How to Heal Acne Holistically & Improve your Complexion

Acne is something most people experience at some point in their lives. It can lead to frustration, often impacts self-esteem, and can physically cause discomfort especially with cystic acne.

Acne can be a multifactorial issue making it sometimes difficult to manage.
The conventional care system tends to focus on long term antibiotic usage, accutane or isotretinoin, and topicals; for some people this is effective at managing the acne. However, many are left with skin frustrations despite western medicine only approaches.

I am all for proper topical care and using effective skincare, but if this alone isn’t enough consider overturning other wellness related stones.

In this blog, we will discuss root cause approaches to acne, functional testing options for more data, environmental issues related to acne and overview of alternative options for managing acne.

Let’s break this down into common “root cause” underlying problems going on and how to handle them:

1. Gastrointestinal tract issues that can cascade to extraintestinal manifestations like acne:

  • Elevated staph or strep (and gut dysbiosis in general and full on SIBO) can cascade to acne on the skin; next we have to figure out why overgrowths ocurred because that doesn’t just happen
  • Low stomach acid (and then why is the stomach acid low?)
  • Intestinal permeability (so many things can “chip away” at the lining and lead to the slang term of “leaky gut”)
  • H. pylori presence (not just overt/diagnostic infection levels but subclinical can also be problematic)
  • Candida overgrowth


What to do: 

  • Get a GIMAP test and do interventions specific to what is abnormal; often times gastrointestinal dysbiosis specifically elevated staph or strep is present. A randomized placebo-controlled clinical trial of teens with acne were given oral berberine supplementation. After four weeks, the participants showed a significant reduction in both the number of acne lesions and the number of inflamed lesions. Berberine has antimicrobial properties.
  • Do the baking soda challenge per the Cleveland Clinic; if low stomach acid suspected, supplement with apple cider vinegar before meals. I would recommend working with a healthcare practitioner on this and view this as an at home screening tool. In the same breath, ACV is low risk high reward possibly, but you need to figure out why your stomach acid is low and screen for nutrient deficiencies. You also may need something strong like betaine HCL. You may also have mineral deficiencies leading to the lower stomach acid and then absorption of nutrients
  • Use studied probiotics: clinical trials have gathered the effect of probiotics on acne, noting positive clinical outcomes. Treatment using various combinations of oral and topical probiotics, including Enterococcus faecalis, Lactobacillus plantarum, Bifidobacterium bifidum, and L. acidophilus, have shown potential in reducing acne lesion counts and severity.

 
2. Find & properly address nutrient deficiencies typically from either not eating consistently enough and/or not absorbing well (underlying gut dysbiosis, heavy metal bioaccumulation inhibiting absorption, low stomach acid leading to poor absorption, undiagnosed or poorly managed celiac disease, intestinal parasites, etc.) 

  • Fix the intake patterns of omega 3 to omega 6; many need more omega 3s as the totality of omega 6s people eat is too much and imbalanced; Minimize or avoid seed oils
  • Adequate Selenium intake
  • Not too much Vitamin A and also not too little intake – double check supplement isn’t more than 5000IU daily in supplement form. Retinol form preferred for absorption for animal sources. Check your vitamin A status as adequate levels are needed to prevent iron from becoming inflammatory and stored in excess in bodily tissues.
  • Adequate Vitamin C intake (not from ascorbic acid in supplements ideally as this can induce a copper deficiency) but from real whole foods
  • Optimal Vitamin D levels as seen in bloodwork;  Clinical trials show that supplementing vitamin D improves acne. Also ask why did vitamin D go low? Too little magnesium? Gluthathione depletion?
  • Adequate Vitamin E intake
  • Correcting zinc deficiencies could decrease the number of inflammatory acne lesions, but make sure to not mega dose on zinc as this can induce copper deficiencies which can lead to iron overload and actually worsen acne
  • Be careful with iron supplements and acne; figure out root causes of low serum iron, low hemoglobin, etc. Is un


What to do:

  • General dietary advice: mediterranean diet recommended and avoid added sugars. 
  • Order bloodwork to screen for deficiencies. It is important to test and not guess. If you don’t have access to a Physician for whatever reason or can’t get in soon, you can self order bloodwork here and have drawn at any Quest labs.
  • Double check you are avoiding megadoses of micronutrients like vitamin A, iodine, certain B vitamins (particularly B6 and B12) that in high amounts for too long could contribute to acne.


3. Hormonal imbalances are a common factor in acne.

  • For example, excess androgen hormones, such as testosterone, can trigger acne.
  • Another example is being estrogen dominant which can cause acne. Estrogen dominance occurs when there is too much estrogen relative to progesterone in the body especially during the second phase (luteal phase) of the menstrual cycle
  • Is insulin resistance occuring – which means your insulin isn’t working well and “stacking up” in the blood and eventually the blood glucose can get too high overtime and lead to diabetes and prediabetes. Many women with PCOS has insulin resistance, and consequently have acne too.
  • Then the next question is why are the hormones imbalanced? It’s rarely “just genetics.” Is or has the person used endocrine disrupting products?


What to do:

  • Test and don’t guess various hormone levels and do interventions specific to the root problems that contributed to the hormonal imbalances. Hormones typically go haywire in response to something. This will likely require evaluation with your healthcare team. If you don’t have access to a provider or cannot get it soon, you can self order labwork here and get drawn at any Quest labs.
  • If testosterone is elevated, green tea daily showed to help lower excess testosterone. Make sure you rule out or rule in medical conditions that lead to elevated testosterone.
  • Stop using products with endocrine disruptors (haircare, skin, cleaning products, tampons, scented laundry detergent, etc.). Use of products that are objectively not good for you adds up. Make simple swaps over time; here is the list of changes to make ASAP!


4. Address heavy metal toxin bioaccumulation in your body

  • Heavy metal bioaccumulation is so common! When they have accumulated in the body, they can wreak havoc in so many ways. Heavy metals can down regulate stomach acid, encourage gut dysbiosis, have antagonistic relationships to certain nutrients and inhibit their normal abosprtion. We are exposed to heavy metals from so many things – poor air quality, heavy metals in the soil, heavy metals in tap water, etc.
  • Non life threatening levels of arsenic, cadium and lead are most commonly associated with acne, as exposure to these metals can contribute to inflammation and oxidative stress on the skin, potentially exacerbating acne breakouts. 


What to do:

  • Stop drinking unfiltered tap water contains which typically contains (depends on zip code – check here) contaminants like chlorine, heavy metals, and hard water minerals that can irritate skin, clog pores, and cause inflammation. Your standard fridge filter and Brita filter don’t count. You need something much stronger like An Aquatru or a Berkey water filter system which are both affordable compared to whole home reverse osmosis – which many cannot afford but would be ideal.
  • Stop showering in unfiltered water. Your skin is your largest organ and dermal exposure to contaminants can also worsen acne. Get a QUALITY shower head filter.
  • Consider using a binder supplement that can pull heavy metals out and take them to the toliet. As always talk with your Doctor before starting a supplement. You need to take proactive measure like preventing further exposure but may need to take reactive measure and use binders to facilitate the metals better leaving the body. I have a whole online course in supporting your body in metabolic detoxification.
  • Rinse your fruits and veggies well with filtered water (as soil often has heavy metals).


5. Test your home and your body to see if you have had a toxic indoor mold exposure

  • Test, and dont guess to rule out or rule in toxic indoor mold exposure; acne can be a downstream sign of this. Read all about testing here and consider self ordering an ERMI dust test (get Kit 1)  if not sure where to start.
  • Toxic indoor mold can potentially contribute to acne due to Candida overgrowth from the weakened immune system through exposure to mycotoxins, which allows Candida, a type of yeast, to flourish and potentially manifest on the skin as breakouts. Ask your Doctor for a candida antibody panel or self order here if you don’t have access to a Physician. It doesn’t replace medical evaluation.
  • Exposure to toxic indoor mold can cause inflammation in the body which is another route to acne. This inflammation, when it comes to skin, can lead to acne breakouts. You may need a post mold exposure protocol which you can read about here.
  • You can do a skin test called an ACTINO TEST (Kit 21) to swab the skin and see if it has colonized on the skin and led to the appearance of acne. Actinos can also be tested for in the dust (Kit 13) of the home and are another microbe that grows from water damage (similar to how mold grows from water/humidity/moisture damage).


What to do:


Bottom line: there is so much more you can do beyond or in additional to medication. Linked here is a general protocol if you need a game plan.

Make sure you have your environment and nutrition in order if your goal is to stop playing downsteam symptom whack a mole. Self schedule a consult package here if you need one-on-one help.

Studies & References:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6678709/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3038963/
https://www.mdpi.com/2076-2607/10/7/1303
https://pubmed.ncbi.nlm.nih.gov/39276224/
https://www.nesaz.com/how-does-h-pylori-affect-acne/
https://www.dldjournalonline.com/article/S1590-8658(03)00645-5/abstract
https://pubmed.ncbi.nlm.nih.gov/27600928/
https://pubmed.ncbi.nlm.nih.gov/34521361/
https://pmc.ncbi.nlm.nih.gov/articles/PMC5446966/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9171177/
https://pubmed.ncbi.nlm.nih.gov/34617215/
https://pubmed.ncbi.nlm.nih.gov/33042936/

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January 22, 2025

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