The Changes You Should Make If You Have Acne — And Why Testing Matters

The Changes You Should Make If You Have Acne — And Why Testing Matters

The Changes You Should Make If You Have Acne — And Why Testing Matters

Acne is not just a “skin problem.” It’s a whole-body signal that something deeper is out of balance—whether that’s hormones, gut health, inflammation, liver detoxification or nutrient status. When we zoom out and look at acne through a functional lens, we uncover several modifiable drivers that can transform long-term outcomes.

Below are the key changes to make if you’re experiencing acne, and the tests worth considering to look more deeply at a root cause.

1. Balance Blood Sugar to Reduce Androgen Drive

Why it matters:
Blood sugar instability increases insulin and IGF-1, which in turn stimulate androgen production (especially ovarian testosterone). Higher androgens increase sebum and clog pores which are two core pathways behind acne.

Changes to make:

  • Add protein + fat to all meals and snacks.

  • Avoid skipping meals if it leads to energy crashes.

  • Reduce high-glycaemic foods (white breads, pastries, sugary snacks).

  • Swap to whole grains, legumes, root veg and quality fats.

  • Reduce dairy as this also stimulates IGF-1 and increases sebum production


2. Support Hormone Detoxification Pathways

Why it matters:
If your body can’t effectively clear used hormones (particularly estrogen and androgens), these hormones recirculate and worsen hormonal acne (particularly along the jawline and chin)

Changes to make:

  • Eat 6–8 cups of colourful vegetables daily for fibre + antioxidants.

  • Increase cruciferous vegetables (unless sulphur sensitive), this group is wonderful for oestrogen detoxification 

  • Ensure daily bowel movements, constipation increases hormone reabsorption.

  • Reduce alcohol, which slows liver detoxification

 

3. Heal & Rebalance the Gut Microbiome

Why it matters:

The skin–gut axis is deeply interconnected. Dysbiosis (imbalanced gut bacteria), SIBO, leaky gut, and high levels of lipopolysaccharides (LPS) can all drive systemic inflammation, oil production, and flare-ups.

Changes to make:

  • Increase prebiotic fibres (chia, flax, oats, green bananas).

  • Add probiotic-rich foods (sauerkraut, kefir, kimchi) if tolerated – but be cautious of high histamine

  • Minimise inflammatory food triggers: ultra-processed foods, excess dairy, high-sugar foods.

  • Increase polyphenols to nourish beneficial microbes (berries, olive oil, herbs and spices).

 

4. Consider the Vaginal–Skin Connection 

Why it matters:

Emerging research suggests the vaginal microbiome influences systemic inflammation and hormone metabolism. Recurrent BV, yeast, or low Lactobacillus dominance can worsen skin flares indirectly through immune activation.

Changes to make:

  • Prioritise vaginal microbiome balance (no harsh washes or perfumes).

  • Address chronic BV or yeast properly rather than suppressing symptoms.

  • Avoid synthetic underwear

 

5. Lower Internal Inflammation

Why it matters:

Inflammation increases sebum oxidation, slows skin healing, and amplifies pustules and cysts.

Changes to make:

  • Increase omega-3s (salmon, sardines, walnuts, chia).

  • Reduce seed-oil-heavy processed foods.

  • Prioritise sleep, especially before midnight, to regulate cortisol.

  • Reduce stress with breathwork, walking, and nervous-system practices.

 

6. Improve Skin Barrier Health

Why it matters:

When your barrier is compromised, you produce more oil to compensate, and breakouts worsen.

Changes to make:

  • Simplify your skincare routine (over-exfoliation is extremely common).

  • Use a gentle non-foaming cleanser.

  • Moisturise with barrier-supportive ingredients (ceramides, squalane, glycerin).

  • Avoid stripping toners and harsh acne benzoyl peroxide if it worsens dryness and inflammation.

 

Functional Testing to Consider for Acne (and Why)

Testing is powerful because acne rarely comes from a single cause. These tests help identify your root drivers so treatment becomes targeted and not guesswork.

 

1. Comprehensive Hormone Profile (Blood or DUTCH Test)

What it checks:

  • Androgens (testosterone, DHEAS)

  • Estrogen & progesterone balance

  • Cortisol patterns

  • Hormone metabolism pathways

Why it matters:

Identifies whether acne is driven by:

  • high testosterone or DHEAS

  • low progesterone

  • estrogen dominance

  • poor hormone detoxification

  • stress-driven cortisol imbalances

Useful for cyclic breakouts, jawline acne, or when symptoms worsen before your period.


2. Complete Microbiome Map / Comprehensive Stool Analysis

What it checks:

  • Beneficial vs overgrowth bacteria

  • Gut inflammation

  • Leaky gut markers (zonulin)

  • Yeast, parasites, opportunistic pathogens

  • Short-chain fatty acids

  • LPS-producers

  • Beta-glucuronidase (linked with hormone recirculation)

Why it matters:

The gut is often the primary driver behind chronic acne. Dysbiosis impairs skin healing, increases inflammation, and affects hormonal clearance. This test reveals what you need to treat or rebalance.


3. SIBO or Hydrogen/Methane Breath Test

Why it matters:

SIBO can drive systemic inflammation, nutrient deficiencies (like zinc), bloating, and worsening breakouts. Many acne patients with chronic gut symptoms have underlying SIBO.


4. Blood Work for Foundational Imbalances

Key markers to check:

  • Zinc

  • Vitamin D

  • B12 & folate

  • CRP (inflammation)

  • Fasting glucose & insulin

  • Thyroid (TSH, T4, T3, antibodies)

Why it matters:

These markers reveal deficiencies that directly affect skin immunity, oil production, and healing, especially zinc and vitamin D.


5. Vaginal Microbiome Swab (if you have recurrent infections and persistent acne)

Why it matters:

Identifies Lactobacillus deficiency, anaerobic overgrowth, BV patterns, or inflammation that may be influencing hormone metabolism and immune responses.


6. Food Sensitivity or IgG Testing (optional)

Not essential, but may be considered for people who strongly suspect certain foods trigger their acne or have seen no improvement with foundational gut work.


Final Thoughts

Acne is complex, but deeply treatable when you identify what's driving it. A combination of personalised diet shifts, gut and hormone support, and strategic testing can dramatically improve skin clarity and confidence—while supporting your overall health.

 

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