Dr. Nicole Sundene, NMD
Holistic Psychiatry & Hormones
Is Your Brain Starved of Progesterone?
Progesterone plays a very important role in the brain and for anxiety and mental health. Women with anxiety and depression should be tested for progesterone deficiency as it can create an adverse impact on mental health when not properly addressed.
A simple progesterone cream or pill can help replace the depleted progesterone levels. We need to monitor our mental health patients properly because too much progesterone can cause anger, agitation, moodiness, and depression. Although I rarely hear that reported as a side effect of taking progesterone cream. Progesterone pills and lozenges are more likely to cause this side effect.
I like the Metabolic Maintenance progesterone cream available via my Vitamin savings page. This cream is in a nice base, is by a trusted reputable company, and does not contain any other herbal medicine ingredients which some of my patients do love having in their progesterone cream, while others with a lot of food and herb allergies such as myself prefer to keep their ingredients simple.
The limitations to OTC progesterone cream is generally dose. Most of the OTC brands I have evaluated provide around 25mg per pump of progesterone that a woman then applies to her wrists, bikini line, backs of knees and non fatty areas. Applying 4 pumps of this body lotion can become annoying and this is when my patients ask for a prescription at the compounding pharmacy so they have a more concentrated cream. However, for my patients over 55 that I am phasing hormones down on these OTC doses are often the perfect amount for keeping hot flashes, insomnia, anxiety, and rapidly aging skin away!
Progesterone cream should always be applied at bed time as it aids with sleep. Some of my anxiety patients do apply some in the morning to also aid with anxiety and hot flashes.
I commonly receive new patients with progesterone deficiency that are on several mental health drugs to compensate for a simple hormone deficiency that begins to occur around age 35. Back in the 90's when I worked for a Hormone Doctor, we gave everyone synthetic estrogen and believed that progesterone cream or pills were not necessary for women that do not have a uterus. Boy were we ever wrong!
This is antiquated hormone thinking, and about as old-fashioned as prescribing Premarin for menopause patients. I no longer work in an office that prescribes synthetic "horsey hormones" and I have since witnessed the dramatic importance of progesterone on mental health.
Women's eyes, and vaginal mucosa also need progesterone cream. Nightsweats and insomnia also can occur from progesterone leaving women in state of chronic fatigue, brain fog, memory loss, difficulty concentrating, and ADHD.
Hormone imbalance can strike more than just the female organs. As a Women's Health doctor, I actually see it impacting women’s mental health even worse than how low progesterone causes heavy bleeding, fibroids, and endometriosis.
While women commonly think of pregnancy when they think of progesterone, I hope this blog will serve as an important mental health PSA about the importance of progesterone for mental health!
When progesterone deficiency is occurring women report to me they are having physical symptoms like insomnia, autoimmunity, night sweats, weight gain, and vaginal dryness.
10 Mental Health Warning Signs of Progesterone Deficiency:
Did you know progesterone cream aids with neuroregneration and works as a neuro-steroid? Those with concussions, and damage to the nervous system such as in Neuropathy, MS, and ALS generally report feeling better on progesterone!
It is time to stop the hormone insanity from the 1990's and JUST GIVE WOMEN PROGESTERONE.
There is absolutely no reason not to give women progesterone cream unless they have a family history of cancer, then I do not prescribe any hormones. I also do not prescribe any female hormones to women that won't get cancer checks such as pap smear and mammograms as that is simply dangerous.
But for mental health reasons, women need more than just estrogen to feel mentally healthy and balanced. They need progesterone, and they also need testosterone. Low testosterone is related to low self esteem and "Imposter Syndrome" in women. I commonly see women with high testosterone behaving more confidently and assertive than their testosterone deficient counterparts.
As I discussed in my article on "Natural Treatments for Night Sweats," synthetic hormones should be put out to pasture with the horses they collect urine from to make them. Prescribing ONLY estrogen to women should ALSO be put out to pasture. Women everywhere should be educated that they need all three female hormones in proper balance to feel mentally healthy.
Let's stop wrongly labeling and stigmatizing women with anxiety and depression, when they should instead be labeled with hormone imbalance or hormone deficiency.
For most women, a simple balanced combination of bioidentical estrogen, progesterone, and testosterone, in a cream or lozenge aka "troche" is really all most need in order to feel optimal mentally and physically. A lot of my female patients don't even require herbs or supplements then to correct their mood because the hormones are doing their job. While I am happy to prescribe herbs for anxiety, I also prefer to use the least amount of things possible along with a very healthy diet to keep my patients healthy.
The best thing you can do for your future hormone doctor to have your hormones tested in the first half of your cycle when they are low and you feel happy so that your doctor can mimic those same levels with bioidentical hormones such as estrogen and progesterone cream if need be for your mental health someday.
If you need my help with your hormones now, simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
When you knock on the trunk of an Ironwood tree it will be VERY SOLID hence the name “Iron wood.” Ironwood contains anti-inflammatory compounds guaiaretic acid and guaiaconic acid. Which is why it was used historically by herbalists to treat gout, inflammation and arthritis.
Energetically Ironwood is known for promoting positive energy and strength which many of us need in these tough times.
Go knock on the trunk of an Ironwood whenever you need to remind yourself how tough you are!
You are always MUCH stronger than you think!
Join me for a FREE presentation on “Hormones, Inflammation & Metabolism” to learn more about how I treat my patients with Naturopathic Medicine!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
By Dr. Nicole Sundene, NMD
Hashimoto’s thyroiditis is one of the most complicated hormonal and autoimmune conditions I commonly treat. I am sure you would not be googling natural solutions to solve Hashimto’s unless you were not getting lasting solutions that actually worked as I describe in my story about “Why I Became a Naturopathic Doctor.”
While I don’t have the autoimmune form of hypothyroidism, I do understand the ups and downs, the good days and flare days, and the other frustrations of having an autoimmune disease first hand. I know what it is like to not get lasting solutions that work, passed around from one uncaring doctor to the next, and wasting my money and time on useless treatment. I have wasted a lot of money in my life on useless natural remedies and prescription drugs to maintain my autoimmune disease and other conditions I have been challenged with such as acne, eczema, psoriasis, ADHD, depression, chronic pain, and anxiety.
Let me take a minute to explain how I help my patients with Hashimoto’s achieve lasting solutions so that they do not have to rely on prescription drugs, and only need natural hormones, herbs, and vitamins.
While our normal medical model in American health care works in a paradigm of: TAKE X Thyroid DRUG FOR X Hashimoto’s SYMPTOM
What I actually want to do as your Naturopathic Hormone Doctor is the following:
#1 Why do you have Hashimoto’s in the first place?
#2 Working to investigate the “Root Cause” of your symptoms.
#3 When did these symptoms start? What else was going on?
#4 Are there genetic or environmental causes?
#5 Are female hormones flaring Hashimoto’s?
#6 Eliminate food triggers
#7 Improve Insomnia so the body can actually heal and repair the joints
#8 Manage Hashimoto’s joint pain naturally
#9 Evaluate adrenal stress hormones that support the thyroid and reduce inflammation
#10 Implement gentle exercise or work with a fitness trainer
#11 Implement counseling for patients with anxiety from Hashimoto’s thyroid storms that transition to depression when the storm has passed and the thyroid hormones are burnt out.
#12 Test vitamins, minerals, and nutrients related to proper thyroid function
#13 Implement natural thyroid hormones, and properly adjust them
#14 Use herbal medicine and supplements for inflammation
#15 Teach my patients my simple 4 week Autoimmune meal program so they can learn how to eat in a healthy Naturopathic inflammation reducing manner that helps women with Hashimoto's actually lose weight, lower pain, and balance hormones. Thus no longer living on Tylenol and Advil for pain, and high amounts of caffeine for fatigue.
Without understanding #1 and #2 on my list, I sadly have seen many Hashimoto’s patients fail with natural medicine. I want every single patient in my practice to be a success story. So please do treat yourself to a Naturopathic visit with me if you want real answers about your Hashimoto's, want the right nutrition for your Hashimoto's, want me to fix the underlying female hormone imbalance that is most often causing weight gain, pain, swelling, and chronic fatigue and the #1 reason why more women have autoimmune disease than men.
While I love helping women with Hashimoto’s, I also have been doing this job for over seventeen years as a Naturopathic Hormone Doctor and I know what it takes to get results. We need to think of this as a process and not just one simple prescription that will magically fix it all.
Trust me, if that existed you know I would already be on it and be blogging about it! 😉
So let's have realistic expectation and work through each challenge around your Hashimoto's symptoms in steps. If that sounds like what you need then please pop over to my SCHEDULE page and let’s get working on your Hashimoto’s symptoms now! I would be happy to help!
Next, I will answer everyone’s most common questions I get about Hashimoto’s.
WHAT IS THE DIFFERENCE BETWEEN HASHIMOTO'S THYROIDITIS AND HYPOTHYROIDISM?
Hashimoto's thyroid treatment is extremely different than regular hypothyroidism in Naturopathic Medicine. In my mind, Hashimoto's requires a completely different treatment plan because it is an autoimmune disease, therefore I am working to balance the immune system as a Female Hormone Specialist and Naturopathic Doctor, in order to improve thyroid function naturally.
Patients with regularly hypothyroidism, such as myself require much less treatment to feel optimal than my autoimmune thyroid patients. Hashimoto's can be one of the trickiest conditions to treat, however many women are unaware they suffer from it.
Many of my patients have been treated for their thyroid for years without knowing what type of thyroid disease they have. Half the time most MD’s could care less what form of thyroid disease the patient has because it does not affect their thyroid treatment. The thyroid treatment is the same for an autoimmune Hashimotos as standard hypothyroidism. This makes little sense since we are comparing apples and oranges.
IS HASHIMOTO'S A HORMONE CONDITION OR AUTOIMMUNE CONDITION?
Did you know with Hashimoto's the real problem is actually the immune system attacking the thyroid, and there is generally nothing actually wrong with the thyroid gland itself? I like to think of the thyroid in this situation as the poor little kid getting bullied in the schoolyard. He is constantly under attack, but otherwise would be completely fine. When we fail to address the immune system in this frustrating autoimmune disease, we fail to ever truly help the patient return their inflammation levels to normal, restore energy, and reduce arthritis, achy joints, swelling and traveling pain that is the hallmark for Hashimotos.
If you are a thyroid patient that has not been tested for Hashimoto's yet, you have constant traveling mysterious aches and pains that no doctor or physical therapist can diagnose…I will bet the farm that the diagnosis is Hashimoto's.
As a thyroid doctor and Hashimoto's specialist, it is extremely important to me to understand my thyroid patient’s diagnosis, and if they have just a “Lazy Thyroid” as I have in regular hypothyroidism, or whether they have an autoimmune disease that is actually causing the hypothyroidism.
WHAT VITAMINS AND MINERALS SHOULD I TAKE FOR HASHIMOTO'S?
Nutrients that most thyroid patients are deficient in can also cause severe adverse reactions for my Hashimotos patients as I describe in my "Thyroid and Iodine" blog. This is why self treating Hashimoto's can be dangerous. I have seen patients harm themselves from too much iodine, zinc, tyrosine, b-vitamins and thyroid cofactors that can throw the sluggish low thyroid into hyperdrive and cause an actually “Thyroid Storm” where the immune system is ferociously attacking the thyroid, resulting in thyroid cell destruction.
During a Hashimoto's thyroid storm the thyroid hormones are dumped into the bloodstream causing the heart to be immediately triggered, as T3 stimulates contractility and thus palpitations, tachycardia and anxiety can ensue from the hyperthyroid storm.
When we work to address the autoimmune condition from a Naturopathic standpoint, we can calm these thyroid storm attacks down and lessen the rate of destruction the thyroid will endure. Once the thyroid has endured enough attacks, and as part of the natural aging process of our glands, most Hashimoto's patients eventually require thyroid replacement hormones.
WHAT IS THE BEST THYROID MEDICINE TO TAKE FOR HASHIMOTO'S?
While it may have a higher likelihood of adverse reactions for those with autoimmune Hashimotos I do see Armour Thyroid work the best to control symptoms and improve fatigue and weight loss. Armour thyroid is a generic term for “Natural Dessicated Thyroid” because the pig gland is desiccated generally there is no reaction to the natural thyroid medication for the majority of my Hashimotos patients and therefore the "rule" that autoimmune patients should not be given Armour thyroid is simply untrue.
WHAT IS THE MOST COMMON THYROID HORMONE YOU PRESCRIBE FOR HASHIMOTO'S?
Around 95% of the Hashimotos patients in my hormone practice prefer Natural Dessicated Thyroid or Armour over levothyroxine or synthroid.
The other choice is synthroid or levothyroxine combined with T3. I do not recommend patients take T4 alone or “T4 Monotherapy” unless they are great converters to T3, the metabolically active thyroid hormone. Because most women struggle with this conversion, especially when in Menopause and Perimenopause as female hormones can impact the thyroid levels and smother them, reduce thyroid function, and cause the metabolism to slow down.
Therefore monitoring the thyroid for women in their forties and fifties is critical in Women's Health.
Women with Hashimotos should find a seasoned Hashimotos Expert that specializes in Naturopathic Medicine, Herbs and Nutrition. Many other hormones can impact the Hashimotos patient such as adrenal hormones, estrogen, progesterone, and insulin. In my mind, there is no patient that needs a Naturopathic hormone doctor more than a Hashimotos patient!
Your naturopathic doctor should be providing hormone testing and treatment to the adrenals which are the underlying foundation of support for the thyroid, in addition to addressing gut health and the microbiome which are also triggering many women with this frustrating thyroid disease.
SHOULD I SELF TREAT MY HASHIMOTO'S?
Some of the most dangerous things I have witnessed patients do as a doctor is read random blogs and self treat their Hashimoto's which can be extremely dangerous and result in a heart attack or stroke if thyroid hormones are too high. Treating Hashimotos properly is extremely complicated and requires a multifaceted approach to correct hormones, nutrition, inflammation, and most importantly balance the immune system, helping it to become less reactive and thus less likely to “bully” or attack the thyroid.
If you would like my help with your thyroid condition simply visit my SCHEDULE page to set up your initial Naturopathic visit!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
By Dr. Nicole Sundene
Seborrheic Dermatitis, dandruff, itchy scalp, scalp eczema and psoriasis are so annoying they drive patients in droves to see me as a Naturopathic Doctor that specializes in Dermatology. This condition can become so severe it can even cause hair loss!
The good news is I have such a high success rate from treating these patients over the past fifteen years that we usually can get an itchy scalp problem better in just a few appointments. Often just one appointment is needed for my Seborrheic Dermatitis patients!
Nothing makes me happier than hitting a "Naturopathic Home Run," aka fixing a chronic annoying Dermatology problem in just one visit. Keep in mind that is generally the case with kids and teens, and that adults generally need multiple visits because their hormones are imbalanced and that is the #1 trigger for seborrheic Dermatitis.
Here is what my solution is to this frustrating skin condition:
WHAT IS SEBORRHEIC DERMATITIS?
An itchy dry, flaky scalp is typically “Seborrheic Dermatitis”commonly referred to as dandruff in adults and “cradle cap” in babies. Most standard anti-fungal shampoos, topical steroids, and topical treatments such as selenium sulfide and pyrithione zinc typically only provide temporary relief because they are not addressing the ROOT CAUSE of their Seborrheic Dermatitis. This requires me to put on my detective cap to figure out what is actually wrong and why the body is sending this negative itchy message that something is not quite right.
The fact that the body is out of balance must be addressed or the shampoo will simply not be enough. Although I do agree these shampoos are helpful for reducing symptoms while the actual cause is treated, they frankly are not the “be all end all”.
First of all seborrheic dermatitis is an inflammatory condition of the scalp that can manifest in the form of mild dandruff to dense, greasy scaling of the scalp. Mild cases of dandruff will typically resolve with the addition of fish oil, biotin and b-complex, zinc, and selenium, however more severe cases of seborrheic dermatitis will require further investigation.
The reason for this is that in babies the condition typically remits after 6-8 months, but in adults the Seborrheic Dermatitis is almost always chronic and will just tend to relapse and remit while it worsens over time. So let’s get this figured out now, shall we?
This condition is commonly correlated with a yeast, Pityrosporum ovale, but that yeast is predominantly everywhere right? It is not some random infectious disease like Ebola, it is simply a common thing in our environment, which gets me thinking…why doesn’t EVERYONE that is exposed to P. ovale have Seborrheic Dermatitis? The reason for that is that not everyone is pre-disposed to being susceptible to such a problem. There is a high familial correlation with this disease. Typically our diet, genetics, environment, lifestyle, and stress levels all contribute to causing Seborrheic Dermatitis, and an illness just chooses to show up on the body somewhere to show us that we are out of balance. Especially with dermatology it is as if your body is screaming at you to pay attention to what is wrong with it when the embarrassing dermatology condition shows up on the face or scalp. We can no longer ignore it and cover it up with clothes. Whether we choose to listen to the message or ignore the message while suppressing it with shampoos and topicals or what not is up to us, but rarely to patients find permanent relief from topical treatments from Seborrheic Dermatitis very similar to my long acne rant about how we need to treat the underlying ROOT CAUSE.
So what is out of balance? Most likely digestion and stress.
When I have worked with patients with very refractory cases of seborrheic dermatitis in the past they have all had food sensitivity components, especially to wheat, dairy, and citrus that needed to be addressed. For whatever reason imbalances in our gut always show up on the skin first. I always know my dermatology patient is going to have a great outcome when they understand the problem on their outside is actually caused by a problem on their INSIDE. My guess surrounding this is that people are naturally pretty vain and will easily ignore a stomachache, but not a skin problem. The body is very wise when sending messages. Also since 70% of our immune systems surround our gut in the form of “Gut Associated Lymphatic Tissue” or GALT, any inflammatory condition will improve by simply going on a trial hypoallergenic diet for several weeks and then testing for food sensitivity once the condition has cleared.
Be sure to start a whole foods diet whenever possible free of your individualized food sensitivities until the Seborrheic Dermatitis improves. Of added interest, this problem is predominantly male which suggests a male hormone component or imbalance. Most hormones are easily brought back in to balance by improving sleep and cleaning up diet and stress.
I would recommend for anyone with an itchy skin problem to read my article on eczema, as in my mind they are all basically the same thing and tend to resolve by using similar traditional nature cure means. All my friends that are Dermatologist friends hate me for saying that but I have worked in both conventional Dermatology for eight years for three Dermatologists and Naturpathic Dermatology for over fourteen years so with twenty two combined years of experience in Dermatology I feel I am entitled to my own opinion.
Of course Seborrheic Dermatitis in adults has been shown with good research to improve specifically from taking zinc daily (start with 15-20mg, but you can bump it up to 50mg daily, yet I would not do this long term as it will throw your other minerals out of balance), as well as selenium (150-200mcg), biotin (10mg), Folic acid (10mg), and B12 (1000mcg), but we really need to address the cause of the inflammation, or most people will have to be on these supplements long term. Please check with me or your own Naturopathic Doctor before starting any new vitamins, herbs or supplements.
For mothers of infants with cradle cap that are breastfeeding you can ensure that you are not deficient in these vitamins and minerals by taking a high quality prenatal vitamin at the full dose (don’t take mega doses of ANYTHING when you are breastfeeding unless prescribed by your Naturopathic Doctor!!!). But ultimately I would investigate food allergies, as a food you are eating is most likely upsetting the baby. Do add cultured foods like yogurt in to your diet to improve your digestion.
Topically a 5% Tea Tree oil shampoo has been shown to be effective against Seborrheic Dermatitis, but I would make my own conditioner instead and let it sit on the scalp. My rationale for this is that shampoos are really drying and the scalp is already dry and irritated. We want the medicine to sit on the scalp long enough to kill yeast in Seborrheic Dermatitis. I would prepare a topical solution using aloe vera gel or borage oil and tea tree oil. Add about 20 drops of tea tree oil to a ten ounce bottle of aloe vera gel. Shake that up and apply it to your scalp daily for 15 minutes to treat the Seborrheic Dermatitis. Depending on your sensitivity, you can add more tea tree oil than that, however it should NOT ever feel like it is burning. Never apply any essential oils directly to your skin without diluting them in aloe or a carrier oil first as they are caustic and will burn you. If you ever experience burning, rinse it off immediately. Topically aloe vera gel and borage oil have also been shown to be soothing for this condition. For babies you can simply rub their head with olive oil and then comb all the flakes out. Please do not treat your baby for Seborrheic Dermatitis without the help of a skilled herbalist or Naturopathic Doctor such as myself. If you need my help simply pop over to appointment SCHEDULE page and I would be delighted to help you!
Remember that if you discover you have food allergies it is not the end of the world, you simply eliminate the food for a period of time while the immune system forgets about it (typically three months for those blood cells to die and forget the food allergy or intolerance), take probiotics daily to reseed healthy gut flora, adopt better stress management coping techniques, and then rotate the foods that were causing the inflammation back in moderately.
As a final note on Seborrheic Dermatitis I would like to add that you should NOT ever take any new supplements without checking with your Naturopathic Doctor first (preferably me) and be sure that you have the correct diagnosis before attempting any home remedies or self treatments for dermatology issues. Heaven forbid my advice ever does more harm than good. Please read my long acne rant about how nothing you put on your skin ever really fixes your skin until we get to the underlying ROOT CAUSE of the Dermatology and Hormone symptoms of Seborrheic Dermatitis.
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene
Holistic Dermatology & Hormones
Dermatology conditions like aging skin, loss of skin turgor, sallow, and blah lifeless skin are a common complaint in my Holistic Women's Health practice.
When women are suffering with Menopause, Perimenopause, Hypothyroidism, Hashimotos and Hormone Imbalance they also complain of dry skin.
Sometimes the hormone imbalance can cause new acne, eczema, psoriasis, hives, rashes, and autoimmune skin issues a woman has never experienced before as the body becomes naturally more inflamed with menopause and hormone imbalance.
While we are working to address "The Root Cause" of the dermatology symptoms this is a generally soothing skin formula that many of my patients report improvement with. As with any herbs, there is risk of Food Allergy or Food Sensitivity.
Although Olive Oil and Rosemary are both anti-aging, a different carrier oil can be used such as coconut, sesame, or avocado oil.
Supersonic Anti-aging Skin Oil
1-5 drops organic Rosemary essential oil
4 oz Olive Oil
4 vitamin e capsules
2 tsp Rosemary Leaf Oil
For my recipe on Instagram I used a premade rosemary leaf oil I had made from rosemary leaves from my garden along with olive oil and then added vitamin e, and 1-2 drops of rosemary essential oil. If omitting the homemade rosemary oil then you may need to add a little more rosemary essential oil.
Combine all ingredients and stir well. Please keep this preservative free formula covered in a dark area. I use this within four weeks of making. I like to mix a couple pumps of the oil with mix my moisturizer this time of year while it is so hot. Dry skin complaints are at their peak right now so I thought I would share this simple remedy for dry skin, anti-aging, and the best part is rosemary is a natural bug repellant.
You may even repel some people as not everyone likes the way this smells so you may want to add a few drops of lavender or mint. Keep mint and rosemary away from the eyes!
This is my best anti-aging tip for the outside of your skin as a holistic dermatologist. Be sure to follow me on Instagram for my latest Naturopathic tips since not every recipe makes it on to my blog.
To treat your skin from the inside eat clean and check out my Dermatology tea blog for anti-aging. I have also been hearing reports from my acne patients that the ginger in the tea is helping clear up their skin and prevent breakouts!
If you need my help with your skin, nutrition, or hormones simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit.
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy
References:
Dr. Nicole Sundene, NMD
Author of "The Hormonal Acne Diet"
Psoriasis is one of the most challenging autoimmune dermatology conditions I can successfully treat. Naturopathic Medicine is absolutely the best way to go, but it does require quite the team approach between doctor and patient as we will discuss today with my psoriasis case, Pamela. I always like a good challenge and when I see a psoriasis patient on my schedule, I get really excited because I know from my twenty five years of working in Dermatology that nothing but Naturopathy is going to eliminate psoriasis permanently. There is no cream or biologic that will permanently make psoriasis go away the way addressing it at it's "Root Cause" will.
So I would like to explain how I do this, so that anyone seeking my help for their psoriasis understands first and foremost all the things we will need to be doing together to resolve it, and is highly motivated and excited to do the things we will talk about today.
First we will discuss the worst case of psoriasis I have ever resolved.
Then I will explain how I have permanently resolved many cases of psoriasis naturally by balancing female hormones in perimenopause, menopause, hypothyroidism, and Hashimoto's using my 5 Step Natural Psoriasis System.
Pamela had the absolute worst case of psoriasis I have ever seen in my twenty five years of experience working in conventional and Naturopathic dermatology. Ironically, Pamela was also my very first official patient after I graduated from Bastyr University. I remember thinking at the time, “Really God, you couldn’t have sent me an easy case of hormonal acne, eczema or dandruff for my very first patient?"
The patches of psoriasis all over her body had become so bad that they began connecting together into giant inflamed sections with little to no normal skin surrounding the inflamed areas. When the psoriasis began to spread to her scalp and face she panicked and sought me out as her Naturopathic Doctor.
I was truly feeling overwhelmed, shocked, and somewhat horrified by the severity of her psoriasis, and I thought to myself, “she needs to get to a dermatologist immediately.”
Pamela read my mind and said, "I have already tried everything, you are my last hope ."
The truth was, Pamela had already been to a dozen different dermatologists over the past 30 years of battling her psoriasis. The only thing that seemed to help her, was a very expensive cream that cost $400 per month, unfortunately, her insurance was not paying for the cream.
Even worse, the psoriasis that began on her elbows and knees, began to spread to her arms, legs, and the rest of her body.
It was getting so bad Pamela now needed two prescriptions of the $400 cream every month, and she could no longer afford to keep up with this expense. Pamela mentioned, she just wanted to take her grandchildren to the community pool in her neighborhood and swim “without feeling like a leper.” (she and I both know that psoriasis is not contagious, however, other people swimming don’t know this.)
When the psoriasis began to spread to her scalp, ears and then her face, she contacted me for help. We began my "Hormonal Acne Diet" as it is anti-inflammatory, removes common food triggers for psoriasis, and helps balance hormones which is why women oftentimes develop psoriasis with perimenopause and menopause.
After hearing Pamela tell me about everything she had tried in conventional dermatology that did not work, I realized we truly had nothing to lose by trying a naturopathic solution. I knew from my eight years of working in traditional dermatology, that naturopathy would not harm her. I knew from years working for the hormone doctor that balancing hormones can reduce inflammation in the skin, as can improving nutrition.
But I also knew it would take a lot of work on Pamela's end with changing her nutrition. So I made it clear to Pamela that nothing I could do for her psoriasis was going to change overnight, and she would need to stay committed, to giving this a solid THREE months to see improvement, and that I would need to work with her monthly to get it under proper control. Pamela agreed, promised she would do "whatever it takes" and said she had no other choice but to try Naturopathy.
We discussed my simple 5 Step Natural System for Psoriasis:
1. Balance Hormones
2. Reduce Inflammation
3. Test and Correct the Dysbiotic Microbiome
4. Identify and Remove Food Triggers with Food Sensitivity Testing
5. Treat "The Root Cause"
Pamela's hormones came back imbalanced. I diagnosed her with perimenopause, adrenal fatigue, and hypothyroidism. She was low in progesterone thyroid hormones, and cortisol which explained the sudden spike in inflammation to me and why her skin was dry and cracking. I saw her skin was already improving on my diet program and removing her food triggers, we treated her hormone imbalance and we agreed to let her plan take some time to work and then follow up again in a month to reassess her plan.
A week before her next follow-up visit, Pamela called to cancel her appointment.
I immediately panicked at the beginning of her voicemail message, I worried that something had gone wrong. But as I listened, she told me “I am completely better now, and I don’t have the slightest itch while on your nutrition program. My skin is glowing and I have never looked or felt better! I love my new diet you put me on, feel amazing, and don’t even want to learn how to moderate it at this point but, I just wanted to thank you for everything you have done for me."
Pamela went on to say, "I am actually in my bathing suit right now, and headed to take my grandchildren swimming at the pool, and be the fun Grandma I always wanted to be with them. I could not have done this without you.”
She also mentioned that her homemade psoriasis medicine costs her only ten dollars a month to make and that she doesn’t even need to use it anymore as long as she follows her naturopathic diet plan and results of her Food Sensitivity Test. When women's hormones change such as in menopause and hypothyroidism this can also cause the skin to become more dry and susceptible to psoriasis.
If you need a caring Naturopathic Doctor I would be glad to help. To treat yourself to a Naturopathic visit simply pop over to my SCHEDULE page, so you can be my next Dermatology success story! Nothing makes me happier than helping women feel good in their skin!
If you or your child are not sure if you can be successful with my Holistic Dermatology methods please first read my post on "How to Be Successful with Naturopathic Medicine" and at least get started with my complete Dermatology Mind-Body-Spirit Program "The Hormonal Acne Diet" so we are feeding your skin the proper nutrients it needs to be healthy and glowing as well as identifying potential trigger foods, eliminating them, and working to remove all inflammatory foods from the diet.
Additionally my program teaches meditation and yoga as stress can flare many chronic dermatology conditions, and therefore is an important "Root Cause" to address for women with skin issues.
So that is how I help my psoriasis patients as a Naturopathic Hormone Doctor in a nutshell. If you are excited to make nutrition changes then we will work well together as a team to execute your Holistic Dermatology Glow Up!
Dr. Nicole Sundene, NMD
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum Depression, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
By Dr. Nicole Sundene
Author of "The Hormonal Acne Diet"
Eczema was getting out of control for Ken, as his hands became painful as they began to crack and bleed from his serious eczema condition.
Overly conscious of the way his hands looked, Ken was embarrassed of the cracking and bleeding and began to avoid shaking hands with people. Eventually, Ken's fingers and hands became so painful, it was difficult for him to ride his motorcycle. It was so bad, at one point he could see he was actually losing the fingerprint on two of his fingers.
Ken finally went to a dermatologist who diagnosed him with Dyshidrotic Eczema and gave him some cream and oral steroids to help reduce inflammation.
But his hands never really got better. He began to worry he had a more serious issue, maybe MRSA because of the erosive nature of his eczema. He actually thought he had flesh eating bacteria.
The dermatologist was prescribing higher doses of steroid creams, but his issues didn’t get better. After 5 appointments for his skin and trying different remedies, there was only slight relief, the skin would not fully heal.
While his Dermatologist seemed happy with some of the progress, and mentioned “it could be worse.” Ken knew his hands were not all the way better. They still continued to feel really itchy and would still form blisters despite all the steroids.
He finally decided to try Naturopathic Medicine to treat the ROOT CAUSE of his skin problem. He felt that there had to be another solution.
Within a month of using my naturopathic approach, Ken’s eczema improved dramatically, and was almost gone! His hands were back to normal within 2 months.
Ken feels better than ever, and is happy in his skin again. The main thing I did for Ken was improve his nutrition. Eczema patients always have triggers we need to identify in their diets as well as hormone imbalance we need to test for to understand why the skin is so unhappy, as I discuss more in my "Hormones and Dermatology" blog. This is why women in perimenopause and menopause develop eczema later in life.
Need my help treating eczema? Simply visit my SCHEDULE page to treat yourself to a Holistic Dermatology visit. I would be happy to help!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
By Dr. Nicole Sundene
Author of "The Hormonal Acne Diet"
Eczema is a skin condition characterized by redness, dryness, itching, and irritation. Mainly it occurs on the arms, inner elbows, knees, back, and head area, but remember that it can affect any skin area. The eczema symptoms may flare up, subsides, and repeat at different intervals. Studies reported that eczema is 15-30% prevalent in children and 2-10% in adults. [1]
Moreover, eczema is highly prevalent in children compared to males. It is estimated that eczema affected approximately 9.6 million children under the age of 18 in the US. Plus, around 31.6 million people in the United States have eczema. Note that eczema occurs in all types of skin, colors, and ethnicities.
Both genetic (mutation in gene Filaggrin) and environmental factors (Irritants and Allergens) are involved in eczema development. Moreover, research studies categorized eczema into seven types based on the area of the skin and symptoms. These include atopic dermatitis (most common form), contact dermatitis, Neurodermatitis, Dyshidrotic eczema, Nummular Eczema, Seborrheic Dermatitis, and Static Dermatitis. [1]
Signs and symptoms of Eczema
Studies reported the following signs and symptoms of eczema that may vary from person to person. [1, 2] These include:
It is important to know that eczema increases the risk of various skin infections caused by bacterial, viral, and fungal pathogens. Also, it negatively impacts daily life activities via sleep disturbance, asthma, and hay fever. [1, 2]
Eczema Diagnosis
There are no specific lab tests and diagnostic techniques for eczema confirmation. The diagnosis involves the evaluation of clinical symptoms such as rash appearance and history. Plus, in some cases, allergy testing and patch testing are also considered for eczema diagnosis. [1, 2]
Eczema Treatment
The treatment of eczema involves the intervention of different therapeutic agents to ease symptoms, prevent a flare-up and improve skin conditions. Both systemic and topical agents are indicated over months or years, depending on the severity of the eczema condition.
Medical research studies reported three treatment approaches for eczema management. [2, 3]
Basic Treatment
Basic treatment involves the application of emollients for the management of skin dryness and pruritus. Emollients restore cutaneous hydration that reduces flaring up the eczema symptoms. Topical emollient decreases dependence on topical steroids. It is important to know that apply emollient on the skin within three minutes of bathing with lukewarm water. The patient can use 250 g of emollients per week as per national institute for health and clinical excellence [NICE] guidelines. The selection of moisturizers depends on the patient's symptoms, skin physiology, and season. [2, 3]
Moreover, always consider other protective measures before the application of emollient. These include a detailed history, allergy tests, and careful evaluation of clinical manifestations to rule out the aggravating factors. Plus, always prefer wool clothing over nylon dressings as wool quickly absorbs sweat and prevents skin scratching. Remember that certain perfume ingredients can also aggravate eczema symptoms. Basic treatment also involves the intervention of psychological support and proper counseling for effective management of eczema complications. [2, 3]
Standard Treatment
Standard treatment includes the intervention of both systemic and topical agents. It is important to know that topical agents are preferred over systemic agents.
Topical agents:
Topical agents include corticosteroids, anti-infective agents, and calcineurin inhibitors. Topical steroids for eczema management are prescribed based on the severity of symptoms, the extent of disease, and distribution skin lesion distribution of lesions. Short-acting corticosteroids are usually preferred over long-term use of corticosteroids due to multiple side effects. Remember that potent corticosteroids are recommended for highly lignified skin conditions. Corticosteroids such as fluticasone 1- 2 times a week are recommended for eczema symptoms. The potential side effects of topical steroids include the development of acne rosacea, striae, perioral dermatitis, skin atrophy, and adrenal suppression. [2, 3]
Topical calcineurin inhibitors such as Tacrolimus ointments 0.03% and Pimecrolimus cream 1% are used as a secondary drug of choice for eczema management. They act as immunomodulators that inhibit the production of cytokines from activated T-cells and inflammatory cells. It is important to mention that these drugs do not possess health risks for 2-4 years and benefit eczema patients having age ≥two years. [2, 4]
The interventions of anti-histaminic agents such as Chlorpheniramine, Hydroxyzine, and Cetirizine help the concomitant urticaria or concurrent allergic rhinitis associated with eczema. Plus, these agents also ease itching during the night and promote a good night's sleep. The side effects of oral histaminic include drowsiness, impair driving ability, and learning capability. Topical infective agents involve applying antibacterial, antiviral, or antifungal formulations that prevent both aggravations of symptoms and skin infections at the site of itching. The potential adverse event includes the growth of resistant pathogens, including methicillin-resistant S. Aureus, with irrational use of topical antibacterial agents. Medical research studies recommend using fusidic acid/mupirocin ointment for local infections and cephalosporin/ penicillinase-resistant penicillins for extensive superinfections without S. Aureus. In comparison, in the case of viral infections, use systemic antiviral therapy with great care. Moreover, it is advised to use antifungal agents for dermatophyte infections as it aggravates the eczema symptoms. [2, 3]
Systemic Therapy:
Standard systemic therapy has opted when the eczema symptoms are recurring and do not respond to the topical agents. The overview of systemic therapeutic agents is given below.
Cyclosporine: It is an immunomodulator that inhibits cytokine transcription and helps manage severe, refractory atopic eczema. The common disadvantage of cyclosporine is the rapid relapse after abrupt cyclosporine discontinuation. Plus, it can cause kidney or liver impairment, tremors, headache, nausea, myalgias, hyperlipidemia, paresthesia, gingival hyperplasia, and high blood pressure. [2, 3]
Systemic Glucocorticoids (Steroids): It helps temporary suppression of eczema symptoms. They are temporarily prescribed for short-term use to control eczema flares. It is advised to gradually discontinue the systemic steroid use once the symptoms subside. Don't stop the steroids use abruptly to prevent the risk of eczema flare-up or rebound. Side effects of glucocorticoids are gastric ulcer, Cushing syndrome, diabetes, osteoporosis, hypertension, and glaucoma. [2, 3]
Antimetabolites: Antimetabolites include Mycophenolate mofetil, Methotrexate, and Azathioprine that help the management of refractory eczema. They are also recommended for resistant pathogens and improve eczema symptoms. It is advised to carefully monitor herpes retinitis, and dose-related bone marrow suppression with antimetabolites use. Side effects of antimetabolites include Liver dysfunction, headache, fatigue, gastrointestinal complaints, gastrointestinal disturbances, pulmonary toxicity, liver dysfunction, and leucopenia. [2, 3]
Interferon-γ: Interferon-γ reduces IGE levels and decreases the expression of th2 cells that help manage severe eczema conditions. They are usually safe for twelve weeks, but they can cause certain side effects, including fever and headache in the initial stage of administration. [2, 3]
Phototherapy: It involves the intervention of natural sunlight as a secondary option in eczema symptoms management. Phototherapy helps both acute and chronic cases of eczema. It uses UVA-1 of 340-400 nm wavelength light for acute cases and UVB of 311 nm wavelength light for chronic cases. UVA radiation may target the epidermal Langerhans cells and eosinophils. In comparison, the UVB radiations act as immunosuppressants and support eczema management. It is advised to carefully consider the phototherapy intervention for skin pain, pigmentation, cutaneous malignancies, pruritus, and erythema. [2, 4]
Allergen immunotherapy: It is another approach toward eczema management that involves the intervention of subcutaneous and sublingual immunotherapies. However, there are not enough studies about its effectiveness. Also, patients show poor compliance with allergen immunotherapies. [2, 3]
Biologics: Studies also reported the beneficial effects of various biologics in the management of eczema symptoms. These include Rituximab, Omalizumab, Pitrakinra, Dupilumab, Infliximab, Mepolizumab, and Tocilizumab or Atlizumab. However, future studies are needed to conclude final remarks about their safety and efficacy in eczema treatment. [2, 3]
Adjunct treatment involves the use of natural remedies, including herbs and supplements, to ease eczema symptoms. These remedies include primrose oil, omega-3, Vit D, Probiotics, and Korean red Ginseng. Different studies reported significant positive effects of these remedies in eczema symptoms management compared to placebo. However, extensive studies are needed to define their roles and effectiveness in eczema treatment. [2]
Studies also reported the use of following natural remedies for eczema symptoms management. [5, 6]
Long term Use of Steroids for Eczema Symptoms:
The long-term use of steroids, both topical and systemic formulation, possesses harmful effects. It is advised not to use steroids for a more extended period in the treatment of eczema symptoms. The long-term use of topical steroids increases the risk of skin discoloration, thin spidery blood vessels, bruising and may develop permanent stretch marks (striae).
Plus, they can also aggravate the symptoms of other skin conditions, including acne, perioral dermatitis, and rosacea. Moreover, the use of systemic corticosteroids for the long term favors the development of morbidities, including local skin atrophy and other side effects. These side effects include Cushing syndrome, diabetes, high blood pressure, glaucoma, gastrointestinal symptoms, and osteoporosis. Thus, the corticosteroids use for a longer term is not safe in the management of eczema symptoms. [3, 7]
Need my help treating your eczema beyond the anti-inflammatory and hormone balancing nutrition in my "Hormonal Acne Diet Program"? Simply visit my SCHEDULE page to treat yourself to a Holistic Dermatology visit!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
References:
Dr. Nicole Sundene, NMD
Author of "The Hormonal Acne Diet Program"
Cystic Acne is a form of Hormonal Acne that does not respond to the same treatments I use for my regular acne patients. Topical treatments for cystic acne are generally ineffective because they tend to only aggravate and dry the skin on the surface while failing to address the root cause of the cystic acne forming deep below the layers of skin.
Today I will share "Dr. Nicole’s #1 Cystic Acne Potion Recipe"
I am posting this simple recipe here for someone that might need it, and also as an important reminder to TEST your essential oils on your wrist before applying to your face. The skin is sensitive and inflamed, especially in hormonal acne and cystic acne. So start with 1 drop of thyme per 1 oz of aloe vera.
Most women use about 2-5 drops of organic thyme or lavender or a mixture of the two. Try one first before the other so we can observe your skin is improving and not aggravated by anything. Allergies are rare with natural medicines but they do happen so it is important to start with a low amount and work up to what is not too strong to smell. This should not sting or burn when you apply it to your skin. It should only soothe it.
Pure lavender can be used undiluted and dabbed on with a q-tip, although I don’t recommend doing this for cystic acne or hormonal acne as oil is the last thing the skin needs and we need to work to make the skin less greasy overall to prevent clogged pores.
In traditional acne, oil from the sebaceous glands trap dirt and bacteria into the pore causing acne lesions. Cystic acne forms below the layers of the skin and generally topical treatments do not help, except what I will share today.
Aloe vera is an important anti-inflammatory treatment that can also help reduce the scarring associated with cystic acne. Thyme has been researched as an effective acne treatment, as has lavender. I find thyme to be far more effective for my acne patients in my Holistic Dermatology and Hormone practice.
If you have cystic acne it is very important that you work with a skilled hormone doctor that understands this condition and can help diagnose the "Root Cause" of the cystic acne. Oftentimes there are multiple hormone imbalances going on that I find, and not just one. Patients will say "I got my hormones checked," and there is 1-2 tests which is not the 5-7 pages of hormone tests that I generally first order for cystic acne patients to determine the hormone imbalance.
A Naturopathic Hormone Doctor will be able to diagnose the multiple factors impacting the skin for your cystic acne which include: 1) Hormone Imbalance 2) Dietary Triggers 3) Environmental Triggers
Without a proper program to address cystic acne at the root cause, such as "The Hormonal Acne Diet Program," patients generally end up with terrible scarring from having cysts form all over their faces from this form of hormonal acne. Once a cyst forms the sac around it will always continue to fill back up with fluid and recur.
If you have cystic acne and need my help preventing permanent scars on your face, simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit. I would be happy to help! I will have scars on my face forever, and as a result of that I hope to always work to prevent women from having scarring due to cystic acne.
Dr. Nicole Sundene
Author of "The Hormonal Acne Diet Program"
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
By Dr. Nicole Sundene
Naturopathic Doctor
Acne, formally called "Acne Vulgaris" is an inflammatory skin condition characterized by pimples on the face or body. Acne can be an especially frustrating women's health condition when hormone imbalance is to blame. Topical treatments are often useless or even worsen the acne by drying out the skin or causing too much chemical irritation.
I never had acne as a teenager because the acne I struggled with in my 20's and 30's was triggered by hormone imbalance and my diet as I share in my story "The Acne Doctor's Battle with Hormonal Acne" Nothing I ever tried for my acne ever worked until I found Naturopathic Medicine! At the time I was working for 3 Dermatologists and nothing they tried could ever help my skin.
This is when I learned about Naturopathic Medicine and Nutrition for Acne as is now available in my complete Mind-Body-Spirit- Glow Up Guide "Hormonal Acne Diet Program."
Nutrition is critical for hormonal acne. There is little sense signing up to work with me on your acne, if you are not going to change your nutrition. I understand it is hard, but it will be necessary and it will be the only way I will be able to fix your skin and hormone imbalance.
The reason why I bring this up, is that the body continues to send negative messages such as acne to us when we are missing the "Root Cause" of the acne, especially if it is caused by a Hormone Imbalance, which is the most common cause for women. Women have a much higher rate of acne than men, despite the fact men have 10 times higher testosterone levels. Testosterone is not the only hormone that causes acne. If it did then men would have acne more often than women? This is why my female hormone balancing Hormonal Acne Diet is so important for women to follow (and yes it does help men with acne too as excess estrogen oftentimes is to blame for male acne.)
Estrogen Dominance, Progesterone Deficiency, and Insulin Resistance are often the culprit behind female adult onset acne. While I am happy to discuss all the latest research for treating acne topically in the naturopathic realm...it is imperative we address and treat the root cause of the acne. Which is often triggered by diet and hormone imbalance and requires a full work up by a women's health doctor that understands hormone imbalance and dermatology such as myself.
In 1999 I started my first job in medicine working for a Dermatologist and also a Hormone Doctor. Interestingly enough life has been training me for many years to understand the delicate balance of female hormones and dermatology conditions which is now my considered area of expertise as a women's health doc. I often receive referrals for patients from Dermatologists and other Naturopathic Doctors to help solve the mysterious hidden link behind complex Dermatology conditions.
How Do I know if I have Hormonal Acne?
Signs that acne is caused by hormone imbalance can be determined at no cost to the patient by simply downloading a period tracker app and tracking when the acne breakouts are occurring. If they are constantly occurring prior to a women's menstrual cycle, or worsening around that time, then we know the underlying cause of the acne is likely hormonal. And until we investigate, test, diagnose and treat the hormone balance, topical treatments will generally continue to fail women and simply do not work until we address the acne at the root cause. I discuss this in my Dermatology webinar that explains the simple 3 step process I use to treat acne naturally.
Generally, acne affects the face, chest, forehead, chin, shoulder, neck, and upper back. In Acne, the hair follicle gets clogged with oil, hair, bacteria, and dead skin cells that result in whiteheads, blackheads, cysts, and other types of pimples. Both estrogen and testosterone can impact the skin and make it more oily. Testosterone especially stimulates the sebaceous glands to secrete MORE oil which then causes bacteria to adhere into the pore and cause a breakout. Women commonly complain about their skin becoming dryer with menopause and too oily with PMS and Perimenopause.
Acne is not just a physical ailment but can also scar women emotionally. I know first hand how much acne can impact a woman's self esteem. When my acne was at its worst I didn't want to go anywhere or even worse, have my photo taken. I wanted to go to college with a paper bag over my head. I would not even smile for my mom in the acne photo I share in my webinar, because I was so unhappy having my cystic acne documented. I was embarrassed of my skin and while I don't ever judge other people for how they look, I bring this up because it may be impacting teens, and young adults adversely by causing them low self esteem, depression, anxiety, stress and isolation.
Studies report that Acne can occur at any age but is highly prevalent among adolescents or young adults and teenagers. Research shows Acne significantly impacts the lifestyle of both teens and adults, causing discomfort, distress, permanent skin scarring, low self-esteem, disfigurement, anxiety, and embarrassment. These negative effects highly contribute to poor social and mental well being. [1, 3]
Acne Causes
Around 80% of acne cases are related to genetic factors. However, medical studies reported that the majority of acne cases are highly connected with the following factors. [3, 4]
Moreover, other factors such as poor diet, stress, excessive oil secretion, and smoking also increase the risk of developing Acne. [1, 3]
Signs and Symptoms of Acne
Signs and symptoms of Acne include the appearance of whiteheads comedones, blackheads comedones, microcomedones, nodules, papules, pimples, cysts, and pustules. Acne can also cause permanent skin scarring and permanent changes to pigmentation. Making it even more important to address as soon as possible for young women and teens so they do not end up with permanent damage to their skin as I have today. We can prevent scarring with Naturopathy and Hormone Balancing! [1, 3, 5, 6]
Acne Treatment
Acne treatments should be targeted towards balancing the skin from the inside rather than just applying topical medication to treat and suppress symptoms. For many years I attempted to suppress my acne with 1) Retinol 2) Differin 3) Doxycycline 4) Tetracycline 5) Facials 6) Proactive. I literally tried everything up until the Dermatologist said Accutane was the only other option! That was when I discovered Naturopathic Medicine for Acne in 2002 while attending Bastyr University.
Natural topical treatments for acne involve managing existing lesions and other symptoms, reducing skin scarring, arresting further progression, and decreasing the risk of other acne-associated complications. The application of treatment interventions depends on the acne severity, the patient’s current medical condition, the patient’s endocrine history, and the nature of lesions. Both topical and systemic therapeutic options are available for the treatment of acne. Moreover, along with pharmaceutical drugs, natural herbs and other treatment modalities also help manage acne symptoms. It is important to know that the application of multiple treatment modalities of acne significantly performs better than single therapy. [2, 6]
Topical Acne Treatment
*Topical treatments will 100% NOT CURE A WOMAN'S ACNE!
Please keep in mind the following information I have compiled for educational reasons for my patients to have a list of treatments that have research behind them and I believe are generally safe to try and understand their different options compared to pharmaceutical agents for acne. Likewise some of my Natural Medicine Acne patients may want to learn about stronger prescription options to utilize while we treat their acne from the inside out. But none of these treatments ever seem to cure acne. The cure is in investigating and treating the hormone imbalance.
My #1 Dermatology pet peeve with treating acne is strictly relying on topical treatments when there is always a Hormone Mystery for me to solve.
Whether the agent is natural or prescription, these topical Dermatology treatments all share the same problem, they are only helpful in controlling the acne via the pore, slowing breakouts, calming the skin down, exfoliation, reduction of inflammation, repair and prevention of scarring. Until we balance a woman's hormones properly they will continue to just suffer with acne especially when they already are diagnosed with PMS, PCOS, PMDD, Perimenopause, CAH, Hirsutism, Infertility or Amenorrhea.
So ladies if you have learned nothing from me today...please take home with you from this "Acne and Hormones" blog that acne is an internal medicine problem not a failure to find the right topical treatment problem. Nothing bores me more to tears, than having patients that want me to treat their acne from the outside with topical treatments. Which is why I have compiled this list of topical natural and prescription treatments for acne. I know this sounds horrible... but I don't really care WHAT you put on your skin. I care about WHY your skin is behaving this way in the first place and I want your skin to go into remission so you no longer need to ever worry about applying things to your acne again.
Nothing on this list will actually cure acne, until we treat the underlying hormone imbalance with your female hormones. But that is just my opinion as a Women's Health Naturopathic Doctor that has helped hundreds of women with their hormones and skin conditions over the past 14 years as well as what I saw over an 8 year period working for 3 Dermatologists. While mild symptoms can be treated and resolved with prescriptions, I would often see my Prescription Dermatology patients with chronic acne, psoriasis, eczema, dermatitis, MRSA, seborrheic dermatitis also fail to improve in the conventional Dermatology model simply because we had not sat down and taken a proper history to address and examine the Root Cause of the skin condition. Sometimes it has nothing to do with Naturopathic Medicine, but it's the time I take to create a thorough history of health complaints and the development of the skin condition that help us solve the Dermatology Mystery. Which is why my "Hormonal Acne Diet Program" works to help reduce inflammation, understand triggers, all while balancing female hormones and lowering the evil insulin.
It is easy to cure skin problems when patients are on board with what I need them to do, and it's nearly impossible for me to ever help patients that want to "put a magical herb from the rain forest on their skin to make it perfect" ...if there was such a thing I would be using it myself but unfortunately Hormone Imbalance in women is such a powerful problem that no magical herb we apply will usually be enough and we need hormone labs to determine the cause.
Natural treatment of Acne
Many different natural herbs and supplements also help the management of acne symptoms. These remedies act on sebum production, bacterial growth, inflammation, and keratinization. Plus, they also provide moisturizing and soothing effects upon topical application that aid the acne treatment. [2, 6]
The latest research for acne natural remedies include:
Herbal Medicines also gaining popularity in the treatment of acne vulgaris: [7]
Natural Topical Treatments for Acne
Generally Harmless Topical Prescription Acne Agents:
Topical Retinoids: Retinoids such as Isotretinoin, tazarotene, tretinoin, motretinide, adapalene, and retinoyl-β-glucuronide control the formation of comedones and lesions. Plus, they help existing lesions, reduce sebum production and improve epithelium integrity. Studies reported that retinoids show anti-inflammatory action and suppress the formation of both microcomedones and comedones. Further, they support the therapeutic action of other anti-acne agents, decrease pigmentation, and repair skin scarring. The common side effect of retinoids includes the flare-up of acne during the first week of application, dryness, irritation, sensitivity to the sun, and chemical sensitivity. [2, 6]
Topical Antibiotics: Antibiotics such as clindamycin and erythromycin are intended for topical application to manage the severity of mild to moderate inflammatory acne. They inhibit the growth of bacteria and decrease their colonization on the skin surface and within hair follicles. Thus, their agents are highly effective against P. acnes bacteria responsible for inflammation of the lesions. Note that topical antibiotics are preferred for a short period of up to 3 months due to the high risk of resistance. Medical research studies recommend using topical antibiotics combined with benzoyl peroxide, zinc, or retinoids to minimize the risk of bacterial resistance. It is recommended to avoid topical and oral antibiotics for acne as long term antibiotics can impact the microbiome and natural flora of the skin. [2,3]
Oral Acne Medications Not Recommended:
When topical prescriptions fail, Dermatologists prescribe oral agents for the treatment of acne. The oral-systemic options significantly improve the nodules, lesions, and scarring. The commonly recommended systemic therapeutic interventions include oral retinoids, antibiotics, and hormonal agents. [2, 6]
Oral Retinoids: Retinoids such as Isotretinoin is a first-line agent for acne associated with severe nodular or inflammatory lesions. It significantly benefits mild to moderate acne and acne resistance to topical agents. Isotretinoin relieves the symptoms of severe acne on the trunk and face. Note that the course of Isotretinoin therapy ranges from 16 weeks to 24 weeks. It decreases sebum production and reduces the risk of bacterial colonization that help the management of acne conditions. [2, 6]
Oral Antibiotics: Antibiotics such as erythromycin, levofloxacin, minocycline, lymecycline azithromycin, roxithromycin, doxycycline, and co-trimoxazole are indicated for the treatment of moderate to a severe acne condition. They inhibit the growth of acne-causing bacteria and also provide an anti-inflammatory activity that manages the acne symptoms. Remember that the use of antibiotics increases the risk of bacterial resistance. So, they are always preferred combined with topical benzoyl peroxide or retinoids to minimize the risk of resistance. Also, don’t use antibiotics for more than 12 weeks. [2, 6]
Birth Control Pills: Synthetic hormones antagonize the effect of androgen on the sebaceous gland and control sebum production. Most oral contraceptives, especially progestins, are used for this therapeutic approach. They halt the action of androgen and increase the sex hormone-binding globulin level in the body. Moreover, the hormonal agents work better in combination with other options such as antibiotics, retinoids, and spironolactone in the treatment of acne. [2, 6]
Topical Corticosteroids: Cystic Acne and Inflammatory acne.
Benzoyl Peroxide: Provides antibacterial properties, prevents pores clogging, and decreases the comedones formation. Benzoyl peroxide helps mild to moderate acne and can be applied for 6-8 weeks as a monotherapy for acne management. Do not combine with topical retinoids as will cause dryness and irritation. Side effects of topical benzoyl peroxide include dryness, erythema, stinging, and burning.
Dapsone, Sodium Sulfacetamide, and Triclosan: Also show antibacterial and anti-inflammatory activities that help the treatment of acne. Note that they are not recommended as first-line agents for acne management.
Other prescription topical options for acne involve chemical peels, dapsone, corticosteroids, niacinamide, sulfur, triclosan, salicylic acid, and sodium sulfacetamide. [2, 6]
Other Oral Acne Medications Not Recommended:
Along with the previously discussed options I don't recommend, other random oral therapeutic agents I consider dangerous when Naturopathic Medicine is safer and more effective anyways include: corticosteroids, ibuprofen, and clofazimine also provide an anti-inflammatory activity that helps manage acne symptoms. Systemic corticosteroids like oral prednisolone help treat the severe form of inflammatory Acne vulgaris, Acne fulminans and Pyoderma faciale.
Types of Acne
Acne is divided into four groups or grades based on the severity of symptoms. [2]
Antibiotics, steroids and accutane are hard on the liver and best for children and teenagers with acne to avoid. Especially when there are much better natural options for acne as long as your child is open to making diet changes and taking herbal supplements. It is important to treat acne immediately at the ROOT CAUSE in order to prevent permanent damage to the skin and acne scars.
Always check with your Naturopathic Doctor before starting new natural treatments or herbal remedies for acne!
Need a good acne doctor? I would be happy to help? Simple visit my SCHEDULE page to set up your new patient visit.
Dr. Nicole Sundene
Author of "The Hormonal Acne Diet Program"
Naturopathic Medical Doctor
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
References
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
