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Midlife Acne


Bottom Line/Health: I know a number of women who have this complaint. They got over their teenage acne, skin’s been pretty good for a couple decades, and then wham! Wrinkles and zits, all at the same time. So, what is happening for the middle-aged acne attack?

Dr. Brooke Kalanick, ND: As women start to go through the perimenopausal years of the fluctuating hormones on to the menopausal time, where they’re just all lower, a couple of things happen to our metabolism. One of the main culprits for acne is inflammation stemming from blood sugar problems. Fluctuations in your blood sugar, high levels of insulin, the hormone that lowers your blood sugar, can really wreak havoc on our pores.

What happens as your sex hormones, estrogen and progesterone, start to wane, is that those blood sugar issues get worse. And while all hormones go down during this time, estrogen, progesterone, and testosterone, these blood sugar issues make testosterone metabolism worse. Hence the breakout. So you start to see more and more of this, “Where did this come from? I’ve been fine for years and years and years.”

Bottom Line: Let alone if you’re in menopause and you’re not even really cycling all that regularly and yet they’re still coming out.

Dr. Kalanick: Yes.

Bottom Line: Best treatment?

Dr. Kalanick: Balance your blood sugar. When women go through menopause, we go for estrogen and progesterone. If you see many doctors, they’re going to say, “Okay, it’s time to take some hormone replacement.” And that can be one thing, but to get on top of all these metabolic problems, whether it’s your skin or your waistline or the things that are happening that don’t have anything to do with just solely getting those estrogen levels up, go back to adrenal health and blood sugar balance.

So not eating too many carbs, but eating enough. Eating frequently enough for you. It takes a little bit of fine-tuning, but women find when they get to this time, everything they used to do doesn’t work anymore. So it’s time to let go of our bias that “this is how I eat, this is what’s always worked for me” and do some experimenting. For most women during this time, a lower carb diet works really well.

And sometimes just some general adrenal support, herbs like Rhodiola or ginseng, can help take the heat off the adrenals as things go through this major fluctuation.

Bottom Line: And how about chromium, which is always helpful for balancing blood sugar?

Dr. Kalanick: Yeah. Then of course, all the nutrients that balance insulin and blood sugar, so chromium, cinnamon, gymnema, and nutrients like alpha lipoic acid is amazing.

Bottom Line: All right. And then how about also, I think we’ve gotten through a lot of the “fats are bad” strategy, but fat can also help manage the blood sugar as well, right?

Dr. Kalanick: Yeah, and it’s particularly omega-3 fatty acids, and lots of that nice fatty fish. And if you’re going to supplement with an omega-3 for your skin, for women I really like krill oil above even regular omega-3s, because it’s got some extra membrane components that can be really nice in normalizing female hormones and healthy for our skin.

Bottom Line: And how about topically? Will the same old Clearasil work on middle-aged acne?

Dr. Kalanick: Yeah, those will still work to deal with the existing blemish, but we always want to go for the mechanism. What’s causing this and how can you get on top of that? During this time, women are starting to see more wrinkles, like you said, so it’s not just breakouts; it’s kind of the worst combination of your youth and your maturing hormones. So using a topical vitamin A is also a good thing to start during this time.

Bottom Line: Topical vitamin A.

Dr. Kalanick: Yeah, some sort of retinoid compound just to help rejuvenate the skin and keep it more youthful-looking.

Bottom Line: All right. Thank you, Dr. Brooke Kalanick.

Source: Brooke Kalanick, ND, is a naturopathic doctor in private practice in New York City. She is coauthor of Ultimate You: A 4-Phase Total Body Makeover for Women Who Want Maximum Results. Date: January 6, 2015 Publication: Bottom Line Health
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