Acne Vulgaris


Struggling with acne can be a devastating condition, impacting social interactions and self-confidence. True You Medical recognizes that acne is a multi-factoral condition involving multiple imbalances within the individual – all of which must be addressed to achieve long-term results. In conventional dermatology, acne is often treated with medications that are designed to address one key issue rather than addressing the myriad of compounding factors. Furthermore, conventional dermatology often fails to address the underlying imbalance and triggers. With this kind of approach, patients often see unsatisfactory results and/or experience recurrence once the medication is withdrawn.

As naturopathic doctors, we specialize in digging deep and optimizing your INDIVIDUAL physiology – detecting triggers and tackling each of your underlying imbalances. It is our goal to remove all of the obstacles standing in your way of clear skin, supporting you with higher interventions when necessary. We conduct a thorough history and offer multiple advanced tests to identify YOUR particular contributing factors.

Our Comprehensive Approach:

Unlike conventional dermatologists, we treat the WHOLE PERSON. Acne is a complex disorder, which requires a comprehensive approach.

  • Advanced Functional Testing:
    • Hormones
    • Micronutrient Panels
    • Microbiome/Gastrointestinal Testing
    • Adrenal Stress Testing
  • Hormone Balancing:
    • Hormone imbalances are becoming increasingly common in our world filled with xenoestrogens, with more and more women suffering from conditions like estrogen dominance and PCOS. We work to naturally balance your hormones through a “hormone-rest” lifestyle, and support your body with supplements to modify hormone metabolism. When necessary, we use bio-identical hormone replacement therapy (BHRT) to help bring your body back to a state of balance.
  • Nutritional Support:
    • Nutritional support is one of the TOP supportive therapies. You will be given a personalized dietary plan which will ensure you are obtaining adequate nutrients to fight acne, reduce inflammation and avoid the top acne-triggering foods.
    • We also offer nutritional IV’s to help maximize your success. You will have the choice to receive the skin brightening IV or a custom IV that is tailored to meet your individual needs based on the results of your micronutrient panel.
  • Detox/Cleanse:
    • Toxins, or a sluggish liver, could be contributing to your acne. When our body is unable to clear toxins through the liver, bowels, and kidneys, they begin to be excreted through our skin. We work to help you lower the overall toxic burden while enhancing detoxification.
  • Gut Support:
    • Some say that all disease starts in the gut, and acne may be at the top of the list. Often times, acne is a sign of an underlying gut infection or dysbiosis. Through specialty testing, we gain a better understanding of how the bacteria in your gut could be contributing to your acne. As naturopathic doctors, we have extensive training in treating gut disorders and optimizing gut health.
  • Stress Modulation:
    • Through adrenal stress testing, we can gain an objective measure of your body’s ability to cope with stress. We then look at the use of herbs, called adaptogens, to modulate your stress response or use nutrients to dampen the unwanted effects of cortisol – the chief stress hormone.
  • Natural Product Matching:
    • Although we do not believe products alone can cure acne, we do recognize the importance of topical therapy. Therefore, we have designed our own line of products, using natural yet effective ingredients.
  • Regenerative Procedures:
  • OFYOUCLEAR - best used to minimize pore size, even out skin tone, and eliminate or drastically reduce pitting and/or hyperpigmented acne scars.
  • OFYOUOXYGEN - is used to kill bacteria in active lesions – drying up a pimple and minimizing the number and severity of acne lesions.

The following educational summary includes the science behind how acne occurs and some of its contributing factors.

Prevalence on the rise:

The prevalence of acne vulgaris is on the rise, affecting up to 90% of individuals at some point in life. While acne used to be considered a disease of adolescence, it is becoming increasingly more common in adults as well – particularly among women. Acne has been considered a “westernized disease,” as the link with lifestyle factors is becoming more evident.

Pathogenesis of acne vulgaris

  • Increased sebum production: Sebum is the fatty secretion released from sebocytes which contribute to skin hydration and barrier function. Excessive sebum production contributes to oily skin, commonly accompanying acne.
  • Follicular hyperkeratinization: Increased proliferation of keratinocytes leads to obstruction of the follicle, essentially plugging the sebocyte with dead cells.
  • Propionibacterium acnes within follicle: ‘P. acnes,’ the main bacteria involved in the pathogenesis of acne, is an anaerobic bacteria that thrives in the lipid-rich environment of sebum. Colonization of P. acnes triggers the immune system and leads to inflammation.
  • Inflammation: Acne progression often happens due to inflammation from a small comedo to an inflammatory papule or nodule.

Types of acne lesions:

  • Open comedo (white heads): These lesions occur with accumulation of sebum and keratin within a sebaceous follicle.
  • Closed comedo (black heads): Oxidized lipids contribute to the dark color.
  • Nodule or Papule: These are follicular ruptures with subsequent inflammation leading to redness, pain, and growth of lesions.


  • Family History: Genetics influence size and activity of sebocytes; additionally, several DNA polymorphisms in genes controlling both hormonal activity and inflammation have recently been identified as potential contributors.
  • Hormonal influences: Androgens, especially dihydrotestosterone (DHT), are known to promote proliferation and activity of the sebocyte. This accounts for why acne arises during puberty when the concentration of androgens drastically increases in both males and females. DHT, the most potent androgen, is formed from testosterone and is mediated by the enzyme 5 alpha reductase. Acneic individuals often have increased activity of these enzymes. Additionally, those with increased susceptibility to acne are found to have a greater density of androgen receptors within the skin.

Lifestyle influences:

  • Diet: The Western diet plays a major role in the increased prevalence of acne. Refined carbohydrates, milk, and dairy products, along with saturated fats, have been linked to increased inflammation, excess androgens, and comedogenesis. Furthermore, deficiencies in common nutrients, such as linoleic acid, zinc, vitamin D, vitamin C, vitamin A are recognized as risk factors for the development of acne. A nutrient-rich low glycemic diet, such as the Paleolithic diet – packed with plenty of vegetables and fish – is being proposed as a clear skin solution.
  • Microbiome:  Acne is an inflammatory disease and much of our inflammation is mediated by poor gut health.The number of bugs in our intestines far outnumber the cells in our body – creating a complex ecosystem which constantly interacts with our own physiology. The harmony, or disharmony, of these bugs, has great influence on our overall health – with many researchers pointing to imbalances in the gut as the root cause of much of modern disease. Food molecules and toxins are able to enter the blood and make contact with our immune tissue. This triggers the immune system to respond – propagating a cascade of inflammatory signals. In naturopathic medicine, we consider the restoration of a healthy gut ‘microbiome’ as an essential component of clearing acne. We work diligently to identify your personal imbalance and associated triggers with the goal of removing pathogenic bacteria and restoring harmony.
  • Psychological/Emotional Stress: It is well recognized that stress can be a trigger for an acne flair-up. Furthermore, it has been found that those with acne exhibit a particular personality with a greater degree of OCD, anxiety, and depression. This association continues despite improvements in skin condition; therefore, it has been proposed that a state of psychological distress precedes and contributes to the state of acne. Additionally, it has been found that sebocytes contain a receptor releasing the hormone responsible for triggering our stress response.
  • External factors: Although most acne patients have been warned about the dangers of “over cleansing,” lack of proper hygiene CAN increase exposure to ‘P. acnes.’ This is why it is typically encouraged to shower after working out, avoid touching the face with dirty hands and wash pillowcases regularly. Mechanical trauma, such as wearing a helmet, scrubbing with astringents, and shaving, can irritate the follicle and contribute to inflammatory lesions. This form of acne is sometimes referred to as acne mechanica.

Learn about the ways True You Medical can help you establish clear, glowing skin