What is acne? And why do I have it?

Acne is one of the most common skin conditions in North America and can affect men and women of all ages and ethnic backgrounds. Acne occurs when the pores in your skin become blocked. Pores are small holes in your skin that connect the outside environment to the internal skin layers through channels called follicles. The skin’s sebaceous glands connect to these follicles and make an oily substance called sebum. Sebum helps cleanse your skin by carrying dead skin cells to the surface but sebum and dead skin cells can form a plug in the follicle. 

There are many different types of bacteria that naturally live on or in our skin. One specific type, called P. Acnes, feeds on sebum and creates an immune system reaction that can cause swelling and redness in this plug. A pimple then grows from the breakdown of the plug. Different types of pimples can occur depending on how deep in the skin the plug forms and whether or not pus is created by the immune system. These can include whiteheads, blackheads, nodules or cysts.

There are many causes of acne including hormonal changes, medications, genetics and skincare products, but we also have to consider the internal environment of your body as well if we want to heal your acne for good. There is a huge connection between your skin and your digestive system. Skin conditions have been related to Crohn’s disease (1), small intestinal bacterial overgrowth (2), leaky gut syndrome (3) and IBS (3). 

Your skin is one of your body’s largest elimination organs and it works alongside your digestive system to clear out waste and toxins. If your digestive system isn’t working well, chances are it’s going to show up in your skin. On the other hand, improving your digestive health can improve your skin as well!

How Do I Heal My Gut?


Probiotics are the “good bacteria” in found in your gut and throughout the mucous membranes of your body. It’s important to keep a balance between the bacteria in your body and probiotics help to do this. They also help regulate digestion and your immune function. Probiotics are found naturally in fermented foods like kombucha, yogurt, kefir, sauerkraut, tempeh, miso and pickles. Some people prefer to take a probiotic supplement to ensure they get enough good bacteria every day.

Remove Food Intolerances

Lots of people notice that certain foods don’t agree with them. Your skin may be one of the ways your body reacts to foods that create this inflammation. Eliminating foods like gluten, dairy, corn, eggs, sugar, soy and processed foods may help improve your skin. Doing an Elimination Diet is a great way to see which foods may be contributing to your poor skin quality.

Repair Your Gut

There are many nutrients that naturally support and nourish your gut tissues. These can be found in the form of capsules, tablets, teas, tinctures and powders. Nutrients such as L-glutamine, licorice root, quercetin, curcumin, digestive enzymes, zinc and omega 3s can all help promote a healthy gut environment. It is extremely important that you consult a professional, such as a Naturopathic Doctor, before adding supplements to your health regimen! They will ensure there are no interactions with your current medications and that you are safe to add these supplements given your health history.

What Else Can I Do To Treat My Acne?

While you’re waiting for your gut to start working better, there are some other natural treatments that can help get your acne under control.

Apple Cider Vinegar

Apple cider vinegar is made from fermented juice of apples and contains high levels of citric acid. It works as an antibacterial agent on the skin and has been shown to kill P. acnes specifically (4). Apple cider vinegar may also help reduce the excess oil that contributes to acne formation as well.

Green Tea

Green tea is a powerful antioxidant which helps fight free radical damage and promote healthy cell function. The active ingredient in green tea, epigallocatechin-3-gallate (EGCG) has been shown to decrease sebum production and inflammation, and inhibits the growth of P. acnes (5).

Aloe Vera

Aloe Vera leaves produce a gel that helps treat wounds, burns and inflammation when applied to the skin. It also contains salicylic acid and sulfur which have both been shown to effectively treat acne (6, 7).

How Does Lifestyle Affect Acne?

Your skin is a reflection of how your body is functioning overall. Optimizing your body’s systems through lifestyle changes can have a huge impact on your health!

Reduce Stress

Stress can negatively affect many systems in your body including your skin. Cortisol is released in response to chronic stress and has been related to increased sebum production (8) and acne severity (9). Getting enough sleep and practicing yoga, meditation, breathing exercises or other relaxing activities may help in controlling your acne.

Exercise Regularly

Regular physical activity is critical to overall health and well-being. It promotes the circulation of blood, helps the body excrete toxins through the sweat, regulates hormones and can reduce stress and anxiety which can all affect skin health. Choose activities you enjoy and participate in them regularly to support your skin and the rest of your body as well.

Don’t Touch Your Face

Think of all the things you touch in a day: doorknobs, computer keys, your cellphone, your steering wheel, other people, and the list goes on… Touching your face can transfer bacteria, viruses, fungi and allergens to your face which can increase inflammation and contribute to acne lesions. This can also spread P. acnes already present on your skin which can lead to more pimples and breakouts.  

Cleanse Properly

Removing the dead skin cells and sebum from your skin on a regular basis seems like a no brainer, but it’s important to do this the right way. Cleansing too frequently or using a cleanser that dries the skin too much can actually cause your skin to produce even more sebum, which could make your acne worse. It’s also important to choose cleansers with as few chemicals, perfumes and additives as possible since these can irritate your skin as well.

Acne is a very common and complex medical condition but there are many natural treatments available. It is important to get to the root cause of your skin condition to target exactly what’s going on in your body. Your Naturopathic Doctor can provide the treatment that will be safe and effective for you as an individual.


1.      Sandborn W. (2012). Ustekinumab induction and maintenance therapy in refractory Crohn’s disease. New England Journal of Medicine, DOI: 10.1056/NEJMoa1203572.

2.      Parodi A, Paolino S, Greco A, Drago F, Mansi C et al. (2008). Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clinical Gastroenterology and Hepatology, 6(7):759-64.

3.      Bowe, W. (2011) Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathogens, 3:1.

4.      Bae JY, Park SN. (2016). Evaluation of anti-microbial activities of ZnO, citric acid and a mixture of both against Propionibacterium acnes. Internationl journal of cosmetic science, 38(6):550-7.

5.      Yoon JY, Kwon HH, Min SU, Thiboutot DM, Suh DH. (2013). Epigallocatechin-3-gallate improves acne in humans by modulating intracellular molecular targets and inhibiting P. acnes. The Journal of Investigative Dermatology, 133(2):429-40.

6.      Zander E, Weisman S. (1992). Treatment of acne vulgaris with salicylic acid pads. Clinical therapeutics, 14(2):247-53.

7.      Breneman DL, Ariano MC. (1993). Successful treatment of acne vulgaris in women with a new topical sodium sulfacetamide/sulfur lotion. International Journal of Dermatology, 32(5):365-7.

8.      Zouboulis C, Seltmann H, Hiroi N, Chen WC, Young M, et al. (2002). Corticotropin-releasing hormone: an autocrine hormone that promotes lipogenesis in human sebocytes. National Academy of Sciences, 99(10):7148-7153.

9.   Yosipovitch G, Tang M, Dawn AG, Chen M, Goh CL, et al. (2007). Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta dermato-venereologica, 87(2):135-9.