Case Study: adult acne

This month’s case study is 40 year old ‘Nicola’ who came to the Clinic for help with her skin


My skin had always been quite clear especially during my adolescent years when so many of my friends suffered with spots. However in the last 2 years I had started to develop spots which seemed to come before my period, but would then linger the rest of the month. Some of them were quite painful particularly around my chin and neck. I went to my doctor who recommended I take a course of antibiotics and some rather potent antibiotic cream to apply topically. I went away feeling disappointed with the advice and did not take the antibiotics because I knew they were not going to tackle the underlying cause.


I was chatting to a friend about this and she said that she thought it might be worth looking at my diet because our skin can be a reflection or what we are eating. I did think my diet was a little unhealthy but never really imagined there could be a connection with my skin. I looked on the internet for local nutritionists and I found the Dr Marilyn Glenville Clinic in Tunbridge Wells. I phoned up immediately and spoke to one of the nutritionists who explained that a lot of patients come to the clinic for help with their skin. This really reassured me so I booked an appointment. She said that zinc is very important for zinc and recommended I have a mineral analysis test beforehand to see if this was low. This involved taking a sample of hair and sending to a medical laboratory for assessment and they can tell whether you are low in zinc or any of the other important minerals.


A comprehensive questionnaire arrived by post the next day and I started to fill it in. As I filled in the two day diet diary I soon realised that my eating pattern was very erratic and there was a lot of sugar. I put this down to stress as I would pick on cakes and sweets to keep me going especially if I didn’t get a proper lunch break. I didn’t really think of it as being a big deal because I wasn’t overweight as some people are when they eat lots of cakes so I thought I was lucky!


During my initial consultation the nutritionist took a detailed history about my health and specifically about my skin. It was very thorough indeed and she asked whether there were any particular times that I would get the outbreaks of spots, where were they, were they painful and what was the healing-process like. I explained that I thought they were linked to my menstrual cycle but couldn’t be certain because they did seem to linger all month.  The nutritionisst had studied my diet before meeting me because there was a lot of red pen circling all the ‘bad’ foods – it was like being back at school! Her main observation was too much sugar and coffee, which I thought she was going to say and not enough fresh fruit and vegetables. I was also eating too many pre-packaged foods which was due to not always having time to cook from scratch.


The nutritionist explained that spots can flare up before a period and one theory is that the adrenal glands are producing too much of the male hormone testosterone in the lead up to the period. She said that because the adrenals play a part in premenstrual spots, it is important to be regulating blood sugar and controlling stress to ensure that the adrenal glands are functioning healthily. To keep blood sugar levels stable she advised that I should be eating every 3 hours and on wholesome protein rich snacks like almond ‘butter’ on oatcakes or a handful of unsalted nuts and seeds. She said that coffee had a particularly disruptive influence on our blood sugar and adrenal function. She also explained how important it is to support the liver when there are skin problems. The liver is our ‘waste disposal’ unit of the body, not only for toxins, but also for hormones and other waste products (which if build up in the body create more ill health). Apparently it can become ‘sluggish’ when we drink too much coffee or just from day to day pollution.


She talked about the importance of zinc for supporting healthy skin and I was actually deficient in this which was highlighted from the mineral analysis test. She explained that this important mineral can get used up rapidly when under stress. She recommended I concentrate on eating lots of nuts and seeds, particularly pumpkin seeds which are one of the richest sources of zinc and fish, plus take a supplement to really boost my levels. The mineral analysis also picked up low magnesium which again is used up when stressed and is important for the production of our female hormones.


The nutritionist asked me to go away and follow the programme for 8 weeks which would then give me two menstrual cycles to assess how I was progressing. Within the first two weeks I had so much more energy and felt more positive about my skin because it had been really getting me down. The usual ‘flare up’ that I was expecting around the middle of my cycle didn’t happen. I still had a few spots come up on my chin but, but nothing like usual. By the second month there was an even more noticeable change. With all the good food and nutritional supplements I was putting into my body, I felt so much ‘cleaner’ and this really did reflect in my skin. I had lots of lovely comments which also helped!


My hair seemed to be more glossy and my nails were growing quickly! Although I hadn’t really thought my hair and nails were in poor condition, they obviously were! When I went back to see the nutritionist for my follow up consultation I took with me my daily diet and symptom diaries I had been keeping to keep a note of my food intake and how my skin was. I found this really helpful because it made me think about what I was putting in my mouth, rather than just grabbing the first thing I could get my hands on! She did say that our hair and nails are also a reflection of what is going on inside our bodies and similar nutrients are supportive.


When I first thought about changing my diet and having to cut out sugar and caffeine it seemed like the hardest thing in the world. However, 6 months into it and I would never go back. I do have a couple of coffees a week – my weekend treat but I really don’t miss them especially because I feel inside much healthier and on the outside it really shows! It just goes to show how all the skin creams and antibiotics you can take won’t have such a long term benefit because they simply mask the symptoms. I wish I had realised this sooner.


Marilyn’s Comment


We see a lot of women at the clinic who suffer with hormone related spots like Nicola. Hormone imbalance is becoming more common due to our lifestyle with more stress, and the environment with our increased exposure to ‘external’ hormones (from our meat and dairy products) and environmental pollutants.


As Nicola realises, it is so much more effective to address the underlying imbalance rather than just taking medication or using creams that heal the spots because they usually come back the next month. Listen to your body – your external health is a mirror of what is happening internally.


If you would like to find out more about our clinics and the tests mentioned, then please see the resources page.



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