Managing Acne Naturally: Lifestyle Changes and Daily Routines

Acne results from the interplay of four primary factors: the overproduction of sebum (oil), the accumulation of dead skin cells, the proliferation of acne-causing bacteria, and inflammation. Various external variables, including lifestyle choices and daily habits, can further influence these acne-causing factors.

Natural treatment approaches for acne target imbalances from within. This article explores effective natural strategies, lifestyle changes, and daily routines that can help manage acne holistically, providing longer-lasting results that don't rely on chronic use of over-the-counter and prescription medications.

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The Role of Lifestyle in Acne Management

Lifestyle plays a significant role in acne management, as factors like diet, stress, sleep, and daily habits can strongly influence the four mechanisms of acne pathogenesis. For instance, a diet high in refined sugars and processed foods can spike insulin levels, which may trigger the overproduction of sebum and exacerbate inflammation. Stress stimulates the release of cortisol, a hormone that can increase oil production and worsen breakouts.

The good news is that small, consistent lifestyle changes can profoundly impact acne-prone skin. Simple adjustments, like improving sleep hygiene, managing stress through mindfulness, or adopting a balanced, anti-inflammatory diet, can help balance the body's internal systems and reduce the frequency and severity of breakouts.

Dietary Adjustments for Clearer Skin

Research suggests that following dietary modifications can result in less severe acne and fewer breakouts.

Low-Glycemic Diet

High-glycemic foods, such as sugary snacks, white bread, and processed carbohydrates, trigger acne by causing rapid spikes in blood sugar and insulin levels.

Elevated insulin levels increase the production of androgens, a group of male sex hormones that stimulate sebaceous glands to produce more sebum. This can clog pores and create an environment conducive to acne-causing bacteria (34, 64). Elevated insulin and blood sugar levels also promote inflammation, which worsens the inflammatory aspect of acne and makes breakouts more severe.

In a study conducted in Turkey, 86 patients kept a food log for seven days. Those with the most severe acne consumed a high-glycemic diet.

Conversely, clinical trials show that eating a low-glycemic diet helps treat acne. In the United States, 2,258 patients were placed on a low-glycemic diet to lose weight. At the end of the trial, 87% of patients reported less acne, and 91% had a reduced need for acne medications. (58)

Examples of low-glycemic foods include (26):

Non-starchy vegetables (e.g., broccoli, spinach, kale)
Fruits (e.g., berries, citrus)
Legumes (e.g., lentils, chickpeas, black beans)
Whole grains (e.g., quinoa, barley, oats)
Nuts and seeds (e.g., almonds, chia seeds, flaxseeds)
Proteins (e.g., chicken, fish, tofu)
Healthy fats (e.g., olive oil, avocado)

Reducing Dairy Intake

In a 2005 retrospective study, over 47,000 adult women were asked to recall what they ate during high school. Cow's milk was positively associated with acne; women who drank two or more glasses of milk daily were 44% more likely to have acne.

Other studies have found similar findings linking dairy intake to increased acne severity. The association between dairy and acne is believed to be due to the presence of hormones in milk and dairy's ability to promote insulin and insulin-like growth factor-1 (IGF-1) secretion. High IGF-1 levels upregulate androgen signaling, increase inflammation, and stimulate sebum production in the skin.

Dairy-free alternatives are becoming widely available, making it easier to reduce dairy intake. Examples include soy, pea, rice, oat, and almond-based milk, yogurt, cheese, and butter.

Anti-Inflammatory Foods

Increasing rates of acne are linked to the Western diet, an inflammatory dietary pattern characterized by a high intake of saturated fat, processed foods, and refined sugars.

A study involving nearly 1,300 participants in South Korea found that patients with acne consumed more instant noodles, "junk food," carbonated drinks, snacks, processed cheeses, pork, chicken, and seaweed compared to the control group, which had a higher intake of vegetables and fish. The patients with acne also had significantly higher serum IGF-1 levels than those who did not.

Eating an anti-inflammatory diet, such as the Mediterranean diet, can reduce systemic levels of inflammation contributing to severe acne types (e.g., nodulocystic acne). The general principles of this diet include consuming whole, nutrient-dense foods rich in antioxidants, healthy fats, and fiber while minimizing processed, refined foods that contribute to inflammation.

Examples of anti-inflammatory foods include:

Fatty fish (like salmon, mackerel, and sardines) rich in omega-3 fatty acids
Leafy greens (such as spinach, kale, and arugula)
Berries (like blueberries, strawberries, and blackberries)
Nuts and seeds
Extra virgin olive oil
Herbs and spices like turmeric, ginger, and garlic

Staying Hydrated

The human body is up to 65% water, and dehydration takes a toll on health – skin included. Dehydration dries out the skin and prompts the body to produce more oil to compensate, which can clog pores and trigger breakouts (50).

Adequate water intake positively influences skin physiology and mechanics, improving the skin's physical properties and overall appearance. While everyone's daily water needs will vary slightly depending on factors like underlying medical conditions, activity levels, and environment, a general rule of thumb for staying well hydrated is to drink at least half your body weight in ounces of water every day.

Building an Acne-Friendly Skincare Routine

The American Academy of Dermatology proposes the following tips for creating a basic skincare routine for acne-prone skin:

Cleansing: Use a gentle, non-comedogenic cleanser twice daily to remove excess oil, dirt, and makeup.
Exfoliating: Incorporate a mild exfoliant into your routine 1-2 times a week to help remove dead skin cells and prevent clogged pores. Physical exfoliants (like cleansing scrubs) that require manual rubbing may irritate the skin. Instead, consider using a chemical exfoliant, such as salicylic acid, to improve skin texture and appearance.
Moisturizing: Use a lightweight, oil-free moisturizer to maintain skin hydration without clogging pores.
Sun Protection: Apply a broad-spectrum, non-comedogenic sunscreen with at least SPF 30 to prevent skin damage caused by sun exposure.
Spot Treatment: For active breakouts, consider over-the-counter or prescription treatments with ingredients like benzoyl peroxide, salicylic acid, or topical retinoids. Evidence supports that natural therapies, including topical tea tree oil, aloe vera, and zinc, can also help unclog pores, reduce inflammation, and kill acne-causing bacteria.

Stress Management Techniques for Clearer Skin

Stress perpetuates acne through a complex interplay of hormonal and immunological factors:

Hormonal imbalances in cortisol, insulin, IGF-1, and androgens induced by stress stimulate sebaceous glands to produce more sebum.
Chronic stress exacerbates systemic inflammation and dysbiosis.
Stress weakens the skin's antimicrobial defenses, reducing the production of antimicrobial peptides that help control acne-causing bacteria like Cutibacterium acnes.

The relationship between stress and acne is cyclical: stress exacerbates acne, and acne-related psychological distress can increase stress levels. Managing stress can break this cycle and improve acne outcomes.

Examples of stress-reducing practices include:

The Importance of Quality Sleep

Given the multitude of reasons our bodies need adequate amounts of quality sleep, it should come as no surprise that the negative consequences of poor sleep quantity and quality extend to skin health. Poor sleep quality has been linked to increased acne severity, which can be explained by hormonal imbalances, inflammation, psychological stress, and impaired skin repair that result from insufficient sleep.

Here are tips to improve sleep hygiene to get adequate sleep:

Establish a regular sleep schedule by setting a consistent time to wake up and go to bed every day.
Avoid blue light-emitting screens before bed that can interfere with melatonin production.
Create a comfortable sleep environment by keeping your bedroom cool, dark, and quiet.
Use natural sleep aids to help you fall asleep faster and stay asleep through the night. Research suggests that chamomile, lavender, and magnesium work in various ways to help you get a restful night's sleep.

Daily Habits to Support Acne-Free Skin

Touching your face can transfer bacteria, oil, and dirt from your hands to your skin, leading to breakouts. Although it can be tempting, popping zits can prolong the time it takes acne breakouts to clear and increase the risk of infection and residual scarring. Therefore, dermatologists recommend keeping your hands off your face and avoiding picking zits. (46)

If you tend to have an oily scalp, the oil from your hair can cause acne along your hairline. Shampoo your hair regularly and keep your hair away from your face. (46)

Cell phones harbor bacteria; on average, 68% of phones are contaminated with antibiotic-resistant bacteria that can be transferred to your hands and face. Clean your phone screen regularly to prevent the transfer of bacteria to the skin.

Exercise doesn't cause acne; however, when sweat mixes with oil, bacteria, and dead skin cells, it can clog pores and trigger acne breakouts. Washing your skin immediately after working out can prevent breakouts by keeping the skin clean of debris that clogs pores.

Holistic Approaches and Supplements

The gut-skin axis refers to the connection between gut health and skin health, highlighting how imbalances in the gastrointestinal system can influence skin conditions, including acne. Poor gut health, characterized by dysbiosis (an imbalance between beneficial and harmful gut bacteria) or increased intestinal permeability ("leaky gut"), can lead to systemic inflammation.

Research supports using probiotics to improve acne treatment outcomes by restoring balance to the gut microbiome. Probiotics help reduce systemic inflammation, modulate immune responses, and support gut barrier function, all of which can positively impact skin health. Studies have shown that probiotics can reduce acne severity, particularly those containing Lactobacillus and Bifidobacterium species.

Supplemental vitamin D can also be a valuable addition to a gut-based approach to treating acne. Vitamin D deficiency is more often measured in patients with acne and is directly correlated to acne severity. Furthermore, giving vitamin D to patients with acne has been shown to improve the symptoms of inflammatory acne. (45)

When to Combine Natural Approaches with Conventional Treatments

Incorporating natural remedies alongside conventional treatments, such as topical retinoids or antibiotics, can be beneficial for managing acne. Together, these therapies can have a synergistic effect, potentially expediting treatment outcomes by tackling both the root causes and surface symptoms of acne.

Patients should always consult a healthcare provider, such as a dermatologist, before significantly changing their skincare routine and acne treatment plan. Integrative dermatologists can help ensure that the natural and conventional treatments complement each other and don't result in negative interactions.

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Key Takeaways

Managing acne naturally involves making lifestyle changes and adopting daily habits that support skin health.
Simple adjustments, such as following an anti-inflammatory diet, getting adequate sleep, managing stress, and maintaining a consistent skincare routine, can make a significant difference.
Consistency is key. Natural methods often take time to show visible results. However, when integrated into a comprehensive acne management strategy, these changes can play a valuable role in improving skin health and reducing acne over time.