Management of Acne starts from within

Contrary to popular belief, acne is primarily not a result of improper facial hygiene. While it typically presents itself on the outside, its more often an unfortunate indicator that there's an internal problem. The most important question to ask is, "why is this happening in the first place?"

The root to acne formation is centered in the oil gland, known as the sebaceous gland. Hormonal changes, inflammatory foods, disrupted skin pH, etc. can lead to changes in the quality and quantity of sebum produced, creating low level inflammation. This inflammation can plug the follicle, results in the closed comedones we all lovingly know as acne. The closed comedo is an ideal bacterial breeding ground, and the more overgrown with bacteria these blocked follicles become, the larger and more cystic the resulting "pimple". If the cyst ruptures below the dermis, the lesions last a lot longer and are more likely to results in permanent scarring.

Hormones

First and foremost, we must investigate hormones. Higher levels of dihydrotestosterone attribute to increased sebaceous gland activity and acne formation. This is common in conditions like PCOS and congenital adrenal hyperplasia, with the most common symptoms being irregular or infrequent menses, adult onset acne, male patterned hair growth around the chin/nipples/stomach/hands, and insulin resistance. However, not all of these symptoms have to be present for hormones to be disrupted, making it difficult to uncover the underlying problem. Hormone Testing can be a useful tool in these cases.
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The liver

While balancing hormones production is important, proper elimination of these hormones is just as critical. Your liver acts as a filter, eliminating degraded hormones and preventing hormonal congestion that results in acne. Alcohol, birth control, environmental toxins, etc all burden our liver on a daily basis, leading to sluggish detoxification and toxins being shifted to our major detox organ, the skin. 
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Diet

A high intake of refined carbohydrates, sugars, and preservatives results in blood sugar spiking, and subsequent boosts in insulin levels. High levels of insulin in the bloodstream triggers sebum production and an increase in pore clogging cells. Dairy also tends to be a problematic food, as it's rich in IGF-1, which also promotes insulin release. An imbalanced, high carb diet may be attributing to you producing all the wrong hormones as an older adolescent or adult.
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Digestion

Just as the liver detoxifies hormones, the colon excretes them. If bowel movements are not regular, degraded hormones sit in the gut waiting to be reactivated and resorbed by "bad" bacteria. Furthermore, consuming foods you may be sensitive to (ie food intolerances) results in higher levels of overall inflammation in the diet every time you eat them. 
Consider: Food Sensitivity Testing
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Topicals 

Last but not least, consider what you put on your skin.
If you’ve been using strong washes or cream moisturizers, STOP. Harsh chemicals strip the natural pH of the skin, leading to higher amounts of oil production from the skin to compensate for the balance. Most creams are glycerin based, which the skin does not properly absorb. Instead, it sits on the surface of the skin, trapping debris and oil within the pores, and preventing the skin from breathing. That sounds like a recipe for acne to me.

Beyond this, certain minerals and vitamins have been shown to be effective treatments for acne prone skin. Zinc, B6, B5 and Vitamin A all have balancing effects on skin pH and sebum production. If you're experiencing acne that has been unresponsive to conventional treatment, or wish to take a more natural approach, feel free to contact Dr. Holmberg, ND here:

Hormones

Acne
Adrenal Fatigue
Anxiety/Depression
Fibroids
Irregular Periods
​Infertility
Menopause
Premenstrual Syndrome
Polycystic Ovarian Syndrome
Discontinuing Birth Control
Weight Gain
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Digestion

Crohns & Colitis
Constipation
Food Sensitivities
Gas & Bloating
Heartburn
Irritable Bowel Syndrome
Leaky Gut Syndrome
SIBO

immune

Allergies
Autoimmunity
Eczema
Frequent Colds & Flu