Skin stuff. I get so many emails on this topic that I figured it was time to address it in a blog post. It took me a while to finally sit down to write this post because skin “issues” are so multi-factorial that it’s certainly no one-size-fits-all and I was finding it difficult to write a post that would be helpful for anyone reading. Essentially it was hard to write a general post about something so individual.
But here we go.
I think it’s important to first realize that just like the pursuit of a flawless body would take extreme measures and you likely would always be chasing after fixing flaws, the same goes for skin. The beauty and cosmetic industries lead us to believe flawless skin is what we all desire. The more we talk about flawless skin, the more I see the parallels between how we view our bodies and how we view our skin. In the same manner we are lead to believe by the diet industry that something is always wrong with our bodies, we are often led to believe there is something wrong with our skin and therefore it needs fixing. I say all that as a preface to this post. Because while yes, there will be medical conditions that affect your skin and your skin can gently tell you, “hey self, we need paid attention to….something is a little off.” – this idea of flawless skin can lead to a lot of unmet expectations and frustration…just like the idea of a certain body size. I think it’s important to remember and process through that.
With that said, I do believe there are some things our skin helps communicate to us. Just like our bodies can help communicate to us when it needs more or less of something.
So what causes skin changes?
Although there is still a lot of uncertainly in the literature between when you consider acne to be adult vs adolescent, adult female acne has traditionally been defined as acne in women 25 years old or older. I define that a bit because the etiology of adult vs adolescent skin issues can be different.
Historically, acne has been attributed to four main factors:
- Sebum production – the oily, waxy stuff produced by your sebaceous glands in your skin that clogs your pores.
- Hyperkeratinization – which basically means keratin (a protein) accumulates and causes dead skin cells to stick together and clogs your pores
- Growth of bacteria called Propionibacterium acnes – this bacteria lives in your hair follicles and when those pores become blocked, the bacteria multiply and contribute to acne.
- Inflammation – this can be caused by so many things but think of this as stress in your life – nutritional stress, exercise stress, sleep stress, psychological stress, physical stress…
While these are traditional causes that are established in the literature, and while these are likely involved in skin issues as we go from adolescent to adult women, the specific factors that lead to a new onset or recurrence of acne and skin issues as we transition into womanhood actually aren’t very clear in the research from what I’ve found. But hormonal fluctuations and genetics seems to play a key role.
I think it’s important to remember when somebody says, “hormonal acne” that really all acne is mediated by hormones. When you get your first pimples as a teenager, that’s due to an increase in androgen production during puberty which causes the increase in sebum production. And the other three reasons listed above are hormonally mediated. So I think a better way to think about “hormonal acne” when we talk about acne that surfaces as we enter adulthood as women is “menstrual acne.” Because really, it’s the monthly hormone fluctuations throughout our menstrual cycles that are likely the key players in skin changes.
Even more important is realizing that just like we cannot control our genetic set point weight, we cannot control our genetics involved with our skin. It is what it is. There are things we cannot change and that is okay. I don’t think we realize how much of our skin appearance is actually out of our control. Example. I have more wrinkles on my face that you average 28 year old. There isn’t judgment there (I’ve had to work on it..) but it’s an observation I’ve made. Then I realized I’ve had wrinkles around my eyes since I was like 10. This is part of my genetics. Can I moisturize and take care of my skin with SPF etc…sure. But I will always have these wrinkles and that is okay. I call them my laugh lines.
As a culture, I think we hyper focus on skin’s appearance, how old we look compared to our actual age, how many skin spots and wrinkles and pimples and freckles and moles we have. I could go on and on and on. What if we thought about what our skin did for us and focused on simply taking care of it for health reasons and not solely appearance? Your skin regulates your body temperature, protects you from toxic substances and harmful effects of the sun/radiation, excretes toxic substances through your sweat and keeps everything all tucked inside of your body. Your skin does so much for you!
So instead of focusing so much on the minutia of you skin – getting rid of that pimple here or softening that wrinkle there, I think the more important thing is doing a little self evaluation of how you are caring for yourself – yes physically with nourishment and healthy movement and adequate sleep, but also mentally and emotionally with self care and stress reduction. Focusing on those things affects skin health because it helps normalize cortisol levels – high cortisol throws your chemical and hormonal balance off. And focusing on those things helps keep the hormonal fluctuations during your menstrual cycle smoother (which cortisol plays a role in too) and less like a pendulum swing. Lastly, part of skin health is wearing sunscreen and putting nourishing products on your skin – I think that’s important to note too. And this isn’t a quick fix. Figuring out how to best care for yourself in all realms of health is a long process, but one that is well worth it.
Food is not the sole reason your skin is finicky. You don’t need to go on an anti-acne diet or eliminate all sugar and gluten and diary from your diet. Research is underwhelming on that. In fact, that actually might cause more stress because of the decision fatigue that comes with figuring out what the heck to eat. Focus on foods that physically nourish your body (fruits, veggies, complex carbohydrates, healthy fats and proteins) while also eating satisfying foods – both are important. Blood sugar regulation is also important. Make sure you’re eating every 3-4 hours and including all the macronutrients at meals (carbs, proteins, and fats). Large swings in blood sugar can affect skin health. Listen to your body and how you feel after eating and let that guide you.**
Is the physical activity you’re doing adding more stress to your life? Is is actually helping you de-stress or is it temporarily numbing you out from stress? Remember that moderate to high intensity movement (anything where you can’t sing the whole time) increases cortisol levels. But also remember it’s about the totality of your life – if you do higher intensity movement, balance that with rest and recovery, make sure you’re eating adequately and taking care of yourself.
I can’t stress the importance of good sleep enough. Get at least 7 hours a night, but ideally 8 hours. This is a big part of self care, putting yourself to bed at a time that allows you to get enough sleep. Research tells us that insufficient sleep raises cortisol levels and causes insulin resistance which affects your blood sugar control. Maybe creating a bed time routine is part of self care for yourself? Maybe ideally you’d like to make a cup of tea and read for 30 minutes an hour before bed. Then do some stretches, brush your teeth and wash your face (or whatever you do for hygiene) and crawl into bed without your phone or any electronics. Start with slow changes each week until you get into a rhythm of care for yourself around bedtime.
How do you care for yourself? Maybe you don’t or have thought about it. Maybe you need to take some time and space to reflect on areas of your life that aren’t a priority, but you’re still investing time and energy into. What are some areas you can set boundaries around to better care for yourself? I think Kylie’s self care box and blanket are great ideas to get you started with this process.
Most importantly, my inner nurse is coming out and telling you to wear at least SPF 30 if you’re going to be out the sun for more than 10 minutes. That’s black and white and something I highly recommend 🙂 But also I think it’s important to put things on your skin that help you and your skin feel it’s best. Everyone has different skin needs – some people have dry or oily or sensitive skin – but I do think it’s important to cleanse and moisturize and care for your skin. And that doesn’t have to cost your entire paycheck. I have been using the Body Merry line that I order off Amazon for over a year now and really like it. I’ve found that starting with the cleanser, then toner, then rubbing on serum and finishing with moisturizer works well and takes all of 60 seconds. The products last me 6-12 months too. That’s just what works for me, find what works for you and your skin.
Skin care is so multifactorial and remember time and time again, genetics play a role. It’s okay to be frustrated at that pimple or wrinkle or red spot while also making space to be gentle and compassionate with yourself. Your skin is more than just appearance, it does so much for us. And I think if we focus on taking care of ourselves as a whole, our skin will be taken care of too. For health reasons and not simply appearance.