Zits! Pimples! Spots! Breakouts! Volcanoes!

Whatever you want to call them, adult acne can be a frustrating and embarrassing problem to have. Some people may never outgrow their teenage spotty years but some don’t even need to go through that phase before being inflicted by painful adult acne. According to the American Academy of Dermatology, more than 50% of women and 30% of men over 25 years old will suffer from adult acne.

Paperbag over headAdult acne is different from teenage acne and hence requires a different approach to treatment. Adult acne is usually on the lower half of the face while teen acne is typically on the upper face. Adult acne is also deeper and appears as cyst, or under the skin which can’t be drained.

So where does this acne come from?

An acne occurs when sebum, the lubricant that naturally moisturisors our skin and hair is trapped under dead skin cells and debris in a hair follicle. Typically, sebum rises to the surface where it is able to condition the skin. If it gets trapped, the sebum clogs the pore, creating an ideal environment for bacteria to grow. This will result in inflammation, cyst, pustules, whiteheads and blackheads. If left untreated, these “volcanoes” can erupt, creating stretched large pores, unsightly scars and even post-inflammatory pigmentation.

You may treat it temporarily with medications e.g. antibiotics, roaccutane and topical creams, from a typical dermatologist but without addressing the acne-prone skin, the problem will soon re-appear. Woman with spot

To treat adult acne effectively, we have to look at addressing the internal causes of acne and have a long term approach using appropriate skin treatments and skin care to achieve a new equilibrium for the skin to maintain its own healthy, breakout-free appearance without harsh chemicals and irritants.

Due to the size of this topic, I want to focus on the internal causes of acne in this blog first so you can address your acne from the source. In my next blog, I will share with you the “3 Magic Words” to control your breakouts, treat your acne and prevent further scars and pigmentation from forming.

So let’s start at the core and look at what causes adult acne from the inside out.



A. Hypersensitivity or overproduction of androgens (male hormones) which increases sebum production. This can be due to:

Polycystic Ovary Sydrome (PCOS)

  • Adrenal Adaptation/ Fatigue Syndrome
  • Stress (excess cortisol increases availability of active male hormones)
  • Insulin Resistance (abnormal sugar regulation)

B. Imbalance of oestrogen (female hormones) and testosterone (male hormones)

Example in:

  • Pregnancy
  • Perimenopause (45-50years old)
  • Menopause (over 50 years old)

C. Ratio of “good” progesterone is low compared to “bad” oestrogen also known as Oestrogen Dominance.

Other symptoms of Oestrogen Dominance are irritability, mood swings, heavy menstrual period, fatigue, weight gain, cold hands and feet, premenstrual breast tenderness, anxiety and low sex drive. This can be found in:

  • PMS
  • Perimenopause
  • Endometriosis

Progesterone helps regulate androgens by preventing the conversion of testosterone into the more active DHT which can result in acne and hair thinning.

1. Work with a hormone specialist to check your hormone levels and treat it accordingly. Treatment may involve lifestyle optimisation, nutritional optimisation, supplementation, botanical herbs or natural hormone replacement therapy. E.g. Natural Progesterone cream can often clear acne if the hormone test shows an imbalance.

2. Make sure you rest and recharge your batteries. Stress often triggers and worsen hormonal imbalance.

3. Reduce “bad” oestrogen by limiting Xeno-oestrogen in your life. Xeno-oestrogens are chemicals found in food and the environment that mimic oestrogen when consumed/absorbed into your body. They are everywhere so it’s hard to avoid them e.g:

  • Herbicides/ Pesticides/ Petrochemicals (car fumes)
  • Plastics (as you can imagine this is a big problem because plastic is used for so many things)
  • Detergents/ Personal Care Products (this is a huge one too, and they also contain Parabens which cause cancer)
  • Contraceptive Creams/ Pills (this has artificial hormones)
  • Canned Foods / Packaged Foods / Food (a lot of food contain high levels because of all the commercial sprays used)
  • Meat and Animal Products (artificial oestrogen compounds are used to fatten up cattle and chicken quickly. Oestrogens are stored in the fat and eaten by consumers)
  • Alcohol and Drugs (especially Cannabis)Hot Flush

These chemicals behave like aggressive oestrogen in our bodies and further throw hormonal levels off balance. They can begin creating problems in children and have been blamed for increasing rates of early puberty.

Use instead:-

  • Glass or ceramics whenever possible to store food and water
  • Heat food up in the microwave in glass or ceramic covered dishes, never plastic
  • Buy hormone-free/organic meats
  • Buy organic produce, vegetables and fruits grown without pesticides, herbicides or synthetic fertilizers or hormones
  • Use anti-oxidant supplementation: Vitamin A, C and E to combat xeno-oestrogen effects. Eat food high in anti-oxidants
  • Use anti-cancer supplement: Di-Indoyl Methane (DIM) to down regulate oestrogens
  • Use simple detergent with fewer chemicals. This includes laundry detergents and household cleaners
  • Use natural pest control not pesticides (instead use a cup of salt in 4 litres of vinegar)
  • Wear natural fibres
  • Use condoms without spermicides instead of birth control pills
  • Don’t use synthetic hormone replacement pills, use natural progesterone cream if you can

4. Take care of your liver

The liver is an important organ to metabolise and get rid of any excess oestrogen. Make sure you eat liver-friendly foods e.g. broccoli, cabbage, cauliflower, lemon, beetroot and garlic and limit your intake of alcohol. You may also want to consider doing a liver detox flush. There are different recipes according to your taste buds and budget but if you want to ensure you’re doing the right thing, I would recommend being monitored by a nutritionist or detox specialist while you’re undergoing the plan.


The common saying goes “We are what we eat!” Glowing, healthy skin is a direct reflection of health and hormonal balance. When our diet and hormones are out of whack, it quickly becomes visible in our skin. Nutritional deficiencies are directly linked to acne not only from a functional perspective but also in how they influence hormonal balance.

Here I share some quotes from my fellow colleague, Rhian Stephenson, a renown Naturopath & Nutritionist.

1. A diet high in refined sugar, saturated fats, and processed foods are all linked to acne due to their effect on insulin & insulin-like growth factor (IGF-1).

These foods cause inflammation and can contribute to increased sebum production, and should be strictly avoided in all cases of acne in order to restore balance.

2. Cortisol – our major hormone involved in stress – has documented effects on the health of our skin. Not only does long term stress affect our digestion, sleep, and hormones, but it also depletes the body of Vitamin B5, B6, and Zinc, all of which are vital for skin health.

  1. Reducing both systemic and local inflammation is a key factor in the treatment plan for acne. Cow’s milk, refined sugar, food intolerance’s alcohol, excess caffeine, and processed foods should be significantly reduced or avoided completely until acne flare ups have calmed down.


1. Check for food intolerance’s – any excess burden on the liver, digestive track, or immune system can contribute to inflammation and toxicity in the system, worsening acne.

2. Ensure that your digestion is on track. Skin is the largest organ of elimination, so any toxins that aren’t eliminated properly through the bowel can cause congestion and oxidation in the skin. Addressing constipation, IBS, and digestive issues is vital to keeping skin healthy

3. Look for nutritional deficiencies and implement a supplement plan specific to your needs. Include lots of nutrient rich, high fiber foods, fruit and vegetables, and essential fatty acids into your daily diet.

4. Support your system with supplements e.g:

  • zinc citrate: helps to heal and repair scarring & assists in insulin balance.
  • Vitamin A, C, E complex: these nutrients are antioxidants specific for skin health that help repair skin and balance hormones, increase elasticity and hydration, balance oxidation in the skin, reduce inflammation, and support collagen production.
  • B complex with extra B6: helps with blood sugar control, supports adrenal glands and hormone balance
  • Fish oil & flaxseed oil: reduces inflammation associated with acne and can help balance hormones.

5. If blood sugar is a problem: add chromium picolinate to help reduce promote insulin balance.

6. A balanced, anti-inflammatory diet that is rich in nutrient dense foods is essential for skin health. This helps to maintain a healthy insulin levels, restore acid/alkaline balance, improve digestion and elimination, support a normal hormone profile.

The basic diet for acne is grounded in plant based foods, lean protein, essential fatty acids, and low glycaemic, fiber rich complex carbohydrates.

7. Anti-oxidant rich drinks: Like green smoothies, sencha green tea, and other herbal infusions are great accessory nutrients that are rich in anti-oxidants and support an overall skin balancing program.

8. Increase foods rich in zinc, vitamin B5, and vitamin A: Eggs, ginger, black beans, avocado, apricots, kale, carrot, brown rice, brazil nuts, chick peas.

9. Increase Vitamin C Rich foods: Kiwi fruit, sweet potato, bell peppers, watercress, broccoli, kiwi papaya, strawberry.

10. Increase dietary fiber and water.

There are other causes of acne e.g. cosmetic ingredients, mobile phones and hair products but all these only exacerbate what is already there. By addressing the internal causes of acne at the same time, you can truly achieve a spot-free complexion.

Don’t forget to read my next blog where I will share with you the “3 Magic Words” to control your breakouts, treat your acne and prevent further scars and pigmentation from forming.

If you would like some help to address your hormonal imbalance or nutritional deficiencies, please call 0207 706 1997 to book a consultation.