As we age, wouldn’t it be great if we could enjoy the healthy skin of our youth without the spots that can sometimes arrive in your 30s and 40s?

The skin is a great barometer for what’s going on inside the gut and if you’re suffering from more than the odd spot, you may need to work on your inner beauty routine and address any dietary or hormonal imbalances.

If you have adult acne, the first step is to ask your doctor to carry out hormonal tests. One of the more common hormonal imbalances associated with acne is an increased sensitivity to, or raised levels of, testosterone and/or androgens. Polycystic ovarian syndrome may be involved in androgen imbalances as well as insulin and blood sugar imbalances.

If your acne tends to worsen mid-cycle or around your period, an oestrogen/progesterone imbalance may be to blame. Nearly half of all women get acne at these times and your doctor may discover that this is due to oestrogen dominance.

Help reduce oestrogen levels by improving liver detoxification with foods, herbs and specific nutrients – while also limiting your exposure to non-organic dairy and meats, xenoestrogens (found in plastics and other industrial compounds) and phthalates (found in perfume).

Get gutsy

Gut health is also critical from a hormonal perspective and oestrogen levels are affected by digestion. A normal bowel transit time allows excess oestrogen to pass out of the body, rather than being reabsorbed. More and more studies are also supporting the link between gut health and acne with recent research illustrating how SIBO (small intestine bacterial overgrowth) is 10 times more prevalent in people with acne. Probiotics can be helpful in optimising digestion and some strains of bacteria that evidence shows to be helpful in the treatment of acne include Lactobacillus acidophilus, Lactobacillus bulgaricus and Streptococcus salivarius.

Manage stress

Cortisol, released during times of stress, has a hand in controlling blood-sugar levels, metabolism and inflammation – which can influence skin health and may contribute to acne. Managing stress therefore, either through meditation or yoga or by taking herbal medicines and nutrients that help to lower and control cortisol, can help control acne. Vitamin B3 and zinc have both been shown to reduce acne and oily skin by regulating cortisol levels, while omega-3s can help to regulate and support hormone health. Again, probiotics can support gut function and reduce cortisol levels, helping you to maintain a sense of calm and peace.

Change your diet

Poor diet and food sensitivities can also be a cause of adult acne. The clue lies in the type of spot – fine red pimples or whiteheads on the face, neck and chest are often due to food reactions while large pimples and cysts are generally hormonal. The first step is to identify any food sensitivities via an elimination diet. Wheat, dairy, sugar and fatty deep-fried or creamy foods are the usual suspects. Eating low-GI, anti-inflammatory foods such as green leafy veg and taking sugar-metabolising nutrients such as chromium, magnesium, calcium and zinc can all help, as will avoiding dairy.

Consider a detox

Your skin is often the first place to show signs of an under-functioning liver as wastes and toxins are eliminated via the skin, resulting in pimples and acne. A detox can therefore give your liver and other elimination organs a spring clean and boost your skin health. Eating an abundance of plant-based foods – including leafy greens, cruciferous veggies – as well as easily digested and probiotic-rich wholefoods, will help. And don’t forget to exercise regularly and drink lots of filtered water! Traditional liver herbs like burdock root, chicory, dandelion root, turmeric and milk thistle can also be helpful.

Improve lymphatic flow

Your skin is your body’s largest elimination organ, so when you’re overloaded with toxins on the inside, it can show on the outside. Lymphatic fluid rests just below the skin so when the lymphatic system is sluggish or unable to rid itself of toxins, the skin suffers. There are lots of ways to improve lymphatic flow – start by drinking at least two litres of filtered, room-temperature water each day. And, incorporate 1–2 minutes of dry body brushing into your daily routine. Walking, jogging, swimming and cycling will also help.

A version of this article originally appeared in WellBeing magazine.

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