Still Breaking Out? Here Are 5 Things Worth Considering
Clearer skin doesn’t always start with a new serum. it often begins with a shift in perspective.
It can feel frustrating when you’re sticking to the cleansers, the serums, and the creams, but acne still keeps on coming up.
If skincare products aren’t cutting it, it might be time to look at skin from a different angle, like looking at skin health as a reflection of inner health.
In this blog post, you’ll learn about 5 things to consider internally when it comes to breakouts.
Disclaimer: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS POST DOES NOT CONSTITUTE AS MEDICAL ADVICE; IS NOT MEANT TO DIAGNOSE, PREVENT, TREAT, OR CURE ANY CONDITIONS OR DISEASE; AND IS MEANT FOR EDUCATIONAL PURPOSES ONLY. THE INFORMATION IN THIS POST DOES NOT REPLACE OR SUBSTITUTE THE ADVICE OF YOUR MEDICAL PROVIDER. SPEAK TO YOUR DOCTOR BEFORE STARTING ANY NEW TREATMENTS OR SUPPLEMENTS OR BOOK YOUR APPOINTMENT WITH ME TODAY.
1. Your Gut Health Matters More Than You Think
The connection between the gut and skin is closer than it seems. An imbalance in the digestive system is suggested to be linked to skin issues, like breakouts.
The data on gut issues and acne:
Out of 199,144 subjects with acne, researchers found that many had gut issues, like irritable bowel syndrome (IBS), peptic ulcers, constipation, and more.
A study published in 2021 looked at IBS in people with acne. In this study, researchers found that out of 300 subjects with acne, 61% had a diagnosis of IBS. When they compared subjects with acne to subjects without acne, researchers saw that “the frequency of IBS was statistically significantly higher in the [acne] group than in the [non-acne] group.”
When looking at gut bacteria and acne:
A 2018 study found that people with acne had lower levels of beneficial gut bacteria compared to people without acne. Studies published in 2020 and in 2024 also found that a stomach bacterial infection, called Helicobacter pylori, is linked to acne.
From my clinical experience, a large percentage of people who see me for acne happen to have gut issues as well. When they see me, I may suggest functional lab testing to those patients of mine to understand their microbiome balance and show them what targeted options are available to them. (Click here to learn more about the gut-acne connection)
2. Hormones could Play a Silent Role
Fluctuations in hormones affect everyone differently, but for many, they are a hidden driver behind stubborn breakouts. And, for many, understanding their hormone patterns helps them take steps that support their skin from the inside-out.
Some hormones behind acne:
Research suggests that androgen hormones, like testosterone, can drive oil production and trigger the cascade of inflammation that lead to breakouts. Beyond testosterone, other androgen hormones include: DHEA and dihydrotestosterone (DHT).
When going deeper, blood sugar hormones, like insulin hormone and insulin-like growth factor-1 (IGF-1), are suggested to impact testosterone. One study suggests that insulin and IGF-1 activate the body to produce more testosterone to potentially trigger breakouts.
To support hormone balance, there are several integrative approaches that a licensed medical provider may suggest to their patient. (Learn more about hormones, acne, and testing here)
3. Nutrient Status is Key
Your skin (and body) depends on vitamins, minerals, and many other nutrients to support its health and resilience. Deficiencies in certain nutrients have been linked to acne.
Researchers found that deficiencies in Zinc and Vitamin D are potentially linked to acne:
A study completed in 2020 found that “subjects with acne had significantly lower [zinc] serum levels”. (Learn more about zinc and acne here)
A study published in 2016 found that “Deficiency in [vitamin D] was detected in 48.8% of patients with acne, but in only 22.5% of the healthy controls”
Now, while it may be tempting to start supplementing with these nutrients, it is always worthwhile that you speak to your doctor before starting anything new, like new supplements. Why? Well, lab testing will determine whether you are actually deficient or not. And importantly, lab testing could help your doctor determine the safe dosage and duration of supplementation for your personal health and wellness.
4. Stress Isn’t Just in Your Head
Many people have told me that stress triggers or worsens their breakouts. If this trigger isn’t addressed, flares could keep on popping up even with the best skincare products.
Here’s how stress influences breakouts:
When the brain perceives a stressor, it triggers a biological reaction and sends out a stress hormone called corticotropin releasing hormone (CRH). According to literature, CRH can drive oil production at the skin level, which is one of the elements necessary for a breakout to form.
CRH also triggers a downstream reaction that activates hormone organs, called the adrenal glands. Once activated, the adrenal glands release two hormones into the bloodstream: Cortisol and DHEA. (We already spoke about DHEA earlier when we talked about androgen hormones and acne)
According to a 2024 review by Del Rosso, et al., cortisol hormone may impact how long a breakout appears since cortisol affects skin healing.
So, learning how to healthfully manage stress could be a missing piece in someone’s skin journey if their skincare products aren’t enough.
There are many ways to healthfully manage stress to promote stress resilience. Due to the variety of options, it’s best to consult your doctor to learn what strategies are best for you given your personal health and wellness and your personal preferences.
5. Your Lifestyle Adds Up
Beyond skincare routines, things like nutrition and daily habits could impact someone’s skin. Paying attention to these factors could complement someone’s efforts to support their skin.
According to researchers, foods that some folks eat may increase breakout-triggering hormones. Scientists found that high-glycemic diets have been to linked to acne, independent of culinary traditions, in a 2022 systematic review. And, high-glycemic diets are reported to elevate insulin and IGF-1, which were hormones spoken about earlier.
Some interesting information about insulin, blood sugar, and acne:
Insulin is the hormone that helps your cells absorb glucose (also known as sugar) from your bloodstream. When cells stop responding well to insulin because of chronically high blood sugar, the body compensates by producing more of insulin, creating a state known as insulin resistance.
Research published in 2012 suggests that insulin resistance may play a role in the development of acne in research subjects. Additionally, a 2023 study found that high blood sugar markers suggestive of pre-diabetes were linked to acne.
Beyond high-glycemic diets, researchers suggest that other foods may trigger breakouts by impacting hormones. Scientists suggest that whey protein in dairy may also trigger higher IGF-1 to potentially contribute to breakouts.
When people see me for holistic acne care, I also consider how their diet and habits could be impacting their skin, and ask them several questions about their diet and habits.
For many, when they understand the biological processes of how their habits are impacting their skin, I’ve seen them become more motivated to make a change.
Rethinking the Way You Care for Your Skin
Sometimes, the path to clearer and more-resilient skin isn’t about adding more steps to your skincare routine. It’s about stepping back and looking at the bigger picture, and shifting your perspective.
When you begin to explore things like how stress, nutrition, gut health, and internal imbalance affect your skin, it opens up new possibilities. When you start to see your skin as a reflection of what’s happening inside your body, you start to see that your skin might be asking for support in a different way. And paying attention to that might just be the shift you’ve been looking for.
If you’re feeling called to explore this path for your skin, consider working with a licensed provider who understands both the science and the deeper strategy behind stubborn breakouts. If you’re located in Los Angeles, you can find me at The Things We Do in Downtown Los Angeles.
You can learn more about how I work as a licensed naturopathic doctor and book your visit by clicking the button below.
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