Hormonal Acne and Your Gut: The Hidden Link to Clear Skin

Hormones are a big culprit for acne. Especially if your acne is cyclical (it pops up around the time of your period) and if it’s on your chin and jawline. But here’s the catch: there’s typically a reason the hormones are off in the first place. Often, trying to “balance hormones” without addressing the underlying root cause is problematic.

The Gut-Hormone Connection

For example, let’s take a look at excess hormones like androgens and estrogen. This often stems from the unsuspecting gut. Why does the gut have anything to do with hormones? Let’s break it down.

1. Increased inflammatory bacteria in the gut leads to an increase in the enzyme glucuronidase- this enzyme causes chaos for hormones. Let's zoom in for a second to discuss.

The Normal Hormone Detoxification Process

1. Conjugation in the Liver (Phase II Detoxification): When hormones like estrogen have served their purpose in the body, they are sent to the liver to be prepared for excretion. The liver attaches a molecule called glucuronic acid to the hormone in a process called glucuronidation. This makes the hormone water-soluble and inactive.
2. Excretion via Bile: Once conjugated, these hormones travel through bile from the liver into the intestines, all set for elimination through a bowel movement. Normally, when you have a healthy gut, the body naturally regulates hormones through this process. However, if there’s gut dysbiosis, this is how excess hormones build up in the body.

Hormone Detoxification: The Role of Beta-Glucuronidase in the Gut 

This is where beta-glucuronidase comes into play.

1. Deconjugation in the Gut: If certain gut bacteria produce high levels of beta-glucuronidase, this enzyme can "cut off" the glucuronic acid molecule from the hormone.
2. Reactivation and Reabsorption: Once the glucuronic acid is removed, the hormone is "deconjugated" and becomes active again. Because it's no longer water-soluble, so it can be reabsorbed through the intestinal wall and re-enter the bloodstream. This process is known as enterohepatic circulation.
3. Hormone Recycling: Instead of being eliminated from the body, the reactivated hormone is sent back into circulation, effectively raising the overall hormone levels in the body. You may have twice as many hormones as you should have because these hormones didn’t get taken out of the body. While the hormones often get blamed, there is a reason for them being higher than they should.

Hormonal Acne

While a certain amount of this recycling is normal, an overactive beta-glucuronidase enzyme can lead to increased androgens and a state of estrogen dominance, where the body has an excessive amount of active estrogen. This can contribute to a range of health issues, including:

• Hormonal acne
• PMS and painful periods
• Endometriosis and fibroids
• Increased risk for certain hormone-sensitive cancers (e.g., breast cancer)

High beta-glucuronidase activity is often associated with a state of gut dysbiosis, where there is an imbalance of beneficial and harmful bacteria. This is why supporting gut health with fiber, gut-regulating plant phytonutrients is a key strategy in helping the body regulate hormone levels naturally.

Inflammation in the gut further causes hormone imbalances and acne through a process called endotoxemia and insulin resistance.

The Gut-Hormone Connection: Insulin Resistance

A compromised gut barrier, often referred to as "leaky gut," and an imbalance in the gut microbiome (dysbiosis) lead to a cascade of inflammation throughout the body and on the skin.

1. Leaky Gut and LPS: When the gut lining becomes inflamed or damaged, its tight junctions weaken. This allows substances from the gut, such as lipopolysaccharides (LPS), to leak into the bloodstream. LPS is a potent inflammatory molecule found in the cell walls of certain gut bacteria.
2. Systemic Inflammation: Once in the bloodstream, LPS triggers a strong inflammatory response. The body's immune cells detect the foreign molecule and release pro-inflammatory cytokines like TNF-α and IL-6. This state of low-grade, chronic inflammation is called metabolic endotoxemia.
3. Insulin Resistance: This chronic inflammation directly interferes with insulin signaling. The inflammatory cytokines block the insulin receptors on cells, particularly in muscle, fat, and liver tissues. This means that even when insulin is present, the cells become less responsive to it and cannot effectively take up glucose from the blood.

The Role of Gut Dysbiosis

The health of the gut microbiome also plays a direct role. An imbalance with an overgrowth of harmful bacteria can lead to a greater production of LPS and other inflammatory compounds. A healthy, regulated and diverse gut microbiome (which feeds on plant phytonutrients and fiber), on the other hand, produces anti-inflammatory molecules like short-chain fatty acids (SCFAs), which can protect the gut lining and improve insulin sensitivity.

In short, inflammation originating in the gut can create a systemic, body-wide inflammatory state that directly impairs insulin's ability to function, leading to insulin resistance and acne.

Plant phytonutrients found in Glojo, Blemish Banisher support a healthy gut microbiome, decreased inflammation, decreased insulin resistance and clearer skin.

3. Chronic stress and nervous system dysregulation impairs insulin regulation. Cortisol is the body’s major stress hormone. It's primary job in a "fight-or-flight" situation is to provide a quick source of energy. Imagine you are running from a bear in the wild. Your cortisol shoots up. Cortisol releases glucose from the liver to give your body immediate fuel to run from that bear. the release of cortisol also inhibits the cells from up taking glucose-making the cells less responsive to insulin- this means glucose is circulating in the bloodstream longer. In a short-term stress situation, this is a beneficial survival mechanism. However, when stress becomes chronic, cortisol levels remain elevated. This leads to a persistent state of high blood sugar and insulin resistance. Over time, the pancreas has to work harder and harder to produce enough insulin to manage blood sugar, which can eventually lead to insulin resistance. Besides being a poor indicator of overall health, this also means more inflammation and increased androgenic hormones that cause acne.

Gut dysbiosis, leaky gut, and chronic stress all lead to hormonal acne. When treating hormone imbalances, it’s wise to consider the cause. Some subtypes of PCOS and adrenal hyperplasia can directly cause hormonal imbalances, but very often, supporting gut health and reducing stress can be all you need to keep hormones and skin happy.

References

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