Common Conditions Treated At Our Toronto Holistic Skincare Clinic

Hormonal acne can be an emotionally taxing and relentless battle. Unlike other forms of acne, which can often be attributed to external factors, hormonal acne stems from internal imbalances and fluctuations in your body’s natural hormonal system. These unwelcome eruptions of blemishes, often concentrated around your jawline, chin, and cheeks, can have a profound impact on your self-esteem and overall emotional well-being. The frustration of hormonal acne goes beyond the physical discomfort and appearance; it reaches deep into your psyche, leaving you grappling with a rollercoaster of emotions, from insecurity and embarrassment to despair and helplessness. Understanding the complex nature of hormonal acne is crucial in addressing not just its physical symptoms but also the emotional toll it can take on you.

We recently had a patient in Toronto at Connected Health & Skin do a discovery consult with one of our Naturopathic Doctors for her persistent, painful acne that had first appeared in her late 20’s. She had reached out because the only options her doctor and dermatologist had given her for her acne was the birth control pill or Accutane but she had experienced limited success with these treatments in the past. She wanted to take a more natural approach to the hormonal acne she was suffering from and wanted the confidence to go without makeup. She wanted a better understanding of the root cause of these breakouts and a plan to better manage them. And she wanted to work collaboratively with a healthcare provider so she was more educated and empowered in her care plan. This is exactly the type of care we provide at Connected Health & Skin – compassionate, empowering, and collaborative – while working to unravel the underlying causes of hormonal acne and provide relief so you can get back to living your life without constantly stressing about your skin.

Just about everything you need to know about hormonal acne can be found in this article. And what can’t be found here you will be given additional resources to further explore the areas where you still have questions.

Use the quick links below or just keep reading and get all your initial questions about hormonal acne answered.

Acne does not just affect young teens going through puberty but instead also affects adults of any age. About 40% to 50% of the adult population ranging from 20 to 40 years old have some sort of acne on their body.

While any gender can have hormonal acne in their adult life, it typically affects women more than men. Studies have shown that about 50% of the women population ages 20-29 deal with acne, and 25% of women ages 40-49 also deal with it.

Why do women experience more hormonal acne than men? Women tend to experience more hormone fluctuations compared to men due to puberty, menstruation cycles, pregnancy and menopause.

Hormonal acne is acne that occurs when a person’s hormone levels fluctuate. Fluctuations of estrogen, progesterone and testosterone can cause zits and pimples to pop up. Typically, these fluctuations happen mostly during menstruation cycles, pregnancy and menopause.

During these times of increased hormones, the body produces more sebum, an oily, waxy substance. This then leads to inflammation, changes in skin cell activity and colonization of bacteria in hair follicles. With this combination, acne starts to appear. Medications, antibiotics, specific foods, depression, anxiety, stress and other mentally triggering elements can contribute to hormonal acne as well.

Hormonal acne blemishes, often characterized by their inflammatory nature and tendency to occur in specific areas like the chin, jawline, and cheeks, result from a complex interplay of biological factors within the body. Understanding the formation of these blemishes requires insight into the intricate hormonal mechanisms at play.

At the core of hormonal acne development lies the role of androgens, a group of hormones that includes testosterone, dihydrotestosterone (DHT), and dehydroepiandrosterone (DHEA). These hormones, predominantly produced in the adrenal glands and ovaries in females, stimulate the sebaceous glands to produce sebum, an oily substance crucial for maintaining skin hydration. However, an excess of androgens can lead to an overproduction of sebum, creating an environment conducive to acne formation.

The increased sebum production, combined with the shedding of skin cells within the hair follicles/pores (aka retention hyperkeratosis), can result in the formation of plugs, known as comedones. These plugs can take two forms: open comedones, commonly referred to as blackheads, and closed comedones, or whiteheads. When bacteria, particularly C. acnes, proliferate within these plugged follicles, inflammation occurs, leading to the characteristic redness, swelling, and tenderness associated with acne lesions.

In addition to sebum production, hormonal fluctuations, like those that occur during puberty, menstrual cycles, pregnancy, or menopause, can exacerbate hormonal acne. Estrogen, another key hormone, plays a regulatory role in counteracting the effects of androgens on sebum production. Fluctuations in estrogen levels relative to androgens can disrupt this balance, contributing to acne development.

Furthermore, genetic predisposition and environmental factors, such as diet, stress, and skincare habits, can influence the severity and frequency of hormonal acne outbreaks. While hormonal acne primarily affects adolescents going through puberty and women experiencing hormonal changes during menstruation, pregnancy, or menopause, it can also manifest in individuals of any age and gender.

In summary, hormonal acne blemishes form through a multifaceted process involving the overproduction of sebum, follicular plugging due to retention hyperkeratosis (excess skin cell shedding), bacterial colonization, inflammation, and hormonal fluctuations. Understanding these mechanisms is crucial for developing effective treatment strategies tailored to address the underlying causes of hormonal acne and alleviate its impact on affected individuals’ skin health and quality of life.

Hormonal acne, a common skin condition characterized by breakouts influenced by hormonal fluctuations, involves several key hormones that play pivotal roles in its development.

Androgens

Androgens, including testosterone, dihydrotestosterone (DHT), and dehydroepiandrosterone (DHEA), are hormones primarily produced in the adrenal glands and ovaries. These hormones stimulate the sebaceous glands to produce sebum, the oily substance that helps maintain skin hydration. Excess androgens can lead to overproduction of sebum, creating an environment conducive to acne formation.

Cortisol

Cortisol, often referred to as the “stress hormone,” is produced by the adrenal glands in response to stress. Elevated cortisol levels can trigger an increase in sebum production and inflammation, contributing to the development of acne. Chronic stress can disrupt hormonal balance, exacerbating hormonal acne outbreaks.

Insulin

Insulin, a hormone produced by the pancreas, plays a crucial role in regulating blood sugar levels. Elevated insulin levels, often associated with insulin resistance or poor dietary choices, can stimulate the production of androgens and increase sebum production. Insulin resistance can also lead to inflammation, further aggravating acne symptoms.

At Connected Health & Skin, we believe in taking a holistic approach to acne treatment that goes beyond traditional dermatology. Our team of Naturopathic Doctors, Corneotherapists, and Holistic Aestheticians is dedicated to addressing the underlying causes of acne and restoring balance to your skin health.

Comprehensive Care

Unlike traditional dermatology, which often focuses solely on surface-level treatments, our holistic approach considers the interconnectedness of your body, mind, and skin. Our Naturopathic Doctors take into account factors such as hormonal imbalances, nutritional deficiencies, and lifestyle habits that may be contributing to your acne.

Customized Solutions

We understand that no two individuals are alike, and neither are their skin concerns. Thus we strive to create personalized treatments plan for all patients that reflect their unique goals. Our team works collaboratively to develop personalized treatment plans tailored to your unique needs and goals. Whether it’s through dietary changes, botanical supplements, or advanced skincare techniques, we strive to address the root cause of your acne and promote long-term skin health.

Emphasis on Barrier Health

Are you struggling with hormonal acne and seeking a natural approach to skincare? Look no further than Naturopathic Medicine!

At Connected Health & Skin, our Toronto team of Naturopathic Doctors specializes in holistic wellness and personalized treatment plans tailored to address the underlying causes of hormonal acne.

1. Understanding Hormonal Imbalances: Hormonal acne often stems from fluctuations in hormones such as testosterone, estrogen, and cortisol. Our Naturopathic Doctors take a comprehensive approach to identify and address these imbalances through targeted interventions, including dietary changes, botanical supplements, and lifestyle modifications.
2. Supporting Hormonal Health: Through evidence-based treatments and natural therapies, we aim to support your body’s natural hormone production and regulation. By promoting hormonal balance, we can reduce sebum production, minimize inflammation, and prevent acne breakouts at their source.
3. Addressing Nutritional Deficiencies: Nutritional deficiencies can exacerbate hormonal imbalances and contribute to acne development. Our Naturopathic Doctors conduct thorough assessments to identify any deficiencies and recommend dietary modifications or supplementation to optimize your nutrient levels and support healthy skin function.
4. Restoring Skin Barrier Function: A key component of our approach is to focus on restoring and maintaining the integrity of your skin barrier. Through Corneotherapy and gentle skincare techniques, we work to repair damaged skin barrier function, reduce sensitivity, and enhance your skin’s natural ability to heal and protect itself.
5. Empowering Lifestyle Changes: Beyond skincare, we empower you with the knowledge and resources to make sustainable lifestyle changes that promote overall health and well-being. From stress management techniques to sleep hygiene practices, we provide personalized recommendations to support your journey to clearer, healthier skin.
6. Collaborative Care: Our Toronto Naturopathic Doctors collaborate closely with our team of Holistic Aestheticians, Psychotherapists, Registered Massage Therapists and Acupuncturists to provide comprehensive care that addresses both the internal and external factors contributing to hormonal acne. By combining the expertise of multiple disciplines, we can offer you a holistic approach to skincare that delivers lasting results.

If you’re ready to take control of your hormonal acne and embrace a natural approach to skincare, we invite you to schedule a consultation with one of our Naturopathic Doctors today. Together, we can uncover the root cause of your acne and develop a personalized treatment plan that helps you achieve clear, radiant skin from the inside out.

We highly recommend working with our team of Naturopathic Doctors and holistic skin therapists to create a comprehensive plan that addresses both internal and external factors contributing to hormonal acne.

Some of the treatments our team may recommend include:

• Lab testing to assess hormones
• Targeted supplementation of herbs and/or nutrients to support hormone balance and reduce breakouts
• Dietary and lifestyle modifications to support healthy hormone balance
• Aerolase NeoClear laser treatments can really speed up healing – it helps to treat active breakouts, prevent future ones and also fade the scarring/hyperpigmentation from past breakouts
• Lumecca IPL to calm inflammation and reduce post-inflammatory hyperpigmentation
• Customized facials/Advanced Acne Facial to soothe inflamed skin and reduce clogged pores while supporting a healthy dermal barrier

When it comes to hormonal acne results can take time. Because blemishes can start to form up to 90 days before they are visible on the surface of the skin we don’t often see the results of treatment right away (it can take 3 months). We have found that those working with a collaborative team of Naturopathic Doctors to address the internal factors and our holistic skin therapists to take care of the external often see faster results.

Our goal is to provide both long term resolution of your hormonal acne as well as some quick alleviation so that you can start to feel more confident and comfortable in your skin as soon as possible.

It is important to know that you won’t clear your skin with just one treatment. As with any acne treatment medications and procedures, it takes time to get results and you will typically need a series of acne facials.

Facials are usually scheduled once every other week to once a month. But you can’t rely on facials alone to get your skin clear. To keep the benefits going, you’ll need to be consistent with your acne treatment and skincare routine at home during your “off days.”

Picture this: you wake up one morning, ready to face the day with your usual confidence, only to find red, bumpy patches sprouting around your mouth. What in the world could this be? Enter perioral dermatitis (aka PD or POD) – a bit of a mouthful to say, but let’s break it down.

Perioral dermatitis is like an unwelcome guest that shows up uninvited around the mouth, leaving behind redness, tiny bumps, and sometimes even flaky skin. It’s like your skin throwing a little temper tantrum, causing irritation and discomfort just when you least expect it.

Now, you might be wondering, “What causes this sudden skin rebellion?” Well, the exact cause isn’t always crystal clear, but we do have some suspects. It could be triggered by a variety of factors like using certain skincare products, especially those heavy on the oils or steroids, or even dental products like toothpaste. Sometimes, hormonal changes, environmental factors, or even stress can play a role in provoking this pesky condition.

But fear not! While perioral dermatitis may seem daunting, it’s definitely manageable. Treatment usually involves a gentle touch – think mild, fragrance-free skincare products and avoiding heavy makeup or creams that could exacerbate the irritation. The Naturopathic Doctors at Connected Health & Skin see patients with PD regularly and are here to help guide you through it and to help it clear up faster if it has been persistent.

The good news? Perioral dermatitis isn’t contagious, so you won’t be passing it on to your friends or family. And with a bit of patience and TLC, those red bumps will likely bid farewell sooner rather than later.

So, if you find yourself in the midst of a perioral dermatitis flare-up, remember: it’s just a temporary bump in the road (pun intended), and with the right care, your skin will bounce back to its radiant self in no time.

• Rash-like clusters of pink or red bumps around the mouth and chin (or nose and eyes) that just don’t ever seem to go away
• Whiteheads may appear on top of the rash
• The skin may flake or peel
• Discomfort – itching, burning, or stinging
• There may be blisters, cracked skin, or bleeding
• It may come and go – seemingly flaring up overnight

While the exact cause of perioral dermatitis is unknown there are certain triggers that it is associated with:

• Hormonal fluctuations
• Topical and nasal steroid use
• Cosmetics and oil-heavy skincare products
• Environmental factors such as wind and heat
• Candida overgrowth
• Fluoride or SLS (sodium lauryl sulphate) in toothpaste and other products

If you suspect that you have perioral dermatitis it’s essential to consult a qualified healthcare provider for an accurate diagnosis and personalized treatment plan. They can evaluate your symptoms, medical history, and lifestyle to determine the underlying cause of your dermatitis and recommend appropriate interventions.

Phase 1: Regression

During the regression phase, the active inflammation gradually subsides, resulting in a reduction of redness, itching, and bumpy skin. This phase marks the initial healing process and brings relief to those who have been dealing with discomfort.

Phase 2: Relocation

The relocation phase involves a shift in the rash’s appearance and location. The original area affected by perioral dermatitis may begin to heal while new areas, such as the cheeks or chin, may become affected. This phase can be disheartening, but it signifies progress in the healing journey.

Phase 3: Oscillation

The oscillation phase is characterized by periods of improvement and occasional flare-ups. The rash may temporarily recede, only to reappear later. This phase can be unpredictable and challenging to manage, requiring ongoing diligence and attention to triggers.

We highly recommend working with our team of Naturopathic Doctors and holistic skin therapists to create a comprehensive plan that addresses both internal and external factors contributing to perioral dermatitis.

Some of the treatments our team may recommend include:

• Lab testing to assess hormones
• Targeted supplementation of herbs and/or nutrients to reduce inflammation and calm the skin while promoting skin healing
• Dietary and lifestyle modifications to avoid triggers
• Customized facials to soothe inflamed skin and support a healthy dermal barrier
• LED Light Therapy to promote skin healing

When it comes to perioral dermatitis results can take time. We have found that those working our Naturopathic Doctors often see results within a matter of weeks.

Our goal is to provide both long term resolution of your perioral dermatitis as well as some quick alleviation so that you can start to feel more confident and comfortable in your skin as soon as possible.

We have found that simple skincare routines work the best for those with perioral dermatitis.

We often pare down clients’ skincare routines and minimize the products they are using that contain heavy oils (yup, even natural products can aggravate perioral dermatitis).

Some of the products we have found to be particularly helpful when treating perioral dermatitis include:

• Hypochlorous acid like the LUMIONskin Oxygen Mist + HOCl or the Zyderma Hypochlorous Face & Body Mist
• Osmosis Skincare Rescue Epidermal Repair Serum
• NeoGenesis MB-1 Probiotic Spray, Booster Serum and Recovery Serum
• Siv Biome Balancing Serum

*products can be found at www.naturaldermstore.ca

Topical steroid withdrawal (TSW) is a dermatological condition characterized by a constellation of symptoms that arise upon discontinuation of prolonged and potent topical steroid use. While topical steroids are commonly prescribed to manage various inflammatory skin conditions such as eczema, psoriasis, and dermatitis, their extended usage can lead to dependency and subsequent withdrawal reactions upon cessation. TSW manifests with a myriad of distressing symptoms, including severe itching, burning sensation, redness, swelling, and flaking of the skin, often significantly impacting the quality of life of affected individuals. Although the concept of TSW has been recognized for decades, awareness of this condition has increased notably in recent years, prompting further research and advocacy efforts to better understand and address its complexities. As awareness grows, so does the need for accurate diagnosis, appropriate management strategies, and support for those navigating the challenging journey of topical steroid withdrawal.

• Worsening of rash/dermatitis and increased redness including in areas where topical steroids were never applied
• Severe burning/stinging sensation of the skin
• Skin is red, dry and crinkles easily – underlying blood vessels may become visible
• Skin depigmentation or dark hyperpigmentation.
• Visible stretch marks on the skin (aka. atrophic striae)
• Skin swelling
• Pimple-like bumps (papules), nodules and pustules
• Extensive wrinkling of skin (premature skin ageing) – “elephant skin”.
• Loss/thinning of hair and/or loss of eyebrows
• Cracked skin
• Frequent skin infections
• Increased and persistent itch
• ·“Red sleeve” sign – palms and soles spared
• ·“Headlight” sign – redness of the lower part of the face but not the nose or the area around the mouth

Phase 1: Inflammation

At the beginning of every flare is inflammation: when the skin appears very red, usually feels warm to touch and is sometimes accompanied with swelling and a general feeling of malaise. If you are beginning withdrawal, this is part of the withdrawal process. If you are experiencing this having already withdrawn for a period of time, it is possible that you are experiencing a flare up from a trigger.

Phase 2: Oozing, crusting & scab formation

If you have used Class 3 steroids and above, you are likely to experience oozing.Ooze, also called exudate, is made of cellular protein in skin cells. When platelets in the ooze are exposed to air, they begin to break apart and form fibrin, which resembles tiny threads. These threads form a web-like mesh that hardens as it dries, forming crust, a clot or a scab. Crusting and scabbing helps 1) prevent any further bleeding and 2) protects the wound so that new skin can be formed underneath.

Phase 3: Proliferation

Proliferation is observed as flaking. Lots and lots of flaking. Unfortunately, the dry and flaky stage of TSW is unavoidable, and in fact very necessary.For the skin to heal up and close all wounds, skin flakes are continuously formed in layers to cover the wound. Keratinocytes are migrated to the wound site and begin proliferating to rebuild the base membrane of the skin. Growth factors are secreted to help this process. As more and more layers are formed, the top most layers are pushed to the surface and eventually flake off. The process will continue until all skin cells are completely healthy.At a less severe stage, flakes reduce in size and eventually the skin becomes simply rough to touch.

Phase 4: Remodeling

Remodelling happens when wounds begin to contract and collagen synthesis happens to strengthen the skin tissue. The skin pulls inwards of wounds, tightening and closing them up. This action can be observed as thin lines along the skins surface around a wound.In this stage, the skin is also working on restoring its elasticity via collagen synthesis – collagen type III is being replaced by collagen type I which has a different tensile strength and elasticity. You may see thin lines forming on the skin. This is usually more easily observed at the joint areas e.g. inner elbows, neck, back of knees.

We highly recommend working with our team of Naturopathic Doctors to create a comprehensive plan that addresses both internal and external factors contributing to each phase of topical steroid withdrawal.

Some of the treatments our team may recommend include:

• Lab testing to assess gut function or cortisol levels
• Targeted supplementation of herbs and/or nutrients to reduce inflammation and calm the skin while promoting skin healing
• Dietary and lifestyle modifications to avoid triggers and allergans
• Red LED Light Therapy to promote skin healing

When it comes to topical steroid withdrawal results can take time. Individuals going through this process may experience flare ups and symptoms for weeks or years.

Our goal is to support you through this journey and to get the flares of TSW to become further apart and less severe over time. We have found that most of our patients with TSW experience improvements in symptoms quickly and feel less alone in the process. Most express that is is a comfort to be working with a team that acknowledges topical steroid withdrawal as a real condition, has experience working with patients who have TSW and who support them and make them feel heard throughout the healing process rather than dismissing them.

We have found that simple skincare routines work the best for those with topical steroid withdrawal and that throughout the healing process what products feel and work the best may change or there may be periods when no products are best.

We often pare down clients’ skincare routines and minimize the products they are using that contain essential oils, plant-derived extracts or other possible irritants or allergens.

Some of the products we have found to be particularly helpful when treating TSW include:

• Hypochlorous acid like the LUMIONskin Oxygen Mist + HOCl or the LUMIONskin Save My Skin Serum
• California Baby Super Sensitive products
• NeoGenesis MB-1 Probiotic Spray
• Dermaviduals Cleansing Milk with DMS and Dermaviduals Oleogel S or Oleogel R

*products can be found at www.naturaldermstore.ca

Quite often when working with patients experiencing TSW they have had disempowering and dismissive appointments with other physicians on their care team. More often than not we have found that patients’ concerns are dismissed and they are told that what they are experiencing is simply atopic dermatitis that is best treated with more topical steriods. Unfortunately, the conventional medical system has not yet fully recognized topical steroid withdrawal as a legitimate condition.

Our role as Naturopathic Doctors allows us the time to actively listen to patients’ concerns and acknowledge their experience while collecting all relevant information and history. We have found that most patients did not feel heard or empowered until they arrived at our office.

We have the unique ability to work with each patient as an individual and to create a plan that supports their journey rather than just a cookie-cutter treatment plan. We are partners in their healing process and create a safe and supportive space for them.

CO2 Lift is a cutting-edge treatment that promotes wound healing by enhancing oxygen delivery to the skin, which accelerates tissue repair and regeneration. This can be particularly beneficial for individuals experiencing Topical Steroid Withdrawal, as it helps soothe inflamed skin and supports the healing process during recovery.