Skin - My First Distress Signal
What was happening underneath — in my gut — told the real story. The Root of The Root Part 2 Click here to read Part 1.
Like so many teenage girls in the late eighties and early nineties, I was handed a prescription and told to trust the process. Cystic acne is a deeper, more severe form of acne that forms beneath the skin rather than on the surface. These lesions are often painful, swollen, and slow to heal because the inflammation is occurring deep within the follicle and surrounding tissue. Instead of typical whiteheads, you’ll see larger cysts or nodules that don’t come to a head, often returning in the same areas like the jawline, chin, cheeks, or back — and they carry a higher risk of scarring. I had normal acne, and dense cyctic acne beginning at age 12-13.
Antibiotics were prescribed for the acne year one, of course there were also topical ointments which didn’t work. Then Accutane entered the picture at age 13. Also birth control was prescribed and taken because the prescription for Accutane required it, so that began at age 14.
Each intervention made a certain kind of sense in isolation. None of them were ever connected to each other, and none of them were ever connected to what came after, until now.
The antibiotic years (ages 13–17) were the founding catastrophe for my gut.
Antibiotic Treatment & Gut Health
Antibiotic treatment has been documented to cause intestinal overgrowth of Candida albicans since the 1960s. Because antibiotic exposure leads to disruption of the gut bacterial community, which affects the interactions between Candida and beneficial gut bacteria, the link is clear. (Springer) But here is the critical nuance that most people don't know: while the bacterial community can recover mostly within 3 months after antibiotic treatment stops, the fungal community is shifted from mutualism at baseline to competition — and this impact on fungi lasts far longer than the impact on bacteria. (BioMed Central)
I wasn't on antibiotics for one course. I was on low-grade antibiotics for approximately four years, from ages 13 to 17. That is not a disruption. That is a complete restructuring of my gut ecosystem during puberty — the most hormonally volatile and immunologically formative period of my life. My gut microbiome never had a chance to establish normal post-childhood architecture.
Accutane added a second layer of gut damage
The research here is genuinely contested, but what's emerging is telling. It fits my story well. Both doxycycline (antibiotic) and isotretinoin (Accutane) have been shown to lead to proliferation of Candida species in acne patients, with the proliferation actually being greater in those receiving isotretinoin than in those on antibiotics alone. (ResearchGate) Accutane can affect all mucous membranes — including causing colitis and ileitis of the intestinal mucosa — and is now listed in the package insert as carrying risk of gastrointestinal adverse effects. It is considered an additional risk factor in patients with personal or familial history of inflammatory bowel disease. (PubMed)
I had Accutane layered on top of 4 years of antibiotics. My gut lining was being hit from two directions simultaneously: bacterial depletion from the antibiotic, and mucosal disruption from the Accutane.
Unexplainable Dysfunction
What came after was decades of dysfunction I couldn't explain.
It wasn't until I began digging — really digging — into my own health history that the connections started to emerge. I discovered I carry MTHFR variants, genetic mutations that impair my body's ability to methylate (release toxins), produce glutathione (body’s master antioxidant), and detox efficiently.
I learned I had been living with the downstream effects of Candida overgrowth for years — a direct consequence of an adolescent gut that never had a chance to recover.
I uncovered a history of black mold exposure in adulthood that had quietly compounded everything, stacking one burden on top of an already-compromised system.
Healing My Gut has Created Wisdom
Understanding where the dysfunction began — tracing it all the way back to those formative teenage years — didn't make me angry. It made me free. Because once you can see the map, you can finally start navigating. We depend on doctors for this, but they are not ‘living’ our experience, and their time with us is very measured, finite, and very separate from other physicians we seek out.
I have pursued healing through many paths: targeted nutrition, functional lab work, gut repair protocols, methylation support, bio identical HRT, functional Medicine MD’s, primary care MD, Gynocologist, Chiropractic care, Accupunture, movement, meditation, therapy, and a deep commitment to understanding my own biology instead of outsourcing that understanding to a system that had never once connected the dots for me.
What follows in part 3 is more science, how oral birth control further played a part in my gut dysfunction, MTHFR understanding, and how different doctors and tools were able to help me rebuild a distressed nervous system, heal my gut, heal my metabolic system, lose ALL the weight, and see myself differently.
Understanding the biological cascade that began in adolescence is exactly what empowered me to share it — and eventually, to heal.
If your story has similar threads, I hope this gives you the same thing it gave me: a map. Dysfunction and dysregulation that lead to autoimmune issues, weight gain, cellular dysfunction begin long before we understand it is even affecting us.
Thank you for reading. I hope you will share with someone who needs this today, and that your day is brighter.
References
PubMed — Isotretinoin affects all mucous membranes including colitis and ileitis; listed in package insert as GI risk factor; additional risk factor in IBD patients: Prescrire International, PubMed (2009)
PubMed — Isotretinoin and antibiotics both cause Candida proliferation in acne patients, with isotretinoin more responsible than antibiotics alone: Journal of Investigative Dermatology via PubMed (2012)
PubMed Central — Estrogen promotes Candida albicans virulence by enabling it to evade the innate immune system; high-estrogen oral contraceptives are a documented risk factor for vulvovaginal candidiasis: Cell Reports, PMC (2022)
