Find the True Cause of Acne in Your Skin, and You’ll Never Look Back

Acne woes can feel overwhelming, no matter what age you are, right? Acne causes discomfort, insecurity, and feelings of frustration.

Waking up to red, puffy, puss-filled, or irritated skin is never fun. 

You assume the cause of acne is mostly your skin (that’s where it’s showing, after all!). 

You’ve tried all the products. 
All the expensive serums and creams. 
The miracle overnight patches. 

You’ve probably even tried a few natural solutions for acne. (Toothpaste on a pimple, anyone?) 

Yet you continue to fall into patterns of breakouts that leave you dry, irritated, and emotionally worn out. Which probably leaves you wondering if you’ll ever figure out what’s causing your pimples. 

We’re here with a bit of good news and a bit of guidance. When you’re able to take a bird’s eye view, sometimes your skin isn’t even the problem. In fact, most times, mainstream medicine leads us to believe skin is the ONLY reason we’re experiencing breakouts and acne. 

But the body is much more complex than that, and at Primally Pure, we believe the skin reflects the whole body’s status, not just the surface. We’re here to show you why the cause of acne is probably not limited to your skin, plus what you can do to get to the root cause of acne. A holistic acne treatment will help you say goodbye to breakouts with a new inventory of management + knowledge to fight back. 

Our hope is that you (and your skin) will find much-needed relief below.

Root Cause of Acne – Inflammation in the Body

Finding the root cause of acne in your body is simple yet complex. We know one thing for sure: acne is an inflammatory response. And we all deal with inflammation on some level. So getting to the root cause of acne poses the question: what’s causing inflammation in your body?

While inflammation is a normal response, to a degree, you don’t want to let it get out of hand or take over. In a world moving at 100mph and technology at our fingertips, inflammation can be caused by just about anything. 

Still, there are reliable answers when it comes to the root cause of acne and, by default, the root cause of inflammation. 

Poor Sleep Quality/Quantity

Let’s start here because this topic doesn’t get enough attention.

30% of Americans don’t get enough sleep (less than 6 hours!).1

And over-exposure to blue light has made matters worse by interfering with our circadian rhythms, which regulate healthy sleep patterns.

Studies show your brain plays an active role in flushing out toxins during sleep.2 So when you’re lacking proper, deep, and restful sleep, your body cannot rid itself of toxins to fight off inflammation in your body – including the cause of acne in your skin. 

Hormones are also released during sleep, contributing to muscle mass, fighting infections, and repairing cells (aka skin regeneration).3

Sleep is not the only cause of acne, but it’s the best way to help your body reset and fight inflammation.

Imbalanced Hormones

You’ve probably heard hormones can be the cause of acne. But hormones aren’t the issue – it’s the imbalance. Your body is designed to function with a specific balance of hormones. And because hormone production happens while we sleep, acne caused by hormones can often accompany poor sleep. Hormonal imbalances can also result from exposure to endocrine-disrupting chemicals.

And yep, you guessed it, a hormone imbalance almost always affects the skin to some degree. Imbalanced hormones raise our stress levels, sending the hormone cortisol (the fight or flight hormone) into overdrive:4

“High cortisol levels prompt the skin’s sebaceous glands to produce more sebum (oil). The additional oil clogs the pores leading to the development of inflammation and bacteria –  resulting in acne.” 


This cause of acne is no surprise. Stress has long been known to affect your body negatively – no one is arguing that. But studies continue to show that stress also directly affects the state of your skin and the severity of acne and breakouts – including its hydration and skin barrier.5

Why does stress so often result in acne? A New York Times article titled “This Is Your Skin on Stress” does a great job of breaking down the psychology + science behind it. This quote from Dr. Loretta Ciraldo, a well-respected dermatologist, is helpful in understanding why stress present itself through skin issues:6

“It takes a toll on the entire being, of course, and a compromised complexion is the least of its consequences. But the skin is the organ that we see.” 

Dr. Ciraldo went on to explain how in times of stress your beneficial oil production is slowed, causing irritation and less protection on your skin surface. Without the protection, your skin loses moisture. It’s bad news from there because your skin decides to kick in overdrive to compensate by producing extra sebum, causing excess oil (and ultimately, breakouts).6

It’s not hard to see how stress is a cause of acne since we know there’s a direct link between inflammation and stress. The important question is: how do you handle your stress?

Excessive Hygiene 

There’s such a thing as too much hygiene. And while hygiene is extremely essential, we’ve taken it to an extreme that might actually contribute to the cause of acne. Dr. Whitney Bowe explained this brilliantly in a recent podcast interview on The Art of Being Well.7 Known for her groundbreaking work with linking diet to skin health, she touched on the importance of letting our skin bacteria flourish:
“We all embraced the germ theory, that all bacteria are bad and we need to scrub down our counters, scrub down our skin. And there was this huge trend towards actually scrubbing, brushing, and exfoliating our skin (Clarisonic was huge, face brushes, and people were scrubbing away).
They wanted that squeaky clean feeling, but that’s partially responsible for why we’re seeing this epidemic of chronic skin conditions – because, in the process of trying to achieve that squeaky clean feeling/environment, we ended up really damaging a lot of the healthy bacterial strains on our skin – and even our gut. And, as a result, we set ourselves up for chronic low-grade inflammation.”

Dr. Bowe believes healthy skin should act like a barrier, trapping moisture to block harmful irritants, allergens, and pollutants from entering your skin. Why? It stimulates inflammation, which is a cause of acne.

Safe to say there’s a delicate balance when it comes to hygiene.

Gut Issues

There’s a clear link between the gut and skin microbiomes, even if it’s not fully understood yet.8 Becoming more accepted as another contributing cause of acne, we’ve seen how gut issues affect your entire body’s health. 

Our skin cells (and the rest of our body’s cells) are formed from what we feed our body.

And as Dr. Whitney Bowe pointed out, “If your gut is inflamed, it’s VERY likely that your skin is going to be inflamed as well, indirectly. Everything talks to the immune system.” That’s why a diet consisting of anti-inflammatory foods can help with your skin health, though the dermatology field never wanted to address it before. 

Dr. Bowe opened up about her education and what’s been missing in the dermatology field. She saw the critical link between diet and skin and set out to do something about it. As she said:7

“Even the giants in my field were talking about how diet does not affect your skin. We were supposed to dismiss it as myth and hand them a prescription for antibiotics. That’s actually what I was taught in my dermatology residency and in medical school. And that’s what all of our resources said – the most reputable websites, the most reputable journal articles, and our textbooks. They all said, ‘diet has no impact on the skin.’” 

Dr. Whitney Bowe’s pioneering research led to her controversial article, “Diet and Acne.” Since then, there have been widespread changes in the dermatology world catching on! Yes!

Aside from food allergies or unhealthy diets, gut issues can also stem from something you didn’t know any better than to say yes to, like topical/oral antibiotics. More on that later.

Whether you like it or not, gut health has strong + direct ties to your skin health and could be contributing to the cause of acne.


We all know we eat too much sugar. It’s just SO hard to cut out of your diet without a lot of effort and habit building, right?

But sugar is one of the most detrimental things you can consume. It’s not only directly linked to the severity of acne9 but also premature aging.

Try your best to limit your sugar intake. Your whole body will thank you!

Toxins in the Environment

Toxins are everywhere – in our houses, the air, and our products

The more we can protect ourselves from these toxins, the less exposed we are to the growth of bacteria, inflammation in the skin, and painful breakouts. The more you eliminate these exposures, the more you eliminate the cause of acne.


A hard truth: some people are just more prone to acne than others.

Unfortunately, there’s not much we can do about this cause of acne. Some people just have genetics that predisposes them to more severe or persistent forms of acne. But don’t lose hope, you can still fight back! 

As you can tell, all these lifestyle factors that contribute to inflammation have a lot of overlap. They’re all working together – for your best or your worst interest. That’s why it’s so important to remember all our choices matter, directly related to our skin or not. And it’s also why conventional acne remedies might not be working…

Conventional Acne Treatments/Suggestions Might Not Be Helping With the Cause of Acne

It’s crucial to understand the misconceptions around prescribed or aggressive skincare. Why? Truth be told, it’s not fixing the root cause, it’s often a bandaid. And when you don’t fix the root cause of acne, you can almost always expect it to return. 

Antibiotics Prescribed for Acne

Though we’ve already touched on this with gut health, it’s crucial to understand how antibiotics work (and how they don’t work for acne long-term). 

With antibiotics, even if you kill off the harmful bacteria causing acne, you’re likely wiping out the good bacteria too – which your skin health depends on! So if you’re not addressing the root cause of acne, you’ll probably need another round after a while. 

And another. 

And another. 

It can become a vicious and exhausting cycle.

On top of that, repeated antibiotics can lead to antibiotic resistance, which is terrifying when you end up in a situation where antibiotics are your only life-saving option.8 And while it’d be easy to blame this all on dermatologists, Whitney Bowe points out that it’s simply what they’re taught – to put out fires until it’s necessary to do more. There’s no incentive to take a proactive or holistic approach. The problem stems from much higher up.

Aside from the fact that it’s not good to mess with your microbiome, we prefer to leave antibiotics to absolutely crucial situations.

Over the Counter (Non-Prescription) Acne Products

We’ve probably all tried some of these popular products – the infamous St. Ive’s scrub or Proactiv regimen that are supposed to fight the cause of acne. But conventional acne products in drugstores are usually created with ingredients that strip or damage skin that’s already inflamed instead of healing and soothing.

Dr. Whitney Bowe painted a clear picture of why these harsh exfoliants and chemical-based products aren’t helping your skin health – or acne:7

“Unfortunately, when we do certain things with our skincare, certain types of cleansing, exfoliating, and skin care habits that we engage in, we can end up with dysbiosis of the skin. The bacterial balance is off on the skin – and that barrier function is no longer able to function properly. The water is evaporating out of the skin's surface. The skin is dehydrated – it’s not as dewy or healthy. 

Similar to how Dr. Ciraldo explained it, a compromised skin moisture barrier means your skin has less protection against pollutants, allergens, and pathogens that should NOT be in your body. They stimulate low-grade chronic inflammation which is the cause of the skin type known as “sensitive.”

Inflamed/sensitive skin doesn’t need to be exfoliated. Popular products with ingredients like salicylic acid are known endocrine disruptors that strip the oil, causing:

  • Dryness and flaking
  • Further discomfort
  • Excessive oil production
  • An imbalanced skin microbiome

The biggest takeaway: there’s far too much exfoliation happening in our skincare – both chemical and physical.

Toxic/Synthetic Acne Remedies That Don’t Fix the Cause of Acne

There are several routes you can go to eliminate acne. And after years of fighting acne, sometimes it’s easy to believe a chemical or synthetic route is your only option, even if it comes with known risks. Some of these last-ditch resorts (or first resort for those with severe and persistent acne) are quite dangerous yet widely used and advertised as a solution. 

Two of the biggest culprits: Accutane and hormonal birth control.

Accutane, often prescribed for teenagers at their wit’s end with acne, was initially used as a chemo treatment. Accutane adds to your body’s toxic load and inflammatory response. It’s a very intense drug that makes your skin extremely dry, sensitive, itchy, and uncomfortable. It poses severe risks with pregnancy or over-exposure to the sun. 

And yes, it might be effective in eliminating your acne over time, but it can do lots of damage to your body in the process.10

Hormonal birth control is another popular option, often viewed as an easy, long-term fix. But the only thing that’s really happening is your body being tricked with synthetic hormones. So, what happens when you come off birth control? Not only does your acne often return, but many women also experience infertility issues or irregular periods for many years.

Lis Hendrickson-Jack, a Fertility Awareness Educator and Holistic Reproductive Health Practitioner, has some pretty interesting things to say about birth control (HCs) in her book “The Fifth Vital Sign”:11

“HCs subject your body to a cascade of hormonal changes that have untold effects on every part of your experience as a woman. They affect your physical body. . ., your emotional well-being. . ., your sex life . . ., your choice of an intimate partner, and they disrupt how your body metabolizes and stores nutrients (B vitamins and others). I can’t tell you how many women I’ve spoken to who had no idea the pill was affecting them…until they stopped taking it.”

These modern conventions are hard pushed as an easy fix, but real skin healing comes from intentional time spent looking at the causes of acne unique to your lifestyle, habits, and circumstances. Aka our holy grail: holistic acne treatment.

Our Recommendation: Try a Holistic Acne Treatment Instead 

Of course, true to our roots, we recommend a holistic acne treatment. Our skin signals what’s going on inside, so if we see the distress on the outside, it’s our body’s way of telling us to slow down and pay attention. Here’s a list of ideas for a personalized holistic acne treatment – so you can focus on slow, impactful healing that eliminates the root cause of acne, leaves your body healthier, and your skin glowing.

Reduce Stress 

Stress is a known cause of acne for most people, but here’s your gentle reminder. This is one of the best natural solutions for acne. Taking time to unwind and minimize stress can do wonders for your skin health. Believe us when we say you’ll want to prioritize this. Mind over matter!

  • Try a massage tool or a massage with a professional if it’s within your budget.
  • Attend a yoga class a few times a week.
  • Look up some youtube videos on breathwork or meditation.
  • Create a soothing routine with a gua sha stone or facial brushing.
  • Schedule a session with a counselor. 
  • Sing in the shower, in the car, wherever you can!
  • Write your stress on paper to release it mentally + free up space.

Overall, remember the importance of a mindful relationship with your body and learn to pay attention to when you need to slow down. Your body will thank you.

Prioritize a Clean Diet

You hear us talk about diet all the time, but it really is true – inflammation is a root cause of acne! Diet affects inflammation – and, like it or not, it affects your skin too.12 This holistic acne treatment may not be immediate, but it’s a game-changer if you apply the following principles:

  • Consume whole foods + healthy fats for cellular repair
  • Prioritize antioxidants to fight external factors + support skin regeneration/healing
  • Avoid inflammatory foods (no sugar, gluten, alcohol) to keep inflammation at bay

There’s enough research out there to convince you to clean up your diet, but with this bonus information, a clean diet is a no-brainer. We love clean diet regimens as natural solutions for acne!

Get Better Sleep

Find ways to wind down earlier + sleep deeper. Not only will you feel better, but your skin will have all the support it needs to heal acne, inflammation, and redness. Start with the basics:

  • Limit blue light exposure before bedtime
  • Create a soothing routine you look forward to
  • Try to go to sleep + wake up on a consistent schedule
  • Use a face mask or blackout curtains to block light during sleep
  • Stop drinking caffeine in the afternoon
  • Avoid eating a few hours before bedtime, so your food has time to digest
    You’ll see improvements in so many areas of your life with better sleep and your quality of life skyrockets.

    Clean Up Your Environment

    Toxins are following us everywhere we go. The more you can eliminate environmental stressors, the more inflammation will decrease, and your skin can thrive. Toxins might not be the direct cause of acne, but they sure don’t help.
    • Check out this post on eliminating toxins
    • Focus on removing products that contain endocrine disruptors that contribute to acne
    • Learn how to avoid greenwashing and label read to avoid chemicals
    • Avoid fragrances which can be very irritating to the skin

      Eliminating exposure to toxins is crucial in protecting our skin microbiome and letting our skin detox and heal on its own. Don’t doubt your body’s ability to recover.

      Don’t Be Scared of Oil + Moisture as a Holistic Acne Treatment

      Oil is a powerful ingredient to reset your skin, maintain moisture, and support graceful aging.  Here’s how to embrace moisture, even with acne:

      • Stay away from alkaline products which can disturb the skin barrier
      • Choose products rich in antioxidants and fats that lock in moisture and protect your skin

        Embrace moisture! Inflamed skin doesn’t need to be stripped and exfoliated – it needs soothing, healing moisture that resets your skin microbiome.  

        Balance the Skin Microbiome

        We believe in the power of re-balancing the delicate skin barrier, known as your skin microbiome. Everyone has a unique microbiome, but there are plenty of ways to support a healthy, full microbiome: 

        • Try a gentle exfoliation through facial brushing to restore circulation
        • Consider a product with tallow to add extra nutrients + moisture
        • Work up a sweat to regulate moisture + detox 
        • Use a toner to reset your skin’s ph after cleansing
        • Let the skin breathe whenever you can + expose your skin to the sun in the mornings!
        • Only use skincare with natural preservatives like rosemary extract and non-GMO vitamin E

          Your skin microbiome is key to happy and healthy skin – prioritize it to reap the benefits!

          Simplify The Cause Of Acne + Lean On Natural Solutions For Acne That Actually Work

          Inflammation is a complex, multi-faceted reaction in our body, but it's the true root cause of acne. If you don’t give enough attention to your lifestyle, habits, and circumstances, it’d be easy to think none of the natural solutions for acne are working. It’s about the bigger picture when deciding the cause of acne with your unique situation.

          Holistic acne treatment can create long-term healing by nudging gentle cell turnover, encouraging lymphatic flow, and supporting a healthy skin barrier. Your skin heals itself from the inside out – and that’s when you find the best results. 

          Ready to get started?



          1. National LibrNaary of Medicine | Short Sleep Duration Among Workers--United States, 2010
          2. National Library of Medicine | Brain May Flush Out Toxins During Sleep
          3. MedlinePlus | Healthy Sleep
          4. Westlake Dermatology | Stress and Your Skin: How Cortisol Affects the Skin 
          5. National Library of Medicine | The Association Between Stress and Acne Among Female Medical Students in Jeddah, Saudi Arabia   
          6. The New York Times | This Is Your Skin on Stress
          7. The Art of Being Well with Dr. Will Cole | Dr. Whitney Bowe: Skin Microbiome Secrets, Myths + Best Practices For Clear, Glowing Complexion
          8. National Library of Medicine | The Gut Microbiome as a Major Regulator of the Gut-Skin Axis
          9. Science Direct | Diet and Acne: A Systematic Review
          10. DrugWatch | Accutane Side Effects
          11. The Fifth Vital Sign by Lisa Hendrickson-Jack | The Pill and Your Fertility
          12. American Academy of Dermatology | Growing Evidence Suggests Possible Link Between Diet and Acne

          Pin your fav blog post below:

          Find the True Cause of Acne in Your Skin, and You’ll Never Look Back | Primally Pure Skincare

          Leave a Comment