adult acne

Q: Dear Dr. Amy: I am 34 years old and have been struggling with adult acne on my face and back since I was 14. I am so tired of having bad skin. Any suggestions? ~ Miko in Minnesota

Dear Miko,

I am so sorry to hear of your decades challenge with acne, you are not alone! About 9.4% of people around the world have acne. While most people associate acne with teenage years, adult acne is also common.

adult acne

I have worked with scores of patients who have acne, from teenagers to middle-aged people and most everyone benefits from taking the deep dive into understanding the root cause of their acne. Taking up an individualized plan to address those underlying causes can take time but is time well spent.

By taking in the right-for-you foods and drink, ensuring adequate hydration, using other gentle, natural medicines, and reducing both stress and topical products that may be clogging or irritating your skin, you can expect to see improvement in your skin. And what’s more, you will likely feel better overall, as your skin is a reflection of many other processes going on in your whole system, so working from the inside, out, your skin can reflect better overall health.

Underlying Causes of Adult Acne

The number one thing to determine is the underlying cause of your acne. Beyond a genetic tendency, common causes of acne are related to: inappropriate-for-you diet, hormonal issues, a microbiome that is out of balance, a tendency for infection, and stress. And, of course for many people, there are overlapping causes that lead to and sustain blemishes.

So how do you get to the cause? Screening and specialty lab work can help assess your biochemistry and how your organ systems are working. A naturopathic medicine work-up will address nutritional deficiencies, food allergens and limiting toxin exposures that negatively impact skin.

With regard to diet, most people with acne improve while on a whole-foods diet, with lots of vegetables, fruit, healthy fats, nuts and seeds, fish and other lean proteins. Another way to help is by limiting processed food, refined sugar, trans fats, fried food, and for many people, removing dairy will also help. Most likely, a naturopathic doctor will recommend specific dietary recommendations based upon your biochemical individuality and other features of your overall health.

hydrating and adult acne

Staying well-hydrated is also important, Water helps to flush normal toxins from your system, works to ensure a bowel movement every day and helps keep the skin from being too dry. While some patients have oily skin that seems to worsen acne, having skin that is dry and irritated can also be a causative factor.

A very important but sometimes overlooked aspect is the microbiome and gut health. It is important to enhance the diversity and robustness of your microbiome, a known aspect in the treatment of acne. You may not be familiar with the brain-gut-skin axis, however it is a significant part of optimizing your physiology. This is done with a careful selection of prebiotics and probiotics with the proper strain, along with adding cultured and fermented foods to your daily diet.

Other Treatment Options

Naturopathic and integrative doctors might also suggest botanical medicine or nutritional supplements based on the underlying cause(s) of your acne. If you have a tendency for cystic acne with local infections, herbs like turmeric (Curcuma longa) and ginger  (Zingiber officinale) might be suggested alongside zinc and Vitamin C. If your acne is much worse leading up to your menstrual cycle as part of premenstrual syndrome, B vitamins along with Vitex negundo (Chaste tree), which has anti-androgenic, hormone-balancing effect might be useful.

Research shows that stress plays a big role in the development of acne. Stress hormones impact your immune system, your sleep cycle and your hormones. Therefore, working to identify and mitigate your biggest stressors is critical.  And learning and taking part in things that help to raise your threshold for feeling stress is also important. Exercise, breathing exercises, mindfulness meditation, time with loved ones, laughter, hugs, creative pursuits are among the many approaches that can help lower the impact of stress. Many activities like this also help dissipate stress you do have, and encourage optimal circulation, important to helping skin issues.

Be careful about what kinds of personal care products you use. Look for items that say non-comedogenic” or “won’t clog pores” for make-up, other skin and hair products, and sunscreen. Creating a cleansing and moisturizing habit with products that take into consideration they kind of skin you have, also helps. 

By working with a naturopathic doctor, you can identify root causes to your acne and create a personalized to prevent further breakouts and work to decrease any scarring that may have developed. Here’s where you can find a naturopathic doctor to work with. Best of luck as you work to find solutions for your acne!


This article is sponsored by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

Amy Rothenberg ND, DHANP is a contributor to INM and practicing licensed naturopathic doctor in Northampton, Massachusetts. Dr. Rothenberg is the American Association of Naturopathic Physicians 2017 Physician of the Year. Dr. Rothenberg’s writing can be found on NaturalMed.org, Better Nutrition’s Naturopathic Health Hub, Medium, Thrive Global, andThe Huff Post. She is the proud mother of 3 adult children.