The Naturopathic Approach to Acne

The treatment of acne can be a real challenge with Western medicine struggling to find effective as well as safe protocols for teenagers and adults. Western medicine generally treats acne with a combination of topical and oral medications that target underlying causes like bacteria, excess oil, clogged pores, and inflammation. Topical treatments include benzoyl peroxide, which kills acne-causing bacteria; salicylic acid, which unclogs pores; and retinoids (like tretinoin or adapalene) that promote cell turnover and prevent pore blockage. Oral antibiotics such as doxycycline or minocycline reduce bacterial growth and inflammation and are trialed for moderate to severe acne. For hormonal acne, particularly in women, doctors may prescribe oral contraceptives or anti-androgen drugs like spironolactone to regulate hormonal fluctuations that contribute to acne. Some individuals can even be prescribed Isotretinoin (Accutane), a powerful oral medication for severe, persistent acne that works by shrinking oil glands, drastically reducing oil production. It’s highly effective but requires careful monitoring due to potential but severe side effects.

At East Valley Naturopathic Doctors, our naturopathic treatment of acne may share some similar approaches as Western medicine but is also designed to treat the root causes without the use of toxic or damaging medications. Naturopathic therapy for acne proposes a three-pronged approach without the use of oral antibiotics that disrupt the gut microbiome or the use of dangerous medications such as Accutane. The first prong addresses the skin microbiome, the second the gut microbiome, and the third the localized skin congestion. 

SKIN MICROBIOME

Healthy appearing skin and the absence of acne, eczema, and rosacea largely depend upon the health of our skin microbiome. The skin microbiome refers to the community of microorganisms, including bacteria, fungi, viruses, and mites, that live on the surface of the skin. This complex ecosystem plays a vital role in maintaining skin health and overall well-being. First and most important, the microbiome acts as a protective barrier against pathogenic microorganisms by outcompeting them for resources and producing antimicrobial substances. It modulates the skin’s immune responses, reducing the risk of inflammatory conditions and infections. It also helps to retain moisture and prevent the entry of harmful substances. In addition, some microbes produce vitamins and other compounds beneficial to skin health. 

Although aging results in changes to the microbiome the three most common influences on the skin microbiome are diet, personal hygiene, and skincare routines. The use of soaps, lotions, and other skincare products can alter the balance of microorganisms on the skin for good or bad. And of course, poor nutrition, poor health, and stress also negatively impact the skin microbiome’s composition and function. Naturopathic medical doctors will often take advantage of safe topical products that target underlying causes like bacteria, excess oil, clogged pores, and inflammation. Topical treatments can include benzoyl peroxide, clindamycin lotion (a topical antibiotic not disruptive to the gut microbiome), which kills acne-causing bacteria; salicylic acid, which unclogs pores; and safer retinoids that promote cell turnover and prevent pore blockage. 

GUT MICROBIOME

Although it is important to have an effective and thoughtful personal skincare and hygiene routine, creating a healthy gut microbiome may be the most important key to promoting a healthy skin microbiome. There are several steps to consider to achieve this:

Intestinal Detox

The majority of inflammation arises from activity happening in the intestinal tract with fungi, yeast, parasites, and bacterial imbalances at the root of most concerns.

Candida

The presence and overgrowth of fungi, yeast, and candida in the intestinal tract causes inflammation in the intestines as well as the skin. It contributes to an imbalance of the gut microbiome and is often present where bloating, sugar cravings, fatigue, and brain fog are also complaints. Interventions can include a strict candida diet, antifungal nutrients, and herbs, or antifungal prescriptions to lower the yeast and fungal load that is hijacking the gut microbiome. 

Parasites

The presence and activity of parasites are often benign, but any sign of diarrhea, stomach pain, fatigue, and malabsorption of iron or other vitamins are suspicious symptoms arising from these ubiquitous bugs. Testing to discover specific worms or protozoa leads to more precise prescriptions and herbal therapy recommendations. Many patients report their skin health improving after treatment of intestinal parasites. 

Bacteria

The intestinal tract houses good and bad bacteria. When we measure the bacteria types and families through available microbiome test kits, we sometimes find more than enough bacteria (think SIBO), or way too little, or we see elevated counts of pathogenic bacteria. The imbalance of bacteria families and types can result in increased autoimmunity and overactive immune responses all resulting in more inflammation and abundance of free radicals aging our body and our skin. Testing of the gut microbiome leads to specific recommendations to improve balance and reduce toxic load with an emphasis on customized fermented probiotic-rich foods. Adding homemade coconut yogurt or kefir, or adding kimchi or sauerkraut, will elevate the diversity and balance of the most important immune barriers in the human body.

Whole Food Diet

The food choices we make provide various nutrients known to reduce inflammation, enhance detoxification, and support healing and regeneration of the body and skin.

1. For healthy skin, you should focus on a diet rich in vitamins, minerals, antioxidants, healthy fats, fiber, fermented foods, and protein. Besides maximizing the vital micro and macronutrients, this anti-aging diet leads to free radical protection, low inflammation, increased cellular detox, and reduced collagen degradation. This is accomplished best through choosing a fresh, organic, whole-food style diet. In comparison, the opposite to that would be a highly processed, packaged, non-organic, and fast food approach. Consider avoiding refined grains, sugar-sweetened beverages, and fried foods which contain trans and oxidized fats and imbalance Omega-3 to Omega-6 fatty ratios which are highly inflammatory. Other processed foods to avoid which are easy to identify by reading food labels include any processed food containing high fructose corn syrup, added preservatives to increase shelf life, GMO’s such as corn or soy, and vegetable oils such as soybean oil. Instead, incorporate a variety of fruits and vegetables, such as berries, oranges, spinach, and carrots, which are high in vitamins and antioxidants such as A(also Beta Carotene), C, E, Carotenoids, Lycopene, Lutein, and Zeaxanthin. These vitamins help repair and protect your skin by reducing damage from free radicals produced by UV light and pollution. Add fatty fish like salmon and mackerel which are excellent sources of omega-3 fatty acids, which can reduce inflammation and keep your skin moisturized. Replace vegetable oils with olive and avocado oils. Nuts and seeds, especially walnuts and flaxseeds, also provide essential fatty acids and zinc. Whole grains(whole cooked and not milled), like quinoa and brown rice, support skin health with their B vitamins and fiber. Additionally, stay hydrated by drinking plenty of water, and consider green tea for its anti-inflammatory and antioxidant properties. Limit processed foods, including added sugars, gluten or processed grains, and excessive dairy, which often exacerbate skin issues. A balanced diet combined with proper skincare, can significantly improve the appearance and health of your skin.
2. For a more individualized approach to determine the hidden sources of skin inflammation and acne consider an IgG food intolerance blood test. Testing can potentially help improve skin health by identifying specific foods that may be causing inflammatory responses in the body, which can manifest as skin issues including redness, irritation, acne, eczema, rashes, and premature aging. Here’s how it works:
   1. Identification of Trigger Foods: Following a simple blood draw, IgG tests measure the levels of IgG antibodies in response to specific foods. Elevated IgG levels suggest a sensitivity to those foods. By identifying these foods, you can adjust your diet to avoid them.
   2. Reduction of Inflammation: Food sensitivities can lead to chronic inflammation and disruption of the gut microbiome as well as the skin microbiome, negatively affecting skin health. By eliminating or reducing the intake of trigger foods, inflammation may decrease, potentially improving conditions like acne and eczema.
   3. Improved Gut Health: There is a strong connection between gut health and skin health, often referred to as the gut skin axis. Avoiding foods that cause sensitivities can improve gut health, create a healthier gut and skin microbiome, and improve skin health.
   4. Customized Diet: Personalized dietary changes based on IgG test results can help you identify and avoid foods that specifically affect your skin, leading to a clearer and healthier complexion, and removing some or much of the guesswork about what foods are safe and which are most likely to be harmful.
3. Probiotics: Include foods rich in probiotics like yogurt, kefir, sauerkraut, kimchi, and other fermented foods to boost beneficial bacteria in the gut. Better yet consider making your own customized yogurts based on your individual gut microbiome testing.
4. Prebiotics: Consume foods high in prebiotics, such as garlic, onions, leeks, asparagus, bananas, and whole grains, which feed the good bacteria.
5. Fiber: Eat a diet high in fiber from fruits, vegetables, legumes, and whole grains to support gut health and detoxification.
6. Diverse Diet: Maintain a diverse diet to encourage a diverse microbiome, which is associated with better health outcomes.
7. Hydration: Drink plenty of water to support overall digestion and a healthy gut lining

SKIN CONGESTION

Skin congestion describes the difficulty of the skin to detoxify properly and to heal and repair efficiently. The presence of androgenic hormones, oily skin, and a history of abnormal skin and gut microbiomes leads to localized skin congestion which favors chronic acne. Once the root causes of gut and skin microbiome imbalance are addressed, we can apply local microneedling therapy to remove the chronic congestion. The leading therapy for removing this type of congestion is SkinPen microneedling. 

By creating controlled micro-injuries in the skin, SkinPen triggers the body’s natural healing response, resulting in the production of new collagen and elastin, clearing congested skin as well as reducing acne scars, enlarged pores, and hyperpigmentation. The micro-injuries created by SkinPen encourage cell turnover, which helps to clear acne, fade scars, and reduce dark spots over time. It also improves skin texture by reducing the appearance of enlarged pores and evening out the skin’s surface. Furthermore, because SkinPen enhances the skin’s absorption capabilities, it allows for better penetration of topical skincare products, making them more effective in addressing specific concerns like hydration, brightening, and even anti-aging. 

Approaching acne treatment from these 3 specific arenas treats the root causes leading to a more perfect and permanent solution that is effective and safe. For more information on SkinPen or gut microbiome testing follow the links below.