Spots have a habit of appearing when you least want them. Before a party, a school photograph or simply when you are already feeling self conscious.
You may be washing your face, trying different products and wondering why your skin still breaks out.
Acne is common during the teenage years, but that does not make it easy to live with. It can really affect confidence, comfort and how you feel about yourself.
A naturopathic approach looks at the wider picture: hormonal changes, food, digestion, sleep, stress and what you put on your skin. The aim is to find manageable ways to support you, without turning your life into a list of foods and products you are afraid to use.
What happens beneath the skin?
Your skin produces an oil called sebum. It helps protect the skin, but during puberty the oil glands become more active.
Oil and dead skin cells can collect inside a hair follicle and block its opening. Changes in the activity of bacteria that normally live on the skin, together with an inflammatory response, can then contribute to spots.
You might notice blackheads, whiteheads, red spots or deeper, painful lumps. Acne can also appear on the chest, shoulders and back.
It is not simply a sign that you are dirty or need to scrub harder. Harsh washing can irritate an already inflamed skin barrier.
Hormones: why puberty changes the picture
During puberty, hormones called androgens increase. These include testosterone, which is present in both girls and boys.
Androgens encourage the oil glands to produce more sebum. Some people’s skin is especially responsive to these signals, even when their hormone levels are within the expected range.
Your family history also matters. Two teenagers can eat similar food and use similar skincare, yet have very different skin.
For girls, breakouts may change through the menstrual cycle. Noticing when they happen can be useful, but acne does not automatically mean that your hormones are abnormal.
Persistent severe acne alongside excessive facial or body hair, or ongoing menstrual problems, deserves individual assessment. Periods can take time to settle after they first begin, so the whole picture matters.
Could dairy be contributing?
Dairy is one of the food groups most often discussed in relation to acne.
Studies have found an association between milk consumption and acne in teenagers. Some have found a stronger association with skimmed or low fat milk. This does not prove that milk causes every person’s acne, or that full fat milk is a guaranteed better choice.
One proposed explanation involves insulin and a growth signal called IGF 1. These signals can influence oil production and processes involved in blocked pores.
This is more complicated than saying that milk contains “bad hormones”. Milk naturally contains proteins and other substances that interact with the body. Organic milk is not automatically free from a possible acne connection.
Cheese and yoghurt have less consistent links than milk. Some people notice a difference when they reduce dairy; others do not.
How could we explore this sensibly?
If dairy seems relevant, a supported trial may help us explore whether changing your intake makes a difference.
We would look at how much you currently have, what replaces it and how to keep your food varied and nourishing.
Teenagers need enough energy, protein, calcium and other nutrients for growth. Removing dairy without suitable replacements can create a new problem.
Skin changes take time. One spot the morning after a particular food does not reliably identify that food as the cause.
Blood sugar and the food connection
Another useful area to explore is glycaemic load: how the amount and type of carbohydrate in a meal affect blood sugar.
Eating patterns built around frequent sugary drinks, sweets and refined carbohydrates may contribute to acne in some people. Trials of diets with a lower glycaemic load have found improvements, although food is only one part of the picture.
Insulin and growth signals help explain how food and skin can be connected.
This does not mean that having acne proves you have insulin resistance or prediabetes.
It also does not mean cutting out carbohydrates. Growing teenagers need nourishment, especially when they are active.
We can begin by making meals more balanced:
- Include protein with meals.
- Choose higher fibre carbohydrates where you enjoy and tolerate them.
- Add vegetables, fruit and suitable fats.
- Have regular meals rather than relying on energy drinks and snacks.
- Choose water over sugary drinks.
Porridge with nuts or seeds, eggs on toast, a bean wrap or a balanced rice meal can all fit. You do not need to label every food as good or bad.
Protein powders and gym supplements
Whey is a milk protein found in many protein powders, bars and shakes.
Some reports and studies link whey supplements with acne. It is worth reviewing if breakouts began or worsened after starting a product.
Bring the ingredients list, rather than assuming that every protein powder is the same.
Muscle building products, hormone boosters and unnecessary supplements also deserve attention. More is not always better, even when a product is marketed as natural.
The gut and skin connection
The gut and skin communicate through the immune system, microbial activity and other signals.
Naturopathic practitioners explore digestion alongside skin symptoms. Researchers are also investigating whether differences in the gut microbiome contribute to acne.
Dysbiosis describes an imbalance or disruption in a microbial community. It is a possible part of the wider picture, rather than something we can diagnose by looking at spots.
If acne occurs alongside persistent bloating, abdominal discomfort, constipation or diarrhoea, those symptoms deserve attention in their own right.
What about leaky gut?
Increased intestinal permeability, often called leaky gut, refers to changes in how effectively the intestinal barrier controls what passes through it.
Its role in teenage acne is not firmly established. Acne alone does not tell us that the gut barrier is damaged.
Rather than assuming a diagnosis, we can explore your symptoms, eating pattern and relevant history.
Could yeast be involved?
Yeasts naturally live in and on the body. Their presence does not automatically mean an overgrowth.
There is not strong evidence that intestinal Candida overgrowth is a usual cause of teenage acne. Acne alone is not a reason to begin an antifungal programme or a restrictive Candida diet.
There is also a separate skin condition called Malassezia folliculitis, sometimes described as “fungal acne”. It can cause similar looking, often itchy bumps, but it is different from ordinary acne and needs the right assessment.
A gentler place to begin
Support can include varied meals, adequate fibre as tolerated, enough fluids and attention to ongoing digestive symptoms.
Some probiotic studies have shown improvements in acne. However, a benefit from one particular formulation does not mean that every probiotic will work.
You do not automatically need a stool test, a gut cleanse or a cupboard full of supplements.
Prescription acne medicines: benefits, risks and monitoring
For moderate or severe acne, a GP or dermatologist may recommend prescription treatments. These can be very helpful, particularly when acne is painful, persistent or causing scarring. They should not be taken lightly.
One of the strongest treatments is isotretinoin, commonly known by the brand name Roaccutane. It is a retinoid related to vitamin A and can produce long lasting improvement for some people. However, it is not a simple or risk free treatment.
Common side effects include very dry lips and skin, irritation, nosebleeds, dry eyes, headaches and increased sensitivity to sunlight. Some people also experience muscle or joint aches.
Isotretinoin can affect blood fats and liver enzymes. This is why medical teams usually arrange blood tests before and during treatment, depending on the person’s circumstances. In rare cases, significant liver inflammation or other serious complications can occur. It is important to report symptoms such as yellowing of the skin or eyes, dark urine, severe abdominal pain, unusual bleeding or marked weakness promptly.
Mood changes, depression, anxiety and thoughts of self harm have been reported during isotretinoin treatment. Research has not established a simple cause and effect in every case, and severe acne itself can affect mental health. Even so, any significant change in mood, behaviour or thoughts of self harm should be taken seriously and discussed urgently with a healthcare professional.
There have also been reports of digestive symptoms during or after isotretinoin treatment, and research has explored possible effects on the gut microbiome. It is not accurate to say that isotretinoin routinely “destroys” the gut or permanently damages the liver. However, the potential risks are real and should be known and monitored appropriately.
Other prescription acne medicines have their own risks. Oral antibiotics can cause nausea, diarrhoea, allergic reactions and, rarely, more serious complications. They can also alter the gut microbiome and contribute to antibiotic resistance, so they are generally used for a limited period and alongside suitable topical treatment where appropriate.
Topical retinoids and benzoyl peroxide can cause dryness, irritation, redness and increased sensitivity.
Combined contraceptive pills and acne
Some combined contraceptive pills are prescribed to help manage hormonal acne. They contain oestrogen and a progestogen and may reduce the effect of androgens on the skin. They can improve acne for some people, but they are not suitable for everyone and should be prescribed after considering personal and family medical history.
Possible side effects include nausea, headaches, breast tenderness, mood changes, changes in bleeding patterns and raised blood pressure. Some people experience lower mood, anxiety or reduced libido. A combined pill can also increase the risk of blood clots, although the absolute risk is small for most healthy young people. The risk is higher in people who smoke, have migraine with aura, have a personal or family history of clotting problems, are significantly overweight or have certain medical conditions.
Seek urgent medical help for sudden chest pain, breathlessness, coughing blood, severe leg pain or swelling, sudden weakness, difficulty speaking or a severe unusual headache.
The contraceptive pill does not usually cause a clinically significant deficiency of vitamins or minerals in everyone who takes it. However, research has raised concerns that some hormonal contraceptives may be associated with lower levels of certain nutrients in some people, including folate, vitamins B2, B6, B12, vitamin C, vitamin E, magnesium, zinc and selenium.
It is not advisable to take high dose vitamin or mineral supplements simply because you use the pill. A balanced diet is the best starting point, and supplements should be considered only when there is a clear reason, such as a confirmed deficiency, a restricted diet or individual clinical advice. Excessive supplementation can also cause harm. For example, too much vitamin B6 can cause nerve symptoms, high doses of zinc can interfere with copper, and high dose vitamin A should be avoided with isotretinoin because it may increase the risk of vitamin A toxicity.
Hormonal contraception may also mask menstrual symptoms or make it harder to assess the natural menstrual cycle. If acne occurs alongside irregular periods, excessive hair growth or other signs of hormonal imbalance, discuss this with a healthcare professional rather than assuming the pill has addressed the underlying cause.
Stress, sleep and the inflammatory response
School, exams, friendships, excessive extracurricular activity, social media, lack of down time and worries about your appearance can all add to the load.
Stress can aggravate acne. Acne can then create more stress, making the experience feel like a cycle.
This does not mean that you caused your skin problems by worrying.
A regular sleep routine, manageable movement, time away from screens and someone you can talk to are useful foundations. Support should make life easier, rather than give you another job to do perfectly.
Skincare: less can be more
An inflamed skin barrier needs care and time to heal.
Repeated scrubbing, picking and using several strong products together can leave skin sore and irritated. Natural ingredients can irritate too.
Begin with a simple routine:
- A gentle cleanser.
- A suitable moisturiser.
- Sunscreen that suits your skin.
- Individual advice about any acne treatment products.
Look for products described as non comedogenic, meaning they are formulated to be less likely to block pores. Even then, individual responses vary.
Avoid using lemon juice, toothpaste or undiluted essential oils on spots.
Hair oil, heavy styling products, synthetic gym clothing and friction can also contribute to breakouts in some areas. Notice patterns without becoming obsessive about cleanliness.
Vitamins, minerals and supplements we often hear about
Zinc is frequently discussed in naturopathic acne care. It supports normal skin function, and studies suggest it may help some people with inflammatory acne.
However, too much zinc can cause nausea and interfere with copper balance. A dose suggested for an adult is not automatically appropriate for a teenager.
Omega 3 fats, vitamin D and selected probiotics may also be considered according to your diet and individual needs. Their roles and the strength of the evidence differ.
Some supplements can contribute to acne like breakouts, including high dose vitamin B6 or B12 and iodine products. This does not mean avoiding foods containing these essential nutrients or stopping a prescribed supplement without advice.
High dose vitamin A, hormone balancing herbs, DIM and hormone boosters should not be used as do it yourself teenage acne treatments. This is particularly important if you are taking isotretinoin, because isotretinoin is related to vitamin A and combining it with vitamin A supplements could increase toxicity.
Herbs and supplements need to be reviewed with your practitioner, particularly if you take medicines, have a health condition or could be pregnant.
What about chocolate, gluten and food sensitivities?
You do not need to remove every food that has ever been blamed for spots.
Chocolate products differ considerably. Milk, sugar and the wider eating pattern can make it difficult to identify which ingredient matters.
There is no reason for every teenager with acne to completely avoid gluten. Suspected coeliac disease needs proper assessment before removing it, because doing so can affect testing.
Broad food intolerance panels do not reliably identify acne triggers.
The most useful approach is to explore a plausible pattern, change one thing at a time and protect your nutritional needs.
A manageable place to begin
Choose a few steps you can realistically maintain.
Eat regular, satisfying meals. Review sugary drinks and any whey supplements. Keep skincare very simple. Notice whether breakouts follow your cycle or coincide with a new product.
If dairy seems relevant, explore it with guidance rather than cutting out several food groups at once.
If you are taking Roaccutane, another prescription acne medicine, the contraceptive pill or a supplement, do not stop it suddenly or add new products without discussing this with your prescriber or pharmacist. Keep any recommended blood tests and report concerning symptoms promptly.
A brief record of symptoms and changes can help. There is no need to inspect your skin repeatedly throughout the day.
Improvement usually needs weeks rather than days. Painful or scarring acne should not be left untreated while you keep experimenting with food.
For parents and carers
Acne can feel much bigger to a teenager than it looks to someone else.
Try not to comment on every new spot or turn meals into an investigation. Ask what kind of support they would find helpful.
Avoid blame about food, hygiene or appearance. A teenager can do everything “right” and still have acne.
If your teenager has been prescribed isotretinoin, a combined contraceptive pill or another acne medicine, speak openly about physical symptoms, digestion, mood and any concerns about nutrition.
Deep painful spots, scarring, persistent symptoms or acne that is affecting confidence deserve timely professional assessment. Nutrition and lifestyle support can sit alongside appropriate skin treatment.
Does this resonate with you?
If you or your teenager are struggling with acne, we can explore the wider picture together.
We can look at food, digestion, sleep, stress, menstrual patterns where relevant, skincare and existing supplements, then find manageable nutrition and lifestyle support.
The aim is to support healthy skin while protecting growth, confidence and your relationship with food.
Please email me at lisa@evolvefemalewellness.com.
Lisa Cahill
Evolve Female Wellness
This guide is for general information, not diagnosis or an individual treatment plan. Teenage skin concerns, dietary changes, herbs and supplements require individual guidance. Prescription acne medicines, including isotretinoin and hormonal contraception, should only be used under the supervision of a qualified healthcare professional.