It’s Not Just Acne- Getting to the Root of PCOS Acne [Podcast with Dr. Shayna Peter]
“In the case of acne, key nutrients can work to reduce inflammation, stabilize hormones, and repair damage to your skin cells, thus healing scar tissue. When you allow your diet to work as your medicine, you are literally creating the opportunity to heal your skin 24 hours a day. Optimal nutrition works around the clock.” – Dr. Shayna Peter
Acne is one of the most common, frustrating and heartbreaking symptoms of PCOS. Dr. Shayne Peter is a functional medicine doctor and holistic dermatology specialist who’s helped thousands of women resolve their acne. In this podcast we discuss nutritional deficiencies, skin care products, and the role of hormones in getting to the root cause of acne. Listen in or read the transcript as we discuss:
- clues acne can give you about your health
- minerals and vitamins that can help resolve PCOS acne
- skin care products that help and hurt
- role of the microbiome on acne
- impact of alcohol on acne
All PCOS Diva podcasts are available on 
Mentioned in this podcast:
- Well Ahead Chicago
- Dr. Peter’s book: It’s Not Just Acne: Boost Immunity, Beat Acne – Break Through to Clearer Skin & A Healthier You!
Complete Transcript:
Amy Medling:
Have you forgotten what it’s like to have clear skin or feel like you’ve tried everything? Have you wondered if you have to deal with acne for the rest of your life? And you’re tired of being on an endless hamster wheel of one treatment after the next and every new skincare product that comes out. If you are one of the many PCs, Divas that struggle with acne, then you’re going to want to listen to today’s podcast with Dr. Shayna Peter. She is a functional medicine doctor and a holistic dermatology specialist who’s helped thousands of women who have tried everything for their skin problems and have been left feeling frustrated, helpless, and hopeless. She’s the founder of Well Ahead Chicago. It’s a functional medicine practice offering health consultations and educational resources for people who have unresolved skin conditions. And she is the author of a brand-new book. It’s Not Just Acne, which I read last night and it’s a fabulous book. And I’m so glad to have you here on the PCOS Diva podcast, Dr. Shayna.
Dr. Shayna Peter:
Thanks, Amy. I’m so excited and so pumped to be here and join you on this conversation.
Amy Medling:
Well, one of the things that I immediately resonated with you and your book is that you think of acne as not just a nuisance and a burden, but you view it as a gift and an opportunity. And that is the way that I view PCOS. I mean, it took me a long time to get to this place of feeling like PCOS is a blessing. And I think that we both are kind of coming at it from the same angle. And I would love for you to explain how acne is a gift and an opportunity.
Dr. Shayna Peter:
Yeah, absolutely. So, I can definitely relay on a personal level as someone who’s struggled with acne myself, so I know firsthand, you know, just how annoying and how frustrating it can be to experience breakouts, especially as an adult, because that’s one thing that we think about acne is that it’s something that we struggled with for a few years as a teenager and then once we’re an adult we’re supposed to be done with that. So, dealing with acne as an adult, it really became this discovery process for me, that I’ve been really grateful for. And it, you know, it actually led me to functional medicine myself because I was in the conventional world initially and not being able to find the answers to acne that I was looking for really pushed me in that direction. And it really became a blessing for me because it became this learning process that allowed me to learn so much more about my health and how to solve other challenges that I was dealing with and being able to connect a lot of those dots and make a lot of those connections between other symptoms that I was experiencing.
And so, reframing how you see acne can be so powerful because with functional medicine and looking at things more holistically you do have the opportunity to prevent a lot more serious conditions down the road and experience a lot of collateral benefits. And that’s one of the things that I talk about in the beginning and a big reason why the name of the book is Not Just Acne is because we do have limiting beliefs, you know, we’re conditioned to have limiting beliefs about acne a lot of times, and just think about it as a skin problem. But, you know, it’s coming out more in the research. The research is evolving more and more that there are a lot of similarities and root causes between acne and some more serious conditions that could be fatal, like autoimmune conditions, cancer. So, that’s coming out in the research and those aren’t things that we think about necessarily when we think about acne, we just think of it as being, you know, a cosmetic thing, but it, if we really pay attention and address those root causes, that it can give us an opportunity to prevent a lot more serious conditions down the road, which, you know, is priceless.
Amy Medling:
Yeah, exactly. And it really relates PCOS because it gives you so many signs that there may be some type of hormonal imbalance, gut imbalance. And you talk about different clues that acne can give you in your book. And we’re going to be talking about that in a minute, but I wanted to just back up. You had mentioned, and this is really the first time I ever heard acne as being mentioned as a possible connector to autoimmune issues. And you even go so far as saying that it could possibly kind of be on an auto-immune spectrum. So, I would just like to hear more about that connection. I know a lot of women listening would too, because so many with PCOS deal with other auto-immune issues like Hashimoto’s and it’s also been suggested PCOS maybe an auto-immune condition.
Dr. Shayna Peter:
Yeah, definitely. So, we were talking about autoimmunity and just thinking about some of the biggest root causes that we know of in functional medicine nutritional deficiencies is a big one, infection. So chronic low-grade infections, a compromised intestinal lining, environmental triggers of environmental toxic load. So those are all major things that we know to be associated with autoimmunity, and those same things can be triggers of acne as well. So, it just may be a situation where people are experiencing the acne earlier in life, but with autoimmunity as you know, and you’ve heard it takes decades for that to develop.
Amy Medling:
Yeah. You know when I was reading your book, I thought about my, my son, Clay, who I’ve shared on the podcast a couple of years ago, he had a major health emergency, I guess you’d say, we found that he had a tumor on his pancreas and he had to have a Whipple which is a major surgery to have this tumor removed on his pancreas when he was 18. And afterwards he developed really horrific acne on his forehead and nothing we did, you know, he tried probiotics, lots of different topicals, and nothing helped until we realized that he needed some digestive enzymes and his food just wasn’t digesting. And once he got those digestive enzymes, his acne went away, it was like a miracle. And you talk about digestive enzymes in your book as one of the supplements that you recommend for folks that are dealing with acne. And I want to, I definitely want to get into that. We’re going to be talking today about minerals and vitamins and how to optimize those and how nutritional deficiencies come into play for acne. But before we do that, could you just kind of talk about the, the different pillars that you discuss in your book? I know we’re not going to get to all of them today. We’re going to be focusing on the nutrition piece, but I just want the PCOS Divas listening to see how you go after that root cause of acne.
So, we’re going to talk, as I mentioned about optimizing vitamins and mineral levels and figuring out how nutritional deficiencies come into play. And I’d love to talk about all the different aspects of the book, but we just don’t have time on the podcast today, but why don’t you tell us what other pillars you cover in the book besides the nutritional focus that we’re going to talk about here in a minute?
Dr. Shayna Peter:
Yeah. So, there are a lot of different aspects that I try to hit in the book to really help people to understand how acne is multifaceted and that’s sometimes why it can be so complex and so difficult to treat. So, some of the other things that I touch on in the book are balancing hormones. So, a lot of people think about acne as being hormonal. And I will say that that’s true in a lot of cases, but I think we have to get away from over-simplifying how we think about hormones. So, there can be different patterns that people have different ways that hormone imbalances express themselves in people differently that have acne, and I talk a lot about what it takes to address root causes of hormones. So, it’s not just about replacing a hormone or blocking it, how to really get to the root cause talk a lot about inflammation.
So, there’s actually a whole chapter on inflammation because at the end of the day, that’s where we’re going with all of this. That’s what we’re trying to identify all the different things that are happening in our body that are contributing to inflammation. So, finding the root cause and then fanning that flame so that we can bring the inflammation down to a normal level, so we started to talk about digestive function a little bit. So, that’s something that I’d definitely like to touch on in great detail and how people can really optimize their digestive health and a lot of the other factors that interplay and affect our digestive health and even healing the gut, how our digestion and how our microbiome affects our gut lining, our barrier between our bloodstream and the outside world.
So, I definitely hit on those things and I talk about detoxification as well. So, you started to talk about that a little bit with autoimmunity, but even earlier in life there are a lot of things that we can do to lead a cleaner lifestyle and reduce our toxic exposure and that can really help in improving acne and a lot of people as well. And I know in this conversation, we’re kind of talking about things from a different angle and not focusing as much on skincare, but that is something that I address in the book as well because it can be helpful and people definitely want to be on a good skincare regimen that helps to fight breakouts and calm their skin but doesn’t irritate their skin. So that’s an issue that a lot of people have with acne skincare that can be so aggressive that it really dries their skin. It makes their skin look unhealthy.
Amy Medling:
But I think people sometimes tend to rely just on the creams and lotions and tonics without realizing that they have to kind of fix what they’re putting kind of into their body to feed their skin, which is like, it’s the largest organ of our body versus putting on. So, I just wanted to read a little excerpt from your book. I thought it was great. And I think it sets up talking about nutrition really well. You say “when we are hungry, it is a signal that we need nutrients, not just calories. If we take it upon ourselves to understand nutrition, we advance towards self-maintenance and healing in general. Specifically in the case of acne, key nutrients can work to reduce inflammation, stabilize hormones, and repair damage to your skin cells, thus healing, scar tissue. When you allow your diet to work as your medicine, you are literally creating the opportunity to heal your skin 24 hours a day, optimal nutrition works around the clock.”
Dr. Shayna Peter:
I love that. Thank you.
Amy Medling:
Why don’t you walk us through the nutritional deficiencies that you talk about in your book and why those can play a factor into acne? What kind of foods we could eat to increase those nutrients? And then maybe at the end, we could probably talk about supplementation. I’m sure you agree, you can’t out supplement a bad diet, so it really needs to start with diet.
Dr. Shayna Peter:
Yeah. So, diet is definitely foundational, so I would say that they’re both important because the challenge with our diet, a good diet is extremely important. Diet is foundational, but our food supply is an issue. Our food quality is just not what it used to be. So, if we’re relying on our diet solely as our source of nutrients, most of us are gonna have deficiencies there, even if we’re on our best behavior. So, both are really, really important.
Amy Medling:
So, let’s start with the fatty acids. Tell us how those play a role.
Dr. Shayna Peter:
Yeah. So the fatty acids play a role, especially Omega three and Omega nine, because they’re, anti-inflammatory so, our Standard American Diet is very high in Omega six, so that’s not an area where we need to supplement most of the time. A lot of the processed foods that we eat, packaged foods, a lot of junk foods. They’re very high in these processed oils that are very high in Omega six and very low in Omega three. And so, when we’re consuming that type of diet, it creates an imbalance in that ratio between Omega six and Omega three, and that can really be a driver of inflammation. So with acne in particular it can set us up to have more breakouts because having high levels of Omega six, it can change the composition of our them and make our sebum and make our sebum more sticky and viscous, where it’s more likely to clog pores and cause breakouts and just overall they’re anti-inflammatory. So that’s going to be really important .With oleic acid, oleic acid is really important because it’s a supportive nutrient that helps with mineral absorption. So we’ll talk about some of the minerals as we go through, but it can be really difficult for us to absorb our minerals if we don’t have high enough levels of oleic acid in our diet.
Amy Medling:
So, I know that women with PCOS have a hard time converting the plant-based Omega threes to the more important Omega three EPA and DHA. So, I think this is one of those cases where we do need some supplementation. What are you, what are your thoughts there?
Dr. Shayna Peter:
Yeah, supplementation is really important and what’s great about a lot of supplements is that we can find some that have been purified to some extent and have a higher levels of some of those active ingredients that we’re looking for in omega-3 fatty acids. So, that’s definitely a benefit that we should take advantage of and also having adequate levels of zinc that can help with our conversion as well of converting Omega three fatty acids into the EPA and DHA.
Amy Medling:
Yeah. Tell us more about zinc. Why is zinc so important for managing acne, especially women with PCOS?
Dr. Shayna Peter:
So zinc, it is so important because it’s one of the few minerals that has profound effects on hormone balance. So, with acne and PCOS in particular, we know that androgens are an issue and with acne, a lot of times people do have higher levels of testosterone and they’re converting their testosterone into the more potent form, which is called dihydrotestosterone. So zinc really helps us because it facilitates that conversion, it is involved with that conversion. So, when we have adequate levels, it can inhibit some of that conversion from testosterone to the more active form dihydrotestosterone, because when the levels of dihydrotestosterone are higher, that’s when we noticed a lot of those androgen symptoms.
Amy Medling:
Yeah. And you also, uh, often see that abbreviated to DHT. So, if you’re familiar with DHT, that’s what Dr. Shayna is talking about. So, zinc is important. Is it hard to get enough to zinc in your diet? Do you think?
Dr. Shayna Peter:
I would say no, but a couple points that I want to make about that. So, if you’re eating more of an omnivorous type of diet, then no. If you’re following more of a plant-based vegan, vegetarian diet, then yes, because the richest sources are typically gonna be animal protein. So, it is going to be more challenging if you’re cutting out those animal foods from your diet. Another point that I like to make on that with zinc is if our digestion is compromised, we can also have difficulty absorbing it. So even though we may be eating it, we may have difficulty absorbing it. If we have, we’re having an issue with our digestion.
Amy Medling:
That’s a great point to make. Okay. The next, the next one in your book is vitamin A. Tell us about vitamin a.
Dr. Shayna Peter:
Yeah. So, vitamin A is kind of like a superstar with, with acne and skin health. So, a lot of your listeners have probably heard of Accutane. So, Accutane is a medication that has been used a lot traditionally to treat acne in some of the most severe cases. And it’s actually a synthetic form of vitamin A. It’s a high dose form of synthetic vitamin A, but vitamin A at the level of the skin, it helps to regulate sebum production. So that’s why a lot of times people notice benefits right away just from taking high doses of vitamin A, but it’s also got, you know, other benefits for acne and skin health and just bringing down inflammation. So, it’s one of the key nutrients that we need to support our intestinal barrier intestinal barrier and the health of our intestinal lining. So, when people think about, uh, inflammation and leaky gut if you have a deficiency in vitamin A, and that’s not corrected going to be an obstacle to healing a leaky gut.
Amy Medling:
That’s, it’s interesting. So, I’m wondering, could you just kind of be sure that you’re taking a good multivitamin that would sort of cover the vitamin A, the zinc? I know the next, the next supplement we’re going to talk about is B6.
Dr. Shayna Peter:
Yeah. So, there are multivitamins out there that have good levels of a lot of these nutrients. So I’m looking to make sure that they meet the daily value is definitely important and looking to see what form, what form the vitamin A is in. So that’s another thing that people need to be educated about because a lot of supplements have beta carotene. And so, beta carotene is not the active form of vitamin A. Our body has to go through a lot of steps to break it down. So, making sure that you’re taking a formula that has the active form. So, retinol palmitate is an active form that’s found in a lot of supplements.
Amy Medling:
Okay. So, for example, the PCOS Diva Essentials multivitamin, our vitamin A is mixed carotenoids and palmitate.
Dr. Shayna Peter:
Yeah. So, a person may need to take a separate vitamin A supplement in that case, but I’m really a big fan of people finding out where they are as opposed to blindly supplementing levels. With some vitamins and specific in a particular like vitamin A because it’s fat soluble, you know, it sticks around. So, it’s more easy for people to develop a toxicity to vitamin A. So, it’s important to be cautious about taking high, high doses of vitamin A if you don’t know specifically where your levels are.
Amy Medling:
So, do you recommend micronutrient testing, like SpectraCell micronutrient tests? Yeah. I mean, I definitely think one of the other supplements that are vitamins that you talk about is vitamin D and I think that’s one of those vitamins that women with PCOS should be tested for to see where their levels are, are at because it impacts so many different body systems. So why don’t you tell us, talk about vitamin D next?
Dr. Shayna Peter:
Yeah. So, vitamin D it is like a super-vitamin, so it has some really profound effects on our immune system, blood sugar. So with PCOS that’s obviously a major concern is blood sugar regulation. So people knowing where their levels are, is going to be really important. And I’m a fan of looking at levels within the cell as well, as well as within the serum. So, usually with standard, uh, labs, they look at the serum level. So sometimes people can have high levels in their serum and in low levels in their cells. So that’s important for them to know because they may think that their vitamin D levels are great, but the vitamin D is not getting into their cells. So, it’s not really doing anything. And another reason why that’s important to identify as because if that’s the case, supplementation is really not going to benefit them. They really need to get their vitamin D from the sun.
Amy Medling:
So how can you tell if the vitamin D is in yourself versus your serum?
Dr. Shayna Peter:
So by looking by doing the comparison by looking at both serum levels and cellular levels, so micronutrient tests like the SpectraCell, will be looking at their cellular level. So if it’s low in the cells and hind the serum, then it’s not getting into their cells.
Amy Medling:
Okay. That’s, that’s good to know. Let’s see. You also talk about chromium and selenium.
Dr. Shayna Peter:
Yeah. So chromium is another nutrient that is really essential for blood sugar control. And one thing that, you know, I see a lot, so I look at people’s nutrient status pretty much every day. So chromium, isn’t a really great indicator because it can be a deficiency that you may see before a more obvious blood sugar issue presents itself. So some of the limitations with you know, just looking at standard labs, looking at glucose. So when people have their annual checkup with their doctor, usually it’s just, you know, a fasting blood glucose that is checked. But having the ability to look at some other things too, like vitamin D levels in the cells and the serum we’re looking at chromium, it can be a better indicator and an earlier indicator if there is a blood sugar issue, even if it’s mild. And so that can be really helpful and preventative in a lot of people. And if you can address that, help prevent the blood sugar issue from developing further.
Amy Medling:
So, what about selenium?
Dr. Shayna Peter:
Yeah, so selenium is like our superstar antioxidant. So selenium is really important is really key because it helps to recycle a lot of our antioxidants. So, like glutathione. So glutathione, that’s the most abundant antioxidant in our body to help shield us from the damaging of picks up a lot of inflammation. So having healthy levels of selenium around is going to be really important so that we can reproduce school to find them.
Amy Medling:
So do you think that just eating a few Brazil nuts a day, do you think that’s a good source of selenium?
Dr. Shayna Peter:
Yeah, so, Brazil nuts, raw Brazil nuts are one of the best sources of selenium.
Amy Medling:
Okay. So we talked about some, some really important nutrients for managing acne. You kind of close up your chapter about diet and nutrients, about eating, you know, kind of getting stuck into eating stress foods, which, you know, I think we all know like chips and ice cream and kind of those like nutrients, sugar-filled devoid kind of grainy foods. Can you just sort of comment about like the problem with eating kind of that standard American diet and acne?
Dr. Shayna Peter:
Yeah, sure. So with the standard American diet, in a nutshell, it sets us up for failure because it is very high in refined sugars, refined carbohydrates, processed oils and fats. So basically everything possible to drive inflammation, to disrupt our microbiome, to cause blood dysregulation. That’s what we get from the Standard American Diet. So, if we’re going to form a diet that’s going to help keep our skin healthy, help keep our blood sugar regulated, we have to be very intentional about choosing foods that don’t fit that criteria. So choosing foods that, you know, there are balanced carbohydrates that are high in fiber, getting a variety of vegetables in our diet, choosing oils that are not processed, that are high in Omega threes and Omega nines. Those are the things that we have to do, and we have to be intentional about it because if we’re not, if we just eat whatever, eat out, it’s not going to happen. We’re going to fall into a standard American way of eating.
Amy Medling:
And it’s, you know, again it goes back to if acne is one of your symptoms, then you really need to get to the root cause. And it’s kind of a wake-up call that your body is out of balance in some way. And it could be these nutrients that we were just been talking about. So, something to definitely look into. Before we wrap up, I do want you to just comment on your thoughts on alcohol. I get that question a lot. You know, is, is alcohol, is there a place for alcohol for somebody who struggles with acne? , what, what’s your thoughts on that? ,
Dr. Shayna Peter:
If you’re, here’s my thoughts. So, if you’re trying to clear up your skin, alcohol is not your friend- blank period. You have to just cut it out. It’s going to be an obstacle to clearing your skin for a number of reasons. So if you’re really serious about clearing your skin up and turning your health around, you’re going to have to eliminate it strictly for a period. I will say that there is a place for small amounts of alcohol, once you’re in a process where you’ve healed, where you’ve healed your gut, but, when you’re going through that healing process, alcohol can be a constant insult.
Amy Medling:
I think that’s sort of the way that I feel about alcohol and PCOS as well. But you know, it’s hard to think about going through my entire life without a good glass of wine with a nice meal.
Dr. Shayna Peter:
No, I get it a hundred percent, but, uh, were you going through the healing process? You know, there’s sacrifices that you have to make strictly for a of time so that you can get the result that you want, because what would be even worse is to be, you know, kind of, kind of eliminating alcohol forever and never really getting the result that you’re trying to achieve.
Amy Medling:
Yeah. And there’s so much in your control, and that’s what I think I really loved about your book. And again, the book’s name is It’s Not Just Acne and it really, uh, gives you the information that you need to move forward and make some lifestyle changes. You know, some information so that you can advocate for yourself at your doctor’s office for the tests that you might want to ask for like that nutrient deficiency labs. And there’s just so much to the book and I really thank you for writing it. It’s honestly, it’s the first book that I’ve read about acne from a functional medicine approach. So, so thank you, Dr. Shana, and could you just tell us where we could pick up a copy of your book?
Dr. Shayna Peter:
Sure. Thank you so much for having me, Amy. I’m so excited to bring more awareness to this. The book can be found at, It’snotjustacne.com and people can also find my private practice where I do telemedicine at wellheadchicago.com.
Amy Medling:
And so just to clarify, if somebody is dealing with acne and they’re listening and they really resonate with your book and our podcast today, they can reach out to you and do a telemedicine call to kind of get to the root causes of their acne.
Dr. Shayna Peter:
Yes, absolutely.
Amy Medling:
Awesome. That’s wonderful. Well, thank you so much again for taking the time to come on the podcast and thank you all for taking time out of your day to listen. And I look forward to being with you again very soon. Bye-bye.
