3 Hidden Causes of Acne Most People Overlook

Have you been trying to clear your acne with skin care products alone, only to end up frustrated with persistent breakouts? You’re not alone. Acne isn’t just a surface-level issue. It’s an internal sign. Let's look at the root causes of acne and how to clear your skin from the inside out.

As a naturopathic doctor, I believe the most common root causes of acne flares are: 

1. High testosterone and hormone imbalances

2. Poor gut health and digestion

3. Blood sugar imbalances and insulin resistance

This blog will break down why these three factors play a significant role in skin health, and what you can start doing today to support clear, healthy skin from the inside out. 

3 common causes of acne

1. Hormonal acne: when testosterone is too high

Hormonal acne is one of the most common skin concerns that I treat. If you’re dealing with cystic acne on the jawline, chin, back or chest, there’s a good chance that androgens (like testosterone, DHT, and DHEA) are at play. 

You don’t need a PCOS diagnosis to have hormonal acne. In fact, even “normal” lab results can still reflect imbalances if we don’t look deeper. 

Signs of androgen-driven acne include: 

• Oily skin or scalp

• Deep, painful pimples or cysts

• Irregular or long menstrual cycles

• Hair thinning or unwanted facial/ body hair

Testosterone increases sebum (oil) production, which clogs pores and feeds acne-causing bacteria. In my practice as a hormone-focused naturopath, I utilize comprehensive hormone testing to identify imbalances and provide natural, individualized support to help regulate hormones.

2. Gut health and acne: the gut-skin connection

If your digestion isn’t optimal, your skin will show it. Research and clinical experience both confirm that acne and gut health are deeply connected. 

Your gut affects acne through: 

• Inflammation: Leaky gut and dysbiosis can trigger systemic inflammation that shows up on your skin. 

• Nutrient absorption: Poor digestion can lead to deficiencies in zinc, vitamin A, and omega-3 fatty acids, which are critical nutrients for clear skin. 

• Hormone clearance: The gut helps detox excess estrogen and other hormones. Constipation or sluggish digestion? Acne might flare. 

Signs your gut may be contributing to acne:

• Bloating, gas, heartburn or reflux

• Constipation or diarrhea

• Food sensitivities

• IBS or vague digestive diagnoses

Improving gut health can significantly reduce breakouts. I will often run stool testing to evaluate the microbiome and tailor gut-healing protocols to improve skin clarity. 

3. Blood sugar and acne: the insulin connection 

One of the most overlooked causes of acne is blood sugar imbalance. When your blood sugar spikes and crashes, it triggers the release of insulin, a hormone that increases testosterone and oil production. 

Signs your blood sugar may be affecting your skin: 

• Energy crashes or fatigue between meals

• Cravings for sugar or caffeine

• Feeling shaky, irritable, or anxious if meals are delayed 

• Acne that worsens with stress or sugary foods

Balancing blood sugar is key for managing acne, especially if it's driven by hormone fluctuations. 

Tips to stabilize blood sugar for clear skin: 

• Eat protein, fat and fiber with every meal

• Avoid skipping meals 

• Cut back on refined sugar and processed snacks

• Stay active and manage stress

This step alone can significantly improve hormonal acne and skin inflammation. 

How to clear acne naturally: where to start

If you feel like you’ve tried everything, from expensive facials to cutting out dairy, but you’re still breaking out, it's time to shift focus from the surface to the root cause. 

In my naturopathic practice in Kelowna, BC, I use a functional medicine approach to acne. We explore your hormones, gut health and metabolic balance to create a personalized plan that supports your body and your skin, without harsh medications or guesswork. 

You're not broken, and your acne isn't hopeless

Acne is common, but it’s not something you have to live with. Whether you’re dealing with hormonal acne, adult acne, or post-pill breakouts, your body is asking for support. 

If you’re ready to stop chasing symptoms and start healing from the inside out, I invite you to book a complimentary discovery call. Let’s uncover what your acne is trying to tell you and create a plan that works with your body, not against it.