What internal factors drive acne?

Acne is driven by four key factors: excess sebum production (influenced by androgens and diet), abnormal skin cell shedding that blocks pores, colonisation by Cutibacterium acnes bacteria, and inflammation. Internal contributors including hormonal fluctuations, gut microbiome imbalance, blood sugar spikes, stress, and dairy or high-glycaemic diets can all amplify these processes.

Does diet cause acne?

Evidence suggests diet plays a meaningful role for many people, though it varies individually. High-glycaemic foods increase insulin and IGF-1 levels, which stimulate sebum production. Dairy — particularly skimmed milk — has been associated with acne in some studies. An elimination trial under nutritional guidance can help identify personal dietary triggers.

How does gut health affect skin?

The gut-skin axis describes the bidirectional relationship between gut microbiome health and skin conditions. Gut dysbiosis, intestinal permeability, and systemic inflammation can all manifest in the skin. Probiotics, prebiotics, and dietary approaches that support gut diversity have shown emerging evidence for improving acne alongside other skin conditions.

When should I see a dermatologist for acne?

Moderate to severe acne — including cystic or nodular acne, acne causing significant scarring, or acne significantly affecting mental health — warrants dermatological assessment. Holistic approaches work well for mild to moderate acne and as adjuncts to dermatological treatment, but severe presentations often require medical intervention including prescription retinoids or antibiotics.

Skinlow Risk

Acne

Find what may help →

Reviewed by Dr. Ciara Magee · Integrative Midwifery26 March 2026Research-supported

Quick answer

Acne is a skin condition involving blocked pores, excess sebum, and bacterial activity, with outcomes influenced by hormones, diet, stress, and gut health. Holistic approaches target internal contributors — including gut microbiome balance, nutritional factors, and stress regulation — alongside topical treatments.

Do any of these feel familiar?

Spots, blackheads, whiteheads, or deeper cystic lumps primarily on the face, back, chest, and shoulders
Oily skin with enlarged pores
Redness, inflammation, and tenderness around lesions
Scarring or post-inflammatory hyperpigmentation following spots
Skin that worsens around hormonal fluctuations — pre-menstrually or under stress
Sensitivity to certain foods, products, or environmental factors