It’s not fair. When I was in my teenage years, and miraculously pimple-free, no one told me that rather than fretting over my first wrinkle, I would spend the better part of my 20s battling acne. Not just any acne, but deep, red, painful cysts that would push their way up from nowhere-land to settle prominently on my chin and take weeks to resolve themselves.

Acne occurs when sebum, the oil in our skin, along with debris like dead skin cells, gets trapped in the pores, or sebaceous glands, and bacteria, namely Propionibacterium acne, begins to populate. The growth of bacteria leads to infection, inflammation and, well, you know the rest. So how do we solve this problem?

Maintaining clear skin, especially if it means balancing hormones is just that: a fine balancing act that can take some time to get right. I believe that we all have our individual recipe for creating beautiful, clear and healthy skin. I’m still trying to work out the kinks in mine, but these are things that have worked for me so far.

1. Hygiene

While I often rolled my eyes at this tip, mainly because my acne is hormonal, it makes good sense for most people with acne. Washing the face with a gentle cleanser twice a day (opt for a natural or foam-free brand and always go for fragrance-free; fragrances act as irritants and can exacerbate acne), removing make-up before bed, refraining from touching the face and changing pillow cases frequently are all extremely important when it comes to caring for skin and avoiding bacterial contamination of pores. After cleansing, I recommend swiping skin with a “toner” made of 1 part apple cider vinegar to 4 parts water, to maintain optimal skin pH and tighten pores.

2. Diet

Although I’m not sure of the mechanism, I’m 100% certain of the link between ingesting dairy, especially cheese, and my voracious outbreaks of cystic acne. Other people who suffer from hormonal acne (acne that commonly occurs at the same time during the menstrual cycle) have observed the same phenomenon. When I abstain from any kind of dairy (avoiding cow’s milk, cheese, yogurt, ice cream, reading food labels and avoiding all milk ingredients) I notice my acne clear up and a reduced number of breakouts. It helps to keep a diet diary, identifying food triggers and their link to acne flair-ups. Dairy sensitivity is a common trigger when it comes to cystic acne. Chocolate, fried foods, and sugar-laden foods especially, are other common food triggers.

3. Inflammation

I was once told by a doctor that he could tell, just by looking at me, that my colon was suffering from intense inflammation. His clue, he said, was the state of my skin, which reflects the state of the colon. It makes sense, as they’re both epithelial tissues and our intestine is responsible for absorbing the water and nutrients we intake from food that our skin needs for optimal health. When we ingest foods that trigger inflammation of the digestive tract, our skin suffers too. Therefore, it is important to develop a clean, allergen-free diet, first identifying food triggers via an acne-food diary or through an Elimination Diet or IgG Food Allergy Panel. It is also important to reduce our intake of pro-inflammatory omega-6 fatty acids, like those found in soy and corn oil and most fast foods, and replace them with anti-inflammatory omega-3 fatty acids, from fish, flax seeds, and walnuts, for example. Adhering to a diet that is high in whole foods: fruits and vegetables, whole grains and lean meats, and low in refined carbohydrates, sugar, fried and processed foods, is also important for keeping inflammation levels low.

4. Supplementation

I have personally never tried it, but many people swear by Borage or Evening Primrose Oil (EPO), for their potent anti-inflammatory effects on the skin. EPO should not be taken, however, with those who have a history of breast cancer or are undergoing hormone-replacement therapy. Balancing levels of estrogen and progesterone, especially for those who are coming off of oral contraceptive pills, can be done by supplementing with Vitex agnus castus, or chasteberry, a hormone-balancing herb. I have tried an estro-detox supplement, which helps clear the liver of excess estrogen, and vitamin B6, which, while not typically prescribed for acne, has hormone-balancing effects and gave me significant results. Ingesting high levels of skin-health-promoting antioxidants like those found in berries, leafy greens and green tea are also important for preventing acne. Talk to your naturopathic doctor about your supplement needs and for proper dosing instructions.

5. Managing stress and making time for self-care

Stress is closely linked to increased levels of inflammation and altered hormonal balance. I personally break out more during intensely stressful periods, like exam time. Taking the time to unwind and pamper yourself is an important factor in caring for skin. Whether you take 20 minutes a week to relax in an Epsom salt bath with a face mask (of egg whites and natural, plain yogurt) and a book, or going for a long walk, yoga class, or just set aside time to engage in your favourite activities, practicing self-care is key for managing stress and maintaining a life of balance. It shows up on your face, too.

6. Listening to your skin

I have tried various things that were supposed to be “so good for acne-prone skin” only to find that they made my skin, red, inflamed and break out even more. On a rampage to remove all toxin-containing cosmetics from my bathroom cupboard, I began using a certain brand of natural cleanser. While other people had experienced positive results with this particular product, I found I broke out even more after trying it. “My skin probably just needs two weeks or so to adjust,” I told myself. After several breakouts later, I finally listened to reason and gave it up. While some things are wonderful for some people, they might not be right for you and your skin at this time. I’ve learned to pay attention when my skin starts protesting and to stop what “great” intervention I’ve started before things start to get completely out of hand.

This article is not meant to serve as medical advice. For a more individualized assessment, please see a licensed naturopathic doctor.


Talia Marcheggiani

Talia Marcheggiani is a naturopathic doctor practicing in Toronto, Canada. She is a graduate of the Canadian College of Naturopathic Medicine (ND) and Queen’s University (BScHons Life Sciences). She is a member of the Ontario Association of Naturopathic Doctors (OAND) and the Canadian Association of Naturopathic Doctors (CAND). She is licensed to practice naturopathic medicine in Ontario under the Board of Directors of Drugless Therapy – Naturopathy (BDDT-N).
Talia believes in treating the cause of disease, not just symptoms, using gentle, natural medicines to help the body return to a state of health and balance. She understands that taking the time to listen carefully to patients’ stories is essential to healing. The healing process is a often a time for growth and self-discovery in her patients that she feels privileged to witness. She focuses her practice on mental health, endocrinology and community medicine.
Learn more about Talia on her website,, follow her on Twitter at @Taliamarcheggia or find her on Facebook.


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