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Updated: Apr 19, 2020

Acne is a skin condition in which the hair follicles in the skin become clogged with oil and skin cells and can also be accompanied by bacteria & inflammation.

Signs of acne can include:

  • Lesions: Comedones (open comedones = blackheads; closed comedones = whiteheads), Pimples that include pus (pustules), Large tender bumps under the skin (nodules), Cystic pockets under the skin’s surface

  • Tenderness localized to an area

  • Location: face, back, chest, sometimes upper arms as well

There are many reasons acne can occur (often, a combination of the below as well!):

  • Hormonal changes: Puberty, Premenstrual syndrome (cyclical acne), Elevated androgens (testosterone, etc.), Polycystic Ovarian Syndrome (PCOS), Pre/post pregnancy

  • Bacterial Infection. Acne occurs as a result of inflammation at the cellular level. Redness, warmth, swelling at the area – all are signs of inflammation. In serious cases of Acne vulgaris antibiotics may be required to prevent spreading or worsening of infection.

  • Dietary triggers. Because acne occurs as a result of inflammation, the immune system is involved. We know that approximately 75% of our immune system is located in our gut (MALT and GALT). Therefore, the foods that we eat can impact inflammatory changes. Food triggers can vary from individual to individual.

  • Mental-Emotional Health. Stress, Anxiety & Depression can often cause acne as well. Psychological stress manifesting as physiological stress through inflammatory pathways.

Strategies for Acne Management:

  • Lifestyle. Any intervention that can reduce oxidative stress & damage and therefore reduce inflammation, can be beneficial. This can include:

  • Optimizing Stress Management (more below)

  • Optimizing Sleep Patterns

  • Exercise

  • Balancing of hormones. Hormones often play a very big role for acne in a lot of the clinical presentations I see. One hormone that plays a significant role in both men & women is CORTISOL. This hormone is released in response to stress. CORTISOL can impact other hormones – estrogen, progesterone, testosterone, thyroid, insulin, etc. If acne is cyclical and corresponds to the menstrual cycle, there is a lot that can be done with testing & assessment of hormones to determine optimal hormone production & metabolizing pathways. This testing is offered in-clinic.

  • Supplements. There have been certain supplements studied and researched to help shift inflammation pathways, provide nutrients and modulate immune responses. Individualized assessments help to determine which supplements can be beneficial.

  • Anti-bacterial medications through your dermatologist to help eradicate infection, if required. If needed, this is often a first line recommendation.

Acne therapies can be different for each person, but the fundamental goal is to determine WHY acne is an issue for that individual. Once we know the WHY, management becomes easier and more directly focused. Naturopathic medical approaches can be beneficial in managing acne long-term.


Dr. Mawji

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