ACNE Root Causes
A Functional & Naturopathic Medicine Approach
Acne is one of the most common skin conditions worldwide, affecting nearly 85% of adolescents and a growing number of adults. While conventional treatment often focuses solely on topical solutions, functional and naturopathic medicine digs deeper to uncover the root causes of acne. By addressing underlying imbalances in the gut, liver, and hormones, and combining this with supportive topical care, we can create a holistic and sustainable healing plan.
Root Causes of Acne
1. Gut Imbalances (Dysbiosis & Leaky Gut)
The gut-skin axis plays a crucial role in acne development. An imbalance in the microbiome, often from poor diet, antibiotics, or stress, can lead to systemic inflammation and worsen breakouts.
Functional Medicine Approach: Focus on probiotics, prebiotics, digestive enzymes, and removing inflammatory foods (dairy, eggs, gluten, refined sugar, seed oils).
2. Liver Detoxification Overload
The liver is responsible for filtering toxins and metabolizing hormones. When overloaded by environmental toxins, alcohol, medications, or poor diet, the liver may struggle to clear out excess hormones and toxins, which can manifest as acne.
Naturopathic Support: Milk thistle, dandelion root tea, castor oil packs, and a nutrient-dense anti-inflammatory diet support liver detox pathways.
3. Hormonal Imbalances
Androgens (like testosterone and DHT) increase sebum production, leading to clogged pores and bacterial overgrowth. Women often see acne flare-ups during PMS, PCOS, or perimenopause due to estrogen-progesterone imbalances.
Functional Medicine Approach: Balance blood sugar (stable glucose and insulin levels reduce androgen spikes), support adrenal health, and consider botanicals like Vitex (chaste tree) for cycle support.
4. Stress
Stress is a major root cause of acne because it disrupts the body’s hormonal and inflammatory balance. When you’re under stress, cortisol levels rise, which increases oil (sebum) production in the skin and can clog pores. At the same time, stress weakens the gut and immune system, making it harder for the body to manage inflammation and eliminate toxins efficiently. This combination of hormonal shifts, excess oil, and inflammation creates the perfect environment for breakouts to form or worsen, especially along the jawline and chin, where stress-related acne is most common.
Functional Medicine Approach:
Supporting the adrenals with adaptogenic herbs like ashwagandha, rhodiola, or holy basil.
Nourish the nervous system with magnesium, B vitamins, and omega-3 fatty acids.
Restoring gut health to reduce inflammation and improve resilience.
Practicing daily stress regulation tools such as breathwork, grounding, journaling, and mindfulness.
Recognizing the role of emotional stressors such as fear, guilt, shame, grief, and toxic relationships through somatic work.
Foods That Can Trigger Acne
What we eat directly affects gut health, hormones, and inflammation. Certain foods are strongly associated with acne flare-ups:
Refined sugar & high glycemic foods: Cause blood sugar spikes → increase insulin → trigger androgens and excess sebum.
Dairy products: Especially skim milk, which may increase IGF-1, a growth factor linked to acne severity.
Fried & fast foods: High in trans fats and refined oils (like soybean and canola) that promote systemic inflammation.
Alcohol: Stresses the liver and raises inflammation, impairing detox pathways.
Processed foods & snacks: Preservatives, additives, and emulsifiers disrupt the gut microbiome.
Eggs - Some people have an immune sensitivity to egg proteins, particularly albumin found in egg whites. This can trigger systemic inflammation, digestive stress, or histamine release, all of which can manifest through the skin.
Gluten - Can increase inflammation and irritate the gut lining, especially in those with gluten sensitivity or leaky gut. This gut inflammation can lead to hormonal imbalances and toxin buildup, which often show up through the skin as breakouts.
By reducing these foods and focusing on whole, nutrient-dense, anti-inflammatory meals, many people notice significant improvements in their skin.
Healing Acne: Inside-Out
Nutrition & Lifestyle
Adopt an anti-inflammatory diet: Whole foods, omega-3s, leafy greens, zinc-rich foods, and antioxidants.
Hydration: Adequate filtered water (consider Sans, AquaTru, or Berkey) to support detoxification.
Stress Management: Meditation, yoga, and quality sleep regulate cortisol, which directly influences skin health.
Targeted Functional Medicine Support
Probiotics (Lactobacillus, Bifidobacterium) for gut balance.
Omega-3 supplements to reduce inflammation.
Vitamin A for skin barrier health and oil regulation.
Note* I like the ClearStem mind, body, skin supplement - code: THENOURISHINGPLATE
Topical Solutions: Supporting the Skin Externally
While healing acne requires addressing internal root causes, topical treatments can reduce inflammation, bacterial load, and clogged pores:
Avoid toxic skin care products and pore cloggers. Check out the Environmental Working Group’s Skin Deep Cosmetic Database here & Clearstems pore-clogging ingredients checklist linked HERE
Skincare brands I use and love:
CLEARstem: Combines anti-acne and anti-aging ingredients without pore-clogging toxins. Use the code: THENOURISHINGPLATE for 15% off at checkout
Krave Beauty - Gentle, barrier-supporting formulas with antioxidants for sensitive, acne-prone skin. I LOVE their cleanser:
Sulfur Treatments: Reduce oiliness and bacteria while calming inflammation.
Tower 28 SOS Daily Rescue Facial Spray: Hypochlorous Acid Spray Helps Reduce Redness and Breakouts
Sofie Pavitt's three-step system - includes: Clean Clean Cleanser, Mandelic Clearing Serum, and Omega Rich Moisturizer, designed to help clear and support acne-prone skin - its SO good
More linked here
Final Thoughts
Acne is not just a skin-deep condition; it’s a message from the body pointing to deeper imbalances in the gut, liver, and hormones. By combining functional medicine strategies (diet, gut healing, hormone balance) with naturopathic support (herbs, detox pathways), alongside clean topical care, we can restore skin health from the inside out.
Healing takes time and consistency, but with the right approach, clear skin becomes a reflection of true inner balance.
Click HERE for a great podcast episode on all things acne
Click HERE for 6 Ingredients That Cause Acne Breakouts
Reference Guide
Bowe, W. P., & Logan, A. C. (2011). Gut Pathogens, 3(1), 1.
Yadav, V. R., et al. (2016). Pharmacological Research, 106, 79–86.
Arowojolu, A. O., et al. (2012). Cochrane Database of Systematic Reviews, 2012(7).
Burris, J., Rietkerk, W., & Woolf, K. (2017). Journal of the Academy of Nutrition and Dietetics, 117(2), 276–289.
Jung, J. Y., et al. (2014). Journal of Investigative Dermatology, 134(2), 301–308.
Zaenglein, A. L., et al. (2016). Journal of the American Academy of Dermatology, 74(5), 945–973.
Before starting any new supplements, talk to your healthcare provider.
