Managing Teen Acne: A Holistic Approach

Teen acne affects up to 95% of adolescents (1). While it may provide some comfort for teens to know that what they are experiencing is common, there is a range in the severity and some teens are impacted more severely than others. Teen acne tends to last 5-10 years, and it often clears up once the individual enters their twenties (1). Teen acne can look like pimples, blackheads, whiteheads, or sometimes cysts on the face, chest, back, or shoulders. Acne occurs when hair follicles become clogged with oil and dead skin cells, leading to inflammation and the formation of blemishes (2).

Hormonal fluctuations during adolescence can play a role in the development of teen acne (3). Increased levels of androgens, such as testosterone, stimulate the sebaceous glands to produce more oil, which can clog pores and lead to breakouts (4). Other factors, including diet, stress, toxin exposure and the use of certain topical skin products, can also contribute to the severity of acne (3).

Conventional medicine typically approaches teen acne by targeting the surface symptoms. The most common treatments include topical creams that often contain ingredients like benzoyl peroxide or salicylic acid, which work to reduce oil production and kill acne-causing bacteria (4).

In cases of moderate to severe acne, oral medications may be recommended. These can include antibiotics to address bacterial infections or hormonal treatments, such as oral contraceptives, with the aim of balancing androgen levels. Another common prescription is isotretinoin (Accutane). Accutane can cause side effects such as joint and muscle pain, extreme dryness of the skin and lips, thinning hair, and changes in eyesight, including night blindness (5). It can also elevate cholesterol levels and, in rare cases, cause liver damage.

Additionally, there are concerns about serious potential effects, like depression and inflammatory bowel disease (IBD), though research on these is still ongoing (5). Because accutane can cause birth defects, teen girls taking accutane are often required to take the birth control pill simultaneously (5).

This is not to say that conventional care needs to be avoided at all costs: there is certainly a time and a place. However, it is important to help your teen understand the potential downsides to these medications and to help them be aware that they have other options available to them.

You may be wondering how the food we consume can affect the way our skin looks. It is important to understand that no system in our body works in a vacuum, and an imbalance in one system can contribute to imbalance in another system. What we eat impacts our skin because the nutrients we consume play a direct role in the health and function of our (skin) cells. The food we eat provides the essential building blocks for skin repair, regeneration, and overall vitality. When we nourish our bodies with an abundance of nutrients to include vitamins, minerals, and fatty acids, we support a healthy inflammatory response, balanced oil production, and the skin's ability to heal and protect itself. Likewise, a diet rich in pro-inflammatory compounds, like seed oils and ultra processed foods, may contribute to excess sebum production, hormonal dysfunction and more.

Because ultra processed foods tend to be very calorie dense, but not very nutrient dense, they often crowd out whole foods in the diet. Therefore, someone who consumes a lot of ultra-processed foods — like a teenager — is likely to consume less of the vitamins, minerals, and other micronutrients that are present in whole foods and required by their bodily systems to function optimally.

Vitamin A and zinc are two such nutrients that benefit skin health (9). Vitamin A regulates skin cell turnover, helping to prevent clogged pores that can lead to acne (9). Vitamin A also supports a healthy inflammatory response (10), and as such may impact the amount of redness and swelling associated with breakouts.

Like vitamin A, zinc is essential for maintaining a healthy inflammatory response (11). Zinc also plays a role in regulating the sebaceous glands, which control oil production (12). In fact, there is some evidence that zinc supplementation reduces sebum production, when compared to a placebo (12). There is research that shows that supplementing with zinc both alone and combined with vitamin A can significantly decrease acne severity (13).

For those looking to support their skin health through diet, incorporating foods rich in vitamin A (such as cod liver oil, beef liver, grass fed butter, carrots, and pumpkin) and zinc (such as pumpkin seeds, lentils, and beef) can be beneficial. 

While the word “fatty" doesn't exactly instill confidence in most teens looking to reduce their acne symptoms, omega-3 fatty acids are actually very important for supporting a healthy inflammatory response (14) and balanced hormones (15) - both of which are involved in acne formation.

Cod liver oil is a great source of omega-3s and also provides vitamin A, making it a supplement that may be especially useful for acne-prone skin.

Gut health plays a significant role in skin health. Our microbiome consists of trillions of strains of bacteria, fungi, parasites and viruses (16), and keeping a balance between good bacteria and opportunistic strains is important for so many areas of our health, including our skin health. We can support a healthy and diverse microbiome by consuming plenty of prebiotic and probiotic foods (17). Personally, I aim to consume at least one probiotic food daily (examples include a glass of kombucha, yogurt, sauerkraut, probiotic cottage cheese, and fermented miso paste) and I take a daily probiotic.

Overtime, an imbalance between the healthy and opportunistic strains of bacteria in our gut (also called dysbiosis) can lead to increased intestinal permeability (also called “leaky gut”) (18). With leaky gut, tiny food particles can make their way into the bloodstream before they are fully digested, which can cause an immune response to occur and can be a contributing factor to chronic inflammation and acne.

To learn more about healing the gut, read this article: How to Heal The Gut.

Food sensitivities, particularly to cow’s milk, have been linked to acne due to their effect on insulin-like growth factor-1 (IGF-1), which can increase sebum production (19). Eliminating common triggers like dairy, gluten, and soy from the diet for a short period of time can help determine if they contribute to breakouts. 

For more information on how to conduct an elimination trial, read this article: How To Conduct An Elimination Diet To Assess Food Sensitivities.

An increased burden on the liver can slow down detoxification pathways (20), and since the liver is responsible for metabolizing excess hormones (21), particularly estrogen, this can be a contributing factor to hormonal imbalances and increased systemic inflammation.

Avoiding environmental toxins from cosmetics, cleaning products, non-organic foods, and plastics can support liver function. Additionally, liver-supportive supplements and herbs like burdock, milk thistle, and dandelion can give the liver some support and encourage the optimal functioning of detox pathways. These herbs and others can be found in Cleanse & Reset, which contains a selection of cleansing & detoxifying herbs for the liver, skin, and more. It can be used alone to support clear skin or combined with Lovin’ Your Liver for added detoxification support.

Castor oil packs are a fantastic way to support your liver. To learn more, read this article: Castor Oil Packs: A Natural Remedy For Liver Health and Detoxification.

Proper hydration is essential for maintaining healthy skin (22). Adequate hydration helps keep the skin balanced, rather than becoming too oily or too dry, both of which can contribute to acne. Water also helps flush out toxins and supports the health of the skin’s barrier. No topical hydration can replace the need for consuming adequate fluids (22).

Teens should aim to drink at least 8-10 glasses of water daily. Adding lemon or cucumber slices can make water more appealing, or try out my homemade hydration drink recipe or some herbal tea.

When helping your acne-prone teen choose topical skin care products, look for options free from common harmful chemicals. At Dr. Green Life, our skincare line is free from parabens, pesticides, sulfates, PFAs, phthalates, petrolatum, SLS, and chemical fragrances.

If more topical support is desired beyond cleansing and moisturizing, a raw honey and activated charcoal mask is a simple home remedy that can calm breakouts. Raw honey has natural antibacterial properties (24), while activated charcoal draws out impurities and excess oil (25).

To apply the mask:

• Mix one tablespoon of raw honey with the contents of one activated charcoal capsule.

• Apply to clean, dry skin.

• Leave on for 10-15 minutes, then rinse thoroughly with warm water.

• Follow with a gentle moisturizer.

Teen acne is common, but it can be incredibly stressful for our kids to deal with. A holistic approach to teen acne addresses both internal and external factors to support skin health in a comprehensive manner.

Hormonal balance is crucial, so opt for clean, non-toxic skincare products and reduce exposure to endocrine disruptors as much as possible.

Nutrition plays a significant role in our skin health and teens that want to improve their skin health should aim to consume plenty of nutrient rich whole foods, especially those that contain vitamin A, zinc, and omega-3.

Staying hydrated, caring for our gut health, and supporting liver function can be helpful, too.

For acute breakouts, try a DIY raw honey and activated charcoal mask to soothe the skin and draw out impurities.