According to the Canadian Dermatology Association[1], 20% of Canadians, or about 7.4 million people live with acne. This statistic makes it clear that acne is a common skin condition, and perhaps makes us question the efficacy of common acne treatments. Conventional acne treatments generally target the physical signs and symptoms but do not address the underlying cause. As a result, acne tends to reoccur and often affects adults beyond the teenage years, which suggests the need for an alternative treatment approach.

One of the principles of naturopathic medicine, is to treat the cause by taking into consideration not only the external presentation of a condition, but any internal imbalances that may be present. In acne patients, root causes may include hormonal imbalances, poor gut health, toxic exposure, and mental/emotional health concerns. According to the Acne and Rosacea Society of Canada, depression is 2 to 3 times more prevalent in acne patients than the general public [2]. This emphasizes the importance of addressing the mental and emotional health of these patients in addition to the physical pathology, instead of focusing on the physical symptoms alone. In fact, the root causes outlined below emphasize that skin health often reflects what is happening inside the body.

What is the root cause?

Hormonal fluctuations during puberty are a common contributing factor for teenage acne. However, these imbalances can continue into adult years, manifesting as acne in addition to other conditions, such as polycystic ovarian syndrome (PCOS). Testosterone is partially responsible for this cascade since elevated levels of this hormone stimulate the growth of sebaceous glands, which are the skin’s natural oil-producing glands [3]. This leads to excessive levels of sebum or oil production, which can clog the pores. As a result of increased testosterone, and other hormone imbalances, an inflammatory substance known as IGF-1 is released to trigger inflammation in the skin.

Diet and gastrointestinal health can also play an important role in the state of the skin [4]. Acne can result from inflammation in the gut. Patients with food sensitivities (commonly to dairy, gluten, and/or chocolate) can experience inflammation and damage to their intestines upon the ingestion of these foods [5]. This inflammation can lead to affect the barrier function of the gut wall and allow passage of larger food particles, waste products and bacteria into the blood; a cascade that is commonly known as “leaky gut”. The resulting immune reaction aggravates skin inflammation and can cause acne.

Exposure to toxins such as pollution, pesticides, plastics, etc., can also manifest on the skin as acne. Together with the other organs of elimination such as the liver, colon, kidneys, and bladder, the skin plays an important role in excreting toxins and waste products from the body. If this system becomes overwhelmed, or when one or more of these organs is not functioning optimally, as in cases of constipation or liver disease, it can often show up as dry, inflamed or acne-prone skin.

Lastly, the root cause that no one wants to hear: stress! In a well-balanced lifestyle, the hormone cortisol is important for waking up every morning and falling asleep every night. However, consistently raised levels of cortisol during times of stress can play a role in the overproduction of sebum [6]. Therefore, counseling and tackling reasons for heightened levels of stress should be part of your acne treatment plan.

When it comes to acne, it is critical to determine the root cause in order to effectively correct the underlying imbalances that are showing up on the skin. Naturopathic doctors are trained to determine the root cause and to treat the whole patient; including mental, emotional and physical imbalances leading to symptoms such as acne. Speak to your naturopathic doctor if acne is one of your concerns, they will help you to address the cause in order to return to optimal health.


[1]Skin Conditions. (n.d.). Retrieved February 1, 2019, from

[2] Depression and Acne. (n.d.). Retrieved February 1, 2019, from

[3] Rocha, M.A., & Bagatin, E. (2018). Adult-onset acne: prevalence, impact, and management challenges. Clinical, Cosmetic and Investigational Dermatology, 11, 59-69

[4] Vaughn, A. R., Notay, M., Clark, A. K., & Sivamani, R. K. (2017). Skin-gut axis: The relationship between intestinal bacteria and skin health. World Journal of Dermatology, 6(4), 52-58

[5] Kucharska, A., Szmurło, A., & Sińska, B. (2016). Significance of diet in treated and untreated acne vulgaris. Postepy dermatologii i alergologii, 33(2), 81-6

[6] Zari, S., & Alrahmani, D. (2017). The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clinical, cosmetic and investigational dermatology, 10, 503-506