A Holistic Approach to Acne: Diet, Hormones, Stress, and Skin

Young woman receiving Acne, Diet, Hormones Treatment in Zen Dermatology in Sacramento CA

Acne is one of the most common inflammatory skin conditions. It can be chronic and lead to scarring, dyspigmentation, and low self-esteem.

There are many causes and triggers for acne that include inflammation, oil production, the skin bacterium Cutibacterium acne, hormonal imbalances, diet, and psychological and emotional stress. 

The good news is that there are a variety of treatments, both pharmaceutical and natural, that can improve acne. The better news is that an integrative approach takes care of both acne and a person’s overall wellness. 

There is no “one size fits all” solution and treatments are individualized to each unique person, so it is important to seek the care of a trusted integrative healthcare provider. The following evidence-based treatments are just a few examples of how diet, hormones, stress, and skin can be addressed in cases of acne. 


Foods with a high glycemic index can be aggravating to acne and are best avoided. These foods release glucose into the bloodstream quickly, and as a result, spike blood glucose and insulin levels. A thorough list of such foods can be found online, but examples include white bread and rice, cakes and cookies, and some fruits like pineapple and watermelon.

Research shows that dairy products worsen acne. Foods like yogurt, cheese, and milk are best avoided in this inflammatory skin condition.


Oral probiotics have been shown to play a role in modulating the immune system and inflammation. A recent study through Zen Dermatology’s clinical research unit has found that the use of a spore-based probiotic supplement taken for 12 weeks can significantly reduce inflammatory and non-inflammatory lesions in people with non-cystic acne.

There are effective pharmaceutical options for managing hormonal acne, and natural supplements that may be considered where appropriate. One example is pumpkin seed oil which has components that reduce the hormonal triggers of acne. Research suggests that using this oil directly on the skin can improve acne and that use as an oral supplement can block androgenic hormones, which may be implicated in acne. 

Stress Management

There is a bidirectional relationship between the skin and the mind. Skin conditions can be a source of stress, and stressful circumstances in our lives can aggravate skin conditions. Taking just a few minutes to focus on our breath can calm the mind and reduce inflammation. One program, in particular, Mindfulness-Based Stress Reduction (MBSR), has been shown to have multiple psychological and dermatological benefits. 

Cosmetic Treatments

A variety of cosmetic treatments can be helpful in the management of acne lesions and acne scars. Microneedling and laser resurfacing are two techniques that can improve the appearance of scarring. Both of these approaches stimulate collagen to smoothen acne scars and enhance the skin’s texture. Other options can include chemical peels, blue light therapy, and topical products. 

While acne can be a chronic and distressing condition, there is a wide variety of promising interventions that can be used to optimize the health of your skin and overall wellness.

RAJA SIVAMANI-Dermatology-CA-Zen Dermatology



I am a native of the San Francisco Bay Area and a board certified Dermatologist. My expertise centers on general dermatology including medical, surgical, and cosmetic services. With training in bioengineering, Allopathic and Ayurvedic medicine, I merge modern research and science with a personalized approach to each patient. My training in Ayurvedic medicine lets me bring in a more humanistic approach to my patient care, science, and research.

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