You’ve just had a miscarriage and your skin is breaking out in acne. Let’s talk about why this happens and what you can do about it.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release Practitioner. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.

Pregnancy hormones

Let’s take a little back step so that the next part makes sense.During the time from conception and through your pregnancy, hCG (Human chorionic gonadotropin) continues to rise which is a hormone produced by your placenta. Furthermore, your hormones change as well with Oestrogen and progesterone rising.

The oestrogen increase will:

• Improve the formation of healthy blood vessels in the placenta and uterus

• Transfer nutrients to the developing baby

• Assist with the development and maturation of the foetus

The progesterone increase will:

• Increase the size of the uterus to accommodate a full-term baby

• Help loosen ligaments in the body as the body shape changes through pregnancy

Pregnancy hormones and miscarriage

When you experience miscarriage, both oestrogen and progesterone will drop quickly. Depending on how many weeks you are pregnant when the loss occurs, hCG (human chorionic gonadotropin) will slowly drop to zero over a few weeks.

Why is there acne after miscarriage

It is due to the change in hormones: the drop in progesterone & oestrogen. Ultimately, it is hormonal acne that you are experiencing.

Oestrogen’s role for skin: supports a healthy skin barrier, hydration & elasticity. Assists with it being acne free.

Progesterone’s role for skin: it inhibits the enzyme 5-alpha reductase which will then reduce the “male hormones” (androgens e.g. DHT or dihydrotestosterone). This means that you will have fewer breakouts and less sebum (which is an oil produced to hydrate and protect your skin). Too much contributes to acne.

If your progesterone is low it can be difficult for your thyroid to do its normal job. If your thyroid is under functioning (hypothyroid) this can contribute to acne as well. One of the reasons is the impact on your insulin levels, if these are tampered with this affects DHT production leading to oily skin (sebum is increased) and androgen induced acne.

Oestrogen is important in maintaining your blood glucose levels and insulin. Insulin is a hormone that manages glucose in the body and gives it a piggy-back into the cells where it is required. But if your oestrogen is low, glucose will increase and when glucose is too high, insulin will take a back seat in managing your glucose levels and it doesn’t respond as it is overwhelmed by the increased glucose (insulin resistance). This means both your glucose and insulin levels are high, this will increase inflammation of the skin & your androgens (male hormones) which will make your skin oilier, and prone to acne.

It is important to note that stress will contribute to acne as well, and let’s face it going through miscarriage is a big stress on the body emotionally, mentally & physically. When you are stressed your body produces cortisol, when cortisol is high because you are not adapting to that stress > inflammation around the sebaceous glands the glands that produce oil. Also, high cortisol will increase sebum production which leads to clogged pores and acne breakouts.

For most women the first period generally happens about 4-6 later. It can take time for your hormones to balance out after miscarriage so your periods may very well be irregular to begin with.

Treatment of hormonal acne

First and foremost, your hormone levels need to be looked at establish exactly what hormones are imbalanced in your case. Because once there is an understanding of which hormones are imbalanced, there are particular herbal and nutritional medicines that treat certain these certain hormones.

THOROUGH INVESTIGATION

• Lady hormones (oestrogen, progesterone, FSH, LH, androgens etc.)

• Vitamin and mineral status – for instance low zinc can result in acne (anti-inflammatory, antibacterial, assists liver detoxification & heals the skin)

• Thyroid testing

• Adrenal testing: either cortisol levels through blood draw or salivary testing

In terms of thyroid testing: I am not talking about just TSH (thyroid stimulating hormone) this is just one little part of such a bigger puzzle. It needs to be TSH, fT4, fT3, thyroid antibodies and urinary iodine and if possible rT3 as well. Because TSH could be normal but your actual thyroid hormones T4 and T3 may not be normal, and if you just had TSH tested you wouldn’t know. T4 converts to T3 which is your active thyroid hormone, so we want to know what those levels are like too. We also want to know if you have enough iodine for your thyroid to be working properly.

What are some things I can do to support my acne?

This is just some general advice for acne; however, it is important to remember that if you don’t address your hormone imbalance your skin won’t really improve. The thing with skin is, it is an inside job.

INSIDE SUPPORT:

One very important thing you can do is to support your organs of elimination: liver & bowels because they are very important in the management of your hormones

Support your liver health:

The liver is involved in detoxifying managing your hormones & improving skin health.

Liver loving foods: spinach, grapefruit, beetroot, green tea, turmeric, lemon juice, garlic, cruciferous vegetables – broccoli, brussels sprouts, cabbage & cauliflower

Support your bowels:

Doing a poo daily is essential in managing hormones & improving skin health. If you are not going daily this can lead to reabsorption of those hormones causing hormonal imbalance.

Bowel love: The big things are fibre, water & exercise.

Found in nuts, vegetables (particularly in the skin) and whole grains such as quinoa and buckwheat, peas, oats, apples, avocado, asparagus and legumes (lentils, chickpeas etc.)

Healthy fats are also helpful. Things like:

Flaxseed oil & chia pudding (chia seeds soaked in dairy free milk with some toppings like berries & LSA – linseed sunflower & almonds)

Support your gut health:

Your gut microbiota, or the good bacteria found there are important for managing your hormones particularly oestrogen. There is a little family of good bacteria known as the estrobolome that will assist with keeping oestrogen “just right”.

Probiotic food / drinks: water kefir, miso, tempeh, kombucha

Healing foods: bone broth to heal the gut lining, reduce inflammation in the body & make it desirable for good bacteria (Good brands are Best of the Bone, Gevity Rx – paste, Nutraorganics – powder).

 Boo to the moo!

Stop eating cow’s dairy because this increases the hormone IGF-1 (insulin like growth factor) similar structure to insulin. If you have high insulin & insulin like growth factor this increases inflammation & increases sebum production which worsens acne.

Furthermore, cow’s dairy results in further inflammation from the A1 casein protein. This is a big protein molecule and difficult to digest and break down.

And if that wasn’t already bad enough for you, it increases mTOR which is an enzyme that stimulates keratin, sebum production & inflammation. Switch to goats or sheep’s dairy products instead because they have A2 casein which is easier for your body to digest, and it is not inflammatory. If you are intolerant to lactose though you would need to avoid them.

Eat protein regularly

This will help balance your insulin and glucose levels reducing the possibility of it spiking. Remember high insulin and glucose contributes to acne. Make sure you eat some form of protein with every meal, even with snacks:

Protein:

Main meals – fish, chicken, eggs, legumes (borlotti beans, chickpeas, lentils etc.), tofu, tempeh.

Snacks – protein balls, nuts & seeds, protein shake (make sure it is dairy free), rice cake with nut butter on it (almond or cashew butter for instance), an apple with nut butter  on it

Sweet thangs

Avoid sugary things like cakes, lollies, soft drink, slices etc.

Avoid things made from white flour: this is a refined carbohydrate which causes a drastic rise in blood sugar levels & contributes to insulin resistance as well. High blood sugar levels & insulin arises in inflammation > hormone imbalance & worsening of acne.

EXTERNAL SUPPORT:

• Use a few drops of tea tree directly on the acne – antibacterial, antimicrobial

• There is a brand that is specific to acne breakouts called Botani: they have a cream called phytoseptic which contains golden seal which is antimicrobial, antibacterial to apply directly on the acne

• Don’t use cleansers that are gel based as these will tend to strip the skin of natural oils and will actually result in further production of sebum because your skin detects it is dried out.

• Using a few drops of jojoba oil prior to your moisturiser can be useful as it is antimicrobial

What I would recommend doing if you have acne breakouts after miscarriage

I would recommend booking an appointment with a Naturopath who specialises in periods and hormones. FYI this is what I do. Naturopaths will take a rather thorough approach looking at your pathology testing in a very different way than a GP or specialist would. The pathology reference range is so broad on a pathology test is so broad. A GP or specialist will only treat you if you are outside that broad pathology range (when the wheels fall off the wagon) because they are trained in treating disease and symptoms. It is no fault of the doctor or specialists they are just trained this way. The thing is though: “Normal test results won’t help you”.

Whereas a Naturopath will be making sure that you are within the optimal range. Because the truth is if you fall outside the optimal range which is a smaller range within the broad range you can still present with hormonal acne. Naturopaths will also look at nutrient levels like vitamins and minerals as well which are essential for hormone balance. Then treatment will be the use of things that support the body like herbal medicine, nutritional medicine, diet and lifestyle advice to improve hormone balance etc.

I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit.

If you have any questions or comments, please pop them in the comments box below 🙂