If you’re still battling with acne after your turbulent teens and trying to figure out what’s going on, this blog is written especially for you.

I know how it feels like having adult acne.

I was a spotty teenager but entering my 20’s, I thought I cleared it.

Then in my early 30’s, it started again with a vengeance. I felt self-conscious, cancelling on romantic dates and affecting my work performance. I tried antibiotics and birth control pills with some result but plenty of side effects. I refused the Roaccutane worried of its side effects. I spent a lot of money on creams which worked well but I had to keep using them which wasn’t very good for my pocket.

So I had to find a better solution.

After much studying, researching and working with my patients 1-2-1 to clear their acne, I found these 10 reasons to be the common root causes. By addressing the root cause, results are longer-lasting, healthier with less side effects.

I’m now in my mid-40s and although my skin is acne-prone, my breakouts are minimal and I know how to take care of my skin inside out so she feels happy without having to depend on too many products.

They often overlap so let’s dive into it.


When it comes to nutrients, there are macronutrients (carbohydrates, protein + fat) and micronutrients (vitamins & minerals). 

They are all important in detoxing, repairing, producing healthy hormones, balancing hormones, immunity and even producing enough energy to run all these processes while keeping you alive!

Problem arises when we are not eating enough nutrient dense food either or prolonged “restrictive diets”, elimination diet, keto diet… any diet really… OR over-exercising or have a super stressful fast paced life that your body is in more wear & tear and your nutrient intake cannot keep up!

This is worsen by drinking coffee, excessive exercise, chemicals in the environment, sleep deprivation, the birth control pill and stress all strip your body of key micronutrients that keeps your hormones healthy and skin clear.

Apart from consuming enough, we also need to question if you’re digesting it and absorbing it efficiently.


The gut contributes to 70% immunity and protects against the external environment. The mucosal lining of the gut has tight junctions which separates friend from foe. It also is in charge of digesting, absorbing, metabolising, assimilation and detoxification.

A damaged and depleted gut micro-biome is one of the most common causes of internal inflammation. This is when microbial environment in the gut is out of balance either too much bad bacteria or not enough good bacteria. There may also be an overgrowth of fungus/parasites or viruses.

This can lead to inefficient absorption of nutrients required for skin health, inefficient detoxification, food sensitivity and heightened immune response leading to leaky gut, migraines and even IBS.

This is commonly seen in women on long term antibiotic use (usually given for acne), stress, the Pill, eating inflammatory foods and lack of fibre or food variety. Inflammatory foods e.g. sugar, dairy, gluten and highly processed food can cause leaky gut syndrome – a condition where microscopic holes develop in the wall of your intestines, allowing molecules to pass through and create an inflammatory response in your body. When your liver and large intestine is not working well, your skin steps up and tries to eliminate the toxins, resulting in skin inflammation and acne.

Some clues where you may have gut issues:-

  • Feeling bloated, nauseas
  • Have stomach cramps
  • Diarrhoea/constipation
  • Cravings
  • Feeling tired
  • May be intolerant or sensitive to food
  • Suffer from skin rashes.


After we eat food, it gets digested into glucose, amino acids and fatty acids. Glucose enters the blood stream and causes a spike in blood glucose.

Our clever body then releases insulin, a hormone from the pancreas to balance the blood sugar level, moving the glucose from the blood stream to other parts of the body to be used or stored.

Problem arises when we eat specific foods or the order we eat them that causes massive blood sugar spikes, or there’s too many spikes throughout the day. Big sugar spikes converts T to DHT (5x) increasing oil production in the skin. More insulin is released to balance the sugar levels but this will in turn stimulate testosterone production leading to more oil production which can block the pores and cause acne.

When there is too much sugar about for a long period of time, the insulin can become RESISTANT and it doesn’t do its job properly, leading to sugar being stored in fat, liver and cells. This results in gaining weight, a congested liver and cell glycation resulting in inflammation. Insulin resistance can also be caused by PCOS, metabolic syndrome and being overweight.

Some clues where you may have a problem regulating your blood sugar levels:-

  • Bad sugar cravings
  • Energy crashes
  • Afternoon caffeine pick me up
  • Never feeling satisfied after eating
  • Feeling irritable and “hangry” when you skip meals
  • Excessive hair on your face, weight gain and irregular periods.


When you are stressed, there is a rise in cortisol hormone which is normal. It’s when there is a chronic consistently high cortisol which can increase wear & tear and increase inflammation. It can also poke “holes” in the skin.

Indirectly, high cortisol affects sleep, digestion, motivation, patience, concentration, moods, joy and energy levls.

It affects the normal production, detoxification and balance of other hormones.

This can include stress that you are aware of and stress that you are not e.g. internal inflammation, emotional stress, mental worries and even spiritual misalignment. There is growing research to show how the brain and skin is connected, the skin often referred as the third brain.

Some clues high cortisol may be hijacking your system:-

  • Feeling wired but tired
  • Brain fog
  • Painful periods
  • Worsening PMS
  • Uncontrollable skin picking
  • Food cravings
  • Difficulty sleeping
  • Feel very uncomfortable slowing down
  • Wild mood swings


Your liver is an important organ for detoxification, especially for excess hormones. 

A well-functioning liver also boosts your absorption of all vitamins and minerals, preventing deficiencies in the first place.

Alcohol, nutrient deficiency, the birth control pill, stress, insulin resistance – all can cause liver congestion.

When detoxification is suboptimal, you can get Oestrogen Dominance (excess Oestrogen) leading to weight gain, skin sensitivity, acne and worsening PMS.

Some tips to help improve liver flow:-

  • Cut down on alcohol
  • Manage stress
  • Optimise nutrient intake and balance sugars
  • Take more foods that cleanses the liver naturally – garlic, grapefruit, beets and carrots, green tea, leafy green vegetables, avocados, olive oil, lemons and limes, turmeric, broccoli, cauliflower, artichoke and brussel sprouts.


Hormones are chemical messengers that allow different parts of the body to talk to each other. Nicely most of the time but sometimes miscommunication can happen or worst, totally ignoring each other.

Hormonal imbalance can lead to increased oil production, inflammation and big cystic acne.

Hormonal imbalance is usually a byproduct of other things e.g. stress, inflammation, drugs or environmental toxins.

Common symptoms of hormonal imbalance include painful heavy periods, irregular periods, PMS, sugar cravings, weight gain, facial flushing, excessive facial hair or hair loss on the head.

I often see hormonal imbalance being treated with birth control pill. This does not fix it. It only masks it. So if you had an imbalance when you started the pill, it often comes back with a vengeance when you stop it.

I mentioned about Oestrogen Dominance above. Other hormonal imbalances that can cause acne are high testosterone, low progesterone, high cortisol and low melatonin.


Our body produces energy through mitochondria– a powerhouse inside the cell to fuel repair and healing. 

If we have inflammation or stress, our body will be in flight & fight, keeping you alive and functioning and is not worried about skin health and clearing your skin. 

If you have gut issues, you may have trouble absorbing the nutrients or extracting the energy from the foods you eat.

If you’re not resting enough or having good quality sleep, you will not recharge your batteries!

If you need caffeine to get you going in the morning, need alcohol at night to decompress and wind down, cortisol could be hijacking you and draining your energy even further.


The skin is a living organ and it has its own ecosystem, immunity, nervous system and hormonal system. The skin is the wrapping of actual life which is you, protecting you from the environment.

The epidermal barrier keeps moisture in and maintains skin microbe ecology.

Skin can become “leaky” i.e. impaired epidermal barrier by internal inflammation and externally by overstimulation with products or skin treatment. When the skin is inflammed, there will be increased oil production in attempt to repair. The skin also feels dehydrated at the same time as there is increased transepidermal water loss.

Some other clues that your skin may be “leaky”:-

  • Redness
  • Sensitivity
  • Inflammed
  • Increased risk of infection/overgrowth

I hope this blog sheds more light on your acne and give you a starting point to work from or dive deeper.

If you require more support and you like my holistic approach, I invite you to check out my self-paced guides and programs.

If you prefer to work 1-2-1, you can check out how I work here

Until next blog, here’s to happier and clearer skin.

To your best self,

Dr Terry