As the name implies, inflammatory-type acne is linked to too much systemic oxidative stress, which refers to an imbalance between free radicals (called reactive oxygen species in medical speak) and antioxidants that neutralize them. This imbalance causes inflammation, which is the body’s response to injury.

Constant exposure to oxidative substances depletes the body’s antioxidants reserves and leaves the skin vulnerable to oxidative damage and acne.

I believe that gut problems are the main, or at least one of the factors in many inflammatory-type acne cases. Signs that your gut isn’t working as well as it could include:

• Any form of bloating or discomfort 30 minutes to 2 hours after meals. People often tell me they didn’t realize how gassy they were until they followed my advice on gut problems. The point is that many people have some gut issues, but don’t realize it because they believe the gas and bloating is normal. Just because everyone is farting after a meal doesn’t mean it’s not a problem. Experience shows that when I don’t eat anything that causes gut problems, I get almost no gas or bloating.
• ‘Poor’ bowel movements. When your gut is functioning properly, #2 should be as easy as #1. It should come out cleanly and without straining or pain. See the Bristol stool scale chart in the gut-health section. Your bowel movements should be #3 or #4 most of the time. Other types indicate either constipation or loose stools and possible gut problems.
• Irregular bowel movements. Again, #2 should happen fairly regularly, usually once or twice a day. Going more or less often could indicate a problem.
• Smelly stools. Offensive smell means there’s unhealthy fermentation going on in the gut. Some smell is normal; we aren’t talking about a rose garden here, but bowel movements that stink up the whole place mean there’s something unhealthy going on in the gut.

I want to stress that some gas and bloating now and then doesn’t mean you have gut issues. These things depend a lot on what you eat, and certain foods, like beans and legumes, lead to more fermentation in the gut (and thus also more gas) than other foods. It’s when you have these symptoms more than occasionally that you should become concerned.

Aside from gut issues, other warning signs of inflammatory-type acne include:

• Acne trigger foods aside from the usual culprits (sugar, high glycemic index carbohydrates, dairy products, and soy).
• Candida infection in the gut
• Auto-immune problems
• Food or environmental allergies