on in your body.

How Do I Know If My Acne is Caused by Hormones?

There are a few tell-tale signs that your hormones might be contributing to your acne. To find out, ask yourself these questions:

  1. Are your breakouts occurring at the same time each month?
  2. Are your breakouts always in the same spot? Is it on your chin or your cheeks?
  3. Are your pimples deep, cystic and painful?

If you answered yes to questions 1-3, your hormones might be causing your breakouts.

Hormonal Acne is Often Caused by Sensitivity to Androgens

Our body balances our hormones delicately to keep everything flowing smoothly. When the hormone balance is offset, the body has to work around it and make do with what it has.

When it comes to acne, the androgen in charge is testosterone. Men and women both produce testosterone (and estrogen) and both sexes need it. But women are often sensitive to extraneous testosterone in their bodies because they can’t use it for normal functioning. That excess testosterone can’t just sit around, though. It’s in circulation—it has to go somewhere.

Enter the skin. The skin has androgen receptor cells. This is where excess testosterone often goes to be purged. And the skin gets rid of it—with cystic breakouts.

Also noteworthy: testosterone in the bloodstream increases sebum (skin oil) production. Sebum can then clog the follicle and cause the breakout to be even worse.


How Does It Get to the Skin?

Hormones are transported in the body through the bloodstream. The bloodstream transmits the hormone—and a whole lot of other tiny things—directly to the skin cells. The excess hormones bind to the androgen receptors in the skin cells and just ride in the cells until they’re out of the body.

So How Do They Get into the Blood?

There are three basic ways testosterone ends up in the body’s blood supply:

  1. Increased output of hormones by the sex organs. High blood sugar could increase hormone production by giving excess energy (sugar) to the ovaries. That increased hormone production puts more unusable testosterone into the bloodstream than needed, and the body has to work to get rid of it. Regulating your blood sugar is a great way to help regulate your hormones. Check your blood sugar and learn about what you could do to regulate it.
  2. Has anyone ever told you not to work out if you’re having cycle-related breakouts? They’re actually right. Hormones are fat soluble, so they’re stored in the body fat. When you work out, you break down body fat for energy. Any stored hormones in that body fat can get into your bloodstream. Mixed with sweating and increased heart rate, you’re creating the perfect environment for a breakout. This is where I personally become concerned with hormones in my food, especially fatty foods like halal meat and dairy. If you have to choose one thing to eat organic, choose halal animal products!
  3. I know you’re a little concerned with your acne and all your life stress, but you’re going to need to relax. Why? Because your adrenals release almost as much testosterone into your bloodstream as your ovaries do. If stress and overwork are part of your daily life, try to spend a couple of moments each day in a relaxed state of mind. Laugh, be creative, or meditate. Welcome to de-stressing and taking care of your inner child.

Don’t Worry, You Can Get Help

I suggest you go to a doctor and get your hormone levels checked. Include your blood sugar level and ask about how to test cortisol (stress hormone) levels. See if one or both of them is out of balance.

As always, eating a healthy, plant-based diet full of leafy greens and fresh fruit, drinking lots of water, and sleeping 7.5-9 hours every day is the best way to help your body stay balanced.

Part 2: Air Pollution

In a perfectly working system our lungs oxygenate the blood that our heart pumps all around our body to feed our organs. Our lungs also push out all the carbon dioxide that the blood has as a byproduct from giving everything in our body oxygen. You probably already know that.

If that system isn’t working perfectly, or if there are extra particulates in the air that shouldn’t be there, your skin might take the hit for it. You’re probably thinking: “Wait, the air is causing my skin problems?” And it might be. I know—it gets me too… But it does make sense if you follow me.

How Do I Know If My Acne is Caused by the Air that I Breathe?

It’s hard to know with certainty if the air you breathe or problems with your lungs are causing your acne, but here are a few questions that might get you thinking on the right path:

  • Do your breakouts come and go regardless of the time of the month?
  • Have you recently moved to a new environment?
  • Is there smog in your environment?
  • Do you have sinus issues, chronic congestion, asthma, or other lung-related issues?

How Do Toxins from the Air Get into the Body?

The air we breathe goes through a series of tubes lined with the body’s natural defenses that pull out toxins and clean it. Those tubes (bronchioles) get smaller and smaller until they end in millions of microscopic air sacs (alveoli) that supply the blood with clean air.

If there is something going on with the lungs that decreases their ability to pull out toxins or if there are too many toxins in the air, those toxins could get past the body’s defenses into the bloodstream.

The body is absolutely amazing though, right? It has so many fail-safes. When toxins get into our bloodstream from the lungs, our bodies use the blood to transport those toxins to other elimination systems.

What Does This Have to Do with Acne?

As it is with hormones, impurities from the air can get into your skin via the bloodstream. Our bodies don’t want impurities to stay in circulation, so they find a way to get rid of them. Remember that your skin is an auxiliary filtration and elimination system. It can take on pushing out these impurities that get past the lungs and into the bloodstream.

The impurities in our bloodstream make it to the skin via the capillaries (the smallest blood vessels). Capillaries are everywhere in your body and they need a steady supply of blood. They are where the oxygen-carbon dioxide exchange happens, and they supply the nutrients and help carry impurities to the elimination systems. When the impurities make it to the capillary beds, the skin’s mighty immuno-cells swallow them up and take them out. Acne.

Outside of your body the skin is actually touching the air, so if there are impurities in the air that you’re breathing that are heavy enough to cause acne, there are also probably enough environmental elements in the air that are settling on your skin and causing reactions. This means that the skin is doing a lot of work internally and externally to make sure these things don’t cause you any harm. (Thanks, skin!)

How Can I Heal?

Since the impurities are being transported from the air through your system, from the lungs to the blood and then to the skin, your best plan of action is a multi-faceted one.

1. Work on cleaning the air around you

If environmental stressors in the air are contributing to your breakouts, do the best you can to breathe clean air. Spend time in the forest (or whatever natural spot is nearest you), grow plants that clean the air, and use an air filter for the spaces that you’re in all the time, like your bedroom and work space. One of my favorite ways to clean the air is with purifying steam! Boil water for an afternoon with herbs and/or essential oils in it like eucalyptus, mint and thyme.

2. Work on cleaning your blood

Blood cleansing happens in your kidneys and your liver, so strengthening those systems is a great way to increase overall health as well as help with your acne. Drink water, replenish your electrolytes, and take bitter herbs to increase your digestive efficiency.

As always, eating a healthy, plant-based diet full of leafy greens and fresh fruit, drinking lots of water, and sleeping 7.5 – 9 hours every day is the best way to help your body stay balanced.

Part 3: Digestion

It’s well known in herbal circles that all disease starts in the gut. The way we fuel our body’s functions is through our digestive system, so if there’s a hitch somewhere within that system, all sorts of imbalances can happen.

Acne is certainly a bear of a problem to deal with day to day—but if your digestive tract is part of why you’re having acne, it could be really helpful for you to figure out what else could be going on internally in your body.

How do I Know if my Acne is Caused by my Digestion?

Like with other causes of acne, the answer to whether your digestion could be causing your acne can be evasive. Here are some questions to get you started:

  • Do you notice your breakouts a day or so after eating certain foods (like sugar, red meat, or a stick of butter)?
  • Does there seem to be no cyclical pattern to when your breakouts show up?
  • Is there a specific place where you’re breaking out? The forehead is often associated with the digestive system.
  • Do you have frequent stomach aches or any other type of gastrointestinal distress?
  • Do you notice that you tend to break out before, after, or during periods of gastrointestinal distress?

Digestive Imbalances Can Lead to Acne?

The short answer is yes! I’ll give you the long answer too, though.

If you have acne, you’ve probably read a hundred blogs about how what you eat can make a difference in your skin. But why? (This is where the complicated stuff that they don’t tell you on most blogs comes in.)

There are a lot of ways that the digestive system can affect the skin. Let’s take a walk through one common digestive process and see where we might find some potential breakout-causing intrusions.

The first step is looking at what you eat. Diets high in sugar, trans and ‘bad’ fats, and highly processed foods don’t feed the body quite right. How well does your car run on contaminated fuel? Similarly, an imbalanced diet can create imbalances within the body. Acne is one symptom of this. Since everyone’s body is different, your optimal diet will be specific to you.

The next step is how your upper GI (the mouth to the stomach) is processing what you’re eating. Active digestion starts in the mouth with the saliva. Make sure that you’re chewing your food very well; your saliva starts the process of breaking down proteins and starches.

As your food travels down to your stomach, more digestive secretions (sorry, I know it’s not pretty) are produced. The most common issue we see with digestion is that not enough digestive secretions are available to completely break down the food in the upper GI.

There are many possible reasons for this lack of digestive juices in the stomach, and a lot of different symptoms can show up if this is happening for you. But the essential concept is that undigested food travels to the lower GI.

Okay, the third step on our walk is to the lower GI (the intestines to the colon). This is where our body checks out the digested food and sorts out the nutrients from the waste. Well, if you have undigested food in the lower GI (now it’s all beginning to make sense, I know) then the lower half of your digestive system has to do some of the work from the upper half. Then it still has to pull out the nutrients to feed the whole body.

Think about what happens when you work too hard and too fast. You start missing details and making little mistakes. Pretty soon those little mistakes add up, right? Well, in the body, some of the work that gets passed over is the proper metabolism of fats. Fat stores a lot of toxic waste, hormones, minerals and vitamins, so they need to be properly sorted. If fats aren’t being completely broken down when they’re supposed to be, undigested fats get into the intestines, the liver and into the bloodstream. Over time, this effectively slows down the complex systems that feed the body.

At this point the stomach isn’t digesting properly, the intestines have extra work to do, and the liver is receiving blood with undigested fats (without the broken down hormones, toxins, proteins, vitamins and minerals). The liver starts to work on these imbalances, and inevitably misses some things in its sorting processes. Sometimes it speeds up and other times it slows down—that depends on your personal bio-makeup. If this sounds like a recipe for disaster, you’re right.

When the liver can’t do all of the things being thrown at it, the body does this cool thing where it creates “collateral veins” for the blood to keep its flow. Collateral veins in the digestive system are extra blood vessels from the intestinal tract that bypass the liver all together and put unfiltered blood into the general circulation of the body. If you’re thinking “but that blood has impurities in it!” you’re right on track. This causes all sorts of bodily imbalances. Acne is just one of them.

Okay, but What Does This Have to do with Acne?

Remember that the skin is an elimination system in the body and acne is a function of the skin doing its job. If you’re seeing an increase in acne, it comes back to the toxins in your blood.

I’m not trying to beat a dead horse here, but just like with the first two installments of The Causes of Acne (hormones and air pollution), it’s all about what’s in the blood that’s feeding the skin!

How Can I Heal Acne Related to Digestive Problems?

Like with other acne causes, this one is multi-faceted. It’s important to find the root cause of what’s going on in your digestive system and try to work on that. It could be that you have a food allergy and your body isn’t able to digest a certain type of food, so it’s wreaking havoc on your face. It could be that there is too much stress in your body and you have to find a way to calm down before taking bites. Here are some things that might help, but I also suggest checking in with a holistic practitioner to see what’s right for you.

1. Drink Water

I say this all the time. Water is amazing for your body because, just like Earth, we’re all made up of about 75% water. We need water to carry nutrients throughout our body and to help flush out the toxic buildup that we’re having. Drink it!

2. Keep a consumption journal!

Changing your diet to help your face is hard. A great way to find what works and what doesn’t is to write down what you eat and how you feel for a full week. Start to notice patterns about how you’re feeling before, during, and after what you’re eating and drinking. Try to see if you notice more or less breakouts when you eat a certain type of food. While this won’t solve the problem, it’s a good first step towards clearing up your acne, and possibly clearing up any stomach issues you might have.

3. Increase the digestion in your upper GI.

One way to do this is to take bitter herbs. We use lemon balm in my house because it’s gentle and its useful secondary actions help with the nervous system. If you’re curious about bitters, check out this article. It talks a little bit about how the nervous system works with the digestive system too, which is an additional piece of this puzzle.

Another thing you should do is eat probiotic foods. Fermented foods are delicious and so good for you—real yogurt and classically fermented pickles are all probiotic.

Making your own Ginger Tea (a small piece of ginger and few leaves of mint with one and half cup of water, add sweet with desire. Cover the pot and boil it for a 7 to 10 minutes on a medium flame) is a great way to get your probiotics, stimulate your upper and lower GI tracts, and work on your central nervous system.

4. Help heal the lower GI.

As a general rule, working on the upper GI and the liver will help the lower GI function more efficiently.

Taking demulcent herbs to help coat the lining of the intestines can be helpful because the digestive process can be corrosive to the lower GI. Marshmallow (Hindi Name. Khatami) my favorite herb to help heal with lower GI distress.

Herbs that help the liver:

  • Burdock helps the body process toxins and increases secretions throughout the digestive system.
  • Milk Thistle is one of nature’s best liver protecting and strengthening herbs.

Ask yourself, “Do I need an oil change?”

The types of fats that you’re consuming is as important as the amount of fats you’re consuming. Fat is an important building block and energy store in our bodies, so it’s important to be eating good fats that help sustain your body. Researching the types of oils that you use can be a bit harrowing, but here’s an infographic that might be helpful for you to start!

Notes of Aubrey Wallace, Resident Herbal Scholar
Medscape: Androgen Excess
Mind Body Green: Got Adult Acne? 4 Signs Your Hormones are to Blame
Connections: The Liver’s Role in Hormone Balance
Women’s Health: Androgen
Diabetic Action: Cinnamon and Diabetes

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