• Mamie Burruss, ND

4 Common Causes of Chronic Skin Issues (And What You Can Do About Them…)

Updated: Jan 15

Your skin is your largest organ and plays an important role in protecting you from the external environment, regulating your body temperature, and eliminating toxins.

But did you know that the health and vibrancy of your skin is a reflection of what’s going on inside your body?

That’s right!

Your dry skin, acne, eczema, psoriasis, melasma, etc. is an outward manifestation of your internal health…in other words, your skin is a mirror for your insides!

The good news is that skin issues can be healed! Here are the top four causes of chronic skin issues, and what you can do about them!

Problem #1: Nutritional Deficiencies

Here’s the truth: people are getting enough nutrients to survive, but most aren’t getting enough nutrients to THRIVE! And if you want healthy, glowing skin, you need sufficient amounts of several key nutrients to make it happen, including vitamins A, E, and C, omega-3 fatty acids, and zinc.

Vitamin A

Vitamin A is one of the most well-recognized nutrients when it comes to skin health, which is why synthetic retinoids have been used for decades to treat acne, psoriasis, eczema, cold sores, wounds, and even burns.

Vitamin A deficiency causes the skin to become keratinized and scaly and suppresses mucus secretion, so it can also lead to a skin condition known as keratosis pilaris that affects approximately 40% of adults. Keratosis pilaris appears as rough patches and small, acne-like bumps with varying degrees of redness and inflammation, typically on the upper arms and thighs.

Vitamin E

Vitamin E is the most abundant fat-soluble antioxidant found in the skin, and its ability to defend against damaging free radicals and reactive oxygen species is one of the primary reasons it’s so crucial for maintaining skin health.

Supplementing with Vitamin E has been shown to improve several skin conditions, including atopic dermatitis, psoriasis, pressure ulcers (bedsores), melasma (especially in combination with vitamins A and C), and acne.

Vitamin C

Vitamin C plays a critical role in making collagen, which is a structural protein found throughout the body that is best known for keeping skin firm and youthful. Deficiencies of vitamin C can manifest as rough, dry skin (suggesting that vitamin C may affect water loss through the skin), and inadequate levels of vitamin C are known to contribute to the development of keratosis pilaris.

Vitamin C is also an important antioxidant, meaning it helps combat free radical damage that can occur as a result of ultraviolet (UV) light exposure or environmental pollutants, such as ozone or cigarette smoke. This helps explain why observational studies have shown that diets higher in vitamin C are associated with better skin appearance and less wrinkles. Vitamin C also plays an important role in wound healing because of its antioxidant properties and vital role in collagen synthesis.

Omega-3 Fatty Acids

Omega-3 fatty acids are a group of polyunsaturated fatty acids with anti-inflammatory properties that includes ALA, EPA and DHA. Our modern diet tends to be deficient in omega-3 fatty acids relative to omega-6 fatty acids, which creates an inflammatory state in the body. This increased systemic inflammation can then contribute to the development of chronic inflammatory skin conditions like acne, psoriasis, atopic dermatitis, and rosacea.


Zinc is an important mineral involved in several physiological processes. In skin, zinc improves wound healing, has anti-inflammatory effects, helps stabilize cell membranes, and acts as an antioxidant to protect against UV radiation.

Several studies have shown that dietary zinc may reduce acne, possibly because zinc is necessary for transporting vitamin A in the blood, which is crucial for skin health. This interaction with vitamin A, as well as its anti-inflammatory properties, may explain why zinc can be helpful for rosacea, as well. Zinc’s antiviral activity may also be useful for preventing or treating warts.

Problem #2: Gut Dysfunction

We’ve all heard the saying “you are what you eat,” but that’s not really the whole story. Actually, you are what you digest and absorb.

The process of digestion—breaking food down into smaller molecules that can be used by the body—can become compromised for a variety of reasons.

Physical or psychological stress, for example, decreases the stomach’s production of hydrochloric acid, which is necessary for breaking down protein. Adequate stomach acid also triggers the release of additional digestive enzymes from your pancreas and gallbladder. This means that lower levels of stomach acid can actually disrupt the digestive process further downstream, in your intestines.

Why does this matter?

Over time, compromised digestion can lead to nutritional deficiencies, which you now know directly impacts skin health. Inadequately digested foods can also ferment in your intestines and cause dysbiosis, which is a term for imbalances in the microbes that inhabit your gut (hello, yeast or bacterial overgrowth!). Food intolerances can develop as a result of insufficient digestion or the presence of dysbiosis, and consuming food intolerances can further compromise digestion—yikes!

So how does gut dysfunction—which can manifest as gas, bloating, constipation, diarrhea, reflux or indigestion—relate to the health of your skin?

Because maldigestion, dysbiosis and food intolerances create inflammation. And that inflammation can show up on the skin in various ways, such as acne, psoriasis, rosacea, or eczema. Over time, dysbiosis in the gut can also contribute to changes in the balance of microbes that live on your skin, resulting in acne or other skin problems.

Problem #3: Hormonal Imbalances

When it comes to skin health, your hormones can play a big role!

Excess testosterone, for example, which increases sebum production at the base of hairs, is a common cause of acne. While “hormonal acne” is typically seen in teens, many adults are plagued as well.

Women are often prescribed birth control pills in an effort to balance their hormones and address their acne. While the pill will reduce testosterone production (and often the acne associated with it), it does so because it interferes with communication between your brain and ovaries. Not surprisingly, this can have long-term consequences that significantly impact your overall health. In other words, this is not a solution—it’s a bandaid!

Melasma, a common skin condition appearing as brown patches on the face, is often a result of excess estrogen (this is why birth control pills and pregnancy can both trigger its development). Many women are in a state of estrogen dominance for a variety of reasons including inadequate fiber intake, chronic constipation, suboptimal hormone metabolism and excretion, medications, and exposure to environmental xenoestrogens (chemicals that can mimic the function of natural estrogen) through commercially-raised meat and dairy, cosmetics and personal care products, plastics, bisphenol-A (BPA), and several other sources.

Hypothyroidism, a condition affecting millions of Americans, is often accompanied by dry, itchy skin, but it can be a case of acne as well. Unfortunately, the standard thyroid testing ordered by most doctors is woefully inadequate to truly assess thyroid health and identify functional imbalances. This means many Americans, especially women, are suffering needlessly from low or suboptimal thyroid function, which impacts far more than your skin!

Problem #4: Toxins

Your skin is one of five emunctories, a fancy word for an organ that eliminates toxins (the other three are your lungs, kidneys, and GI tract, but I also consider emotions to be an emunctory). The skin, along with the other emunctories, helps the body get rid of waste and toxins created during normal metabolic processes, as well as those you acquire from the outside world.

Over the course of a day, the average person encounters a constant stream of toxins. Many of these did not exist prior to the mid-twentieth century, meaning humans didn’t evolve dealing with these chemicals, and it’s definitely taking a toll on our collective health!

So where do these toxins come from?

The food we eat, the air we breath, the water we drink, and the products we use are all sources of toxins that can clog the liver, disrupt the balance of the bugs that live in the gut, disturb hormone balance, block insulin receptors, damage genes, disrupt your normal sleep-wake cycle, and compromise DNA repair and recovery. Yikes!

When the level of toxins is more than the body can handle, or if there is dysfunction in any of the other emunctories forcing the skin to pick up the slack, this can show up as acne, various rashes, or other skin afflictions. Chemicals from the products we use throughout the day can also directly impact skin health and contribute to dryness, acne, and rashes.

For every problem, there’s a solution.

Over the years, I’ve seen a variety of chronic skin conditions improve significantly or disappear completely when nutrient deficiencies are addressed, the health of the gut is restored, hormones are balanced, and detoxification and elimination are supported.

Every person has a unique health picture, so it’s important to work with someone that can help you identify your particular needs and provide the right support for your body. That said, I’m all about empowering others to regain control of their health, so read on to find out four ways you can start supporting the health of your skin now!

4 Ways to Improve the Health of Your Skin!

1) Eat a rainbow of color.

Different colored vegetables and fruits are higher in different nutrients, and as you learned, many skin conditions are related to nutritional deficiencies (as a bonus, the fiber in these plants bind toxins so you can eliminate them!). To ensure you’re getting the spectrum of nutrients you need to support the health of your skin, eat a rainbow of colors every day, and make sure to include foods that are high in vitamins A, C and E, omega-3 fatty acids, and zinc:

Vitamin A: liver, fish liver oils (such as cod liver oil), cream and butter from pastured cows, and egg yolks from pastured chickens

Beta-carotene: several vegetables, such as carrots, sweet potatoes, spinach, and kale

  • Helpful Tip: Beta-carotene can be converted into vitamin A by the body, but this isn’t an efficient conversion, and about 50% of people have a genetic variant that further reduces the conversion by 30-70%! This means vitamin A supplementation may be necessary for a period of time, especially if you don’t regularly consume foods high in beta-carotene.

Vitamin E: egg yolks, spinach, chard, turnip greens, sunflower seeds, almonds, walnuts, bell peppers, asparagus, collards, kale, broccoli and brussels sprouts.

Vitamin C: citrus fruits, broccoli, cantaloupe, brussels sprouts, cauliflower, bell peppers, guava, dark leafy greens, kiwi and strawberries

  • Helpful Tip: Vitamin C is heat-sensitive, so lightly cooking these foods or consuming them raw is best if you want to maximize your vitamin C intake.

Omega-3 fatty acids: cold-water fatty fish, such as sardines, salmon, mackerel, anchovies and black cod.

  • Helpful Tip: ALA, which can be converted to EPA and DHA in the body, is found in several plant oils, such as flaxseed, hempseed, walnut and wheat germ. Unfortunately, the conversion of ALA to EPA and DHA is quite inefficient. To get the greatest anti-inflammatory benefit from omega-3s, it’s a good idea to consume dietary sources of EPA and DHA: cold-water fish, pastured eggs and dairy, and grass-fed meats.

Zinc: organ meats such as liver and kidney, red meat, egg yolks, shellfish, nuts, seeds and legumes

  • Helpful Tip: Zinc is best absorbed from animal sources. The zinc in plant foods is much less bioavailable because it’s bound to phytates. Soaking nuts, seeds and legumes reduces their phytate content, helping to free up more zinc for absorption.

2) Cut out inflammatory foods.

Gluten, dairy, soy, corn and sugar are known contributors to inflammation, and in some people, eggs, potatoes, and nightshades are quite problematic as well. If you’re struggling with a chronic skin condition, try eliminating these foods for at least three weeks.

Avoid packaged goods, processed foods and refined carbohydrates; these are lower in nutrients and often accompanied by inflammatory preservatives, additives and food coloring. Focus on consuming a variety of whole foods, and choose organic whenever possible (if you want clean skin, you have to eat clean food!). Pastured meats are far less inflammatory and more nutrient dense than those fed a “vegetarian diet”, so opt for grass-fed, free range options if you consume animal products.

3) Minimize your exposure to toxins.

We are exposed to toxins everyday, and unfortunately we don’t have much control over some of those exposures. However, one major source of toxins that we can do something about is personal care products.

Most cosmetics and personal care products contain chemicals that are known to disrupt hormones, alter gut bacteria, and even cause cancer. The problem isn’t necessarily that one bottle of lotion containing hormone-disrupting phthalates (though for some individuals, that’s enough over time to throw things off balance). It’s the fact that your body encounters a constant stream of health-disrupting chemicals over the course of the average day (not just from your personal care products!), and this has a cumulative effect that leads to a clogged liver, an increased toxic burden, and a variety of health issues. This is why I often support my clients through a liver-loving detox program, especially if acne or other skin complaints are part of their overall picture!

Switching out your products for more natural options and reducing the amount of beauty or personal care products you use can make a huge difference when it comes to the health of your skin. Even products marketed to help problem skin, like acne, contain chemicals that can disrupt your hormones and clog your liver, which you’ve learned can create issues with your skin!

The Environmental Working Group’s (EWG) Skin Deep Cosmetics Database is a helpful and free resource for assessing skincare options, and the Think Dirty app even allows you to scan barcodes to easily access information about the health and safety of many personal and skincare products. I personally love Annmarie Gianni skincare (and here’s a link that will save you $25 off your first purchase of $75 or more!).

4) Get a handle on stress.

Stress is a big deal when it comes to skin health because it’s extremely inflammatory. And thanks to the hustle and bustle of our modern society, almost everyone is under some form of chronic stress, whether they recognize it or not. Over time, stress can impact several areas, including hormonal balance, gut function, memory and cognition, immune function, sleep, and skin health.

Deep breathing is one of the fastest and most effective ways to reduce stress because focusing on your breath brings you into the present moment and engages your parasympathetic nervous system (the “rest and digest” part of your nervous system). When you’re present and your body isn’t in “fight, flight or freeze” mode, you can more effectively manage challenges that arise and support the healing your body is continuously trying to accomplish.

Enjoy this simple breathing exercise when you wake up, before bed, and during times of stress to help shift your body into a more relaxed, present and healing state.

Place one hand on your abdomen and the other hand on your chest. Use your hands to help focus your attention on expanding your belly, instead of your chest, during inhalation. Exhalations are meant to be slow, controlled, and ideally longer than your inhalations.

  1. Inhale for 4 counts

  2. Hold the inhalation for 4 counts

  3. Exhale for 8 counts

  4. Hold the exhalation for 4 counts

  5. Repeat for at least 2-3 minutes

Restoring the health and vibrancy of your skin is possible!

I hope you’ve found this article informative and helpful, and most of all I hope you’ve learned that your appearance is more than skin deep and there’s SO much you can do to support the health of your skin!

Help spread the word by sharing this valuable information with others who may be struggling with chronic acne, dry skin, eczema, psoriasis, melasma, or other skin afflictions.

And if you’re struggling with a chronic skin issue, consider working with a naturopathic doctor or functional medicine practitioner who can help you identify YOUR root cause(s). The body is an interconnected whole, so chronic health conditions, including skin problems, are usually caused by multiple factors and require assessing and supporting the health of your entire body.

For more information about working with me to optimize the health of your skin, please visit www.DrMamie.com or schedule your complimentary Strategy Session. Your skin will thank you!

This article was originally featured in The Southern Wellbeing.


©2017-2020 by Mamie Burruss, ND.  All rights reserved.

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