We’re back for another edition of Thyroid Thursday and today I want to talk about acne and hypothyroidism. Is there a connection between having acne and having hypothyroidism? Whether it’s cellular hypothyroidism, a lack of T3 in the cell or glandular hypothyroidism, where the gland isn’t making enough thyroid hormone most commonly caused by Hashimoto’s but it can be caused by a number of other things. The answer to that is there is a connection. But there isn’t a really clear cut reason why. So I want to give you my interpretation of what I’ve read and why acne and hypothyroidism have a tendency to kind of be seen together.
The four common themes we see in the literature regarding why acne develops is, there’s a growth or an increased growth or proliferation of the follicular cells, an increased keratinization of those cells. There’s some type of change in either increased sebum which is the oily stuff that’s released from your sebaceous cells, too much of it. Or it could be a change in the composition of that sebum that allows it, the acne to proliferate. We typically see that acne is associated with some level of inflammation in the cells and tissues. And, that there’s an increased growth of the stuff called cutibacterium acnes or we’ll just say C. acnes and that’s a bacteria that is often found in and around the cell, in and around the acne. Now, C.acnes is a skin bacteria and there’s some argument whether it’s the real cause or not but they commonly see increased levels of C.acnes with people who have acne.
There is a lot of literature saying that there’s an increased incidence of acne in people who have Hashimoto’s Thyroiditis. The reason for that may be that we have disrupted levels of thyroid hormone, T3, reaching the cells causing that cellular hypothyroid state. What we see is that when you have hypothyroidism or hyperthyroidism, you can have increased sebum production. But even in hypothyroidism, there may actually be increased sebum production, sebum production and I’ll explain why in a second. It could really be that in a hypothyroid state the sebum, the concentration of the things that are in the sebum are altered which allows for more acne production. When you have a hypothyroid state, you have decreased blood flow to those tissues and that’s important. Because when you have decreased blood flow, you have decreased oxygen. The C.acnes is a facultative anaerobe which means it can live in a low oxygen state. When you have cells that are in a low oxygen state, we don’t utilize glucose as efficiently as we should and we have an increased production of lactate or lactic acid. The C acnes can actually feed on lactic acid which may allow it to overgrow.
Also, when we have decreased T3 in the cells, it’s usually associated with inflammation. We know that acne is typically associated with a more inflammatory state so more inflammation, more deactivation of T3, and these mechanisms can occur. The third part is that when you have decreased T3 in your cells, your cells become more insulin resistant. When your cells become more insulin resistant, then we have increased insulin needing to be produced to try and drive glucose into cells. When you have increased insulin, it results in more insulin floating around in the bloodstream. It drives up the production of androgens, and it also increases the production of this stuff called insulin-like growth factor 1. Both the androgens and insulin-like growth factor 1 can increase the follicular cell production so it increases those cells. So hypothyroidism can drive all of these actions or be associated with all of these actions. This is the connection as I see it, of why we see people with hypothyroidism having more acne. Now, there could be other mechanisms involved as well but this is the tie to hypothyroidism and acne.
So what should you do?
Well, one of those things is reduce your, clean up your diet. Reduce the carbohydrate load. That reduces the amount of insulin that needs to be produced, decreased insulin-like growth factor, decreased androgens and therefore you’re gonna have probably less of this going on.
The second thing to do is reduce whatever’s causing your cell’s stress. Improve your sleep, improve your breathing habits. We talked about improving your diet. But most importantly, reduce the toxin exposure. You get toxin exposure especially for people who are putting a lot of stuff on their face, things that are gonna create damage to the skin. Look at your beauty products that you’re putting on your skin, things that are high in alcohol. That may dry out the skin and create disruption and create damage. Probably most importantly, especially for the female population, there’s a whole load of things that you’re putting on your skin that can be really toxic to the skin, stimulating damage to the cells, inducing cellular hypothyroidism and leading to more acne.
A great resource to go to to find what are some safe and healthy products to put on your skin is ewg.org, the Environmental Workers Group. They’ll talk, they’ll have a list of products, skin products, beauty products that are safe and protective for the skin. Hope this one helps. If you have any questions, please reach out to my office at 610-558-8920 or click here to schedule your complimentary health discovery call.