Woman with clear face with no acne

The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part Two

In Part One of this post, I explained the link between PCOS and adult acne. I also explained why PCOS is misunderstood and underdiagnosed. If you haven’t read it yet, make sure you go back and read Part One here. In Part Two, I’ll explain how I help women address adult acne and PCOS in my clinic.

How I Help Women With Adult Acne

Whether or not you have a clinical diagnosis of PCOS, adult acne is almost always related to hormone imbalance. In my clinic, I use a multi-faceted approach to treating hormone imbalances.

Step 1 is always proper testing to determine exactly what type of hormone imbalance you’re dealing with - there is no “one size fits all” treatment, so proper testing is critical to healing. Every woman I work with recieves a customized plan for healing based on her test results, symptoms, and lifestyle - but there are some general recommendations I start with for many women:


  • Optimize Your Diet For Hormone Health
  • Nurture Your Microbiome
  • Lower Stress
  • Promote Ovulation
  • The Right Skin Care Routine


Optimize Your Diet For Hormone Health

You don’t need to go on a no-carb diet or severely restrict to optimize your diet for healthy hormones (in fact, that is probably the worst thing you can do!). Start with balancing your blood sugar and insulin. Almost all women with PCOS (regardless of weight) show some signs of insulin resistance.

You can counteract this and get back to healthy blood sugar by:

  • Optimizing the amounts and types of carbs you eat. (It’s not about cutting carbs completely. Instead, eat more whole-food carbs, fewer processed carbs.)
  • Moving more! It doesn’t have to be in the gym - walk more, hike, dance, swim, just stay active throughout the day.
  • Using key supplements. The exact supplements and doses matter, so work with a pro to add in things like inositols, d-pinitol, curcumin, chromium, and berberine - if they are right for you.

Key nutrients for healing acne are:

  • Vitamin A - natural sources are cod liver oil, liver, pastured egg yolks.
  • Zinc - zinc has been shown to clear acne as effectively as antibiotics! It also interacts positively with Vitamin A. Dietary sources are organ meats, beef and lamb, oysters and scallops.
  • Omega-3 fats - These fats are anti-inflammatory and reduce your skin’s reactivity to UV light, too. EPA and DHA are the best sources - find them in fatty fish or a high-quality supplement.

You should also consider cutting dairy from your diet. I don’t like to make blanket dietary suggestions, but for women with acne and PCOS, cutting dairy is almost always helpful.

Here’s why: there is a hormone in milk (from cows, goats, sheep, and camels) called insulin-like growth factor-1 (IGF-1) which mimics insulin in our body. IGF-1 is a growth hormone (which makes sense, as milk is for baby animals!).

In most people, a little dairy here and there can be well-tolerated -  humans have a binding protein for IGF-1 that inactivates it. But for women with PCOS or hormonal imbalance who already are likely to be insulin-resistant or have high insulin, the added burden of IGF-1 can be a problem. This is amplified because women with PCOS have LESS of the binding protein for IGF-1 and higher IGF-a levels than other people do, too. And the ovaries of women with PCOS are more sensitive to IGF-1 (and other growth hormones), too.

IGF-1 can also cause your ovaries to overproduce testosterone (an androgen) - which is something we’re trying to minimize.

Not only all of that - but IGF-1 also increases sebum production and inflammation in the skin - sebum is oil on your skin - and encourages new cell growth. As new cells grow, old ones die and are shed.This means more oil and old skin cells potentially clogging pores and causing acne.

For all of these reasons I do recommend you try cutting out dairy if you’re dealing with PCOS or acne. Grass-fed butter and ghee are OK to keep in, as they are almost entirely fat and don’t contain much, if any, IGF-1.

Nurture Your Microbiome

A healthy microbiome is critical for both hormone health and lowering overall inflammation to help calm your skin.

The right gut flora is a main player in regulating your hormones, especially your estrogen levels. If you have too much of the wrong bacteria, the result can be increased estrogens in circulation.

Eating a whole-foods-based diet and taking probiotics are obvious ways to care for your microbiome - but if you’re already doing that and still having gut issues, I highly recommend advanced stool testing. Common gut infections like Blastocystis hominis, H. pylori, candida, and staph or strep overgrowth in the gut correlate to acne in patients. There is also a huge connection between Small Intestine Bacterial Overgrowth (SIBO), candida, and acne - especially rosacea.

Endotoxins released into the bloodstream by a leaky gut (aka increased intestinal permeability) are also a major cause of inflammation in the body and can impact the skin, too.

Lower Stress

This is the advice everyone hates - but it is the MOST important step toward achieving long-term health.

The reason people hate the advice to lower their stress is because they feel like most of their stressors are outside their control (bills, deadlines, work, family drama!) - but the truth is that there are many small steps you CAN control that can help reduce the burden of stress on your body.

Some simple but powerful things you can start doing right now:

  • Get quality sleep - that means going to bed with 7-8 hours before you have to wake
  • Avoid blue light after sunset  - get the glasses, change the settings on your phone, and dim the lights inside
  • Start a daily meditation/gratitude practice - just 5-10 minutes can set the tone for your entire day

Promote Ovulation

Supplementation should always be done only after proper testing and consulting with a practitioner. That being said, there are supplements that can support and promote ovulation that I use with my patients:

  • Flaxseed and DIM to address excess estrogen
  • Saw palmetto, reishi, pygeum, zinc, white peony/licorice, and green tea to slow the conversion of estrogen to testosterone
  • Vitex (aka chasteberry)  to support Hypothalamic-Pituitary-Ovarian signalling and progesterone production.
  • Adrenal and thyroid support, as needed (this is why you need proper testing!)

The Right Skin Care Routine

A pimple here or there  - or a bad breakout after you use a new face wash - is potentially a topical issue. That means it has to do with what you’re putting on to your skin from the outside, externally. But most cases of adult acne are more a result of internal imbalances (like we’ve been talking about in this article).


That being said, what you put on your skin still matters. Don’t use harsh products externally on your skin. Instead, try more simple options. I love:

  • Mother Dirt spray (promotes a healthy skin bacteria)
  • NERD skincare system
  • Homemade masks with Manuka honey, tea tree oil, turmeric powder, and apple cider vinegar 

This Is A Whole-Body Issue

I hope you take away this key point from this article: acne is a whole-body issue, not just a skin thing!

Whether you have PCOS or not, if you have adult acne, it is a sign that something isn’t working right in your body. From gut issues to hormone imbalances, there are multiple overlapping, underlying causes that could be causing your skin troubles.


But, I also hope you now understand that PCOS is underdiagnosed and misunderstood - and it could be affecting you.


Once I discovered that truth, I was finally on my way to #clearskineveryday (not to mention better moods, healthy monthly cycles, & healthier hair and nails!).


I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with adult acne, I’d love for you to book a free 20-minute root cause symptom analysis  consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.


Woman sleeping in chair

How I healed from 6 years of severe insomnia-- and you can too!

It is estimated that up to 50% of adults in the US  are  affected by insomnia, with up to 60 million having chronic sleep trouble. Twenty percent of Americans report that they did not wake up feeling refreshed on any of the past seven days. These numbers are staggering, when you think about the incredible number of studies proving that adequate, good quality sleep is essential for disease prevention, mood, and brain function.

I went through a time in my 20’s where I simply couldn’t fall asleep. For hours, I would lay awake, tossing and turning, getting angry and frustrated at my increasing alertness. After a while frustration would turn to worry…..  “how am I going to function tomorrow….I need to be up at 7 to make it to work/class/etc”,   “Am I ever going to be able to fall asleep naturally again in my life?”

I seriously believed that I had forgotten how to do something that I had taken for granted my entire life up until that point. To just. Go. The. F. To. Sleep.

Sleep Matters

When my clients mention that their sleep is less than optimal, I take it seriously. No matter what the main health issue is, if you aren’t sleeping well, the body and mind just can’t repair fully. Lack of sleep makes us inflamed, stressed, shifts our hormones for the worse, and impairs blood sugar balance. Our levels of patience, concentration, and creativity suffer. That word or name we are grasping for remains elusive as we struggle to communicate our thoughts.

Studies show that we tend to make poor food choices the next day.  Poor sleep can even lead to weight gain, without a change in diet.  Difficulty falling asleep, or staying asleep, inevitably leads to being less than fully awake and refreshed during the daylight hours—  for years; I felt like I was half of myself. And that’s no way to live.

Finding My Root Causes

Resolving my insomnia required a pleiotropic (multi-faceted) approach. Testing and supporting my adrenal hormones was the first step:

Cortisol Results

(This is a saliva panel from before I used the DUTCH Adrenal test for assessing the HPA axis in my practice. You can see that my morning cortisol was super high right when I woke up, suggesting that it had been high at night.)

However, it turned out that I also had  three  parasites and candida overgrowth causing inflammation, which had to be addressed before my adrenal hormones and bio-rhythms could repair. (And this was despite not having many digestive symptoms at the time!)

Test 1

Test 1 Results

Test 2

Test 2 Results

Test 3

Test 3 Results

The inflammatory compounds from parasites and yeast in my gut, were neurotoxins.  Exposure to these in my bloodstream was creating inflammation and oxidative stress in my brain that contributed to sleep and memory problems.

Metabolism Markers

And my progesterone levels were lower than my post-menopausal grandmother’s would have been! (Progesterone production takes a back seat to cortisol production when your body is reading that you are under constant stress... *or inflammation).

To make things worse, my estrogen was through the roof. This relative excess of estrogen to progesterone is called Estrogen Dominance , and can make life in a woman's body fell like...well...a pain in the ass! (Think PMS, breast swelling and tenderness, heavy menstrual bleeding, fibroids and cysts, or weight gain around the hips and thighs....oh, and did I mention insomnia?)

Sex Hormones

Addressing each of these issues, over a period of about a year, gradually brought about a shift in my insomnia. Even after the first month of treatment, sleep started to come easier and easier.  And it just got better and better from there.   I felt like I had gotten my life and myself back!

5 Steps to better sleep

Modern life, with our artificial lights, tablets and screens, digital notifications, and indoor living give our bodies the exact opposite of the signals we need to promote sleep.  While testing and treating these or other underlying causes for any case of insomnia may be necessary in the long run, we just can’t “out-supplement” diet and lifestyle.

Taking steps to set yourself up for success during the day, and early evening, is essential for anyone who’s sleep is less than optimal. There are many things you can do on your own, to give your body and mind every chance of sinking into a deep, restful sleep, naturally.

Sleep Tips

Sleep is one of the most important aspects of improving hormone balance and repairing body systems, from the brain to the digestive tract. Here are additional tips to facilitate this process:

Tip 1: Train the brain to feel sleepy & awake at regular times:

  • Set fixed times for bedtime and rise-and-shine- As much as possible, keep to this schedule, even on weekends, regardless of how much sleep you got the night before.
  • Avoid daytime naps- as this reduces your sleep drive at night.
  • Keep the lights off -If you have to get up during night to use the bathroom do not turn on the light. Use a small nightlight so that you can see enough to move safely.
  • Sunlight Exposure- get at least 30 minutes per day, sunglass free. Even in a cloudy sky, the natural spectrum light is bright enough to trigger your brain with a powerful signal that it is daytime. Natural light exposure helps establish healthy sleep/wake hormonal rhythms—it has only been recently that we’ve spent the majority of our lives indoors, under artificial lights. It’s essential to do this in the morning, within the first hour of being awake.  For any kind of insomnia, it’s best to wake and go to bed at the same time every day.  However, if you wake at 7 AM most days, but 9 on weekend, set your daily time outside to be 9:15-9:45 to ensure consistency, grab a mug of tea, and head out the door.

Tip 2: Develop a strong mental association between your bedroom & sleep:

  • Use the bedroom only for sleep (or sex)- don’t read or watch TV in bed.
  • Get into bed only when you are sleepy- If you are unable to fall asleep, get up and go into another dimly lit room, rather than lying in bed awake.

Tip 3: Avoid being over-stimulated at bedtime:

  • Avoid Alcohol – it may help you fall asleep, but all the sugar in the alcohol will cause a rapid rise and subsequent drop in your blood sugar which will cause you to wake up. Even low-sugar alcohols like vodka can disrupt your sleep pattern, causing lighter sleep or frequent waking. Avoid alcohol within 3 hours of bedtime, and avoid it completely if you are struggling with insomnia.
  • Ditch the Caffeine- Did you know that even a morning cup of joe at 7 AM can disrupt your sleep? This is especially true in people who have genetic caffeine processing issues, due to gene SNPs such as COMT.  The “caffeine kick-back effect” is more common than you would think! Avoid caffeine completely if you are having sleep problems. Avoid it after 2 PM as a general rule, even if you don’t suspect you are overly sensitive to its effects.
  • Slow Mental activity -stop doing active mental work at least 1 hour prior to bedtime. This includes surfing the web, watching Netflix or movies, emailing, Facebooking, or texting. We all need wind-down activities to switch out of “doing” and “problem solving” mode. Earlier in the evening, meditation, yoga, books, audiobooks, and yes, at the very least, even watching a TV show or playing a game on your Ipad is fine (assuming you are using precautions to avoid blue-light listed below)—anything that helps you switch into relaxation mode and away from the whir of  thoughts and pace associated with wakefulness.
  • Get Moving!- Exercise at least 30-60 minutes every day. Even walking works.
  • Avoid Blue light Exposure— Have you ever noticed that the light near the end of the day, around sunset, is naturally warmer with more reds and pinks? Blue light from screens inhibits melatonin production by signaling that it is day time. Our brains respond to dimmer light and warmer light by winding down activity, but you need at least 2 or more hours of these lighting conditions prior to bedtime for optimal relaxation.
    • Install apps on electronic devices that dim blue light and use warmer spectrum tones,  such as f.lux on Mac,  Nightshift for iPhones, or Twilight on Android.
    • Dial down the brightness on dimmer lights, screens, and digital devices.
    • These apps do a fairly good job, but if you are more sensitive to light and the apps don’t cut it, also consider buying a pair of blue-blocking glasses (around $10-15—-yep, these come in a ton of super-groovy styles now that they’ve caught on). Some people even install amber-colored light bulbs such as these around the house.

Tip 4: Create an environment supportive to sleep.

Your room should be:

  • Dark- cover LED lights on bedside clocks, consider blackout blinds. An eye-mask with cup shaped or curved nose pieces can work just as well.
  • Cool- Your body naturally cools off when you sleep, and if your room is too hot, it can be hard for your body to give off its heat. Around -65°F is ideal for most people.
  • Comfortable- use a comfortable mattress and pillow that is supportive to your neck, depending on your sleeping position. Consider using a “side sleeper” pillow for under your neck when sleeping on your side. Consider using a body pillow to hug and put between your knees to align your back and shoulders at night. I personally love the PharMeDoc C-shaped body pillow for side sleeping as it supports both neck and hips. Yes, it is marketed for pregnancy (and is a must have for pregnant women!)—but it’s great for non-pregnant people who like to sleep comfortably too!
  • Quiet –Some people swear by reusable silicone earplugs like these for the best noise cancellation.  I prefer the super soft foam kind so they aren’t uncomfortable.  You can use them several times before they lose their “squish” and look a little grubby—then toss ‘em and grab a new pair. These plugs block out even my husband’s snoring on the loudest night!
  • You can also use a white noise machine, if you don’t like the feeling of having something in your ears. Different people prefer different sounds. I don’t use one of these, but patients have told me good things about them.


Tip 5: Eating for healthy sleep

  1. Stop Munching- avoid being too full at bedtime. No food for at least three hours before sleep, unless you suffer from severe hypoglycemic issues.
  2. Don’t Under-eat:  Hunger and low blood glucose can give you insomnia and can wake you up in the middle of the night. Most people’s bodies naturally help them to eat the right amount, but if you’ve been intentionally trying to lose weight, or restricted eating because of digestive or other health issues, your appetite signaling can easily get off, and so can your sense of what is enough food. If you’re not sure that you’re eating enough try this:
    • Use an online calculator like this one to figure out your approximate caloric need.
    • Use a food tracking app such as  MyFitnessPal to keep track of your calories for a few days.
    • If you’re under-eating, bumping up your calories may be the silver bullet solution to help you sleep deeper and fall asleep easier.
  3. Eat high nutrient foods, especially minerals: Mineral deficiencies (like calcium, magnesium or potassium) are a common factor with insomnia. The best way to ensure high nutrient content is to eat a variety foods each week, including fruits, lots of above ground veggies, root veggies and tubers of different colors, animal proteins, liver or other organ meat, seafood, and bone broth. If you don’t eat dairy be sure to get plenty of calcium containing leafy greens, and or herbs that are high in calcium to supplements, Many people need supplemental magnesium as well. Even on an otherwise healthy, whole foods, Paleo type diet, you can still have deficiencies of essential nutrients if you are eating the same foods day in and day out.
  4. Eat enough carbs: Carbs are super important for sleep, in several ways.
    • You need dietary carbohydrate in order to produce melatonin in your brain. Melatonin counters cortisol, among other things. Without enough melatonin in your brain, sleep isn’t happening!
    • People with Adrenal Fatigue may have insufficient cortisol levels to stabilize their blood sugar for long periods of time. I notice that people with low cortisol often suffer on low carbohydrate diets, because their body can’t shift into carb generation mode in the liver (which is where your body sources stored carbs between meals). When your blood sugar drops while you’re sleeping, adrenaline kicks in and you wake up out of a dead sleep, wondering what is going on. To avoid this, consume more of your carbs at your evening meal, close to bed time.
    • Each person’s carbohydrate need varies widely based on activity level and baseline metabolic rate. It can also differ at different phases in life. Depending on age, gender, activity level, pregnancy status, and weight maintenance goals, people need anywhere from 50-350 grams daily. With sleep difficulty, I recommend that my clients not go below 75 grams daily. The only way to know what is right for you is to experiment and observe.
    • Again, take activity level into consideration —if you are training for a triathalon, 50 grams per day is simply not going to cut it. If exercise looks like a walk to the mailbox daily, you aren’t going to need above 150 grams. Adjust these levels until you find the right fit for you.

Tip 6: Develop An evening ritual helps prepare your body/mind for sleep.

Here are some possibilities to choose from:

  • Journal- If you are someone who lays awake thinking of your to do list, get it all out on paper before-hand. Planning for the next day by writing a brief list can help short-circuit the mental spinning. Alternately, write down what you are grateful for that day, or journal. Consciously release and hurts or resentments you are feeling.
  • Have a cup of herbal tea (e.g. “Sleepy Time”)
  • Have a bath with Epsom salts—start with 1 cup in a warm (but not overly hot) bath. Add relaxing essential oils like lavender, chamomile, sandalwood, or vetiver if you enjoy these.
  • Use a diffuser in your bedroom & use lavender essential oil before bed.
  • Do some gentle stretching, or yoga. I personally love using my foam roller to roll out kinks and knots.
  • Try progressive muscle relaxation--this has been shown to help reset cortisol rhythm. There are many version of this available on Youtube, such as this one.
  • Do “4-7-8” breathing:
    • Breathe in through nose for 4 counts
    • Hold your breath for 7 counts
    • Exhale through mouth for 8 counts
    • This combination of count ratio slows heart rate and relaxes the sympathetic nervous system.

Do the same ritual every night, as you are training your body and mind to unwind from the day and giving it the message that it’s time for sleep.

Tip 7: Supplement Support:

Ideally, supplements should only be used after the above steps are being taken consistently. But tossing and turning night after night can really put a damper on your mood, not to mention your glucose control, sugar cravings, weight, hormone balance, and overall health. There is no one sleep supplement that works for everyone, and these are just several recommendations that are generally safe for people to experiment with on their own.

If you are still struggling, work with your practitioner to identify key issues that are at play with your insomnia, such as hormone imbalances, parasites, inflammation, neurotransmitter issues, toxicity, sleep apnea, or other causes.


  • L-Theanine- 200-400 mg
  • Magnesium- up to 1200 mg, in divided doses daily. Use the chelated forms for best tolerance.
  • Liposomal CBD- 1ml-4ml before bed.
  • Calming Herbs – Lemon balm, Passion flower, Valerian root (like this blend)

Looking for further help with improving your sleep? We'd love to help you!