Acne can be a source of frustration and embarrassment for roughly 40% of adults, with women experiencing it more frequently than men.
The conventional solutions offered, such as antibiotics, Acutane, and Spironolactone, frequently come with unwanted side effects and do not address the root cause. If you’ve tried “standard” options like long-term antibiotics, Accutane® (isotretinoin), or spironolactone, you’ve probably noticed the trade-offs: side effects, short-term relief, and very little conversation about why your skin is breaking out in the first place.
A quick word on Accutane
Conventional therapies can be effective, but they don’t address root causes. Accutane, for example, is associated with a wide range of adverse effects, including joint pain, tendonitis, high cholesterol, photosensitivity, hair loss, mood changes, and liver enzyme elevations, among others. Because of this, baseline and ongoing laboratory tests are required (cholesterol, triglycerides, HDL, liver function tests, and a complete blood count), typically every 4–6 weeks. Of particular concern, isotretinoin is teratogenic and linked to spontaneous abortion and congenital malformations, so strict pregnancy precautions are essential.
If you’re here, you’re probably looking for a different approach. What’s driving your acne, and how do we correct it?
Identifying the root cause of your acne
Multiple factors contribute to the development of acne. When trying to determine the cause of your own acne, it is helpful to have a deeper understanding of the causes so that you can rule them out one by one.
Root Cause #1: Hormonal Acne
One of the most common causes of acne in adult women is androgen-driven acne—think jawline, chin, and neck breakouts, often flaring the week before your period. A key enzyme, 5α-reductase, converts testosterone to its more potent form (DHT). When it’s upregulated, women can notice acne, hair thinning, hirsutism, and sometimes PCOS features.
What upregulates 5α-reductase? Insulin resistance, high triglycerides, and systemic inflammation.
What helps while we address the root cause:
- Targeted botanicals that can downshift 5α-reductase activity (e.g., reishi mushroom, nettle root, green tea extract, saw palmetto, and a balanced intake of polyunsaturated fatty acids).
- Testing: A DUTCH urine test can illuminate your androgen pathways and whether you favor the 5α-reductase route.
Root-cause corrections to work on in parallel:
- Improve insulin sensitivity (nutrition, movement, fiber, sleep).
- Resolve inflammation (gut, diet, environmental triggers).
- Correct nutrient deficiencies (more below).
Root Cause #2: Nutrient Deficiencies
The skin is metabolically hungry. Deficiencies in zinc, vitamins A, D, and E are linked to higher inflammation and impaired barrier repair.
- To check, consider micronutrient testing, such as Metabolomix or SpectraCell Micronutrient panels, which can help identify deficiencies.
- Heads up on B12: High-dose B12 (injections or >5–10 mg/week orally) can trigger acne in some individuals by altering bacterial gene expression. If your skin flared after starting B12, consider discontinuing injections or supplementation and seek out food sources of B12 instead.
Root Cause #3: The Gut Microbiome and Dysbiosis
The gut microbiome has a significant influence on the skin microbiome. An increasing number of studies suggest that the health of the skin is closely linked to the health of the gut microbiome and the gastrointestinal tract. The standard American diet, Antibiotics, food additives, and pesticides disrupt the balance between beneficial and pathogenic microorganisms, contributing to inflammation and acne.
Beneficial bacteria like Lactobacillus and Bifidobacterium produce short-chain fatty acids (acetate, propionate, butyrate) that support skin immunity and barrier function—propionate, in particular, helps keep opportunists in check.
- How to check: Whole-genome sequencing stool testing provides an in-depth understanding of what’s overgrown and needs to be reduced, what’s missing and needs to be restored, and which microbial functions (such as SCFA production) require support.
Probiotics: What They Can (and Can’t) Do
While we’re on the subject of the gut microbiome, we might as well talk about probiotics. Probiotics can help calm acne by producing antibacterial proteins that reduce the activity of Cutibacterium acnes (formerly known as P. acnes), a bacterium known to cause acne.
Probiotics don’t colonize the gut permanently. They pass through your gastrointestinal system and are excreted in about three days. To maintain the benefits of that probiotic, you need to take it consistently. They are a band-aid, not a solution.
Strains to consider for acne
- Bifidobacterium lactis HN019 (Florassist by Life Extension)
- Lactobacillus acidophilus NCFM (Probiotic Pearls by Integrative Therapeutics)
The Bottom Line
Adult acne is a signal from your body that there is deeper work to do. When we address insulin resistance, inflammation, nutrient deficiencies, the gut microbiome, and hormone metabolism, your skin naturally heals as a side effect of a healthier system.
If you would like help customizing this process by selecting appropriate lab testing, targeted supplementation, developing a nutrition strategy, and creating a step-by-step plan, you can book an Initial Consultation here.
We’ll test, not guess, and work through the drivers of acne one by one so your results are real and lasting.