By: Michell Miller, MSACN and Diana Orchant, RDN.
We love talking about skin health and some of the most important strategies for really getting to the root problem of our skin, whether this is acne, rosacea, psoriasis, dermatitis…you name it. Want to know the secret to clear skin? Let’s dive in!
Our skin is our largest organ. It reflects our overall health status and serves as a mirror of our internal health. Skin issues are generally looked at as an external symptom of an internal problem. So what do we do? We get to the root cause!
Getting to the Root Cause of Skin Issues
When the skin is off, this is our body giving us a tap on the shoulder and saying something’s not right. “Please pay attention to me!”
We always use the example of a dying plant. If you have a plant that’s dying, what do you do? You look at the soil, examine the roots, give it water, sunlight, and a little TLC. You would never just grab green paint and start painting the leaves to correct the color. That sounds absurd!
Meanwhile, the beauty and pharmaceutical industry has been trying to get us to believe that just covering and masking the issue is enough, but this is just a band-aid effect.
Let’s first take a step back and discuss some of the conventional approaches to skin health.
Conventional Skin Care
We typically think of different types of creams, topicals, or facial cleansers. If you need to ramp it up a bit more, there are steroids, a variety of antibiotics, and various medications that can be used. Not to mention, many individuals are asked to take these on a long-term basis, resulting in detrimental downstream effects.
Topical treatments take the approach of tackling directly what’s on the skin’s surface. However, whether this is a steroid cream or a natural product, the problem is that it’s only skin deep. However, we want to get to the root of the problem and look at what’s going on inside. Just like, if a mirror is cracked, glue won’t fix the problem, though it may help temporarily.
This is where our approach comes in. It’s based on evaluating and identifying the root cause of your skin issues to solve these issues altogether.
The Five Pillars of Skin Health:
These five pillars are used in identifying and eradicating the root cause of skin issues:
- Liver Detoxification
- Identifying Food Reactions, Sensitivities, Intolerances, and Allergies
- Balancing Hormones
- Healing Gut Inflammation
- Optimizing Blood Biochemistry
1. Liver Detox
So, let’s first dive into our personal favorite, liver detoxification. Conventional medicine often explains how the liver can detox on its own–hey, that’s its job! However, over the last couple hundred years, we have added a lot of new stresses on it that weren’t exactly intended. Whether it be medications, environmental toxins, processed foods, or alcohol, our liver can easily get bogged down (or backed up!) and make it harder for the liver to function as well as it should.
A great example of this is what we call “the dishwasher effect”. Just like your liver is supposed to be detoxing and filtering out what’s not needed, a dishwasher is supposed to be cleaning dishes. In a commercial kitchen, individuals submit their dirty dishes to the back of the restaurant to be cycled through the dishwasher and cleaned. On a normal day, a commercial kitchen may have a good influx of dishes, and they have enough people to allow those dishes to be cleaned and keep that whole process moving as it should.
But what about on a day when the restaurant is overbooked or some workers call out sick? This results in a huge influx of dishes and fewer individuals to help out. The dishwashing room gets bogged down, and it’s usual process becomes a bit sluggish. The next day or week, the dishwasher will likely need to be cleaned out, the restaurant will need to slow down in order to make up for the craziness that ensued. The same goes for the liver–give it too much to process over time, and you’ve got to give it the reset it needs to function properly.
But wait…what actually causes the liver to get bogged down in the first place?
Alcohol is an obvious factor that can affect liver health. We can feel a hangover which indicates that our detox system is on overdrive. Even foods like sugar, trans fats, and processed and fried foods force our body to require a bit more detoxification, as these items can easily bog down the liver.
There are many internal factors that can elevate our liver enzymes, which slow down our liver function, as well.
- High cholesterol levels
- Elevated Iron levels
- Heavy metals (i.e. aluminium, mercury, arsenic, etc.)</li
- Various medications
The efficiency of our liver detox pathways can greatly impact our skin health.
So let’s do everything we can to get these pathways into the best working order!
Xenoestrogens are chemicals in our environment that mimic estrogen in the body. Excess hormones as a whole can bog down the liver, but also these faux hormones can greatly impact liver detoxification. Examples of this include pesticides, plastic water bottles and tupperware, and various endocrine disruptor chemicals in our personal care products…to name a few.
Liver Detox 101:
This is all cool and fun, but how does one actually detox the liver? When many hear liver detoxification, they think of trends and fads, but we are not talking about a juice cleanse or putting maple syrup and lemon juice in your water. We’re talking about true liver detoxification, the scientific process, and how this works.
Some of the components that actually help upregulate the phases of detoxification include:
Consuming a variety of cooked, cruciferous vegetables and various herbs. We will often use various herbs and nutrients in practice, whether that be milk thistle or N-acetylcysteine, to upregulate the glutathione in our body. Glutathione, the master antioxidant in the body, can also be taken to get rid of some of those free radicals or reactive oxidative species which can cause underlying inflammation. These are areas we’ll often address with clients, when it’s evident that liver detoxification is needed.
Liver detoxification is not a calorie-restricted program because certain amounts of calories and amino acids are needed to upregulate the 4 phases of detoxification. It’s remarkable to see what this can do and we often see these results showcased in before and after blood work.
We also think of activities that not only feed the detox pathways, but also assist them and make them work more efficiently. Examples here include sweating, whether that be through exercise or via an infrared sauna to get that deeper cellular detoxification.
The whole process is such a testament to the power of food, nutrition and lifestyle changes and the drastic effect these measures can have on the body.
2. Food Reactions
Another component to consider is food reactions. Food reactions can range from food intolerances, (such as lactose intolerance where you might lack the right enzyme to break something down) to food allergies, (which are an IgE reaction and a more immediate reaction to a specific food or allergen).
There is also a category of food sensitivities, which occur typically as a delayed reaction to a food, which is determined via an elimination diet or an IgG and/or IgA test.
All of these various food reactions can wreak havoc on the skin, and there are hundreds of different ways that individuals can react to food.
For example, for some, food reactions may manifest as an upset stomach or having a headache. For others, it might manifest as cystic acne, eczema, or psoriasis.
This underlying idea is that if you have a food intolerance, food allergy, or food sensitivity, it’s important to figure out what the food culprit is. This is key because not only is this issue creating inflammation in the body, but it’s going to be difficult to reach any of your health goals until you can eliminate and find a way to counterbalance the inflammation that’s occurring.
While many of the more inflammatory foods can fall into this category, many are surprised that ‘healthy foods’ can even pose issues in certain individuals (yes, we’re talking tomatoes or cashews). Regardless of the food, it’s important to dive into this to get to the root of the problem.
3. Balancing Hormones
Unbalanced hormones can result in breakouts, (especially jawline or cystic acne) or getting that big pimple right before or after your cycle. These skin issues can happen at different phases in life, whether it be puberty, after giving birth, or after going off of birth control.
So many women struggle with this, but we see it most commonly when women transition off of oral contraceptive pills. We see clients struggle with cystic acne, oily hair, and/or worsened PMS symptoms, just to be told they should get back on the pill to “balance” their hormones, OR take another pill to mask the issue OR use a variety of topicals to deal with this internal imbalance. As a society, we often see conventional medicine offering the option of going on birth control pills, or medications like Spironolactone, or using prescriptions that are going to be affecting your hormones and therefore affecting your skin.
But for how long? These options are a temporary fix that do not balance the hormones, they run your hormonal system or specific pathways as a temporary fix… and this is usually where functional medicine comes in to try to pick up the pieces and start back at the top with liver detoxification as a first step to mitigate hormonal imbalance. We think of it as re-priming the dishwasher to get everything moving, and then we can start using some different tactics to rebalance the system out.
Getting to the Root of the Problem
This story often results in higher-than-normal levels of estrogen throwing off the skin–something we see time and time again. Coming off of a birth control pill, which builds up estrogen and hijacks your hormones for a while can be taxing on the system. So, as much as we would love to say, there’s a quick fix to that, or just use a specific face wash and topical cream, there’s a deeper root problem that needs to be tackled here in order to get lasting results.
For some, it is high estrogen, or high levels of testosterone, maybe resulting in PCOS (Polycystic Ovary Syndrome). For others, it could be a result of going off of birth control and seeing how that affects overall hormone levels. There are various herbs that can be used to address this in addition to proper detoxification and dietary changes.
Stress and Hormones
Another interesting concept is how much stress affects the menstrual cycle. It’s pertinent right now because a lot of individuals are cooped up at home or frequently wearing masks, and they expect because they’re not wearing much make-up their skin should be in good shape, but in reality, it’s been the opposite.
The stress of what’s going on in the world can absolutely cause and worsen some cases of acne. Now combine that with hormonal imbalance and it strikes the perfect balance of imperfect skin.
Our hormones–cortisol, sex hormones, and insulin, have to be balanced together. They’re affected by what we eat and our environment. They are like a beautiful dance– always kind of trying to stay within a harmonious balance of each other. If one gets thrown off, everything else starts to go down with it, like a domino effect, resulting in downstream effects. Digestion may start to change a bit, skin may start to flare-up, mood swings set in and you may experience night sweats or water retention. This is normal if hormones are out of balance, but the key is keeping the dominos in line so symptoms remain at bay, and our skin can get a break.
Now that we understand the hormonal cascade, let’s dive into our favorite herbs. Again, these are going to be specific for an individual’s condition, and testing must occur first and foremost. Once we can assess hormone levels, inflammatory markers, and nutrient levels, we then can apply the proper next steps.
Therefore, it’s hard to just list off a bunch of herbs and supplements that can help with PCOS because it really comes down to the hormone levels that we’re trying to balance out. Also, herbs themselves have an energy to them, so we choose the type of herb that best fits the individual, their energy, and their test results.
There are many great compounds that help to drive down excess estrogen levels. Diindolylmethane (DIM), which is found naturally in many cruciferous vegetables, can help drive down estrogen levels, pushing it down the correct pathway. For high testosterone levels, on the other hand, studies have also shown that mint, peppermint, or spearmint tea, as well as herbs like white peony and licorice, can be helpful for driving down these higher levels.
There are just so many good herbs that can be utilized. It’s a beautiful form of medicine that has been around for thousands of years. They can help bring vitality and balance to the body without worrying about side effects (when used correctly!).
4. Healing Gut Inflammation
Our next pillar is to heal gastrointestinal inflammation, aka heal the gut. We don’t guess, we test, and this means looking deeper to figure out what’s going on in our gut. We want to get the scoop on your poop! All health begins in the gut.
If you know that eating sugar or fried foods causes a breakout, or that antibiotics are frequently prescribed for skin issues, then we know there is a clear connection between the gut and the skin.
Gut testing looks into the good and bad bacteria, digestive markers, yeast overgrowth, absorption capability, and imbalances in the microbiome causing inflammation. If we’ve learned one thing, it’s that we have way too many patients walking around with an inability to break down food properly, low digestive enzyme function, and low levels of beneficial gut bacteria. We also see overgrowth of yeast or candida strands and different kinds of pathogenic bacteria strains.
Unfortunately, we also find many clients that are walking around with parasites…which are certainly not helping GI inflammation.
Once we find out what’s going on, we focus on rebuilding the gut and making it as strong as it possibly can be. While this often results in clear skin, we also see other benefits such as improved digestion and mental clarity.
If this doesn’t convince you enough, let’s discuss the connections between various skin conditions and gut health.
Psoriasis is an autoimmune condition, and there is nearly a fourfold increased risk of developing Crohn’s or ulcerative colitis for individuals who have psoriasis. Individuals presenting with SIBO, or small intestinal bacterial overgrowth, are 10 times more likely to have acne.
Then there are GI patients who come in and say, “my number one goal is to fix my gut health. I have so much gas, bloating, and various issues. My skin’s not great, but I’ve got to fix my GI health.” We do stool testing and we get their gastrointestinal system completely under control. They’re feeling good and then wow, what a coincidence! They also end up having clear skin, as well.
5. Optimizing Your Blood Biochemistry
So, let’s dive into our final pillar, which is optimizing our biochemistry (especially our various vitamins and minerals).
We know that Zinc and Vitamin A are critical for skin turnover. The famous acne drug, Accutane, has a (scary) high-dose vitamin A.
So many of the B vitamins are necessary for our skin health and development, as well. But then many medications, including the birth control pill that are used to get skin issues or hormonal imbalances “under control”, deplete the body of B vitamins.
Ironic, isn’t it? To rectify this, want to ensure we are testing for and optimizing those nutrient levels.
We also love to add in omega-3 fatty acids, Vitamin E, and Vitamin D. A great supplement that combines all 3 of these components (plus Vitamin A!) is cod liver oil. It’s very nourishing for the skin and is great for gut health, as well.
Many individuals suffer from Keratosis Pilaris, which are bumps on the legs or on the back of your arms. These are often a sign of your skin calling out for help. It can often be mitigated by omega-3 fatty acids and these fat-soluble vitamins (A and E). We think about it as moisturizing your skin with these good quality oils from the inside out.
Diet and Clear Skin
When it comes to diet and skin health, we generally start by minimizing inflammatory foods, focusing mainly on gluten, dairy, soy, corn, and sugar.
We often remove those initially from the diet while we’re detoxing and healing the gut (for at least a week). Reducing inflammation while we’re focused on balancing hormones, gives individuals a much quicker return on their investment, resulting in a quicker turnaround for skin health.
Of these 5 inflammatory foods, dairy is often the biggest culprit. Dairy can be inflammatory especially to the skin. It also may fall under the category of “food intolerance,” if you don’t have the lactase enzyme to break down the lactose sugar found in dairy products. Dairy also contains hormones. Even if you’re buying dairy products with no additional hormones adding, they still exist as naturally occurring hormones. These growth factors can really stimulate acne in some, which is why certain individuals notice their acne calms down after eliminating it.
Sugar is another major culprit. It is not your skin’s friend. Sugar can cause the skin to have poor cell turnover, resulting in some of these cells getting stuck. There’s a reason why individuals often break out after a crazy weekend filled with alcohol and sugary foods. Not only are these items inflammatory, but the sugar is feeding the skin, disrupting the gut microbiome, and throwing off the body’s insulin levels. This then affects hormones, can put stress on the liver…and all of a sudden these pillars start to come together.
What’s the secret to clear skin? We wish we could say that there was a magic cream or a magic pill. We know this entire process can be quite overwhelming, but a few small changes in due time can do wonders.
We wish everyone knew this starting at age 10, right? Skin is a reflection of an internal environment, a deeper level of health. It’s reassuring to know that if you’re taking care of your whole body, your skin will follow suit.
We always recommend testing. Get these vitamins and minerals checked, get heavy metals checked, look out for your cholesterol levels. Perform gut testing. It’s been a game-changer for us and so many of our clients. Work with a functional nutritionist to get yourself some answers!
Knowledge is really powerful here. Knowing what is triggering your acne or triggering any symptoms will open up so many doors to truly handling the root cause. Just to be informed and know that if you have that glass of milk or that candy bar, what it’s going to do to you and how it’ll make you feel. Just having that knowledge is super powerful and that’s what we want to give to you.
If you suffer from chronic skin issues and all the creams, scrubs, and medications just aren’t working, maybe it’s time to start looking at and treating the root cause. We can help. To get started on your path to clear, beautiful skin, give us a call or start by filling out the form below.