If you struggle with acne, it can be easy to focus only on what is happening on the surface of your skin. You might have tried different cleansers, creams, exfoliants, facials or prescription treatments, only to find that your acne continues to return. While topical skincare certainly has an important role to play, acne is not simply a skin problem.
Your skin is influenced by what is happening throughout the body, including your hormones, blood sugar regulation, gut health, nutrient status, inflammation, stress levels and lifestyle.
At Pure Health Nutrition, we take a whole-body approach to acne. Rather than simply asking, “What can we put on the skin?”, we also want to understand “Why is the skin behaving this way in the first place?” This can help us identify the underlying factors contributing to acne and create an individualised treatment approach that supports clearer, healthier skin from the inside out.
WHAT IS ACNE?
Acne is an inflammatory skin condition that develops when hair follicles and their associated sebaceous (oil) glands become blocked and inflamed.
Acne can present as:
- Blackheads and whiteheads
- Small bumps or clogged pores
- Red, inflamed pimples
- Pustules
- Deeper cystic lesions
- Persistent congestion
- Post-inflammatory redness or pigmentation
- Acne scarring
Acne most commonly develops on the face, but it can also affect the chest, back, shoulders and other areas of the body.
While acne is particularly common during adolescence, it can continue into adulthood or develop for the first time in your 20s, 30s or beyond.
And importantly, adult acne is not something you simply have to “grow out of”.
When acne persists into adulthood, it can be useful to look beyond the skin and investigate potential hormonal, metabolic, nutritional, digestive and lifestyle contributors.
WHY DOES ACNE DEVELOP?
There generally isn’t one single cause.
Acne is influenced by several interconnected processes within the skin and body.
Some of the key factors we consider include:
- Androgen hormones
- Blood sugar and insulin regulation
- Excess sebum production
- Blocked pores and abnormal skin cell turnover
- Inflammation
- Gut health and the microbiome
- Nutritional deficiencies or imbalances
- Stress and sleep
- Hormonal changes throughout the menstrual cycle
And, commonly, it is a combination of several of these factors.
1. Elevated androgen activity
One of the most important hormonal considerations in acne is androgen activity.
Androgens are a group of hormones that include testosterone and DHEA-S. While often thought of as “male” hormones, women naturally produce and require androgens too.
The issue is not necessarily that your testosterone is dramatically elevated.
You can experience acne even when your blood hormone levels fall within the conventional laboratory reference range.
This is because acne can be influenced by androgen sensitivity at the level of the skin, as well as the amount of hormone circulating in the blood.
Androgens can stimulate the sebaceous glands, increasing sebum production and contributing to changes in the way skin cells behave within the hair follicle.
This can contribute to:
Increased androgen activity → increased sebum production → greater likelihood of clogged pores → inflammation → acne.
This is one reason hormonal acne often appears around the jawline, chin and lower face, although acne can occur anywhere on the body.
Hormonal acne may also follow a predictable pattern around your menstrual cycle, often worsening in the days leading up to your period.
Other signs that may suggest increased androgen activity include:
- Acne that is worse around ovulation or before your period
- Excess facial or body hair
- Hair thinning
- Irregular menstrual cycles
- Oily skin
- Difficulty regulating blood sugar
- Signs of PMOS
This doesn’t mean that every person with acne has a hormonal imbalance.
Rather, it highlights why understanding your individual hormonal picture can be an important part of an acne investigation.
2. Blood sugar and insulin
Your blood sugar regulation can also influence acne.
When we eat carbohydrates, they are broken down into glucose, which enters the bloodstream. Your pancreas then releases insulin to help move glucose from the blood into your cells.
When insulin levels are repeatedly elevated, this can influence several pathways involved in acne, including androgen activity, sebum production and skin cell growth.
This is one reason we often consider fasting insulin and HbA1c, alongside the broader clinical picture, when investigating persistent acne.
You don’t need to have diabetes to have blood sugar regulation that could be improved.
Signs that blood sugar regulation may warrant attention can include:
- Strong cravings for sugar or refined carbohydrates
- Energy crashes after meals
- Feeling hungry again shortly after eating
- Difficulty going long periods without food
- Increased abdominal weight
- Family history of insulin resistance
- Acne alongside other signs of androgen excess
This doesn’t mean you need to completely eliminate carbohydrates.
In fact, carbohydrates can form an important part of a healthy, balanced diet.
Instead, we generally want to focus on the quality and combination of your meals, including adequate protein, fibre, healthy fats and lower-GI carbohydrate sources.
3. Excess sebum and blocked pores
Sebum is an oily substance produced by the sebaceous glands.
Your skin needs some sebum to maintain healthy hydration and barrier function.
The problem occurs when there is excessive sebum production, particularly when this is combined with changes in skin cell turnover.
Dead skin cells can accumulate within the hair follicle and mix with sebum, creating a plug.
This can result in:
Excess sebum + dead skin cells → blocked follicle → comedone → inflammation → acne lesion.
This is why simply “drying out” oily skin isn’t necessarily the answer.
Over-cleansing, harsh exfoliation and excessively stripping the skin can compromise the skin barrier, potentially increasing irritation and sensitivity.
Supporting acne-prone skin is therefore about finding a balance between managing congestion while maintaining a healthy skin barrier.
4. Inflammation
Acne is also an inflammatory condition.
Once a follicle becomes blocked, inflammatory pathways can become activated, resulting in redness, swelling and the formation of inflamed pimples or cysts.
Dietary and lifestyle factors can influence the body’s overall inflammatory environment.
This doesn’t mean that eating one inflammatory food will suddenly cause a breakout.
Rather, we look at the overall pattern of your diet and lifestyle.
A diet rich in colourful vegetables, fruit, omega-3 fats, fibre, herbs, spices and minimally processed foods provides a broad range of nutrients and plant compounds that support normal inflammatory regulation.
On the other hand, a diet consistently high in highly processed foods, refined carbohydrates and added sugars may be less supportive of healthy metabolic and inflammatory balance.
5. Gut health and the skin
The gut and skin are closely connected through what is often referred to as the gut-skin axis.
Your gut microbiome plays important roles in immune regulation, digestion, nutrient metabolism and inflammatory signalling.
This means that digestive health can be relevant when someone presents with persistent inflammatory skin conditions, including acne.
This doesn’t mean that acne is simply caused by “bad gut bacteria”.
The relationship is much more complex than that.
However, if acne occurs alongside symptoms such as:
- Bloating
- Constipation
- Diarrhoea
- Reflux
- Food intolerances
- Abdominal discomfort
- Significant changes in bowel habits
then gut health may be an important piece of the puzzle.
Supporting the gut can involve improving dietary fibre intake, increasing plant diversity, supporting regular bowel movements and addressing any identified digestive concerns.
6. Hormone detoxification and elimination
Your body is constantly metabolising and eliminating hormones.
The liver plays an important role in hormone metabolism, while the gastrointestinal tract is involved in eliminating compounds that have been processed by the liver.
This is why regular bowel movements and adequate fibre intake are particularly important when supporting healthy hormone clearance.
If oestrogen and other hormone metabolites are not being effectively eliminated through the bowel, some metabolites can be reabsorbed into circulation.
This process is influenced by the gut microbiome and an enzyme called beta-glucuronidase.
Rather than focusing on aggressive “detoxes”, we prefer to support the body’s natural detoxification pathways through foundational nutrition and lifestyle.
This may include:
- Eating plenty of fibre
- Including cruciferous vegetables regularly
- Eating bitter foods
- Supporting adequate hydration
- Maintaining regular bowel movements
- Minimising excessive alcohol intake
- Ensuring adequate protein and micronutrient intake
7. Stress and sleep
Your skin doesn’t exist separately from your nervous system.
Chronic stress can influence the HPA axis, your hypothalamic-pituitary-adrenal system involved in the body’s stress response.
Stress can also affect sleep, digestion, blood sugar regulation, inflammation and hormonal signalling.
For some people, periods of increased stress coincide with noticeable changes in their skin.
This doesn’t mean stress is “causing” your acne.
Rather, it can be one contributing factor within a much bigger picture.
Sleep is equally important.
During sleep, your body carries out essential processes involved in tissue repair, immune regulation and hormonal balance.
If you’re consistently sleeping poorly, it may be harder for your body to regulate the processes that influence healthy skin.
Supporting sleep might include:
- Aiming for 7–9 hours per night
- Getting morning sunlight
- Keeping a relatively consistent sleep and wake time
- Limiting caffeine later in the day
- Reducing screen exposure before bed
- Creating a calming evening routine
And remember: you don’t need a perfect lifestyle to have healthy skin.
The goal is to create sustainable habits that support your overall health.
Can diet really improve acne?
This is one of the most common questions we hear.
The answer is that diet can be an important piece of the puzzle for some people, but there is no single “acne diet”.
Research has identified associations between acne and dietary patterns involving glycaemic load, dairy intake and overall dietary quality, but individual responses vary.
This is why we don’t recommend unnecessarily restricting large numbers of foods simply because you have acne.
Instead, we focus on adding more of the foods that support skin health.
Build balanced meals.
A useful starting point is to structure meals around:
Protein + low-GI carbohydrates + healthy fats + fibre
For example:
Breakfast:
Eggs on sourdough with avocado, spinach and berries
Lunch:
Chicken or tofu bowl with quinoa, roasted vegetables, leafy greens and olive oil
Dinner:
Salmon with roasted sweet potato, broccoli and a large mixed salad
Snack:
Greek yoghurt with berries, chia seeds and nuts
This combination can help provide the protein, fibre, essential fats, vitamins and minerals your skin needs while supporting more stable blood sugar levels.
Prioritise protein.
Protein provides amino acids required for tissue repair, immune function and the production of many important compounds within the body.
Aim to include a quality protein source at each meal.
Examples include:
- Eggs
- Fish
- Chicken
- Lean meat
- Greek yoghurt
- Cottage cheese
- Tofu and tempeh
- Legumes
- Lentils
- Beans
Eat plenty of colourful plants.
Aim for a broad variety of vegetables, fruits, herbs, spices, nuts and seeds.
These foods provide:
- Antioxidants
- Polyphenols
- Fibre
- Vitamin C
- Folate
- Carotenoids
- Magnesium
- Potassium
- Other important phytonutrients
Rather than focusing on one “superfood”, dietary diversity is key.
Aiming for 30+ different plant foods each week can be a simple way to increase dietary diversity.
Don’t fear dietary fats.
Healthy fats are an important component of a balanced diet and provide essential fatty acids required for normal cellular and inflammatory function.
Include foods such as:
- Extra virgin olive oil
- Avocado
- Nuts
- Seeds
- Tahini
- Chia and flaxseeds
- Oily fish
Omega-3 fatty acids, in particular, are important for healthy inflammatory regulation.
What about dairy?
Dairy is often discussed in relation to acne.
Some research has found an association between certain dairy products and acne, particularly in some populations and with milk consumption.
However, this does not mean that everyone with acne needs to remove dairy.
If you suspect dairy may be contributing to your skin, this is something that can be assessed individually rather than automatically eliminating all dairy products.
It’s also important to consider what you are replacing dairy with.
Removing a nutritious food without replacing the nutrients it provides isn’t necessarily an improvement.
What nutrients are important for healthy skin?
Your skin requires a wide range of nutrients to maintain its structure, barrier function, repair and immune defence.
Depending on your individual history and pathology, we may consider nutrients such as:
Zinc
Zinc is involved in immune function, wound healing and skin health.
Low zinc status may be relevant in people with acne, particularly where dietary intake is inadequate.
Food sources include:
- Oysters and seafood
- Red meat
- Eggs
- Pumpkin seeds
- Legumes
- Nuts
Vitamin A
Vitamin A plays an important role in skin cell differentiation and normal skin function.
Food sources include liver, eggs and dairy, as well as beta-carotene-rich plant foods such as carrots, pumpkin, sweet potato and leafy greens.
Supplemental vitamin A should not be taken casually, particularly during pregnancy or when pregnancy is possible, as excessive intake can be harmful.
Vitamin D
Vitamin D has roles in immune and skin function.
Where deficiency is identified, correcting this may form part of a broader treatment plan.
Omega-3 fatty acids
Omega-3 fats are important for normal inflammatory regulation and can be obtained through foods such as salmon, sardines, mackerel, chia seeds, flaxseeds and walnuts.
Iron and other nutrients
Iron, B vitamins, selenium, magnesium and other micronutrients may also be relevant depending on your individual diet, symptoms and pathology.
This is why we don’t recommend taking a large number of supplements simply because you have acne.
More supplements does not necessarily mean better skin.
The goal is to identify what your body actually needs.
What blood tests may be useful?
If acne is persistent, severe, hormonal or accompanied by other symptoms, blood testing may provide useful information.
Depending on your individual presentation, your practitioner may consider investigating:
- Total testosterone
- Free testosterone
- SHBG
- DHEA-S
- Androstenedione
- LH and FSH
- Oestradiol
- Progesterone where clinically appropriate
- Fasting insulin
- HbA1c
- Thyroid markers
- Vitamin D
- Iron studies
- Zinc
- Other markers based on your symptoms and health history
The exact testing required will depend on the individual.
Importantly, blood tests are only one part of the picture.
Your menstrual cycle, acne pattern, digestive symptoms, diet, exercise, stress, sleep, medications, contraception and family history can provide equally important information.
What about supplements?
Supplements can be useful when they are targeted towards an identified need.
Depending on the underlying drivers, a practitioner may consider nutrients or herbal medicines that support areas such as:
- Androgen regulation
- Blood sugar balance
- Zinc status
- Inflammatory balance
- Liver function and hormone metabolism
- Gut health
- Nutritional deficiencies
However, acne treatment should not become a long list of supplements without understanding why each one is being used.
Your treatment should be individualised according to your symptoms, pathology, medications, health history and goals.
It is also important to remember that some supplements can interact with medications or may not be appropriate during pregnancy.
Always seek individualised advice before starting therapeutic doses of supplements or herbal medicines.
What about skincare?
A whole-body approach doesn’t mean ignoring the skin itself.
Your skincare routine still matters.
For acne-prone skin, the goal is generally to:
- Keep the skin clean without excessive stripping
- Avoid aggressive scrubbing
- Support the skin barrier
- Choose non-comedogenic products where appropriate
- Avoid constantly changing products
- Use appropriate acne treatments recommended by your healthcare professional
- Wear sunscreen during the day
For moderate to severe acne, painful cystic acne or acne that is causing scarring, it is important to work alongside a GP or dermatologist.
Medical acne treatments can be highly effective and may be an important part of your care.
A naturopathic approach can complement appropriate medical and dermatological treatment rather than replacing it.
How long does it take to improve acne?
There is no universal timeline.
Skin changes take time, and acne often reflects processes that have been developing for weeks or months.
Some people notice improvements relatively quickly after addressing a key trigger, while others require several months of consistent nutrition, lifestyle and therapeutic support.
It’s also important to remember that new breakouts don’t necessarily mean your treatment isn’t working.
The skin has its own cycle, and changes in inflammation, hormones and sebum production can take time to become visible.
This is why we prefer to monitor the overall pattern rather than judging progress based on a single breakout.
You may notice:
- Fewer new breakouts
- Less inflammation
- Reduced oiliness
- Fewer premenstrual breakouts
- Faster healing
- Improved skin texture
- Reduced congestion
- Less post-inflammatory redness over time
These can all be meaningful signs of progress.
Where to start
If you’re struggling with acne, the goal isn’t to find another quick fix.
It’s to understand why your skin is behaving the way it is.
That may mean looking at your hormones.
It may mean improving blood sugar regulation.
It may mean addressing nutritional deficiencies.
It may mean supporting your gut.
It may mean improving sleep and stress management.
Or, more commonly, it may mean addressing several of these areas together.
At Pure Health Nutrition, our Clinical Nutritionists and Naturopaths take a whole-body approach to acne. We look at your skin presentation alongside your menstrual cycle, hormones, nutrition, digestion, lifestyle, stress, sleep and pathology to identify potential contributing factors.
Rather than simply asking “What supplement should I take for acne?”, we want to understand the underlying picture and create an individualised treatment plan that supports your skin and your overall health.
Because healthy skin isn’t just about what you put on your skin.
It’s also influenced by what you put in your body, how you nourish yourself, how you sleep, how you manage stress and how well your body is functioning as a whole.
Clearer skin starts with understanding the whole picture.
If you’re struggling with persistent, hormonal or adult acne, book an appointment with the Pure Health Nutrition clinic to investigate the potential drivers behind your acne and receive personalised nutritional and naturopathic support.
References
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Parvizi, M. M., Saki, N., Zahra Rostami Ghotbabadi, Kamali, M., Nastaran Salmanpour, Namazi, M., & Mehdi Pasalar. (2025). Medicinal Plants for Acne Vulgaris: An Evidence‐Based Review of Treatments Promoted by Social Media. Journal of Cosmetic Dermatology, 25(1), e70628–e70628. https://doi.org/10.1111/jocd.70628
Proença, A. C., Luís, Â., & Duarte, A. P. (2022). The role of herbal medicine in the treatment of acne vulgaris: A systematic review of clinical trials. Evidence-Based Complementary and Alternative Medicine, 2022, 1–22. https://doi.org/10.1155/2022/2011945
Yang, J. H., Yoon, J. Y., Kwon, H. H., Min, S., Moon, J., & Suh, D. H. (2017). Seeking new acne treatment from natural products, devices and synthetic drug discovery. Dermato-Endocrinology, 9(1), e1356520. https://doi.org/10.1080/19381980.2017.1356520