Acne is often treated as a purely surface level issue. Spot creams, antibiotics, benzoyl peroxide, stronger retinoids. But for many people, the breakouts return as soon as they stop.
That is because acne is rarely just a skin problem.
Emerging research shows that acne is closely connected to the microbiome which includes the trillions of microorganisms that live on our skin and inside our digestive system. When this complex ecosystem becomes imbalanced, inflammation rises and breakouts can appear or worsen.
As a functional medicine and dermatology doctor in Manchester, I look deeper to understand why acne is happening, not just how to temporarily suppress it.
Here is how the microbiome can influence acne and what you can do to improve both your inner and outer skin health.
The Skin Microbiome and Acne
Our skin is home to beneficial bacteria that protect against inflammation, strengthen the skin barrier, and support healthy oil production.
When this microbiome is disrupted through harsh skincare, over cleansing, antibiotics, stress hormones, or diet, the less helpful C acnes bacteria can dominate.
This imbalance leads to:
- More oil and blocked pores
- Increased redness and inflammation
- Slower healing and longer lasting marks after acne
Restoring the right microbial balance is important for calmer, clearer skin.
The Gut and Skin Connection
Your gut microbiome influences:
- Hormones that regulate oil production
- Immune responses that drive inflammation
- Digestive function and nutrient absorption
- Stress resilience through the gut and brain connection
Research shows people with acne often have gut dysbiosis, IBS, constipation, or food sensitivities. When the gut is struggling, the skin can become an exit route for inflammation.
Why Traditional Acne Treatments May Not Be Enough
Topical treatments may only be addressing the visible symptoms.
Antibiotics can improve acne in the short term but can also damage the gut microbiome which may trigger recurrence or worsening of acne later.
This is why functional dermatology takes a root cause approach, looking at internal factors such as:
- Digestion and stomach acid
- High sugar or refined diet raising insulin
- Omega 6 to omega 3 imbalance driving inflammation
- Hormonal shifts including stress and PCOS
- Sleep and nervous system balance
- Nutrient deficiencies such as zinc vitamin D and B vitamins
Supporting what is happening beneath the surface can transform outcomes.
The Inside Out Approach
My functional dermatology programmes include:
• Microbiome and barrier repair
• Personalised nutrition guidance
• Medical skincare tailored to your needs
• Hormone and metabolic assessment
• Gut support and targeted supplementation
• Regenerative in clinic skin treatments if needed
Every plan is designed to calm inflammation, support healthy oil balance, and restore the microbiome on and under the skin.
