Published November 9, 2023 You thought you were over the acne hump and then, boom, your acne is back in your 30s. An unfortunate truth is that hormonal acne, and acne in general, can come about at any age – not just when your hormones are changing throughout puberty. While it’s hard to pinpoint the cause of adult acne as it totally depends on you and your specific constitution, we can delve into some of the ways acne might present on your face and what that means. Because, as much as we don’t want to admit it in the moment, acne is a sacred messenger telling us that there’s something going on internally that needs our attention. Stress If stress is at the root of your adult acne, you probably already know that. But actually doing the things that mitigate your stress is the real kicker. When your body experiences a stressor, your adrenal glands release cortisol (among other hormones) to better prepare you to fight or run – this is where the frequently used term “fight or flight” comes in. Your sympathetic nervous system takes over and you get the classic symptoms of rapid heart rate, quicker breathing, and sweating. The flood of stress hormones increases sebum production in your skin, which results in more clogged pores and, in turn, more breakouts. So if you notice yourself breaking out after, say, a build up to a big work presentation or spending time around triggering family members, you’re probably dealing with stress acne. On the other hand, if your breakouts are happening around the same time every month and are more or less in the same location on your face, that is likely tied to your menstrual cycle. Supporting hormone detox with gentle liver support and gut support can be really helpful for hormonal acne. We all know that stress is unavoidable, but if you’re constantly feeling like you’re existing in fight or flight mode, you’re living with chronic stress. If left unchecked, you may start to experience inflammation, hormonal imbalances, and depleted minerals, among other symptoms. All of which contribute to acne! So as you can see, it’s a bit of a spiral, but there are certainly things that you can do to help get you back on track. Lifestyle changes that minimize your stress levels are the name of the game here. Only you know what helps with your stress levels, but a few well-researched modalities are yoga, breathwork, meditation, spending time in nature, journaling and just simply walking. Inflammatory foods If your hormone levels are healthy, you don’t feel chronically stressed and yet you find yourself with persistent adult acne, you might want to look into your diet. In this day and age it’s common to immediately launch into an elimination diet for any sort of skin concern, which isn’t always healthy or even necessary. Instead of overhauling your eating entirely, you can start to look at a few of the foods that are known to trigger acne – like dairy and refined sugar. The thinking here is that most dairy contains hormones (androgens) which in turn cause increased sebum production and acne. There is some evidence that consuming raw dairy (unpasteurized) doesn’t have the same impact on your skin and may actually boost your gut microflora, which could in turn help your acne! Another great option is goat milk, or better yet, raw goat’s milk or kefir. But, fair warning, there is definitely a funk that might take some getting used to! Ever notice that you wake up with a zit after eating lots of sweets? That could be because consuming refined sugar increases your serum insulin concentrations (blood sugar levels), causing elevated sebum production, higher androgen levels, and suppressing sex hormone binding globulin (SHBG). One easy hack you can use to minimize blood sugar spikes is to simply eat protein and ideally a bit of fat with your sugar, like having a few nuts with your chocolate. Androgen levels If you’re experiencing deep, cystic nodules along your jaw, neck, chest, and/or back, this could very well be androgen (testosterone) related acne, which we often see in women with PCOS. PCOS tends to get worse in your 30s because of several metabolic factors: you become more sedentary, you lose muscle (your most insulin sensitive tissue), and insulin resistance/metabolic dysfunction throws off not just your testosterone levels but your progesterone, too, as ovulation is effected. Estrogen dominance If you’re experiencing acne right around ovulation (when estrogen surges) or the week before your period (PMS week), and these breakouts often occur on the cheeks or forehead, this type of acne can be related to estrogen dominance and a lack of progesterone in relation to estrogen. You’ll want to focus on boosting progesterone naturally (with key nutrients, a healthy diet, and perhaps herbs like Vitex), and you’ll also want to support your body’s detoxification pathways in eliminating and metabolizing estrogen. Cruciferous veggies and omegas are key for estrogen metabolism, and improving actual estrogen clearance requires two things: liver support and fiber. You want to buckle down on liver-detox-pathway supporting herbs like Burdock Root, Dandelion and Milk Thistle (found in Liver Juice!), and these herbs work even better if they’re taken right before a meal that contains a hefty dose of fiber (beans, veggies). As liver-supporting herbs encourage your body to release more bile, which contains not just excess estrogen but excess toxins as well, fiber will ‘mop up’ the bile and usher this hormone-and-toxin containing substance out of your body via your stool. Whenever someone is dealing with estrogen dominance and pre-cycle acne, upping fiber (both dietary via beans, and supplemental via inulin or psyllium husk) is one of the first things to look to in combination with liver support.