By Dr. Amy Rothenberg, originally published for the Institute for Natural Medicine

Acne is a challenging and difficult to handle skin problem that affects nearly 10 % of the population worldwide. Research shows the hardest hit group is teenage boys, but anyone can develop acne at any age. Acne can have an impact physically and emotionally and on one’s quality of life. People with acne have described issues with self-image, self-esteem, ability to make friends, finding jobs as well as anxiety and depression. Naturopathic therapies for acne can be beneficial not only for your skin, but also for your overall health.

How does acne form?
Our skin has tiny sebaceous glands that naturally secrete sebum (an oily substance) into the hair follicles. Sebum normally flows up the hair shaft and onto the skin, where it lubricates the skin and hair. However, when hair follicles become blocked with sebum and dead skin cells, acne may start forming. Inflammation in the area then occurs alongside excessive keratin and normal skin bacteria that gets trapped, which can further plug the hair follicle. When this inflammatory process is up and running, it can be difficult to stop.

Acne can have many contributing factors. It runs in families, so heredity is one difficult-to-control aspect. Other causes include shifts in hormones, such as reaching adolescence (when androgen hormones kick in and trigger the growth of sebaceous glands). However, adults can also have persistent acne. Starting or stopping oral contraceptives to taking certain medications can also cause acne. Other contributing factors include exposing the skin to heavy oils, pore-clogging cosmetics, and even for some, unfavorable or a change in climate.

A naturopathic physician will look for the root cause of acne. Their examination will help to learn when it started, what makes it better or worse and what kinds of treatments, both conventional and natural, you have tried.

Your ND will also work to understand your acne in the context of the rest of your health. This may include a review of digestion, urination and respiration systems. Oftentimes your ND will want to run lab work to help determine how each system is working. They may run specialty lab work, too, in order to assess your digestion and nutritional status, as those may contribute to acne.

You can expect questions about your overall lifestyle related to work and home, the main stressors in your life, and how you handle that stress. Do you exercise and what do you do to relax? Naturopathic doctors look at you as a whole person and by so doing, they gain a clearer understanding of the factors that led to your acne, which in turn leads to a personalized treatment plan.

Diet is often a first step to assessing and treating acne. In several studies of populations around the world, there is simply no acne. In these populations, there is limited influence of a Western diet, meaning no refined foods, very low sugar content, no processed foods, no fast foods, limited dairy and lots of local fresh fruit, vegetables and fish. Your naturopathic doctor has extensive training in therapeutic nutrition, and will work with you to educate and inspire you toward the diet that is right for you to help address current breakouts and to prevent further blemishes.

For most patients this includes at very least, a whole-foods diet, with lots of vegetables, fruit, healthy fats, nuts and seeds, fish and other lean protein. They will likely suggest limitations on processed foods, refined sugars, trans fats, fried food, hydrogenated vegetable oil, and for many people, dairy, as it can cause flare ups.

Recommendations beyond that are specifically based upon your biochemical individuality and overall health. This may also include a discussion on how to enhance the diversity and robustness of your microbiome, which is known to be an important component in the treatment of acne. When working properly, our brain-gut-skin axis optimizes the part of your physiology that support skin health.

Supplements are another consideration. There are many botanical medicines that may have a positive impact on the treatment of acne. Your naturopathic doctor will help you decide which are best for anti-inflammation, anti-infection and anti-androgenic for hormone balance. There are also nutritional supplements, again based underlying cause, which may be indicated like zinc, Vitamin C and probiotics.

Addressing stress is also a key part of the treatment for acne, which is why exercise, mindfulness meditation, talk therapy, creative expression, and/or community involvement can help. Essential oils may also be beneficial. For instance, lavender essential oil has evidence showing it may soothe anxiety, which might help minimize acne as part of a bigger treatment plan.

Above all, you can expect a naturopathic doctor to create a plan of action, along with your input and direction. Many patients have found clearer skin and a general improvement in overall health with naturopathic approaches to acne.