What REALLY Causes Acne?

The answer you’ve all been waiting for… Well, it depends. We are all different and so are the skins we walk around in. There are however, some common threads that I see in most adults with acne. I am going to talk primarily in regards to acne in women, due to the prevalence of post-pill acne and the effect that fluctuating sex hormones can have on the skin.

Post-Pill Acne

You go on the pill sort out your acne prone skin (probably as a teenager with little to know information about how the pill works, the side effects and potential long term risks) and it clears your skin right up. Miracle, right!? At some point you may decide that you know longer want to be on the pill, and your skin is surely sorted out by now right? So you come off the pill and find that actually, your skin is worse than ever! About six months later, your skin is probably at its craziest and you’re ready to give up and go back on the pill just to clear it up. Some women repeat this cycle many times! When you are on the pill, the synthetic hormones that are being released into circulation suppress ovulation and the production of adult skin sebum. The suppression of sebum and hormones leaves your skin clear as a baby’s bottom. When you come off, not only is your body readjusting, trying to ovulate, produce natural sex hormones and come out of hibernation, you get a rebound in sebum production - you are now producing more sebum than you ever have in your life! Cue acne. Combine this with vitamin and mineral deficiency, gut inflammation and liver congestion (all of which can be exacerbated by the pill) and you have a recipe for a face full of acne.

Imbalanced Blood Sugar

If you suffer from acne or breakouts, some insensitive person at some point has probably suggested quitting chocolate and fried food. The idea that diet is the sole cause of acne is a myth, but highly processed, refined and sugary foods certainly don’t help when you are trying to heal your skin! That is because these foods are typically high GI - the simple carbohydrates are taken up quickly into the blood and burned rapidly for use as energy. These same simple carbohydrates trigger the secretion of insulin-like growth factor (IGF-1) which (long story short) affects the production of androgens (like testosterone). Higher circulating levels of androgens are known to change the characteristics of skin cells, hair follicles and sebum in the skin. Once pores are clogged, they can become inflamed - leading to pustular cysts.


Consumption of dairy products has also been linked to acne due to a similar triggering of IGF. Aside from the production of IGF-1, dairy is quite a cold and congestive food. It increases the production of mucous and can contribute to lymphatic congestion (lymph being the fluid that helps to drain metabolic waste out of tissues, including the skin).

Gut Inflammation / Leaky Gut

The skin reflects what is happening within. This includes what is going on in the gut. Inflammatory foods (wheat, sugar, dairy), psychological stress, pesticides, bacterial imbalance and medications can cause an immune reaction in the gut leading to inflammation that can become systemic. When skin becomes angry and red (around and in between cystic acne) this can be an indication that gut health needs to be addressed as a part of acne treatment. There is also a high correlation between acne and sub-optimal stomach acid production. Stomach acid is vital to regulating bacterial balance in the gut and breaking down foods so that we can absorb the proteins, fats, vitamins and minerals needed for healthy skin.

Lymphatic Congestion

Where hormonal acne has been ruled out, or in cases of acne that seem to come out of nowhere during adulthood, lymphatic congestion is a prime suspect. The lymphatic system is like a sewerage system for the skin - the lymph fluid drains into lymph nodes and glands and eventually to the liver where metabolic waste, inflammatory mediators and other ‘rubbish’ is detoxified and excreted from the body. When there is a burden on the liver, a lack of movement or stagnant lymph, the body tries to reduce the burden and uses the skin as a back up route of elimination. So the junk comes up and out through your skin. The accumulation of fluid can also lead to puffiness, fluid retention, baggy eyes, other skin issues like eczema, cellulitis and dull uneven skin. There are often other signs too that suggest the other routes of elimination (lungs, gut, kidneys, liver) are under stress or under active.

These are the factors I most commonly see in my clients who are looking to treat their acne. Only with a holistic approach can we get long lasting results with acne. Conventional options are often a short term solution or become less effective over time. By treating the causes of acne, not only can the skin improve but other areas of health can start to change for the positive.

If this article has resonated with you and you are curious about how Naturopathy can help, please book a discovery call or send me an enquiry through this website. Having suffered from chronic acne personally, I can assure you that there is hope for clear skin. If you’re ready - book a consult and let’s chat about what is going on for you.

This article is not intended to diagnose or treat in any way - please always consult a health professional if you are concerned about your health or your skin.

Alexandra McPhee