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Acne
Acne is a signal from hormones, blood sugar, inflammation, and the gut, not just the skin. We address the signals so the skin can steady.
What you may be noticing
Breakouts along the jaw and chin that flare before your period. Deep, painful cysts that leave marks. Acne that returned in adulthood or appeared after stopping birth control. You may have tried every cleanser, antibiotics, or hormonal treatment, with relief that faded once you stopped.
Why it is rarely one thing
Acne is not caused by dirty skin. It is the visible result of four processes in the oil gland: increased oil production, clogged pores, bacterial growth, and inflammation. Each of those is influenced by internal signals.
Androgens increase oil production. Insulin and the related growth factor IGF-1 increase androgen activity and skin cell growth, which is why high glycemic diets and, for some people, dairy are linked with acne in research. Inflammation from the gut and elsewhere amplifies the response.
I also look at clearance. The liver processes and packages used estrogens and androgens, and the bowel carries them out. When those pathways are strained, hormones can recirculate. In my clinical experience, acne alongside skin tags, body odor changes, or puffiness often reflects strained liver and lymphatic clearance rather than a primary gland problem. That pattern is a working hypothesis, and it is why I open drainage before adjusting hormones.
Location offers clues. Breakouts along the jaw and chin that follow your cycle point toward hormonal and androgen signaling. Widespread inflammatory acne with digestive symptoms points toward the gut and inflammation. Acne that began after stopping birth control often reflects a rebound in androgen activity as the body recalibrates, sometimes within a PCOS pattern.
Medications from your dermatologist may be part of your care. Comprehensive care adds the upstream work, so the skin is not fighting the same signals every month.
Patterns we look for
- Androgens: testosterone, DHEA-S, and SHBG.
- Insulin resistance and blood sugar instability.
- PCOS patterns in women.
- Liver processing of hormones and bile flow.
- Bowel regularity and lymphatic congestion.
- Dairy and high glycemic foods in sensitive individuals.
- Gut microbiome balance and intestinal permeability.
- Zinc, vitamin A, vitamin D, and omega-3 status.
- Estrogen and progesterone balance across the cycle.
- Stress and cortisol, which raise oil production.
- Skin care products that clog pores or add to the toxic burden.
How I evaluate it
A comprehensive functional neurological exam assesses stress physiology and autonomic balance, which influence hormonal and inflammatory drivers.
Functional labs may include an androgen panel with SHBG, fasting insulin and glucose, HbA1c, cycle-timed hormones or a complete hormone metabolite map, a thyroid panel, liver enzymes, zinc, vitamin D, inflammatory markers, and comprehensive stool analysis. Sudden severe acne with rapid hair growth, voice changes, or irregular cycles needs prompt medical evaluation.
How we address it
- Open drainage: a daily bowel movement, hydration, and lymphatic techniques that begin at the collarbones and move outward.
- Support the liver in processing and clearing hormones.
- Stabilize blood sugar and restore insulin sensitivity.
- Identify food triggers, including a trial without dairy when appropriate.
- Balance androgens and cycle hormones by addressing upstream drivers.
- Repair the gut and reduce inflammation, and restore zinc, vitamin D, and omega-3 status with targeted categories of support.
- Calm the stress axis, and simplify skin care to gentle, clean, non-clogging products.
Your skin is a messenger. When the message changes, the skin can change too.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.