If you regularly browse websites throughout the acne-sphere, especially websites devoted to healing acne naturally with alternative medicine, you may have read that a toxic liver is one of the big hidden causes.
You might have read that the liver needs detoxifying, that in the 21st century our livers are full of toxins which must be flushed out, or that nutritional deficiencies are impairing the liver’s many vital functions.
Many of these alternative acne-clearing websites get it right when they reject traditional pharmaceutical treatments such as benzoyl peroxide, Accutane, and antibiotics. Those treatments only put a plaster on the problem – they don’t treat the root cause.
But it’s in identifying the root cause where these websites slip up. Put simply, most of what you read on the internet about liver disease causing acne is total fantasy! Half of the theories you’ll see are completely made up. Most aren’t based on a shred of scientific evidence.
That’s why in this article we’re going to go through the myths about liver health and acne one by one. We will determine whether your liver function really does affect acne in any meaningful way.
Read on and gain some of the most important scientific knowledge on clearing acne available.
Theory one – a weak liver diverts toxins to the skin
This is the most common acne-liver theory on the internet. It’s especially common on alternative medicine websites, both dodgy ones and well-meaning ones, and it’s the one that’s misleading the highest amount of people.
The theory goes like this: in the 21st century, we enjoy tons of conveniently made processed foods and cosmetics, ready to use with less effort than breathing. But there’s a downside – the awesome advancement used to create those products comes in the form of industrial chemicals and toxins. Toxins are now flooding the modern world and flooding into our bodies.
Our detoxification systems are completely overloaded, and hence the liver cannot handle them all. One of our main detoxification organs is actually the skin, ranking in third place after the liver and the kidneys. Hence, when the liver gets weak, it shifts some of the burden to the skin.
Endless rivers of toxins are pushed out through the skin pores in sebum, where they combine with p.acnes bacteria and other inflammatory chemicals to create acne. If our livers were healthier, we could end this process and stop acne.
Is it true? Well, the first section is – it’s true that unnatural chemicals are infesting our foods and personal care products. It’s true that our bodies haven’t learnt how to process them without harm instantaneously in the 100 years since they were invented.
A large proportion of modern health epidemics may be caused by the contaminants natural health gurus refer to as toxins. Aluminium builds up in brain tissue and leads to neurological defects like Alzheimer’s, phthalates in plastic can reduce male fertility, and mercury is linked to diabetes.
Make no mistake that the threat is real. What’s not real is the acne theory outlined above. Your skin never takes over when the liver fails. If the liver’s functioning collapsed to that extent, you’d be in a serious mess. Consider an extreme alcohol whose liver and eyes turn yellow with jaundice when he needs a liver transplant. That’s what real liver failure looks like.
If your liver was failing in its most basic duty, to detoxify toxins, that would also show up as sky-high liver enzymes, but studies on acne patients don’t show them. Isotretinoin, the common prescription acne drug known as Accutane, is known to cause liver damage in some cases, so many studies have been conducted on acne patients’ liver health.
This one analysed the liver enzymes of 13,772 acne patients before they started a course of Accutane. 94.9% of the acne patients had normal liver enzymes, with only 4.9% having above average levels. This Brazilian study was even more conclusive; out of 120 acne patients analysed, again before they started an Accutane cycle, 98.9% had totally normal liver enzymes.
There’s simply no evidence for the skin pushing out toxins theory. Most likely, 1-5% of the global population has liver problems anyway due to alcohol, prescription drugs or a bad diet, meaning that acne patients as a group are no different.
These days, detoxification regimens involving lemon juice, milk thistle, rare exotic fruits from rainforests, colloidal silver, meteorite minerals and all the rest are more popular than ever. “Detoxing” is an international craze. It’s likely that a savvy marketer identified an opportunity and invented the above theory to sell some supplement.
The only real evidence is the fact that human skin is involved with the excretion of some toxins. For instance, sweating can remove heavy metals like mercury, arsenic, and also BPA through the skin pores. That’s one reason why I recommend sweating to improve acne.
However, the liver diverting toxins to the skin theory is a pure invention. Don’t be fooled!
Theory two – a weak liver causes elevated androgens
As you probably know, hormones such as DHT and testosterone cause acne by binding to androgen receptors in the sebaceous glands of your skin. This stimulates them to produce more oil (sebum), which clogs the pores and causes acne.
The liver/hormone theory circulating the internet states that the liver must eventually break down and detoxify every androgen in your bloodstream. However, nowadays most of our livers are bombarded with a never-ending river of toxins. The liver’s detoxification capacity is overwhelmed.
Hence, the hormones are simply rejected and sent back to the bloodstream, where they build up to far higher than average levels. Worse, your liver can no longer process natural androgens from food either, such as the IGF-1 found in dairy products, or the artificial hormones (bovine growth hormone) that are used to produce cheap meats and dairy.
Hence, this leads to androgen levels which are dramatically higher than average and tons of acne.
However, upon closer inspection this theory falls apart as well. Firstly, like theory number one there is no scientific evidence to support it. That doesn’t discount the theory entirely; the liver does regulate hormones and the theory makes more sense than the first. But it’s a similar story as with the first theory; if your liver was so badly damaged that it couldn’t even process androgenic hormones, you’d know about it. Acne would be the least of your problems.
Secondly, a healthy liver can actually lead to higher testosterone levels. The liver manufactures, breaks down and regulates many hormones; that’s one of its main functions. But it’s a much bigger player in estrogen; your liver breaks down estrogen and unhealthy estrogen metabolites such as 8-hydroxy-estrogen and 16-hydroxyestrogen.
Estrogen is a known antagonist of testosterone, and this study and this study both found that non-alcoholic fatty liver disease was associated with lower testosterone levels. Furthermore, a healthy liver controls compounds which limit the activity of testosterone, such albumin and sex-hormone binding globulin (SHBG), which binds to free testosterone in the bloodstream.
Finally, the importance of testosterone and DHT in actually causing people’s acne in the modern world is massively overstated. Testosterone levels have plummeted in generation after generation of men since the early 20th century. The average man’s testosterone has fallen from a range of 2000ng/DL to 800ng/DL to just 1070ng/DL to 270ng/DL.
Yet by all accounts, acne has gone up, especially adult acne. Chronic inflammation, too many carbohydrates, and high processed vegetable oil consumption are far bigger factors in the modern acne epidemic.
Improving your liver health is a smart idea for your health, but it won’t lower androgen levels, if that’s what your goal is. The one acne hormone that liver health does have a big effect on is insulin. Scroll down to discover more info on that.
Theory three – liver flushes can remove unhealthy toxins
The theory is similar to the first one. We’re exposed to so many toxins that the liver is congested and cannot process them all. These toxins reportedly build up and up in the liver itself.
Then there’s a key difference: instead of forcing themselves out through the skin, the excess toxins instead roam around your bloodstream wreaking all kinds of inflammatory havoc that causes acne.
A liver flush is designed to “flush” this massive toxin build up out of the liver using treatments which include fasting for a couple of days, then consuming lemon juice, olive oil and Epsom salt. There’s many other treatments too, involving milk thistle, eating nothing but apples for two days (or any other fruit), an all-kale diet, or baking soda, and so on.
This is the type of detoxification strategy popular among celebrities and hippies. There’s actually more truth to it than others, but there’s a key problem: toxins do not build up in the liver. Some toxins do remain in the human body, but they tend to be stored in fat cells, or wherever the toxin was first applied.
Some toxins such as mercury may build up in brain tissue (not good). Fluoride, for instance, is known to stick to the pineal gland. Aluminum has been found in the upper-outer quadrant of female breast tissue due to its presence in common antiperspirants.
The liver does not escape this fate entirely; it’s known to accumulate heavy metals such as cadmium, arsenic and mercury. Many health enthusiasts object to eating the liver of animals for fear of eating heavy metals stored in them.
But generally, the liver itself does not store toxins any more than any other organ. It’s a processing unit, not a storage facility. Hence, flushing your liver will not improve its ability to detoxify harmful contaminants from your body.
Nevertheless, this theory does have more value than others. For one thing, it IS a smart idea for acne to remove toxins from their stores around the body. Mercury accumulation can gradually inhibit the responsiveness of insulin receptors in glycogen stores, fluoride in the pineal gland can cause sleep deprivation, and phthalates can increase inflammation around the bodily cells.
The less toxins stored around your body, the better for acne. Fasting will work by inducing a state of autophagy, which is where after 12 hours of zero calorie intake your body enters a heightened state of detoxification. The toxins will be ripped out of their stores extra fast and then removed.
However, taking lemon juice, olive oil, and Epsom salt is pointless. The point about a liver that’s choking and full of toxins meaning that more contaminants remain in the bloodstream to cause acne is totally false too.
Firstly, this again would show up as elevated liver enzymes, which acne patients do not have. Secondly, the best way to lower levels of chemicals and heavy metals in the bloodstream is to simply avoid them in the first place. Most companies won’t tell you that because they want to sell you their profitable solution: detox kits.
The second best approach which only a few trustworthy natural health websites bring up is increasing your levels of glutathione, the most potent detoxifying agent in the body.
Glutathione is also an antioxidant, but in the form of glutathione s-transferase, it is responsible for reducing, detoxifying and finally removing an extremely wide variety of toxins in both stage 2 and stage 3 detoxification. Glutathione tackles mercury, it tackles BPA, fluoride, and endless other toxins.
By supercharging glutathione you massively accelerate your ability to remove these chemicals and your blood levels will fall. It beats liver flushing for detoxifying your blood any day, because the specific toxin build-up that liver flushing targets does not exist.
If avoidance is number one, and boosting glutathione is number two, then intermittent fasting and autophagy is number three. Fasting is the most useful aspect of the liver flushing phenomenon; the rest should be ignored.
The real role the liver plays in acne
The three theories we have just discussed mostly deal with an overloaded liver, whether caused by an overload of toxins within liver or too many toxins it has too process on a daily basis. That condition does not cause acne, but there’s one liver disease which does – non-alcoholic fatty liver disease.
A fatty liver is exactly what it sounds like – fat deposits (steatosis) slowly build up in the liver and choke out its all-important functioning. NAFLD affects an estimated 30% of Americans – even kids are showing up to the hospital with a fatty liver due to soft drinks and candy. It’s estimated that up to one in every three people in the UK has early stages of NAFLD.
Unlike a liver that’s overloaded and cannot function properly due to alcohol, for instance, a fatty liver will not show up as elevated liver enzymes. In fact, non-alcoholic fatty liver disease is notoriously hard to diagnose; physical exams and blood tests yield no results at all. The most reliable way to diagnose NAFLD is a liver biopsy, an expensive and rarely performed procedure.
How does a fatty liver cause acne? Mainly by causing elevated levels of insulin, which stimulates your sebaceous glands to pump out more sebum and increases the sensitivity of the sebaceous glands to androgens like DHT.
Generally, I advise you to decrease insulin sensitivity by emptying the energy from your muscle glycogen stores through exercise and eating less carbs. Less glycogen filling the glycogen stores allows the receptors to become more responsive to insulin when it comes knocking to drop off more energy, and for blood insulin levels to fall.
However, glycogen stores aren’t only found in the muscles; your liver is a major glycogen store as well. That means that your liver can develop insulin resistance just like the muscle stores, and according to several studies, that’s what a fatty liver can cause:
- This 1999 study set out to examine whether non-alcoholic fatty liver disease and insulin resistance were associated with each other. They were: patients with a fatty liver had much high insulin resistance, fasting insulin levels, and post-meal insulin levels. NAFLD was found to be associated with insulin resistance and hyperinsulinemia (elevated insulin levels) even in lean patients.
- This big review from 2010 analysed the link between insulin resistance and non-alcoholic fatty liver in detail. The scientists stated that “insulin resistance in NAFLD is characterized by reduced whole-body, hepatic, and adipose tissue insulin sensitivity”, and that “NAFLD may increase the risk of type 2 diabetes”. Type 2 diabetes is basically the end stage of insulin resistance.
- Type 2 diabetes is commonly a result of obesity, but scientists in this 2005 review wanted to explain why even some lean individuals commonly develop type 2 diabetes. They speculated that a fatty liver could be the cause: “the fatty liver may help to explain why some but not all obese individuals are insulin resistant and why even lean individuals may be insulin resistant”. They commented that once a liver gets fatty it over generates many unhealthy substances, including C – reactive protein (linked to inflammation), VLDL cholesterol, and excessive amounts of glucose. One of those substances, plasminogen activator inhibitor-1, has itself been linked to insulin resistance in many studies.
It’s also well known that the majority of patients with type 2 diabetes, super-advanced insulin resistance, have non-alcoholic fatty liver disease. 80% of type 2 diabetics have a fatty liver according to one analysis.
The truth is that if you want to heal your liver to clear your skin, it is reducing the fat content that you should focus on, not flushing it with detox strategies. Doing so takes a while, but reducing your fasting insulin levels should help to make your skin less oily and less covered with acne.
The single most important strategy is to minimise your intake of fructose, the sugar found in fruits and vegetables in varying ratios with glucose. Unlike glucose, which can be processed by every cell in the human body, only the liver can convert fructose to energy.
If too much fructose floods in too quickly then the liver cannot convert it to glycogen all at once, and converts some to fat instead, which gradually builds up in the liver. Fructose from fruit such as apples or strawberries is safe; there’s plenty of fiber to slow down its progress into the liver.
But if you drink fruit juice, eat high fructose corn syrup or agave nectar (which contains 85% fructose), which have not one ounce of fiber, the sugar will be like a tsunami. Excessive sugar from fruit juice and soft drinks is why even many kids are developing a fatty liver these days.
Nutrients such as magnesium are also important. Choline, found in eggs and organ meats, is a particularly important one as it encourages the liver to dump its existing fat content. Excessive carbohydrate consumption can lead to fat storage in the liver, and the good news is that eating less carbs is one of premier strategies for clearing acne anyway.
The main mechanisms through which an unhealthy liver supposedly causes acne – by pushing toxins through the skin, by not processing androgens, and by accumulating toxins – are completely false.
The main liver disease that can cause acne is one that few acne websites ever discuss – non-alcoholic fatty liver disease (NAFLD).
Hopefully you’re now extra educated on the science behind acne and ready to formulate your own master plan. Remember, some aspects of detoxification are correct – removing stored heavy metals and chemicals through intermittent fasting and boosting glutathione is very smart.
Be vigilant though, because the whole detoxification phenomenon is among the most deceptive and mythical topics currently orbiting alternative medicine. The liver myths above are simply an extension of that.
The word “detoxification” alone is always a reason to be sceptical unless you’re browsing the most scientific of scientific journals.
Thanks for reading!