#079 Acne: Root Causes & Natural Solutions with Robyn Johnson, RD

Robyn Johnson is a Functional Medicine Dietitian Nutritionist. Her passion for using food and lifestyle as medicine found her after a personal battle and triumph with psoriasis. She specializes in helping women optimize their health & hormones by finding the root cause of their symptoms. Robyn runs a virtual private practice and is the co-creator of Her Hormones Academy, an online program for women who want to improve their health and hormones with food and lifestyle. Robyn believes healthcare should be individualized and that starts with each person understanding how their body works and what their body needs to truly thrive!

www.nutritionbyrobyn.com

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Transcript

spk_1:   0:00
welcome to the less stressed life podcast. This is your host, Krista Bigler. Private practice Integrated. A nutritionist helping people across the U. S. Reverse digestive issues. Exuma and Auto Immunity via phone and video. Consult toe. Learn more. Visit less stressed nutrition dot com Now onto the show today on the Lester's like we have Encore guest Robin Johnson, one of my favorite dietitians. She's back to talk about acne today, and Robin is a functional medicine dietitian nutritionist. Her passion is using food and lifestyle as medicine after her personal battle in triumph with psoriasis, she specializes in helping women optimize their health and hormones by finding the root cause of their symptoms. Robin runs a virtual private practice and as the crow creator of her hormones academy and online program for women who want to improve their health in hormones with food and lifestyle. And this is a topic that Robin's been talking a lot about, and it affects a lot of people. So I'm super excited to have her come and chat about this today.

spk_0:   1:00
Thanks for having me back Krista.

spk_1:   1:02
So we were just showing off air about a lot of things, but I was asking you about different types of acne. So let's talk about kind of the ebb and flow like sometimes people get acne as babies. Sometimes people get it, as teenagers tell us about. If there's different types of acne.

spk_0:   1:17
Yeah, so there's quite a few. And this is where it can be challenging for people who maybe even have it at different stages of life. And there's not a real pattern. So some of the different types include hormonal, which is often rooted with there's different types of hormones. And we can get into that but often seen Maurin women. There's inflammatory types. There's infectious types. There's stress related types. There's topical or irritants that often is just in one area, where something like, say, you have headphones on all the time and it's just area or there's combinations of different types, which is where the navigation of you know, using the different signs and symptoms can be really helpful.

spk_1:   2:01
Cool. Talk to me a little bit more about the the process that happens when you get stress. Acne

spk_0:   2:08
stress could be any form, and we could be talking about inflame inflammation from got stress. We could be talking about emotional stressors, and we know that these stressors of any sort haven't impact on our immune system. Our court is all our sex hormones, and so the way that it can be impacting acne could actually be through any one of those mechanisms. But really, what someone would notice is there more stressed from an emotional standpoint and their acne gets worse. Or oftentimes, with the gut related acne, you'll see the acne show up. Usually it's like all month long. It's not just cyclical, and oftentimes you'll see it, too, on the back or like upper shoulders and on the cheeks and forehead. So it's not always just like jawline type, and you've got the relationship with insulin. And so we know a stress. You get higher release of hormones like D H E A from the adrenal glands, and that's the stress related response. And so when you have higher levels of D H E A, which is in a precursor to things like testosterone and testosterone metabolites like DHT, those hormones are going to stimulate skin cells, which grow faster and produce more oil, which is then going to mean blocked pores and acne. And so that's really the mechanism in it. It roots in the skin cells and it roots in the testosterone and hormone relationship.

spk_1:   3:31
So with acne, you just meant wouldn't oil and it made me think of with acne. Is it always too much oil in a poor doing the wrong thing? Like, Is there there? Is that the traditional kind of definition, or is it couldn't be different.

spk_0:   3:44
That's typically what's gonna actually create the acne? Yes, okay, now there's different types, or there's different mechanisms or reasons that that will actually happen. But in terms of what's happening on the skin, yes, that's one of the most common reasons you're gonna see acne.

spk_1:   3:59
So, you know, in the last couple of years I'm full of, like, Random Questions Day. In the last couple of years, oil based cleansers and oil based like night creams and serums have become really popular When we think, just like both, what makes sense? If someone already has oily skin, we would think that maybe that would be counterintuitive, but that's not necessarily the case. Do you know anything about these oil based products? Well,

spk_0:   4:21
so this is doubly more of the esthetician type person. I work a lot more with, like the internal component. However, we definitely know that the ph of the skin matters and the topic A ls that you're using matter and the oil production matters. And so it's kind of like similar to, you know, the more you wash the oil out of your hair or the more you wash the oil out of your face, you're affecting what your body your skin is in producing. And so there's certainly a relationship, I would say with clients, so I definitely am focusing more on the internal. And then, you know, we're gonna look at their top pickles and and assess the cleanliness and that type of stuff. But usually by the time clients are seeing me, they've already experimented a lot with different topic ALS,

spk_1:   5:02
right? Totally. It's what we were talking off air about working with skin issues and how we want it to be so simple because it seems topical. But it's not a lot of things going on under the old iceberg,

spk_0:   5:13
inner and outer components, for sure.

spk_1:   5:16
Yeah, it's frustrating. So, um, you kind of almost maybe gonna rob another, have a hole about people that washing hair and all that thing. But that's another story for another day. Let's talk about common root causes. Attack me. We just talked about that somewhat. But is there anything to add?

spk_0:   5:32
Yeah, for sure. So I would say the most common ones that I see would be the hormonal type and the inflammatory type. And that's probably because I focus more on women's health, but with the hormones. So we're talking about things like insulin, which is a hormone, which I kind of talked about that mechanism. But we're also talking about sex hormones, which usually the reason that acne is triggered from a sex hormone standpoint is the relationship between testosterone and estrogen and testosterone and progesterone. And so, when I recommend a lot of people do, if you are battling acne is try to keep track of when it's happening. Is it cyclical? It all like in relation to your hormones? It Did it show up after birth control? Do you have PCOS Or you know, there's a lot of cyclical stuff that you can kind of journal and track, and if that's the case, you're you're likely looking at it, or I am hormone based acne and then the harder part would be navigating. What type or where's the imbalance at? And then we also have the the insulin type, which I talked about. Essentially, you're you're increasing production of androgen precursors in the skin, which is then boosting that oil production. And then the other big one would be the inflammation type. And so this typically isn't very cyclical. This is usually more of an all month type, and then we have to go down the rabbit hole of what's causing the inflammation right. And this is, as you know, the challenging part of our job. And it could be got related. Like LPs. It could be food inflammation. It could be oxidative stress. It could be histamine. There's lots of different potential interplanetary triggers that air relating to the acne showing up.

spk_1:   7:17
Right? You know, I was talking to someone about this yesterday, a client who had impaired glucose insulin interaction with my girl nutrients. We saw that show up on testing. We were talking about insulin and its relationship to her acne. And then she was asking me if she could drink alcohol and so on. And so, um, I was saying about I was telling her about how alcohol can help aroma ties, um, androgens into estrogen and possibly create different kinds of acne there. Um, what are your thoughts about this like, would you say, um, how do you think Alcohol place and in general,

spk_0:   7:53
Yeah. I mean, that's gonna be so individualized like we're talking about offer. You know how someone's liver detoxifying when you're talking about estrogen like you just mentioned, that's a whole process on it in its own. So if you're drinking alcohol and you don't have great estrogen metabolism are liver detoxification within the liver, you're just adding to the burden burden of the hormonal issue that's going on. And those issues within a liver are also potentially factors for someone's acne showing up. So if you're in the motor in the zone of figuring out what's going on, I always say, Take out the obvious ones that we know are not serving our health.

spk_1:   8:33
Yeah, I'm jealous of all the people who have these issues on the inside but still have beautiful skin because that was not me. So

spk_0:   8:39
I can either. Oh my gosh, that you and me both. That's why I think we both have a soft spot in our hearts for the skin issues because we know the, you know, the physical pain that comes with it, but also the emotional pain that comes with it.

spk_1:   8:50
Yeah, I've actually had people have this whole array of issues this whole laundry list of symptoms and or diagnoses. But they don't call someone until it starts presenting on their skin. Because once it hits that appearance, it's a different level of emotion and anguish, et cetera.

spk_0:   9:07
Yeah, I mean, and I think that kind of goes with weight loss being a big goal. You know, those physical pieces are definitely triggers that people finally reach out for help.

spk_1:   9:16
Yeah, I hadn't thought about that correlation, but it's such a good point. Okay, uh, let's talk about certain foods that create an environment for acne.

spk_0:   9:25
So then it could be many lots of individual individuality here, but the biggest to that, if someone were to start with, would be sugar or the process carbs, category and dairy. And this really circles back to the pathways that I mentioned, which are the insulin with sugar. A lot of process carbs were definitely impacting our blood sugar. and our insulin levels, which then goes Hold down that hole rabbit hole of stimulating the skin cells to produce more testosterone pieces. But then the dairy we know not only is dairy just a direct, it directly increases the skin cell growth, but it also is a big increase of I. G F one or insulin growth like factor. And so you get the same signals as the insulin that you get from that which it ends up triggering the same pathways. And this won't be the same for everybody. So not everyone who eliminates sugar or dairy is going to see a difference totally depends on the type, but those were the biggest food categories. And that's why I mean in the last 2030 years of research, looking at the relationship between diet and acne. All of the interventions are many of them look at reducing sugar, reducing process carbs and reducing dairy because of those known pathways.

spk_1:   10:46
Right? A side note you were talking about being about dearie and growth factor, and so we think about always mentioned people. The reason we have dairy is because of a hormonal process that Calvin's experiencing. So you're gonna take on those hormones a bit. Um, an estrogen in general is a like a growth hormone, right? So

spk_0:   11:06
exactly exactly And mr mean to, you know, histamine dairies of a history trigger and could be one of the reasons going on in the gut. So that's why when you you know when you google or look up acne and food, dairy is almost on everything because it's one of the biggest ones that people do see a difference with,

spk_1:   11:26
Um I feel like we've just covered how hormones play a role in acne. Did we miss anything?

spk_0:   11:31
No, I think we got that one. Okay, cool. So I guess to that the only other difference would be too narrow, narrowing on estrogen and progesterone in terms of sex hormones. Because the reason I have people look at is your acne. Showing up in certain times of your cycle is because that can be really good information. And the reason you see acne would, if it's hormonal, is really because of the relationship between testosterone and estrogen arrest or testosterone progesterone. And we need healthy amounts of both estrogen and progesterone to combat what's going on the testosterone and so It's really like that Goldilocks thing because too much of any of any of those progesterone, testosterone or estrogen can be an issue Brackney. And so if you see that it's cyclical, you know that is an area that you need to dig into,

spk_1:   12:29
right? Let's talk about that cycling, because if we see a cyclical, let's talk about let's say it's it's common to see it maybe a week before your period, right, because we see what a surge of estrogen at that time. Would you say That's the correct reason. And then what about right after ovulation as well?

spk_0:   12:45
So flip that before, before ovulation you're seeing increased in estrogen. And typically this is not when people see their acne, most of the time they see it in the second half of their cycle and in at that point, so it's pre period acne, and you should see an increase in progesterone as estrogen will be lower and testosterone usually remains the same. So one of the most common reasons that people are seeing acne there is because progesterone is much is too low in relation to the testosterone, and there's lots of potential reasons for that. But the goal. There is a make sure you're actually ovulating to produce progesterone at all. And then there's a lot of dietary things that can be done to help progesterone production, and I do see this the most. What I'm noticing is a lot of women who are experimenting with lower carb or fasting, and they're doing that, like to push it too far. Doing it too long. You're you could be decreasing your total hormone production and therefore, if progesterone is lower or estrogen is lower than you're more likely to see that acne show up. So if someone's listening to this and they're thinking like, Yeah, that's me, then that may be an area to look into.

spk_1:   14:01
Okay, that makes a lot of sense. That was one possibility. You said There's a lot of possibilities of progesterone being too low in relationship to testosterone. Can you cover a couple others?

spk_0:   14:10
Yeah. So big. High stress is another one, um, reasons for not ovulating in general. So this could be like over exercising again. Not eating enough could be nutrient insufficiencies. Things like vitamin e, Vitamin C could go down a lot of rabbit holes of specific nutrients, but it really comes down to optimizing your eggs and optimizing population because ovulation is why you produce progesterone. So you have to make sure you're ovulating every month to get that progesterone.

spk_1:   14:44
So for someone not ovulating, they're probably just did General increased risk for acne

spk_0:   14:49
over. Oh, for sure for sure.

spk_1:   14:51
Okay, cool. Um, is there another person that's in it? Add in at an act. Increased risk? Where do you feel like we just covered that

spk_0:   15:00
meaning pre period or just in general, I would say, someone who's coming off of birth control. Uh, that's a common time because your body is relearning to make those hormones your own hormones. And so if you notice that, then you're gonna have to give the body sometime or really focus in on optimizing those. And the reason I'm keeping a lot of the tips and tricks short because they're so many. And this is the type of stuff that we go into detail and the online course. He mentioned her Homans academy because it is so complicated and so you can't really cover it in a you know, 32nd answer. And so if someone notices pre period acne or post birth control, acne or acne with PCOS, I would like I would encourage you to think of that is OK. I have really good evidence now, and I've narrowed it down to ah hormone type and now go to the next step of more investigation,

spk_1:   15:57
right? I like that. I think the other thing that makes this tricky is for me with hormones. When I see pictures of how things are working and timelines, it makes it easier to understand. Right then, if someone's just, if you're just hearing in your ear a little bit, because when things happen in a cycle and how things increase in decrease, that makes a lot more sense. When you see an image, absolutely, you can like more, much more quickly explain it. So we talked about the second half of the cycle being the most common. You have the pre, um, because of progesterone being too low in relationship testosterone, right? That's what happened. That's what's happening in the second half of the cycle. Is that what you're saying?

spk_0:   16:33
Yep, because progesterone helps regulate that testosterone metabolism, so you need it.

spk_1:   16:37
So what about when it's in the first half of the cycle, then what do you think?

spk_0:   16:41
It's typically not as common for it to just be in the first half and not in the second half. If it's, I would honestly say I've actually never seen it just in the first

spk_1:   16:51
being. All

spk_0:   16:51
that I've seen it happen. I've seen it happen just at ovulation, so that around ovulation, that three day ish period when someone might notice that. And usually that's because of a quick change in estrogen.

spk_1:   17:04
Two things fluctuating too quickly. Okay, All right. Um, what are your top nutrition strategies for healing acting? We talked about sugar and dairy that we may have covered it all already right. There's a

spk_0:   17:16
few more. I mean, I would say the biggest one is if you haven't tried a try Elimination of dairy and sugar. I would say Give that a go for 6 to 12 weeks. And that's the hardest part is we're working with hormones here, so you do have to give the body time. And what you're eating now is impacting your eggs or what? You're ovulating in three months, so you really, really have to be patient with that and then some other ones are eating for balance blood sugar. So helping with that insulin relationship keeping healthy carbs, Healthy fats, healthy proteins at regular mealtimes that you can help stabilize that blood sugar and then another. Big one is antioxidants. So making sure that you're getting colorful rich fruits and veggies because they've actually done studies that show individuals with acne have significantly less amounts of things like beta carotene, vitamin C, vitamin E, vitamin A And so if you can get those in foods than you're helping support those antioxidants which combat the oxidative stress.

spk_1:   18:16
Cool. So recap it takes a while. So 6 to 12 weeks you have to do that experiment. And a lot of people are not doing it that long honestly. And then be very colorful for the anti accidents and, you know, protein found kharbata meal. Okay, um, what outside of food and nutrition, what are some other strategies for improving acne?

spk_0:   18:36
The biggest one would be stress, and I know that that's not the sexy answer some people want. And I've had clients where that is the root cause and, you know, we can find that by obviously there's certain types of testing you could do to look at court is all in stress relationships, but you rule other things out and you see the life and you see the patterns, and that is one of the hardest ones because it does involve more of the lifestyle changes. But it is a very big factor that a lot of people kind of wanna want to ignore because the other things faster.

spk_1:   19:07
You hear that? That's one of that's, like, sometimes a primary reason. We'll do hormone testing later on because we want to see if things were getting stuck in stress. Yeah,

spk_0:   19:17
we want the validation to say, Hey, like, this is why,

spk_1:   19:20
right? Exactly. And I would say, I think I've said this before on the podcast. I would say those that are not unable to dial down their stress or do not make it a true priority have a very hard time improving all symptoms and all that,

spk_0:   19:33
and it's, you know, overwhelm its mindset. I personally have fallen in love with breath work, so that's if those those who can't meditate I feel like breath work is amazing because you have something to focus on. So if something someone hasn't tried it, give that a Google.

spk_1:   19:47
Yeah, I was actually really happy. I saw on instagram stories the other day. Someone I know was went through a surgery and I don't know where it was for cancer. And his daughter was writing on the hospital board, but diaphragmatic breathing, this isn't a clinic. And I was so happy to see that that was an intervention that was being is there. I just thought I don't know about it and I might ask when I see these people next, But I just thought it was I was very happy to see that

spk_0:   20:15
That's awesome. I think we'll be seeing it more and more. And then another non nutrition component is the topic ALS. And like I said in the beginning, I'm definitely not the expert in that. But we we do want the skin to have a lower pH. And so the types of cleansers you're using and the moisturizers and all of that can have an impact on the skin. Especially if the type of acne is more of an irritation type or an infection type or ah, inflammatory type. The topical piece is a big factor.

spk_1:   20:46
Yeah, that makes sense. Okay, uh, let's see. So if someone's having occasional breakouts, especially if they're an adult, what do you recommend?

spk_0:   20:56
Occasional breakouts? I would still say Investigate the tight because there's still a reason. So journal the patterns used some of the things we've talked about today to experiment, you know, pay attention. Did you go on vacation the week before and have a lot of milk or cheese? Like personally, I know if I overdo it on dairy, I will get a break out. And so you know when you're getting it and then reverse and see if there's something that may have been the trigger for that.

spk_1:   21:23
Yeah, I would totally agree. It's so annoying when you eat using your like,

spk_0:   21:28
sometimes you know it's gonna happen and you're just like it's worth. It

spk_1:   21:31
actually came from cheese for lunch, and I thought, Don't really like when I've broken out. I don't know. I don't know that it's actually you know, I think things can improve over time, honestly, and how your body handles. And I know things have improved, so I'm like, Well, I'm not really sure you're not. But, you know, I was still stuck in the mindset that yeah,

spk_0:   21:49
And I think that having that mine said, that can be helpful for people. Because when you talk about things like, you know trialist sugar and dairy elimination, if they've never done that, they think, Well, then I'd have to remove it for my entire life. And that's not always the case it can be. You remove it, you identify that. It's a factor, and then you get to choose moving forward when you're gonna have it and what you're willing. You know where your bucket level is.

spk_1:   22:14
And if you improve other factors related to how dairy is processed in your own body, um, it may reduce the severity or how much you're breaking out from it. I believe so. Exactly cool. So if someone's listening to this and they're dealing with acne or they dealt with occasional acne or they're like, Oh my gosh, I have this problem and it sucks what you want to leave people with.

spk_0:   22:36
I do have a free acne webinar that I've done with a Kelly who is my co creator of her home. It's Academy, and so that's on my Web site, Nutrition by robin dot com, you can find that a full, like our long acne webinar. And then, if you really want to dig into more of everything here than her hormones, Academy is targeted for things exactly like this, especially the hormone related acne

spk_1:   22:58
cool. And it is a very broad academy. So excellent, Robin, thanks again for coming back on sharing a little bit. I love doing these micro topics. I think it's especially when they affect so many people. It's fantastic because even a micro topic, you can get kind of deep into, um, and still it doesn't you know it's not ours and ours. That was a good time. Thanks so much.

spk_0:   23:19
Thanks for chatting by

spk_1:   23:21
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