A functional approach to acne

A Functional Approach To Acne

Episode 47

Acne is a common condition affecting millions of Americans of all ages. While usually regarded as a cosmetic issue, acne can be the herald of a much deeper problem hiding within the body. The skin is a beautiful organ with numerous functions, and dysregulation in its function can cause acne.
This episode discusses:

☑️The skin’s functions

☑️How acne forms

☑️The root cause of acne

☑️How you can holistically heal your skin

Lifestyle Medicine with Dr. Harris

5 Pillars of Great Health Wellness Program

Free Personalized Lifestyle Assessment

Episode Transcript

Dr. Richard Harris: Hello, and welcome to the Strive for Great Health Podcast. I’m your host, Dr. Richard Harris. And this episode is the idea of my lovely wife, Brittany Harris. So thank you, baby, for this wonderful idea. And also, I just want to thank my Lord and Savior, Jesus Christ, for allowing me to come and speak with you guys today.

Thank you, guys, for listening. I really do love the interaction I get with my listeners. It’s been amazing. And so, thank you for being with me on this ride. I’m still trying to figure out this whole podcasting thing, but you know, we keep it moving. We keep it going. And we’re going to jump into what we’re talking about today, and that’s a functional approach to acne.

So what is acne? So hair follicles become plugged with oil and dead skin cells. And that can also be pores. One of the two that gets clogged, and that causes inflammation. And that can cause what we know as acne. So there’s multiple different types of acne. There’s the whiteheads, which are also called closed comedones.

So if you want to be at a party and say something intelligent and be like, hey, I opened up my comedones today. Don’t do that. You’re not going to be cool. All right. Let’s jump back in. cause I’m not funny. Uh, blackheads. These are open comedones, so they’re open pores that are plugged. They’re not plugged all the way, but they’re plugged pores.

Whiteheads are close pores. It’s all there, completely closed. So that’s why it’s a closed comedone. And that’s why it’s open comedones. You can have small tender bumps, the medical term for this as papules, you can have large bumps underneath the skin., so these are nodules, and you can have painful pus-filled lumps, and that’s cystic acne, which is usually the most common type of acne in adults.

So just some stats on acne, 50% of teens will experience acne. I know I did. Uh, but it cleared up; most of it will clear up in their twenties. Some people, however, it persists into their fifties. And most of the people who it doesn’t clear up are women, usually women between the ages of 20 and 35; there’s some data that shows it up to 50% of women may have some form of acne past their teenage years.

And adult acne is usually cystic. It’s usually on the lower half of the face. , where teens is mostly on the upper half, and it’s sometimes on the neck, chest, and back area as well, but usually the lower half of the face, usually below the nose, usually around the lips and chin area. So what, what are the functions of skin?

All right. Cause to know about acne; we have to know [00:03:00] what the skin’s job is to know what causes acne. We have to know what the skin is doing. So the first function of the skin is a barrier function is a protective function. It protects us from chemicals in the environment from getting in our bloodstream, uh, bacteria and fungus and all those foreign invaders from getting in the skin actually has immune cells that help survey the environment and helps protect things that aren’t supposed to get in from getting in. The skin is also an elimination organ. It’s actually the biggest elimination organ in the body. Your skin is the biggest detoxifying organ in the body, and your skin is actually an organ.

And one of the ways we do that is through sweating. We eliminate toxins through sweating. The skin also helps us regulate temperature. How’s it do that well there’s convection, which is like cooling air or water on the surface of the skin. There’s conduction, which is transferring the heat to another object.

It’s like when you sit on a cold chair; the chair gets warm because you’ve transferred your heat to that heat. And then there’s irradiation, which sounds like, you know, we’re all about to become Bruce Banner and get gamma rays. But all that means is you transfer heat to another object without touching it.

And there’s perspiration and then which is sweating and then evaporation so that water converts the gas, and that actually cools our skin. Another way skin helps regulate temperatures., it helps to divert blood from the skin to keep us warm. So it’ll divert blood from going to the skin where it can exchange heat with the environment to our internal organs.

The skin helps us sense our external environment; touch, that’s extremely important. It’s extremely important to know what’s going on in our environment around us. Your skin also has absorption functions. Yes, it does function as a barrier, and it does function to protect us, but your skin can absorb things that are placed on it as well.

More on that in a minute. And as we talked about in the vitamin D podcast, your skin helps synthesize vitamin D and other related compounds. So let’s talk about a function of the skin, of what we call the sebaceous glands. So the sebaceous gland secretes something called sebum, and it’s an oily and waxy substance, and it’s meant to protect, moisturize, and coat our skin.

It is a natural oil made by the skin, and the highest concentration of these glands are on the face. It may have antioxidant and antimicrobial properties. And the reason teens get a lot more acne is one cause of hormonal changes. But those hormonal changes cause two, a 500 times increase in sebum production.

So they have more of this oil. That’s [00:06:00] clogging up more of the hair follicles and sweat glands and pores. And that’s leading to acne. So at the surface level, what causes acne, excess oil production, clogged follicles and pores, sweat glands, bacteria inflammation. Let’s dive more into the root causes of these things.

One of the main root causes of acne is hormone imbalances. One of the things that you can see is what we call estrogen dominance. And that’s where you’re making too much of the bad type of estrogen, or your estrogen to progesterone ratio was off. And this can be due to gene abnormalities. You can have an abnormality in a gene called COMT, which is involved with estrogen metabolism.

You know, that’s something that we test for on some of our [00:07:00] genetic tests. You can have toxins that mimic estrogens or imbalance hormones; those toxins that mimic estrogens are called Xenoestrogens. And so these are not our body’s own natural estrogen, but they bind to our body’s own natural estrogen receptors and cause problems.

There are many toxins that imbalance our hormones. And we talked about that in the toxin podcast. I also talk about that a lot in my wellness class; I just updated my wellness classes with a whole section on avoiding toxins because it’s so important. And they’re one of the main reasons why our hormones are imbalanced.

Unbalanced. I talk good. Sometimes mood swings. These are symptoms of hormone imbalance, headaches, anxiety, weight, gain bloating, but [00:08:00] another common cause of estrogen dominance is birth control pills. On the other side of the hormone coin, you’re going to have excess androgens. Androgens are typically thought of, of the, as the male sex hormone, but they increase sebum production.

So PCOS, which is a state that is extrinsically linked with hormone abnormalities, usually excess testosterone, but also is related to insulin resistance, is a state where you can see a lot of acne, and that’s because of increases sebum production. It can be genetic.  Stress is a big one. So stress unbalances our hormones.

And so you get more cortisol production, which decreases the production of [00:09:00] progesterone, which can lead to that estrogen dominance we talked about, but stress can also cause some issues with blood sugars. So insulin resistance is a major cause of acne. That’s why another reason why PCOS patients have a lot of acne.

And the reason for this is the high intake of processed foods, sugars, and carbohydrates increases IGF-1. So if you eat a lot of processed foods, That’s associated with insulin resistance. Every 10% increase in processed foods, you intake increases your risk of developing diabetes, which if you listen to the insulin resistance podcasts, insulin resistance is an underlying mechanism of diabetes.

So 10% increase in processed foods,15% increase in the risk of diabetes, Sugar consumption, excess [00:10:00] carbohydrates, especially refined processed carbohydrates. You get insulin resistance. But what happens in that insulin resistance is they actually have a high insulin state, which increases IGF-1 and high IGF-1 actually increases sebum production.

Another reason nutrition is associated with acne is because sebum is a natural fat; it’s made from the fats that we intake.

So if you’re eating poor quality fats, you’re going to have poor quality oil. You know Dr. Ziglar, and I talked about this on the eye health podcast about anything that our body’s using to make our own natural oils. If you’re eating poor quality oils, your body’s gonna make poor quality oil. So poor quality fats coming in equals poor quality fats going out.  Poor quality oils going out. And just all by itself, insulin resistance also stimulate sebum production. So you’re starting to see nutrition could be a major impact on acne, but it’s also due to food sensitivities. And we talked about the difference between food sensitivities and true allergies on our food sensitivity and allergy podcast.

We’re not talking about, in this case, overt IgE, you know, those anaphylactic, those severe throat closing,  lung filling up with fluid, can’t breathe, wheezing, that kind of allergy. This is more of a low level; causes migraines or acne or skin rashes or bloating, abdominal pain, fatigue type sensitivity. One of the main ones is gluten.

Gluten has been associated with skin abnormalities, and that’s with celiac disease, and that’s with non-celiac gluten sensitivity, which is actually a real thing. We see this all the time.

Microbiome imbalance. Microbiome is so huge when it comes to our overall health; there is a gut skin access. If you have dysbiosis, and we talked about the causes and what you can do for dysbiosis in the dysbiosis podcast that increases inflammation, causes hormone impairment, causes inflammation, which I just said twice.

I’m on a roll today, guys, and this can lead to acne. So dysbiosis can lead to leaky gut. And what can happen with leaky gut is that you’re getting toxins that are moving out of the intestines and may deposit in the skin. And there’s some evidence that [00:13:00] phenol and para-cresol, which are two markers of dysbiosis, they’re two bacterial products that are made when our gut is out of balance, accumulate in the skin. And there’s some evidence that these reduce skin barrier integrity by reducing keratin. Keratin is one of the main molecules that helps keep our skin tight. Keeps our skin hydrated.  Dysbiosis has also been associated with dermatitis, psoriasis, and acne.

You can also have skin dysbiosis. So before I was talking about microbiome with the gut dysbiosis, but you can also have skin dysbiosis, local skin, imbalanced bacteria, and this can cause localized inflammation, and this can increase sebum production, which is going to clog up those pores, which is going to cause acne.

Also, a pretty interesting fact is that C-sections are associated with increased risk of developing acne. And the reason for this is vaginal delivery. The microbiome of the of the child is more closely related to the intestinal microbiome of the mother. More lactobacillus, more prevotella. While a C-section is more likely related to the microbiome of the skin, more staph, more corynebacterium, and more propionibacterium, which is maybe one of the main causes of acne.

Now the whole propionibacterium acne or P acne, or, you know, some people are trying to rename it, C acne. You can just think of it as maybe the acne-causing bacteria. It is a normal part of our flora. But there are certain subtypes which are more [00:15:00] prone to causing inflammation and sebum production.

And this happened with skin dysbiosis when that normal skin flora is altered, and those subtypes that cause more sebum production are shown to do so by inducing more of that IGF-1. It’s pretty interesting. Some studies have shown that a topical solution of lactobacilli or lactobacteria, whichever you want to say, can reduce staph colonization on the skin and help reduce skin pH.

So what can happen if there, if the skin pH is disrupted, usually through too much cleaning, and we’ll talk about that in a minute. The pH it actually increases. And then you can get some bacteria to grow that are not supposed to be part of our [00:16:00] normal skin flora, and that can cause skin dysbiosis. And so lactobacilli topically applied was shown to reduce staff colonization and reduce skin pH, helping to restore that normal skin flora.

So what’s another cause, impaired detoxification/toxin overload. And so we talked about this a lot with our toxin podcast. This is environmental toxins, synthetic toxins, makeup, and personal care products. You know this is some, I fought with my wife for, for a long time. You know, I always tell her she looks the most beautiful when we wake up in the morning, and it’s just her and me.

And she looks gorgeous to me. She never believes me, but I tell her that all the time. And I always told her, look, I think you look the most beautiful without makeup. And she used to wear a lot of makeup, and she would have problems with cystic acne and that improved when she [00:17:00] stopped wearing so much makeup, I’m like, listen, this is full of toxins.

These personal care products are full of toxins. And we’ll talk about what you can do to check your personal care products in a minute. But if you’re having issues with your liver, if you’re having issues with your gallbladder issues with constipation, if you’re dehydrated, if you’re not moving, you’re not going to move toxins out of your system.

We’ve talked about the lymphatic system. It’s our other system in our body. You know, we think about veins moving fluid back to the to the heart and arteries, moving fluid to the body, to the tissue, or the lymphatics also help drain toxins from our tissues. So it only works. If you move, if you’re not moving, your lymphatic system kind of just sits there.

It needs muscle contraction to work because it’s a low-pressure system. If you’re dehydrated. You’re not getting enough [00:18:00] blood flow to your kidneys, and then your kidneys are not filtering. Your liver is not filtering. If you’re constipated all the time, you’re not helping toxins to move through your digestive track.

You know, we talked about fiber, we talked about bile acids, both of those bind up toxins that we ingest and help excrete them. So they’re not taken into the bloodstream. And then the liver also, there’s something called the first-pass effect. So the liver will get toxins from the blood from the gut before it hits the bloodstream, metabolize them and help them to be removed from the system.

So all of these things can actually impact acne. Stress., again, stress is a major factor. Inflammation increases sebum production. It changes the way the steroids work on the skin, causes hormone imbalances increases insulin resistance. So you have to control your stress and then over cleaning the skin. So we have a huge phobia of bacteria in this country when we don’t really don’t need to our, our, our fear of bacteria is causing issues. We’re overusing antibiotics; we’re overusing antimicrobial skin, cleaners, and washes. Our normal flora is there to help us. We absolutely needed; it is so essential to your health, so if you’re over-cleaning your skin, especially with some of these skincare products.

You’re removing good bacteria, which is leading the dysbiosis in the skin. Also, many of these products are what we call astringent. These are drying agents, and that can actually paradoxically lead to increased sebum production, more inflammation, [00:20:00] irritation, and then worse in the skin dysbiosis. So how do we treat this holistically?

Well, there are some supplements that can help; Vitamin A can reduce sebum production. If it’s overproducing. Zinc helps regulate the immune system. It’s involved with skin healing, and it can help fight dysbiosis. If the problem is you’re not making high-quality oils, using high-quality oils can help.

And so, fish oil helps us produce cleaner sebum, decreases inflammation, and decreases IGF-1. Some products will have evening Primrose oil. It’s an anti-inflammatory fatty acid. It’s actually an Omega six fatty acid, but it’s actually an anti-inflammatory Omega six fatty acid.  Saw Palmetto can help balance hormones, and it can help reduce facial hair and acne in women.

Coconut oil. It’s a great moisturizing agent; it’s antimicrobial. And so a lot of products contain coconut oil, where people just put organic virgin coconut oil on their skin. I put it on my hands. It does great for keeping my hands moisturized. CBD, you’re seeing a lot of CBD skincare products. I’m a huge fan of CBD.

You can check out our CBD podcast, but it’s anti-inflammatory, it’s hydrating. It’s antimicrobial. Collagen,  collagen is a primary building blocks of connective tissue; it helps anchor your skin. It helps your skin function properly as a barrier. It helps keep your skin hydrated.

Apple cider vinegar. There’s some data that shows that using Apple cider vinegar as a rinse can help with eczema, it can help balance the skin pH, and then Vitamin D. Vitamin D is made locally in the skin and has helps the skin with, uh, [00:22:00] inflammation with uh antioxidation. And then there’s some Vitamin D byproducts that are made when heat hits a vitamin D in the skin that actually have some anti-tumor properties and helps the skin stay healthy

Detoxification. If the problem is that there’s too many toxins and you’re eliminating them through the skin, which is causing inflammation, you want to detox. So glutathione, exercise, sauna, making sure you’re hydrated. These are all very important things we talk about in the detoxification podcasts. You want to use gentle cleaning products and hydration products.

So I highly recommend that everyone checks out either environmental working group or EWG and their skin deep cosmetic database. This lets you know some information about the products you’re using and the effects it can have on your health. [00:23:00] If there’s dysbiosis, prebiotics or probiotics can help. And there are even probiotic skin creams that you can use locally to help with that local skin dysbiosis.

If stress is a problem, stress management and proper sleep are essential. So that’s one of the things that I worked with Brittany on was stress. And when we were able to get her stress levels down, her acne improved. Hormone balance. If the hormones are out of whack and that’s causing acne, we need to balance the hormones.

And we have a whole podcast on hormones as a root cause of chronic disease and how what you can do to balance your hormones. And, of course, nutrition. So always, always, always, always, always nutrition. The most important thing for your health that you do every day is what you put in your body. [00:24:00] Whole food, nutrition plan.

Avoid those simple sugars. Those refined carbs use low glycemic index, carbs, fruits and vegetables, berries, citrus fruits, avoid sugar-flour in gluten. If you’re having acne, that could be a major trigger for you. You want to avoid dairy products treated with hormones because that could be causing your hormones to be out of whack.

And you want to add bone broth; bone broth is healing for the gut. It has collagen. So it’ll help work on your gut and your skin at the same time.

So this has been a podcast focused on something that is a cosmetic issue, but that cosmetic issue usually has some underlying health implications and associations. So when I see someone struggling with acne, I’m thinking, okay, there’s some underlying issues here that we need to address that could manifest itself as another disease later in life or another condition, or may be associated with other symptoms.

And so that’s holistic medicine. We’re looking at everything in totality, and we’re looking at balance. So I hope you found this podcast informative. Thank you for taking the time to be with us and to listen. I really appreciate it. This has been the Strive for Great Health Podcasts with Dr. Richard Harris.

Have a blessed day.

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