Acne

Adult acne is often driven by hormonal changes, chronic stress, inflammation, blood sugar imbalances, certain medications, and lifestyle factors. Many adults are surprised to develop acne despite having clear skin as teenagers. Because adult acne is frequently linked to internal factors, treatment often requires looking beyond skincare alone.

Hormones called androgens, including testosterone, are some of the primary drivers of acne. These hormones increase oil production in the skin, making pores more likely to become clogged. Other hormones involved in blood sugar regulation, such as insulin, can also influence acne development.

The best acne products depend on the type and severity of acne. Ingredients such as benzoyl peroxide, salicylic acid, adapalene, and niacinamide are commonly used to reduce breakouts and inflammation. In general, gentle products that support the skin barrier tend to work better than harsh products that excessively dry the skin.

Yes. Stress can increase hormones such as cortisol that influence oil production, inflammation, and the skin's healing process. Research consistently shows that acne often worsens during periods of increased stress, even in people who otherwise have good skincare habits.

Acne typically causes blackheads, whiteheads, and clogged pores, while rosacea is characterized by facial redness, flushing, visible blood vessels, and sometimes acne-like bumps. Although they can look similar, they are different conditions with different underlying causes and treatment approaches.

When blood sugar rises quickly, the body releases more insulin. Higher insulin levels can increase hormone activity, oil production, and inflammation, all of which may contribute to acne. Research has shown that diets high in refined carbohydrates and sugary foods are associated with increased acne severity in some individuals.

Yes. Polycystic Ovary Syndrome (PCOS) can increase androgen levels, which stimulate oil production and contribute to acne. Acne related to PCOS often appears along the jawline, chin, and lower face and may be accompanied by irregular periods or unwanted hair growth.

Most acne treatments require patience. Because the skin renews itself slowly, noticeable improvements often take six to twelve weeks. Deeper forms of acne may take longer to fully resolve, especially if hormonal or inflammatory factors remain unaddressed.

Research suggests that probiotics may help support a healthier gut microbiome and reduce inflammation, which may indirectly benefit some people with acne. If there is an imbalance in the skin microbiome, there is often an imbalance in the underlying gut microbiome. This should be addressed before adding in probiotics. Often times, an herbal antimicrobial is best before probiotics.

Research has found an association between dairy consumption and acne in some people, particularly with skim milk. Dairy can influence hormones involved in oil production and skin inflammation. However, not everyone is sensitive to dairy, and responses vary between individuals.

In clinical practice, I have seen many people improve faster when removing dairy. I have also reversed acne in those who are still eating dairy. It’s best to know how your body tolerates, or doesn’t, dairy with your acne flares.