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Understanding the Causes and Triggers of Acne

picture of a woman holding a hat up to her face to hide her acne prone skin due to hormonal imbalance
Don’t hide your skin, clear your acne


Acne, a common skin condition affecting millions worldwide, is more than a superficial concern. As we explore its origins, we uncover a complex interplay of factors beyond mere hygiene or genetics. This comprehensive guide delves into the science behind acne, shedding light on its causes and triggers. From the perspective of both conventional dermatology and naturopathy, we aim to provide a nuanced understanding of acne and explore natural treatments, with a special focus on hormonal acne.

I. The Basic Causes of Acne

Acne vulgaris, the scientific term for common acne, is a multifactorial skin disorder that primarily affects the pilosebaceous unit—the hair follicle and its associated sebaceous or oil-producing gland. Several key elements contribute to the development of acne:

Sebum Production

The sebaceous glands produce an oily substance called sebum, which is crucial in maintaining skin hydration. However, overproduction of sebum can lead to clogged pores, a breeding ground for acne-causing bacteria.

Follicular Hyperkeratinization

Skin cells are constantly shed and replaced. In acne, these cells can stick together and block the hair follicle, contributing to the formation of comedones, or what we commonly know as whiteheads and blackheads.

Bacterial Involvement

Propionibacterium acnes (P. acnes), which normally resides on the skin, can proliferate in clogged pores. This leads to inflammation and acne lesions’ characteristic red, swollen appearance.

II. The Role of Hormones in Acne

While the basic mechanisms of acne involve sebum, hyperkeratinization, and bacteria, hormones, especially androgens, play a pivotal role. Androgens are male sex hormones present in both males and females but are typically more abundant in males. Testosterone, a type of androgen, stimulates the sebaceous glands to produce more sebum.

Hormonal Fluctuations

Hormonal changes can trigger or exacerbate acne, such as those that occur during puberty, menstruation, pregnancy, and polycystic ovary syndrome (PCOS). These changes influence sebum production and the likelihood of follicular hyperkeratinization.

Insulin-Like Growth Factor (IGF-1)

Diet plays a role in acne development, and one dietary factor linked to acne is insulin-like growth factor (IGF-1). High-glycemic foods, like refined carbohydrates, can elevate blood sugar and increase IGF-1 levels, promoting sebum production and inflammation.

III. The Naturopathic Perspective

Naturopathic doctors (NDs) approach acne holistically, considering the interconnectedness of the body systems and addressing the root causes. Key elements of naturopathic acne treatment include:

Nutritional Interventions:

Naturopaths often emphasize an anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids. They may also recommend specific nutrients, such as zinc and vitamin A, known for their skin-healing properties.

Botanical Remedies:

Herbal remedies have a long history in traditional medicine for treating skin conditions. Naturopaths may prescribe botanicals with anti-inflammatory and antimicrobial properties, like tea tree oil or berberine.

Hormonal Balance:

Naturopaths work to balance hormones naturally, often through dietary modifications and lifestyle changes. Addressing insulin resistance, for example, can be a key strategy in managing hormonal acne.


Understanding the science behind acne empowers us to make informed decisions about its treatment. While conventional dermatology addresses symptoms, naturopathic approaches seek to address the root causes. A collaborative approach that combines both strengths can provide a comprehensive strategy for managing acne, including the often complex landscape of hormonal acne. Through ongoing research and a commitment to holistic care, we inch closer to unlocking the mysteries of acne and offering effective, personalized solutions for individuals seeking clearer, healthier skin.

IV. References

  1. Zaenglein, A. L., Pathy, A. L., Schlosser, B. J., Alikhan, A., Baldwin, H. E., Berson, D. S., … & Bhushan, R. (2016). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 74(5), 945-973.
  2. Cordain, L., Lindeberg, S., Hurtado, M., Hill, K., Eaton, S. B., & Brand-Miller, J. (2002). Acne vulgaris: a disease of Western civilization. Archives of Dermatology, 138(12), 1584-1590.
  3. Kucharska, A., Szmurło, A., & Sińska, B. (2016). Significance of diet in treated and untreated acne vulgaris. Advances in Dermatology and Allergology/Postȩpy Dermatologii I Alergologii, 33(2), 81.
  4. Melnik, B. C., & Schmitz, G. (2009). Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Experimental Dermatology, 18(10), 833-841.
  5. Vaughn, A. R., Branum, A., & Sivamani, R. K. (2018). Effects of Turmeric (Curcuma longa) on Skin Health: A Systematic Review of the Clinical Evidence. Phytotherapy Research, 32(4), 597-612.

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