Raise your hand if you thought that your breakouts would be a thing of the past, once you reached adulthood. Yeah, our hands are raised, too. So why on earth do our chins, jawlines, neck, shoulders, and back continue to show signs of our 16-year-old selves?
Because your hormones don’t disappear once you turn 21! Although they typically start to stabilize and become more routinely cyclical, your hormones still naturally rise and fall over the course of your menstrual cycle. And for many of us, our hormones need some support thanks to, well, life. Stress, diet, and sleep (the usual suspects) all affect your hormones. And when your hormones are out of sync, the result is hormonal acne, among other discomforts. The good news is that since hormonal breakouts are a sign of hormonal imbalance, by supporting our hormones, we can clear that acne!
So, we’ve connected with Alisa Vitti, hormone and functional nutrition expert, creator of FloLiving, and pioneer in biohacking for those with menstrual cycles, to give us some tips on how to do just that.
(Please note, the following is being republished from Alisa Vitti’s blog. Therefore, this article has not undergone the usual protocols for content on the Allbodies site. Allbodies reminds you always to check in with your care team, and your body, whenever you introduce anything new!)
Let’s dive in!
Meet your Menstrual Cycle, aka Your Infradian Rhythm
The first step toward clear skin all month long is to understand what’s happening in your body over the course of your infradian rhythm.
During your menstrual cycle (which could be between 21 and 35 days), estrogen, progesterone, and testosterone levels naturally rise and fall. When your system is healthy and you’re cycling normally, these fluctuations occur in familiar patterns. Specifically:
- During the follicular phase (the first days of your cycle up until ovulation): Estrogen levels begin to rise.
- During the ovulation phase (mid-cycle): Estrogen and testosterone rise until they peak.
- During the luteal phase (which occurs right after ovulation and up until you start bleeding): Estrogen, testosterone, and progesterone rise in the first half and then fall.
- During the menstrual phase (bleeding): All hormone levels fall to their lowest levels.
The hormone changes that happen during each phase affect different aspects of your life in a variety of ways, including your energy levels, concentration, and communication skills, among others. Know what else they affect? Your skin!
How Fluctuating Hormones Affect Skin
Let’s dig into how. Estrogen and progesterone levels affect the thickness of the skin differently during each phase of your cycle. In the follicular phase, and especially during ovulation, high levels of estrogen boost collagen (1), make the skin thicker, and improve elasticity, creating that ‘ovulation glow.’ However, if your estrogen level gets too high, it can also cause pimples (we’ll come back to this).
Testosterone levels also change during the different phases. In the first half of the luteal phase, along with estrogen and progesterone, it rises, helping keep skin thick. But testosterone is a double-edged sword with respect to skin. Studies show (2) a link between spikes in testosterone and acne.
This is a crucial point in your cycle where you either become vulnerable to breakouts or continue to have clear skin. What causes some of us to break out and others to notice barely a blemish? The difference is in the body’s ability to process and eliminate efficiently the excess estrogen and testosterone in the system as levels rise. If your body isn’t processing hormones during your luteal phase, and eliminating them, properly, the excess estrogen and testosterone accumulate and fuel acne. This happens in two ways: The excess estrogen causes estrogen dominance and skin inflammation, and the extra testosterone triggers the sebaceous glands to produce more oil.
Thus, for those with optimally functioning endocrine systems, these hormonal peaks don’t cause a lot of problems. But if you don’t process hormones correctly, this can result in acne.
The second half of your luteal phase and the days during your period can also cause skin problems. During these phases, estrogen, progesterone, and testosterone drop. The drop in estrogen causes your skin to get thinner, retain less moisture, and produce less collagen. If you have skin conditions during the luteal phase, the rise and fall of progesterone can make the problem worse.
Signs that Acne is Caused by a Hormone Imbalance
There are a number of signs that your breakouts are due to a hormonal imbalance. Timing — that is, when you break out — is one major sign. For instance, breakouts during the luteal (premenstrual) phase are a sure sign that your hormones are out of balance and could use some TLC.
Another sign of hormonal pimples is where you get it. Breakouts along the chin and jawline (3) are a sign of hormonal breakouts, as are pimples on the temple. These stem from liver congestion due to excess estrogen. Here are some more telltale signs of specific hormone imbalances and root causes of acne:
- If you break out all the time, the cause is inflammation, so incorporate inflammation-fighting foods into your diet such as cruciferous vegetables and foods high in omega-3 fatty acids, like salmon and egg yolks.
- If you break out during stressful situations, the cause is high cortisol and unregulated insulin. Focus on balancing blood sugar and limiting high-sugar foods.
- If you break out after 35, the cause is the erratic hormonal shifts related to perimenopause. Make it a priority to engage in The Cycle Syncing Method® to bring balance back to your monthly hormone shifts.
- If you break out during postpartum/miscarriage, the cause is correlated to plunging levels of estrogen and progesterone and the return of menstruation. If your period has returned, your priority here should be engaging in phase-based self-care, by practicing The Cycle Syncing Method®.
Hormone- and inflammation-driven acne are caused by imbalances in your body that need to be addressed at the core. Any long-term fix for reducing acne must go beyond skincare strategies. A holistic, sustainable fix for adult acne must include food, supplement, and lifestyle strategies (more on that later!).
Four Factors Contributing to Hormone Imbalances That Can Cause Cyclical Acne
As we mentioned, hormone imbalances are the root cause of adult acne, and there are several key ways our hormones get out of balance. Here are five main factors that can cause hormonal imbalance:
- Micronutrient deficiencies: In order for the body to make enough hormones — and to eliminate excess hormones efficiently and effectively via the liver — we need optimal levels of key micronutrients. When our bodies are deficient in specific micronutrients, we will be more prone to breakouts.
- Your detoxification system is sluggish: During the second half of your cycle, estrogen and testosterone peak. If your detox system (lymphatic system, liver, and large intestine) is congested and can’t get rid of these excess hormones quickly enough, estrogen builds up in your body (estrogen dominance) and causes problems (like skin inflammation). The extra testosterone sends signals to your sebaceous glands to produce more oil. Acne is the result.
- Inflammation: Chronic inflammation, which is fueled by a variety of common factors — like eating inflammatory foods, being too sedentary, or exposure to toxic chemicals — is a root cause of acne (4).
You’re not getting enough exercise (or sex!): Both exercise and sex help flush the stress hormone cortisol from the body — and keeping cortisol moving out of the body is essential for glowing, gorgeous skin. If you’re not moving enough or clocking enough amazing orgasms, the evidence could show on your face.
Why the Conventional Acne Treatments You’re Using Aren’t Working
The traditional treatments for acne often don’t work, and there’s a reason why commonly-prescribed medications fail:
- The birth control pill: The pill disrupts your microbiome, endocrine system, and micronutrient levels – all essential systems for keeping your skin clear. You may have clear skin while you’re taking it, but not without added side effects that can worsen issues like PCOS, plus increase your risk for some reproductive cancers. Once you decide to stop using hormonal birth control, a common symptom of the withdrawal period is acne. And this acne is often worse than before, due to the internal disruption that has occurred as a result of the medication.
- Antibiotics: Antibiotics do incredible damage to the microbiome because they don’t distinguish between good bacteria and bad bacteria—they just kill all of them—and robust gut health is important for clear skin. As with hormonal birth control, when you come off of the antibiotics, the acne may not only return, it can be much worse than before because of the microbiome damage.
- Spironolactone/Aldactone: This steroid is nothing like the hormones your body produces on its own. It disrupts your body’s production of testosterone (5) by confusing your body with a synthetically-similar steroid. Plus, spironolactone use can trigger one of the most common hormone imbalance issues (and cause of acne)—estrogen dominance—as well as depression, blood clots, and increased risk of some cancers (6). Spironolactone is not safe to take long-term, and is not going to prevent acne beyond the point that you are using it.
- Isotretinoin (originally Accutane): If you’re prescribed isotretinoin, then you are also prescribed hormonal birth control, because isotretinoin causes birth defects. There are other side effects—including an initial worsening of acne—and severe depression. The original patented drug, Accutane, was discontinued after many users developed inflammatory bowel disease and use of the drug was associated with increased risk of suicide. Usually this medication is offered as a last resort, but rarely have diet and lifestyle changes been part of prior acne-treatment protocols.
Instead, you can start to treat the root cause of hormonal imbalances, and consequently hormonal breakouts, through lifestyle changes, and we’ve got some prime tips on how to do just this.
How to Solve Cyclical Acne for Good — Your Step-By-Step Guide
The skin is the largest organ of detoxification, and one of your top goals for easing cyclical acne is eliminating the excess hormones and other toxins from your body. Here are Alisa’s top strategies for saying goodbye to cyclical acne for good. Pay special attention to the supplements section. Targeted micronutrients in the form of high-quality supplements are what really move the needle on your skin health.
Step One: Understand that hormonal breakouts are an “inside job.”
The root causes of acne start deep within your body. They don’t start at the level of the skin. That means that any changes you make to your skincare routine will only help so much…and, if you do nothing else, the root causes of your acne will continue to smolder. So your first step in easing your hormonal pimples is shifting your mindset. You can only truly address hormonal breakouts by understanding it for what it is — a condition with internal root causes — and then using food, supplement, and lifestyle strategies to address those root causes
Step Two: Practice The Cycle Syncing Method™.
The Cycle Syncing Method™ is the practice of living in a way that gets your hormones working for, rather than against, you. It involves tailoring your self-care and hormone-support routines to your unique needs during each phase of your hormone cycle. It is also what differentiates the Flo Protocol from other hormone support programs, and it is what will ultimately make the biggest difference when it comes to clear skin. The first step in practicing The Cycle Syncing Method™ is to track your cycle. Once you know what’s happening in your body each week of the month, it’s time to match what you eat, how you move, how you plan your schedule, and how you interact with others, to your hormones.
Remember, you have options. While experimenting with birth control it’s important to keep track of how your body reacts, both mentally and physically, to the pill. If there is something that feels not quite right don’t be afraid to speak up, ask questions, or switch. There are tons of options out there and you’re not stuck to a brand or form of birth control—birth control is a totally personal and flexible decision.
Step Three: Eat your way to clear skin.
Food is one of the most powerful levers you can pull when it comes to easing hormonal acne. That’s because the right foods address not just one but several root causes of acne. Specifically, you can use food to one, reduce system-wide inflammation, which fuels acne (4); two, address hormone imbalances, like estrogen dominance, which exacerbate skin issues; three, support your body’s natural ability to detoxify (7); four, balance your blood sugar and improve insulin sensitivity, which calms your oil glands (8) and decreases the bioavailability of androgens (8) (high levels of androgens can trigger breakouts); and five, correct micronutrient deficiencies (9) that can contribute to breakouts.
Wanna do a deep dive on eating for acne, including which foods to prioritize? Use the Flo Living Cycle Syncing System to support you in learning which foods to eat (and when in your cycle to eat them!) to reduce those pesky breakouts.
In the meantime, here are some of the key foods that make hormonal breakouts worse:
- Dairy – In addition to the fact that a lot of US dairy products contain synthetic hormones that contribute to hormone imbalances, dairy is inflammatory — and inflammation is a root cause of acne.
- Peanuts – The same allergens in peanuts that cause certain people to have serious adverse reactions can cause many other folks to experience skin inflammation.
- Soy Isolate – This form of highly-processed soy can create estrogen overload in those who are already hormonally-sensitive.
- Canola, sunflower, safflower, vegetable oil – These cooking oils have more omega-6 fatty acids than omega-3 fatty acids. A high ratio of omega-6 fats to omega-3 fats is inflammatory — and hard on the skin.
- Caffeine – Coffee and black and green teas strip your body of essential B vitamins, magnesium, and zinc, all of which are important for healthy, glowing, and clear skin.
- Gluten – Like dairy, gluten is inflammatory, and can increase the likelihood of breakouts.
Step Four: Find good skin care.
There is a plethora of organic skin care lines to address acne-prone skin. Alisa suggests options from Marie Veronique to Renee Rouleau Anti Bump Solution. Check out Credo Beauty and Cap Beauty for more excellent options. This is an important step because, if you’re giving up the medicated topicals, you will need something to help with skin turnover, pore decongestion, excess oil, and cysts. Try a variety out for yourself and see what suits you best.
Step Five: Use targeted supplementation to clear your skin.
As we mentioned, we saved one of the most critical steps for last. The right supplementation can make all the difference between slightly improving your acne and clearing it for good. You will read a lot on the internet about micronutrients that are best for skin, but after nearly 20 years of research — and of using these same supplements to clear her own hormonal breakouts — this is what Alisa recommends:
- Magnesium. A lack of magnesium causes skin inflammation. Taking magnesium combined with calcium in supplement form can lower the amount of the C-reactive proteins in your body that cause this inflammation. Calcium is part of our tissue matrix – bones, cells, and skin – and is very important for skin cell renewal.
- Omega-3s. Getting your omega-3 fatty acids in fish or flax oil will produce almost instant results. Clearer, softer, smoother skin, as well as stronger hair and nails – you can see it happen in days. These fatty acids have a big-picture, whole-body effect, and also provide results in the short term. Alisa also advises supplementation. It is hard to overstate the importance of omega-3 fatty acids to skin health.
- Zinc. Zinc deficiency is a very common issue for many. When we are deficient in zinc, our pores become easily irritated by bacteria and show redness. A large-scale scientific study (10) concluded that zinc supplementation is very effective even when compared to commonly-prescribed antibiotics. Alisa also recommends having a little bit of grass-fed liver every week as part of a meal or as a snack. It’s full of copper and vitamin A. The copper will balance out the zinc in your body, and the vitamin A is what your liver needs to detoxify from excess hormones. A well-functioning liver boosts your absorption of all vitamins and minerals, and prevents deficiencies from developing in the first place.
- Probiotics. We need probiotics for a healthy gut. Common symptoms of a damaged and depleted microbiome are acne and other skin issues such as rosacea. Probiotics are particularly important in treating hormonal breakouts, as your microbiome assists your body in processing and eliminating excess estrogen. If you’ve been on the Pill or antibiotics for any length of time, probiotics could be key to getting your skin back on track.
- B Vitamins. Your skin needs B vitamins to regenerate and renew, as these vitamins provide the energy all of your cells need for fuel. Taking a good B-complex every day that includes a high level of B6 will target hormonal and premenstrual acne. B6 prevents skin inflammation and the overproduction of sebum (the oil your skin makes that can cause acne issues).
Always remember that once you have the right information about how your body really works, you can start making health choices that finally start to work for you. For more support, check out the rest of Alisa’s amazing tools:
You got this!
Written by: Alisa Vitti + the Flo Living Team
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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