A ROOT-CAUSE APPROACH TO ACNE

Learn how this Toronto Naturopathic Doctor worked to solve her own Acne

Why Acne Needs More Than a Topical Solution

Acne is one of the most common skin concerns, affecting up to 80% of people at some point in their lives. For many, it begins in adolescence and continues into adulthood, disrupting confidence, mood, and overall quality of life. If you’ve tried countless creams, cleansers, or even prescription medications only to see temporary improvement or worsening flare-ups, you’re not alone.

The reality is that acne isn’t just a surface-level issue. While conventional dermatology often focuses on topical or pharmaceutical symptom relief, acne is almost always a reflection of what’s happening internally. Hormones, digestion, inflammation, stress, and even environmental factors can all influence the health of your skin.

That’s why my Naturopathic Approach to managing acne starts from within - focusing on a root-cause approach to clear skin. By using advanced testing such as the DUTCH test for hormones and the GI-MAP stool test for gut health, we uncover the deeper drivers of breakouts. From there, we design personalized treatment plans that restore balance, support long-term clear skin, and improve overall health.

If you’re looking for a natural, evidence-based treatment for acne that goes beyond the surface, read on to learn how naturopathic medicine can help.

Why Conventional Acne Treatments Often Fall Short

Dermatology has long relied on antibiotics, topical creams, oral contraceptives, or isotretinoin (Accutane) as the first line of defence against acne. While these approaches may help temporarily reduce breakouts, they often fail to deliver lasting results—and in many cases, create new issues.

• Topical creams (benzoyl peroxide, retinoids) may reduce bacteria or oil production but can also irritate, dry, or damage the skin barrier.

• Antibiotics may reduce acne-causing bacteria, but prolonged use disrupts the gut microbiome and can lead to digestive issues or antibiotic resistance.

• Oral contraceptives may suppress acne by altering hormone levels, but they mask the imbalance rather than correcting it, and discontinuation often triggers rebound breakouts.

• Accutane (isotretinoin) may provide dramatic results but carries risks of dryness, joint pain, elevated liver enzymes, and mood changes.

These treatments rarely ask the most important question: Why is your skin breaking out in the first place?

The truth is that acne is not a random occurrence—it’s a symptom of underlying imbalances in your body. Unless those imbalances are addressed, breakouts often return once medications are stopped. This is where naturopathic medicine shines, by digging deeper into root causes and offering holistic, sustainable solutions.

The Root Causes of Acne: What Your Skin Is Telling You

Skin health reflects internal health. When acne persists despite conventional treatments, it usually points to imbalances elsewhere in the body. The most common root causes include:

1. Hormonal Imbalances

Hormones play a major role in acne, especially in women. Androgens (like testosterone and DHEA) increase oil production, which can clog pores and trigger breakouts. Many women notice flare-ups before their period, during times of stress, or when coming off hormonal birth control.

Key hormonal contributors include:

• Excess androgens (testosterone, DHEA) lead to oily skin and cystic acne

• Estrogen-progesterone imbalance, often seen in PMS or PCOS

• Insulin resistance, which increases androgen activity and worsens acne

• Cortisol dysregulation, where chronic stress drives inflammation and hormonal imbalance

2. Gut Health and the Microbiome

The gut-skin axis is a powerful link. Imbalances in the microbiome, leaky gut, or digestive dysfunction often show up as skin issues, including acne, eczema, or rosacea. Research has shown that people with acne frequently have higher rates of gut dysbiosis and intestinal permeability.

Common gut-related contributors include:

• Overgrowth of harmful bacteria or yeast (Candida, small intestinal bacterial overgrowth)

• Low levels of beneficial bacteria that regulate inflammation

• Leaky gut, allowing toxins and food proteins to enter circulation and trigger immune reactions

• Digestive enzyme deficiencies leading to poor nutrient absorption (zinc, vitamin A, omega-3s—all critical for skin health)

3. Chronic Inflammation

Acne is fundamentally an inflammatory condition. Whether triggered by food intolerances, gut imbalances, or environmental toxins, systemic inflammation increases sebum production, clogs pores, and worsens scarring.

4. Stress and Cortisol

Stress directly impacts acne through the HPA axis (hypothalamic-pituitary-adrenal). Elevated cortisol increases sebum production and inflammation, while disrupting sleep and blood sugar balance. Stress also weakens the skin barrier, slowing healing and worsening scarring.

5. Diet and Lifestyle

Diet plays a powerful role in acne development. Foods high in sugar, dairy proteins, and refined oils have been strongly associated with acne flare-ups. Conversely, anti-inflammatory diets rich in vegetables, omega-3 fatty acids, and antioxidants help calm inflammation and support skin healing.

Functional Testing for Acne: Finding the Root Cause

Rather than guessing what’s behind your acne, naturopathic care in Toronto uses functional lab testing to pinpoint imbalances.

The DUTCH Test (Comprehensive Hormone Testing)

The DUTCH test is a dried urine test that measures sex hormones, adrenal hormones, and their metabolites. It goes beyond standard bloodwork by showing not only hormone levels, but also how your body metabolizes them.

For acne patients, the DUTCH test helps identify:

• Elevated androgens (testosterone, DHT, DHEA) are driving oil production

• Poor estrogen clearance, leading to hormonal congestion

• Cortisol patterns indicating stress-related breakouts

• Progesterone deficiency contributing to cycle-related acne

With this information, targeted therapies can rebalance hormones naturally instead of masking them.

GI-MAP & GI 360 Test (Comprehensive Stool Analysis)

The GI-MAP/GI360 stool tests provide a detailed analysis of the gut microbiome, including bacteria, yeast, parasites, and markers of inflammation.

For acne patients, it helps identify:

• Dysbiosis (imbalance of good and bad bacteria)

• Yeast or fungal overgrowth

• Intestinal permeability (leaky gut)

• Inflammation markers that drive systemic skin issues

By restoring gut balance, systemic inflammation decreases, nutrient absorption improves, and skin health follows.

Food Sensitivity and Nutrient Testing

Some patients benefit from food sensitivity testing, which highlights hidden triggers like dairy, gluten, or soy. Nutrient testing can also reveal deficiencies in zinc, vitamin D, omega-3s, and antioxidants—all critical for skin healing.

Together, these tests provide a roadmap for treatment that goes beyond trial and error.

Natural Treatment Options for Acne

Once testing identifies root causes, a personalized treatment plan can address acne from multiple angles.

1. Hormone Balancing

Naturopathic therapies for hormone-related acne include:

• Herbal support: Chaste tree (Vitex) for progesterone support, spearmint for androgen reduction, DIM or sulforaphane for estrogen metabolism.

• Liver detox support: Cruciferous vegetables, milk thistle, and B vitamins to improve hormone clearance.

• Stress management: Adaptogens like ashwagandha or rhodiola to regulate cortisol.

• Blood sugar balance: Diet strategies and nutrients like inositol, magnesium, and chromium.

2. Gut Healing

For patients with GI-MAP findings of dysbiosis or leaky gut, therapies may include:

• Antimicrobial herbs (oregano, berberine, garlic) to reduce harmful bacteria or yeast.

• Probiotics and prebiotics to restore microbial diversity.

• L-glutamine and zinc carnosine to repair the intestinal lining.

• Digestive enzymes or bitters to improve nutrient absorption.

3. Nutrition & Diet for Clear Skin

Dietary strategies focus on reducing inflammation and supporting skin repair:

• Removing acne triggers: dairy, sugar, refined carbs, and processed foods.

• Prioritizing anti-inflammatory foods: leafy greens, berries, turmeric, fatty fish, and flax or chia seeds.

• Including healthy fats: avocado, olive oil, walnuts, and omega-3s.

• Hydrating with filtered water and green tea for antioxidants.

4. Detoxification Support

The skin is one of the body’s detox organs. Supporting the liver and lymphatic system reduces the burden on the skin. Strategies include:

• Herbal support (dandelion, burdock, milk thistle).

• Infrared sauna or sweating therapies.

• Dry brushing and lymphatic drainage.

• Whole foods like beets, leafy greens, and cruciferous vegetables.

5. Natural Skincare

While internal therapies do the heavy lifting, topical care still matters. Naturopathic skin care emphasizes barrier-friendly products, such as:

• Oils like jojoba, rosehip, or argan.

• Gentle exfoliants like clay or oatmeal masks.

• Zinc oxide sunscreens.

• Avoiding parabens, synthetic fragrances, and harsh surfactants.

This minimizes irritation and prevents further disruption of the skin’s microbiome.

Stress, Sleep, and Lifestyle: The Hidden Factors in Acne

Stress management is often overlooked in acne treatment, but it plays a critical role. Cortisol directly influences oil production and immune function. Chronic stress worsens hormonal imbalances and inflammation, making breakouts harder to control.

Naturopathic strategies include:

• Adaptogenic herbs (ashwagandha, holy basil, rhodiola) to regulate cortisol.

• Nutrient support: magnesium, B-complex vitamins, and omega-3 fatty acids.

• Lifestyle tools: meditation, yoga, breathwork, and time in nature.

• Sleep optimization: consistent routines, blue-light reduction, and calming nighttime practices.

  
  

Better stress management not only calms acne but also improves overall energy, mood, and resilience.

Case Example: Healing Acne with Root-Cause Medicine

A 32-year-old woman presented with persistent cyclical acne along her forehead, cheeks and jawline. She had tried birth control, an IUD, topical creams, and even cosmetic treatments, but breakouts continued to occur month after month.

Testing revealed:

• Elevated testosterone and poor estrogen clearance on the DUTCH test + a dysregulated cortisol pattern.

• Gut dysbiosis and mild leaky gut on the GI-MAP.

• Zinc and vitamin D deficiency on nutrient testing.

Treatment focused on balancing hormones with herbal therapies, modified exercise routines to better fit her cortisol patterns, supporting estrogen clearance through diet + supplements, repairing gut lining, replenishing zinc, and removing dairy from her diet. Within four months, her cystic acne had reduced by over 70%. Within a year, her skin had cleared completely and she was confident without makeup for the first time in years.

This case highlights how addressing root causes can provide long-lasting results where conventional therapies fall short.

Spoiler alert, this case was me.

Conclusion: Clear Skin Starts from Within

Acne is not just a cosmetic issue—it’s a signal from your body that something deeper is out of balance. While conventional treatments may suppress symptoms, naturopathic medicine seeks to uncover and treat the underlying drivers, whether hormonal, digestive, inflammatory, or stress-related.

Using advanced testing like the DUTCH test and GI-MAP to provide answers, not just prescriptions. By addressing the root cause and supporting whole-body health, we help patients achieve clear, healthy, and glowing skin—naturally.

Ready to Heal Your Skin Naturally?

If you’re tired of cycling through creams and prescriptions without lasting results, it may be time for a deeper approach.

📍 Book a consultation with Dr. Courtney Holmberg, ND, in downtown Toronto. Together, we’ll uncover the root cause of your acne and create a natural, personalized plan to support clear skin from the inside out. Give the Toronto Naturopathic Clinic a call to schedule your visit at 647 351 7282, or book online virtually across Ontario.

✨ Healthy skin is possible—when you start healing from within.