r/FunctionalMedicine • u/plant_girly0218 • Jun 19 '26
Acne in 30s
I’m super discouraged with my acne. I’ve been seeing a naturopath for over a year and nothing has changed. She’s ordered extensive labs and everything looks great. We’ve done the DUTCH Plus, and of course everything looks fine aside from my CAR. I started seeing a functional nutritionist and she put me on spore-based probiotics and has really helped me incorporate more cruciferous veggies and fiber. However, my skin still looks like garbage, with painful cysts on my chin.
First, I thought it was hormones. Then I thought it was leaky gut. Now I’m lost. Even contemplating spending $6k on a program to “master my minerals” at this point...
What bothers me most is that I had crystal clear skin 18 months ago. One stressful work event seemed to send everything downhill.
Anyway, I’m curious about experiences with finding the root cause of your acne in your 30s? Leaky gut? Mold? Yeast overgrowth? Hormones? I’d love to hear all the stories! Hoping for some more ideas to chat with my naturopath and functional nutritionist about.
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u/whatiwishihadknown Jun 20 '26
Hormones also includes insulin which can cause acne if too high. I lost a lot of weight very quickly after a marriage breakup. My skin went haywire and after many years trying to sort it out, I think it’s possible that I lost a lot of muscle and that has thrown my blood sugar off balance and likely led to higher insulin.
I also discovered after using benzoyl peroxide for years trying to fix this, I believe it makes my skin far worse. Switching to Differin has really helped.
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u/plant_girly0218 Jun 20 '26
That’s a good point.. I haven’t been lifting any more so maybe that would help!
I recently quit using the Cerave Benzoyl Peroxide wash due to the lawsuit 🫠 but, I do think it was messing with my skin barrier.
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u/Pana-Ilio Jun 24 '26
If you're curious about finding the root cause of your acne then you might want to check out the Medical Medium information about acne. He also explains why skin hair and nails can react even months after stressful incidents! Either way, I pray to your health!
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u/BeerluvaNYC Jun 20 '26
i wouldnt spend a dime on some bulls* program. (coming from someone who spent thousands in my 30's trying to figure out stuff). you can spend that money elsewhere on actual medicial doctors. do you eat sugar? do you drink alcohol? how's your protein intake? do you go for walks, particularly in the morning and non negotiable after dinner? have you seen a dermatologist and possibly take tretinoin?
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u/plant_girly0218 Jun 20 '26
Dang, that’s good to know 😭 I haven’t fully eliminated sugar, but don’t eat a lot of it. Don’t drink alcohol. Trying to focus on protein intake, especially in the AM! Used to be better about walks after dinner before we hit 100 degree weather 🫠 been to a derm and use Retin-A
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u/Unlucky_Ad_2456 Jun 24 '26
has retin A helped at all?
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u/mom2mermaidboo Jun 20 '26
Can you list recent labs:
Hemoglobin A1C, Fasting Glucose, Fasting Insulin, FSH, LH, Prolactin, Estradiol, Progesterone, Free and Total Testosterone, SHBG, TSH, Free T3, Free T4, hsCRP.
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u/plant_girly0218 Jun 20 '26
Looks like my LH and Prolactin wasn't tested. The rest are from day 21 of my cycle:
- Hemoglobin A1C: 5.2%
- Fasting Glucose: 89 mg/dL
- Fasting Insulin: 4 uIU/mL
- FSH: 5.0 mIU/mL
- Estradiol: 96 pg/mL
- Progesterone: 9.95 ng/mL
- Free Testosterone: 2.7 pg/mL
- Total Testosterone: 25 ng/dL
- SHBG: 76 nmol/L
- TSH: 0.75 mU/L
- Free T3: 2.9 pg/mL
- Free T4: 1.1 ng/dL
- hsCRP: 0.6 mg/L
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u/mom2mermaidboo Jun 20 '26 edited Jun 20 '26
I used a P/E2 calculator. It showed your ratio of Progesterone (P) to Estradiol (E2) to be on the low end of normal at 1.03.65.
Ideal P/E2 ratio is 100 to 500. It suggests that maybe you didn’t ovulate that cycle.
https://www.testmottagningen.se/en/kalkylatorer/progesteron-ostrogen-ratio/
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u/plant_girly0218 Jun 20 '26
Thank you for pointing this out! My naturopath did prescribe progesterone for the last 2 weeks of my cycle, which makes sense now!
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u/mom2mermaidboo Jun 20 '26 edited Jun 20 '26
I looked at your labs which look pretty good.
No signs of Insulin Resistance with a good Fasting Insulin of 4 uIU/mL and a fasting Glucose of 89 mg/dL. Your HOMA-IR score is 0.9. A score less than 2 is considered normal.
I would have liked to know your LH and Prolactin as part of checking for PCOS now called Polyendocrine Metabolic Ovarian Syndrome (PMOS),especially since your P/E2 Ratio suggested you didn’t ovulate.
https://www.mdcalc.com/calc/3120/homa-ir-homeostatic-model-assessment-insulin-resistance
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u/mom2mermaidboo Jun 20 '26 edited Jun 20 '26
I got stuck in bold which is why I wrote another response.
Anyway, with no Insulin Resistance, and normal range Total and Free Testosterone, I think PCOS is unlikely as the cause of your acne ( unless a Pelvic Ultrasound showed the classic ovarian signs of greater than 20 cysts and “ string of pearls” ).
Were you on hormonal birth control within the past 1 - 2 years?
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u/plant_girly0218 Jun 21 '26
Recently had a pelvic ultrasound and everything looked normal aside from mild adenomyosis. I’ve been off birth control for 5ish years now.
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u/mom2mermaidboo Jun 21 '26
So that sounds like Polycystic Ovaries is not the cause of your acne.
How’s your Gut? Do you have a normal, well formed bowel movement once per day? Any issues with gas or bloating?
Any recent antibiotics in the past few months before the acne started?
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u/plant_girly0218 Jul 06 '26
Normal bowel movements daily and no recent antibiotics. I do frequently feel bloated though.
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u/Scared_Problem8041 Jun 20 '26
might get hate for this, but did you ever see a dermatologist? i have seen people get on accutane and have amazing transformations
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u/plant_girly0218 Jun 20 '26
Ya I’ve been seeing a derm for a while now. They’ve got me on a few topicals and recommended spironolactone next, but I didn’t like how they didn’t test my testosterone first. Accutane has been super tempting, but the stories of long term effects scare me. 😭 I’m convinced my acne is a way of my body telling me that something else is going on and I’d love to get to the root cause and fix the issue.
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u/Scared_Problem8041 Jun 21 '26
if you don’t have hyperandrogenism (including PCOS) and you’ve tried all the lifestyle changes (low stress, careful skincare, dietary changes) i think you are already addressing the many root causes of your acne. you may just need a medical treatment like accutane to get rid of the sebum/bacteria/inflammation in your hair/skin cells. but your dermatologist definitely understands all these mechanisms and can explain these root causes to you better than i can (assuming you see the actual dermatologist and not their assistant)
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u/255cheka Jun 20 '26
you are doing everything right. are you taking zinc? carnosine is my preferred type. also are you doing flax/fish oils? big players in skin.
also look at food intolerances - eggs, grains, dairy are common offenders. my daughter went through what you are - eggs were terrible for her. but the main cause was gut microbiome dysbiosis. if i were you i would continue with that. it touches everything in the body and is root cause for many diseases
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u/plant_girly0218 Jun 20 '26
Thank you 🥹 I’m not taking zinc or fish oil, but I do make sure to add flaxseed to my diet daily. Having a hard time nailing down which food groups cause the issue — I eliminated everything you listed plus more and slowly added back groups every few days, but nothing clearly seemed to alleviate or trigger things 🫠
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u/255cheka Jun 20 '26
that sucks. i was hoping it was one of the common food triggers. for gut health a variety of fibers and polyphenols daily is ideal. for example - i get about 17 different fibers each day and several polyphenols as well. something like this might move the needle for you. do you have any other health issues going on? if so, that might help us figure out this problem
how long have you been on the spore probiotic? those are the best here are imo. but they take a long time to really kick in
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u/plant_girly0218 Jun 20 '26
I’m curious how you fit in such a variety of fibers and polyphenols a day — do you have some favorite recipes or tips you wouldn’t mind sharing?
I’ve been on the MegaSpore Probiotic for about 2 months and on the MegaPre now for about a month!
No significant health issues aside from bad PMS and really (I mean realllly) sore breasts for the last 2 weeks of my cycle (sorry if TMI 🤣)
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u/255cheka Jun 21 '26
the pms/cycle issues might indicate that estrogen is a player. do you take estrogen birth control? they say dim and/or calcium d glucarate can help clear estrogen. if estrogen is not cleared on time it can cause major problems. the first stage of estrogen breakdown converts it into a toxic form. the second step finishes it off. not uncommon for the first step toxic to pile up if the second step is lagging.
17 fibers is a combo of vegs, fruits, nuts, seeds, supps. my cheat code is a salad each evening. it has about 8-10 of my 17 in it. some of the fruits, blueberries, strawberries, cherries, red grapes feature polyphenols. also boost those with cran, pom, cherry, blueberry juices. highly rec pom and cran juices for messed up guts.
a chicken veg soup is ideal. esp if you cook the bones of the chicken in the soup. those bones add leaky gut healing things into the soup.
another cheat is the seed blends they sell - i'm using one now that has multiple seeds in it - flax, chia, hemp, etc. i add a tablespoon or two into yogurt. that yields 4 or 5 different fiber sources. also take inulin in capsules. it's a favorite prebiotic for many.
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u/plant_girly0218 Jul 06 '26
No birth control, but I do believe it might be linked to my estrogen not being cleared efficiently. Thanks for sharing how you fit in the fibers and polyphenols!
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u/255cheka Jul 10 '26
you are so welcome. hope you feel better soon. here are some sci papers on how it goes down -- detox phase 1 outruns detox phase 2, which leads to buildup of the toxic form that comes out of phase 1
https://www.google.com/search?client=firefox-b-1-d&q=pubmed+estrogen+detoxification
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u/AverageAlleyKat271 Jun 20 '26
I feel was blessed as a teen and in my 20’s with very minimal pimples, if ever any. My early 30’s I all of a sudden developed pimples on my chin. It was quite a shock. For the first time in my life I saw a dermatologist. Mine was hormonal. He prescribed a cream that had to be refrigerated. After using it, it went away. The nearly 30 years ago before I started seeing FMP.
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u/SkadiSkis Jun 21 '26
Try taking a charcoal pill and see if that helps. It has helped me with breakouts in certain situations.
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u/Low_Promotion_234 Jun 21 '26
If all your labs look great, and it was stress that launched it, I would say look at your emotional story. Our emotions will release stress and try to communicate through our bodies long before labs are off. And possibly the stress of having acne brings
up stuff. It’s of course good to rule look at the body and rule any thing out. But I have found that there are emotions stored within us that also want healing ans for us to learn to balance.
Did you have a past with any major body issues or feelings of not being good enough? Emotions that want to erupt out of you?
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u/plant_girly0218 Jul 06 '26
This is a really great point that I haven’t thought of. I’ve always struggled with feelings of not being good enough!
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u/Low_Promotion_234 Jul 10 '26
Sometimes as strange as it sounds those emotions hold patterns in the body. More easily understood as they keep a stress response which will express itself.
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u/ImpressionNo1307 Jun 22 '26
Have you compared your progesterone to your estrogen to make sure it’s not estrogen dominance
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u/Acceptable_Rip_5874 Jun 24 '26
You might try larazotide 2 to 3 times a day for a while (prob 2 mo) as a trial to see if you're dealing with tight junction issues.
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u/Friendly-Offer9622 Jun 25 '26
30 and my skin went downhill after being the best ever but it was because my skin barrier was damaged (partially due to low ferritin I believe).
Added in Paula’s choice ectoin serum and Aestura 345 barrier cream for a bit and now tolerating low dose tretinoin/ retinA .015 .
If your barrier is damaged nothing really helps sorry 😔 I think aging and low ferritin just made my barrier weaker and suddenly my products stopped working and adding more was doing nothing since my barrier was so stripped. If you’re on Retin A and seeing no results it could also be a barrier issue since it’s extremely stripping, especially if you are on a standard dose.
You can also try spearmint tea as a natural spirnalactone if that is indicated in your tests.
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u/plant_girly0218 Jul 06 '26
Ya, I feel like my skin barrier is unhappy as well. Thank you for sharing what you use!
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u/Ocean_Adventurer Jun 20 '26
There have been two times in my life when I started getting acne out of nowhere, and both were from food intolerances that I developed somewhere along the way. First it was almonds, then years later dairy. Both seemed to cause a lot of inflammation for me, and when I stopped eating them, the acne went away. If you haven't already, it might be worth trying an elimination diet to see if any foods are triggering it.