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Skin, is a vital organ. It acts as both a protective barrier from the outside world as well as a “vent” for us to move toxins, fluids, and heat buildup (i.e. inflammation) from the inside to the outside. In Chinese medicine, it is considered the “third lung” because of its capacity to breathe for us. It is alive and even has its own microbiome! These are little microbes that live on the skin’s surface whose job is to create the most perfect environment for the skin to function and thrive. This outer microbiome is, of course, fed by our inner microbiome (a whole other topic!).

Antibiotics, retinoids, and benzoyl peroxide are often the front line of defense for allopathic dermatologists. They kill bacteria, bleach and dry out the skin, force the skin to turn over new cells rapidly, and reduce or eliminate the skin’s natural production of oil. Not to mention, because they are prescription medications, our body has to work to eliminate them from our systems once we have used them, mostly the job of the liver.

I understand the use of topical medications. They sometimes carry the promise that they can quickly reduce the appearance of acne. Who wouldn’t want that?

But at what cost? Creating more vulnerability in the immune and endocrine systems? Compromising a person’s microbiome, which can destabilize mood, hijacking our hormones, and even disrupting fertility? The issue with topical medications is that they are not resolving the root cause of a person’s acne, so when you stop the medication, it will just return. This is why we get hooked on these medications for years and scared of the backlash when we stop using them.

The root cause of acne I have found consistently in my private practice to be heat and dampness that has built up inside the body, leading to inflammation, overproduction of oils, and a more acidic internal environment. The skin is simply responding naturally by trying to “vent” this heat, inflammation, and thickening of the body’s secretions (known as dampness in Chinese medicine) from the inside of the body to the outside. It is actually quite smart that the skin responds in this way. And this is how acne medications work: they suppress this natural response.

Where do the heat and dampness come from?

The #1 culprit? Dairy
The #2 culprit? Sugar

When clients come to me wanting to transition off of topical prescription medications, I am over the moon to go on this journey with them! But I wouldn’t want them to stop taking their prescriptions just yet. Not until they have done some of the deeper work. Changing up the diet to something more natural (vegetables, fruits, seeds, nuts, and meat — or other proteins the body understands) is absolutely necessary to heal the skin. Eliminating sugar and dairy is vital. I would also add eliminating the top 5 food irritants for thoroughness and to expedite the healing process, which includes dairy, but also, wheat/gluten, corn, soy, and eggs.

To counter the heat and inflammation, drinking plenty of good water and eating cooling foods are important such as: lemons, limes, cucumbers, celery, melons, pears, asparagus, leafy green vegetables, mushrooms, sesame oil, and drinking chrysanthemum tea.
To counter the dampness, we don’t want to immediately consume astringent foods because remember, the dampness is a healthy response to a diet that is irritating, thickening our body’s natural secretions, and increasing our inflammation! And many of the medications are already very drying.

Restoring the microbiome is vital if someone has been on antibiotics. From what I have seen in my private practice, it takes about a year for our microbiome to restore after one round of antibiotics. Eating well and including probiotics in your regimen (not just probiotic supplements but also the skins of organic fruits and vegetables and fermented products like kimchi, sauerkrauts, etc.).

Emotional stress also majorly impacts the microbiome. And so do toxins as they put more stress on the body’s detoxification pathways: skin being one of them. Doing what we can to eliminate stress in all regards will be hugely helpful in healing the skin.

And even with the deeper work, there still might be a backlash coming off of medications because they have been suppressing your body’s natural impulses for however long you have been on them. You might also go through a bit of a detox process coming off of them and get headaches or breakouts in strange places. So I always tell clients to expect some sort of rebound reaction, even though some of them might not react at all. Drinking warm lemon water each morning, taking baths, and skin brushing can help with this.

We can’t deny that we live in a culture that is pretty wrapped up in aesthetics; and skin that is expressing acne or rashes is looked at as though something is wrong with the person. It is the antithesis of “beauty”. I understand. As a teacher, writer, and practitioner of holistic healing if I had acne, some of my clients and students might think that I am unhealthy and not practicing what I preach when it comes to lifestyle, nutrition, etc. when all that could have happened was that I drank one too many glasses of wine or ate too much spicy food the night before.

Perhaps the deeper work for us all is to evaluate the stories that we have created about those who struggle with acne and work to create a softer place for “blemishes” and other aesthetic imperfections to land.