By Lisa Zukerman (BHSc Nat)
Acne is one of the most common skin conditions I treat in clinic. Put simply, acne starts when a hair follicle becomes blocked. Once that happens, oil, skin cells and bacteria become trapped, creating the perfect environment for inflammation and breakouts. But it’s so much more than that.
Understanding the underlying drivers is the key to achieving clear skin long term, because breakouts, congestion and inflammation are always symptoms of something deeper.
As a naturopath (and former skin therapist), I see acne as a signal from your body that something is out of balance. The skin is our largest organ and it reflects what's happening internally, so when skin becomes inflamed and breakouts appear I’m looking at your liver, gut health, stress levels, immune system involvement, hormones and nutrient depletion.
Not All Acne Is The Same
Not all acne is the same. So there is no one size fits all when it comes to treatment. Some common acne presentations I see include:
Hormonal acne: tends to show up around the jawline, chin, back and chest and is often linked to hormonal imbalances, stress, insulin resistance or changes throughout your menstrual cycle.
Post-pill acne: can occur after coming off the oral contraceptive pill. The pill often masks underlying hormonal issues, so when it's removed, those imbalances can reappear with a vengeance. It's very common to see acne flare around 3-6 months after stopping the pill. Note; if you are thinking of coming off the OCP there are many things we can do beforehand to minimise rebound acne.
Fungal acne (technically called Malassezia folliculitis) is caused by an overgrowth of yeast within the hair follicles. Our skin has a microbiome which can become imbalanced and a fungal overgrowth is one example of this. It often appears as small, itchy bumps and may be associated with factors such as gut microbiome dysbiosis, antibiotic use (oral and topical), immune dysregulation and digestive issues.
Rosacea: While not technically acne, rosacea is an inflammatory skin condition with a strong immune and vascular component. It commonly presents with facial redness, flushing, sensitivity and acne-like lesions and is particularly common during peri-menopause and beyond.
So How Do We Treat It?
Alongside individually prescribed topicals and targeted treatments at SSKIN, this is where naturopathy shines! I look at the body as a whole, and piece together what's going on for you. I’ll start with some routine blood tests and analyse them through a naturopathic lens, using optimal ranges rather than the reference ranges from the lab. By looking at patterns over time, I can gather valuable data about inflammation, nutrient status, blood sugar regulation, liver function, iron stores and hormonal health. Functional testing like a gut microbiome test or cortisol saliva test may be indicated also.
Looking Beyond The Skin
I will investigate gut health and digestion, do you have a daily bowel movement to eliminate toxins and hormones from the body? Do you have an overgrowth of pathogenic bacteria in your gut that is contributing to inflammation and hormone recycling? Is your liver efficiently processing hormones and metabolic by-products? Are you absorbing the nutrients from your food?
How is stress impacting your nervous system? Are you getting deep restorative sleep? What’s your menstrual cycle like? Do you have signs of unopposed oestrogen which could be driving up testosterone levels? Are you iron deficient?
From a skin perspective, I'm always assessing three key areas: skin barrier function and pH (what are you applying topically?), sebum production and quality, and retention keratosis (how effectively your skin sheds dead skin cells). When one or more of these become disrupted, breakouts can occur.
The Gut-Brain-Skin Connection
The gut-brain-skin connection is real, and factors like stress, sleep, digestion and food choices can have a significant impact on breakouts. Reducing inflammatory foods, providing key nutrients for skin function and healing, as well as supporting the nervous system and addressing stress, can make a big difference to long term change.
There Is No One Size Fits All Treatment
And here's the thing: there is no one-size-fits-all acne treatment. I could see ten people with acne and create ten completely different treatment plans because the underlying causes are never the same.
That's why quick fixes don’t work.
By combining your SSKIN treatments and skincare with naturopathic support, we can address both the external and internal drivers of acne, because it’s all connected.
My goal is to help you understand what's driving your acne, address the root causes and create lasting change so you can feel confident in your skin again.
Ready To Get To The Root Cause?
If you're ready to take a deeper look at your skin health, ask the girls at reception about booking a naturopathic consultation with Lisa next time you're in the clinic.