Acne is often treated as though the problem begins and ends with the skin. We scrub it, dry it, peel it, medicate it and cover it with creams. While topical treatments can certainly help, persistent acne may be telling us that something deeper is influencing what is happening at the surface. The skin is simply the external manifestation of something unbalanced internally.
Hormones have a powerful effect on the sebaceous glands that produce the skin’s natural oils. Androgens—including testosterone, DHT and DHEA—can increase oil production and influence how skin cells behave within the follicle. This is important for both men and women. In fact, someone can have hormone levels that fall within a normal laboratory range and still have acne because hormone conversion, receptor sensitivity and the balance between different hormones also matter.
Blood sugar is another important piece. Frequent sugar and refined carbohydrates can repeatedly elevate insulin and influence insulin-like growth factor-1, or IGF-1. These signals can increase androgen activity, oil production and skin-cell growth, creating an environment where clogged and inflamed follicles are more likely to develop.
The adrenal glands also contribute to the hormonal picture by producing DHEA and other androgen precursors, while chronic stress alters cortisol and blood-sugar regulation. The thyroid, pituitary and hypothalamus help coordinate metabolism and hormone production throughout the body. In women, ovarian hormone imbalances and conditions such as PCOS can contribute. In men, testosterone, DHT, stress hormones and insulin resistance may all influence the skin.
The liver and digestive system are equally important. The liver metabolizes hormones and many other compounds the body needs to process and eliminate. Constipation and poor digestive function can further interfere with normal elimination. Environmental exposures—including chemicals in food, water, plastics, pesticides, personal-care products and other sources—can add to the body’s workload. Some compounds can interfere with normal hormone signaling, which is one reason toxicity and environmental exposure deserve consideration when acne persists.
Nutrition provides the raw materials the body needs to manufacture and metabolize hormones, repair skin and control inflammation. Adequate protein, healthy fats, zinc, essential fatty acids, vitamins and minerals all matter. A diet dominated by sugar and processed foods can work against those processes.
Acupuncture approaches acne by looking beyond the blemish itself. Treatment can address digestion, liver and bowel function, circulation, inflammation, stress, sleep and other systems that may be contributing. Two people with nearly identical acne may therefore receive very different treatments because the reasons their skin is struggling may be completely different.
Clear skin isn’t simply about what we put on the outside. When acne keeps returning, especially after adolescence, it is worth asking what the skin may be revealing about what is happening inside.
The skin may be where we see the problem, but it isn’t necessarily where the problem began.
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Podcast Episode 41 Addressing Your Skin Health Podcast Episode 75 How to Have Healthier Hair and Skin
