Even thinking about adult acne makes me cringe. I mean really, anyone who has had big, fat, red zits as an adult can relate to the pain and even embarrassment of the unsightly blobs. My story is unique to me, because the last time I checked every physical body is different from another. There may still be parts of my experience to which you can relate. For those of you with acne who cannot relate to my story, keep reading! There are some strategies for acne-management that are still effective for you.
So, my zits were cystic and red and painful. They were hard round bumps that wouldn’t just go away either. Zits as a teenager came and went for me in like 2 or 3 days. As an adult they lingered, sometimes for months. I’m not kidding. It was awful. The discoloration of my skin was a reminder that haha, puberty might be over, but your hormones are still all jacked up. I just wanted to flip off mother nature while sarcastically saying, “Thanks for the experience.”
The first round of adult acne came in my mid to late 20s, perfectly timed right before I got married. At the time I was not fully integrated into the nutrition and functional medicine world as I am now, though I was resistant to taking oral medications for it. So, I decided to see a dermatologist, who quickly prescribed multiple creams that most teenagers use. Guest what, they didn’t work. Why? Because hello…I was not a teenager and, although I didn’t realize it at the time my acne was not a dermatological problem! The retinol A was so harsh on my skin that it made other areas breakout in red, itchy splotches. Round 2 of treatment came in the form of blue light therapy to which I did not respond well. On top of the treatment itself, I had to take steroids to control the inflammation and ran a low grade fever for several days. People were also scared to look at me for a good 2 weeks, during which time I got more zits. That was so frustrating, and I was mortified at what I had done to myself. The dermatologist office said it was just a bad reaction, but it was still “normal” and recommended that I come back in for another treatment. Um no thanks. Like any polite, skeptical patient, I just ignored their recommendation and never went back. So, after that I tried Proactive, which also didn’t work…duh…read the ingredients.
As I continued to seek solutions for my acne I also started noticing other signs of dysfunction. My blood sugar would drop too low after workouts and big meals, so my level of hangry was off the charts. I was stressed out all the time, worked too much and studied too much. I also had a bad habit of working out like a crazy person. And to bring it all together my menstrual cycle was unpleasantly unpredictable. For some one who wants to be the epitome of healthy, there was a lot of shit going wrong. Excuse my language, but I don’t feel hormone imbalances and adult acne are polite, so I don’t want to be polite when discussing it.
I finally found an osteopathic physician with a functional medicine approach. After changing my diet and taking a ton of supplements I finally had better control of most of my ailments and happily discovered my skin was clearing up. The good news is this lasted for several years. The bad news is I did not maintain all of those lifestyle changes and I got a fresh round of zits 8 years later.
Fast forward to now, when I have a master’s in dietetics, an obsession with functional medicine and access to quality food and supplements, and I am cured! Well, maybe cured is a strong word. I now have an understanding of what causes my zits and how to manage it. I have also gone through cycles of being willing to make necessary changes and seeing good results, then getting lax and living with more zits.
So, what’s my deal? I have poly cystic ovarian syndrome (PCOS). Approximately 5-10% of women of childbearing age have PCOS. There is not one singular test that diagnoses PCOS, rather it is a cluster of symptoms that may include weight gain, hormonal imbalances such as insulin resistance and excess androgens (fancy way of saying higher than normal testosterone levels), excess hair growth in unsightly areas (chin, upper lip, areolas), acne and multiple cysts on ovaries or enlarged ovaries. I’ve experienced all of these symptoms at one point or another. What’s even more exciting is that the hormone imbalances also cause mood swings and some of the more notable signs (excess hair and acne) really took a toll on my body image.
So, what did I do about it?
- Work with qualified health professionals to get the support I need for determining which changes are most important and what supplements may be most helpful FOR ME!
- Eat more fresh vegetables than any other type of food. I use the Environmental Working Group’s list of the Dirty Dozen and Clean 15 to guide me through the world of organics. I eat a minimum of 1 serving of vegetables with every meal. Most days I consume over 1 pound of vegetables.
- Limit fruit, avoid all fruit juices and shun all sugar sweetened beverages. Fruit is not bad because it contains a lot of great vitamins and minerals and it has fiber…yay fiber! Fruit does have a lot of naturally occurring sugar though. Because I have had insulin resistance and fluctuating blood sugar levels I do not need to add to the problem by dumping more sugar into it and making my body work harder. I typically eat 2 servings or less of fruit each day.
- Consume grass fed, free range animal products and wild caught fish. Conventionally raised animal products contain added hormones to increase the rate of growth and size of the animal. Clearly I do not need extra hormones, since as I mentioned earlier mine are all out of whack. Grass fed, free range or pasture-raised animals have some other health benefits, such as higher amounts of essential nutrients such as omega-3 fatty acids that fight inflammation and vitamin K2, among several others. (Explaining all the goodness of vitamins and minerals will have to be saved for another blog post.)
- Drink more water and less alcohol, in fact, avoid alcohol most of the time. I do not drink heavily, but I do enjoy wine and hard cider. I love dark beer, but don’t drink it anymore because it contains gluten. Alcohol itself is an endocrine disruptor, which is another fancy term with a simple meaning and basically sends your blood sugar on a roller coaster ride which is hard to control for several days after consumption. The beauty of drinking more water is that it helps us get rid of a variety of toxins.
- Avoid dairy, gluten, soy, nuts and seeds.
· Dairy is one of the most common food sensitivities. Dr. Sara Gottfried provides a great overview of dairy’s effect on hormones and health in The Hormone Reset Diet. Approximately 75% of people cannot make the enzyme, lactase, needed to breakdown lactose, which is the naturally occurring sugar found in milk. It is a major cause of inflammation for many people who are sensitive to a specific milk protein known as casein. Conventional dairy has also been linked to rises in growth hormone and insulin, both of which trigger fat deposition (increased weight gain) and blood sugar dysregulation. For me the bottom line is I get zits. No amount of scientific evidence is as strong as my own personal experience.
· Gluten is found in barley, wheat and rye. It is a food glue used in a gazillion different processed foods, most of which we are completely oblivious to because the food label does not say gluten, barley, wheat or rye. Gluten itself is a protein that provides structure to many baked goods. Unfortunately, it too is on the list of the top 8 most allergic foods. The problem is our guts really do not know what to do with gluten. When our guts are not working perfectly, which let’s face it most of our guts are not, gluten damages the tight junctions that maintain the integrity of our gut lining. When the gut lining is damaged the large gluten molecules can leak out of the gut and into the blood stream and cause a variety of reactions, such as skin rashes and acne, dry coughs and brain fog just to name a few.
· Soy, nuts and seeds are all plant-based food sources that may be very healthy for other people. For me though, these foods contain an excess of phytoestrogens. This plant-based version of the hormone estrogen found in the human body exacerbates hormonal imbalances. In my case it further increased estrogen dominance and made PMS symptoms even worse. I’ll spare you the details of my monthly discomforts, but suffice it to say I can control them through mindful eating and managing my hormones.
Let me also be super honest and say that despite knowing this information and understanding all of the science (which I did not include in the blog post…waiting on my future book deal for that…kidding), I still stopped and started dairy like 14 times. I am also well-aware that I have been “glutened” while dining out and on very rare occasions have knowingly consumed it. It also took me the longest to even recognize that I am not able to tolerate nuts and seeds. The bottom line is that this is a lifestyle change. It comes with the traditional learning curves of any change and has led me through a number of successes and failures along the way. All in all, I have learned a great deal about myself and how food affects my health.
Since I am still alive and well I cannot say “the end” to this story. The journey continues, but for now I am done sharing. Go forth and prosper, and I will do so gluten-free, dairy-free and nut-free. Be well.