Pimples don't end when puberty stops. Things like stress, environmental pollutants, diet, and hormonal imbalances can all lead to blemishes well into your adult years (and even into perimenopause). 

Amanda sat down with Dr. Keira Barr, a prominent leader in women’s medicine who specializes in hormones, skin, and mind-body medicine. They discussed how stress and hormones affect skin, the best supplements for treating blemishes, and how to adjust your thinking when it comes to dealing with pimples.

What causes blemishes?

“Acne’s primary components are oil, dead skin cells, bacteria and inflammation,” Dr. Barr explains. It’s an inflammatory skin condition that consists of blackheads and whiteheads, which are caused by excess sebum production and clogged pores. 

The human skin microbiome contains an abundance of the bacteria Cutibacterium acnes. C. acnes regulates essential skin functions, such as mitigating oxidative stress and balancing lipid production. When there is an imbalance or loss in the diversity of C. acnes in the skin, it causes blemishes (or other skin disorders, such as rosacea or dermatitis).

The primary root causes are: 

• Genetic predisposition 
• Hormonal imbalance
• Diet 
• Stress
• Environmental factors

Stress, hormones, and skin

Stress can be one of the main causes of pimples. “Your skin has its own hypothalamic pituitary adrenal axis that can generate stress hormones, as well as the sympathetic adrenal medullary axis that releases your catecholamines like adrenaline and your noradrenaline,” Dr. Barr explains.

“Cortisol is your primary stress hormone, and the release of it can wreak havoc on your skin because it can directly stimulate your oil glands. That's why when you’re experiencing stress before a big event, you might break out. The stress response can also shift the innate microbial environment on your skin and alter skin cell turnover. So when we’re stressed, everything gets out of whack.”

To mitigate the effects of stress on your skin, it’s important to manage your stress levels and regulate your body’s cortisol production. Here’s where to start:

• Get enough sleep. “Sleep is your number one key way to rejuvenate your skin,” Barr explains. “Melatonin is the most potent antioxidant that your body can produce naturally, and that will help your body recover from the oxidative stress from the day.” Cortisol levels gradually rise throughout your sleep cycle, so getting an adequate amount of sleep each night will help to regulate stress and keep skin in a balanced state.
• Eat a balanced diet. Many studies show a relation between consuming large quantities of dairy, carbohydrates, and sugars and an increase in blemishes. As proper nutrient intake helps to balance cortisol levels, you may try cutting out high-glycemic foods and focusing on omega-3 fatty acids and anti-inflammatory foods, (like leafy green vegetables, nuts, olive oil, and lean protein) to combat the side effects of stress.
• Focus on hydration. Dehydration can cause stress on your body, elevating your cortisol levels and leading to excess sebum production. Support your functions by drinking an appropriate amount of water each day, particularly with electrolytes and minerals for better absorption. 
• Supplement with vitamins, minerals, and adaptogens. There are many supplements that may help to fill in the gaps in your nutritional needs. Adaptogens can also help to balance stress levels to keep skin healthy and prevent non-cystic acne from flaring up.

Are supplements good for treating pimples?

Some studies show that supplementing with the right vitamins and minerals (along with a nutrient-dense, balanced diet) can have a positive effect on treating pimples.  While supplements themselves won’t immediately banish your breakouts, they can help to balance both your intestinal and cutaneous microbiome, which will help to manage sebum production.

What are the best supplements for pimples?

Magnesium for skin

“Magnesium helps perform so many functions in our body,” Dr. Barr explains. “Depending on the form of Magnesium — especially with acne — if there is gut dysbiosis or if people tend to be constipated, it helps to move things through. Magnesium Citrate would help the body eliminate the toxins.

Magnesium Glycinate can help with sleep and regulating the nervous system. As we know, stress can be a significant factor in acne; not only in stimulating those oil glands, but also the experience of having acne can create a lot of anxiety and overwhelm. So Magnesium can be helpful in calming the body.”

B Vitamins for skin

“Pantothenic Acid, or Vitamin B5, has been researched in terms of being supportive for acne and skin cell turnover and integrity,” Dr. Barr explains.

Vitamin D for skin

Vitamin D has an immunoregulatory effect (limiting the production of proinflammatory cytokines), as well as an antimicrobial effect. It also supports the production of antioxidants, which nearly 50% of those with pimples are lacking, certain studies show.

Zinc for skin

Zinc also has anti-inflammatory, immune-balancing, and antioxidant properties. According to certain studies, Zinc supplementation had a beneficial effect on those with certain skin conditions.

Adaptogens for skin

“If you're then going to supplement, what are things that are going to help your body deal with oxidative stress?” Dr. Barr asks. “Well, certainly your adaptogens — Ashwagandha, Rhodiola, Lemon Balm — things that help regulate your nervous system are going to be really important.”

What to take away

If you’re addressing pimples at any time in life, Dr. Barr encourages you to try to offer your skin some forgiveness — and learn to work with it, not against it. “For those who are struggling with acne, eczema, melasma, things that may be visibly difficult to contend with, your body is simply doing what it thinks it needs to be doing to maintain the function and integrity in the best way that it can,” she says. “Approach your condition from that place of compassion and kindness towards your body and yourself to work together versus against each other.”