Transcript lightly edited for readability. Percentages and studies mentioned on air reflect the hosts' clinical experience unless linked in Sources below.

Why does acne keep coming back after creams and treatments?

0:00 Liz Roman: It's coming out your skin, whether that's acne, it's rosacea, it's eczema, it's psoriasis. If you're not pooping every day, you're not detoxing. Even if you're pooping every day, you can still be constipated. Because if we don't get to the root cause, it's gonna come right back. It's like holding a beach ball underwater. Once you remove that pressure, maybe that cream or whatever that Band-Aid solution is, it's gonna all come back and rear its nasty head.

0:23 Becca Chilczenkowski: I see this even during perimenopause. I think as the hormones start to fluctuate again and we lose progesterone, people start experiencing acne again in life or when they never had it to begin with. Forehead I think is definitely stress, some digestion, but a lot of more so stress. Cheeks are, like, liver, gallbladder detoxification, and jawline and chin are typically more hormonal. We know that any type of skin condition, 80% of it is internal.

0:46 Liz Roman: People are like, "I've had rosacea for years. I've had psoriasis for years." And I'm like, "Well, you've had gut dysfunction for years." You got pimps on your face, then this is the episode for you. Welcome back to the Health Revival Show. We are talking all things acne and how do we address acne, what do we evaluate, because many of you are probably like I was as a teenager, who was just told to take the very harsh either Accutane or the skin treatments that were very very drying and exfoliating. So Proactiv was the line that I was scarred by as a teenager.

1:20 Liz Roman: I don't know if you guys know what that is, but they used to even sell it out of vending machines at the mall. And it was, like, the astringent and it was just really harsh on the skin. So if you are listening to this, maybe it's not you, maybe it's your friend, maybe it's your daughter who's going through it in puberty, this episode's for you. And with that, I would say share this with them. All you gotta do wherever you're listening is copy the link, send it over, and be like, "Hey, my girls Liz and Becca broke down acne today. You gotta listen to this episode." Because we're gonna give you some actionable steps that you can take that are gonna help you resolve the root issue, not just give you a cream that your doctor might do that's gonna maybe Band-Aid or mask an underlying issue.

2:00 Liz Roman: Because if we don't get to the root cause, it's gonna come right back. It's like holding a beach ball underwater. Once you remove that pressure, maybe that cream or whatever that Band-Aid solution is, it's gonna all come back and rear its nasty head.

Why am I getting acne in perimenopause when I never had it before?

2:13 Becca Chilczenkowski: And I mean, I see this even during perimenopause. I think as the hormones start to fluctuate again and we lose progesterone, people start experiencing acne again in life or when they never had it to begin with. I'm very fortunate that I never really dealt with it — my brother dealt with horrible acne to where, like, it scarred really, really bad on his face. And he did Accutane. And you know, I'm not gonna not say he has a bunch of gut issues now. So I think that there is probably that was going on before all of this, and he really does not tolerate dairy.

2:45 Becca Chilczenkowski: It's, like, a known thing in our family. So I'm sure that there was some stuff going on that was driving the acne. But I feel so bad 'cause I-

2:52 Liz Roman: And talk about Accutane though and how horrific it is, and I don't-

2:57 Becca Chilczenkowski: So bad for your liver

2:58 Liz Roman: It's horrible for the liver, but I don't think that people realize that how, like, suicidal people become when they're on Accutane. So, mom, wherever you're at, stop the freaking car and turn around and go back to the doctor and get your daughter off of Accutane because there are so many other things, and we can dive into that too while we're in this episode, that you can be doing. Get off of that as fast as possible, please. We would beg you. It is horrific for your body.

Editor's note: Isotretinoin carries a prominent warning about depression and suicidal thoughts, though a direct cause-and-effect link has not been established. If you or your child notice mood changes while taking it, contact the prescriber right away. Please don't stop or change any prescription without talking to the prescribing doctor first.

3:25 Becca Chilczenkowski: Yeah, it's not good.

What does the location of your acne mean?

3:26 Becca Chilczenkowski: So let's dive into kind of what we look at is a lot of times, like, facial mapping. This is by no means, like, the end all be all of where the acne is and exactly what's driving it, but I think that it does have some warrant in terms of what we see consistently clinically at least in terms of where we're seeing the acne and kind of what, you know, what is a piece of it. So start with the top of the head, the forehead. This a lot of times can be stress related, digestive related, kind of like an irritable bowel type situation because the… If someone's breaking out up there, we need to look at also hair products and what they're using that, like, they may be getting on the forehead with their hair, right, being so close to that area.

4:09 Becca Chilczenkowski: But I see a lot of times this related to the digestive system and stress, poor diet, things going on in the gut a little bit more so. So forehead a lot of times is more digestion. Between the eyebrows we're kind of in this, like, zone. They call it, like, the T zone, right? So the eyebrows also can be that whole detoxification gut/liver axis 'cause the liver plays a big role when it comes to kind of that eyebrow area above the eyebrows in between the eyes type situation.

4:39 Liz Roman: Gallbladder typically.

4:40 Becca Chilczenkowski: Cheeks. Yep. Yep.

Can mold in your home cause acne?

4:42 Becca Chilczenkowski: Cheeks I see be more detoxification. So for a lot of the clients that I've seen, and even friends of ours, cheeks and then chin sometimes is mold. So I've seen this in a number of cases to where they are living in mold and when they get out of it, it doesn't, like, all get better, but then the treatment that they are doing starts to work a lot better. And I've seen this with one of my big acne cases, and then our friend Lindsay went through this, and she was living in mold, and her acne would, like, get slightly better and then get worse, get slightly better and then get worse.

5:18 Becca Chilczenkowski: And so I would definitely not put it past the environment and what you're being exposed to, because I do find that cheeks and chin is a big detoxification factor. So, like, we know how much mold stresses out your liver and gallbladder because mold is eliminated via bile and it's a fat-soluble toxin. So that's something that I think doesn't get enough press.

5:40 Liz Roman: Not saying, but I'm saying I was right 'cause I said to her so many times, I'm like, "Girl, you've got to do it." And then I remember the day she called me and the guys were there checking the AC units, and she's like, "Oh my God, it's all up in here," you know? And actually I just heard from another friend of ours who's a provider, they found over 7,000 spores in their AC unit, and her daughter has also been struggling a lot with acne and just — you know, other GI issues.

Is your acne coming from candida, hormones, or your liver?

6:07 Liz Roman: When we talk about this, I wanna think, you know, what could be the conditions that we would look for? And, you know, you already mentioned digestive you know, issues. But more specifically, we are gonna be looking at the fungal side of things. So it could be absolutely mold mycotoxin thing in the environment. It could also be candida that's being fed by a poor diet and a lot of sugar, which also we know drives inflammation, stresses the liver. So it's all gonna be interconnected here, and that's just something that you would wanna think about as ground zero of the diet especially.

6:41 Liz Roman: And then, you know, I would also ask if you're noticing this pops up during, you know, stressful times or ovulation or menstruation, right, it's kinda more cyclical, then this is where we're gonna say, "Okay, it could be more hormonal imbalance. How can I go back and support the liver to detox my hormones?" Because again, just like mold mycotoxins, our liver packages up all kinds of different toxins and utilized hormones or metabolized hormones and sends it back to the gut to be eliminated through your stool, also through the kidneys, some go there, and then obviously our skin via sweat.

7:18 Liz Roman: But that shit will come out your skin.

Can constipation cause acne even if you poop every day?

7:19 Liz Roman: So if you're not pooping every day, you're not detoxing. Open that drain first. Look to the liver. I believe 90% of constipation is liver/gallbladder issues. When we really look at the mechanisms that can help motility, yes, we can work on, you know, more [migrating motor complex] and things that can be more prokinetic to give that stimulating movement downward with ginger and bitters and all these kinds of things, but many people don't realize because that Grand Central Station is so overloaded, we are experiencing more of a backup. Even if you're pooping every day, you can still be constipated, and a telltale indication is that you're more tired and shit's coming out your skin, whether that's acne, it's rosacea, it's eczema, it's psoriasis.

8:08 Liz Roman: All of those inflammatory skin issues your body has to try to eliminate some way, somehow. And so if you're not fully emptying, you can see that happen here more. And I would just say go back to, again, foundations. Ground zero. You wanna make sure that you're hydrated. The solution to pollution is dilution. You're evaluating your water quality, your air quality in your environment, and then that you're supporting your body with a lot of antioxidants, bioflavonoids, things that can really help your liver and your kidneys out to get rid of this stuff.

8:39 Liz Roman: Because most people will just say, "Okay. Well, I notice that it's here, so I'm just gonna go on birth control," because if it's a hormonal issue, like, that's gonna be all that it is.

How can you tell fungal acne from hormonal acne?

8:48 Liz Roman: If it's a fungal issue too, I thought Rachel Shere, one of our friends, she did a presentation on this, did a really good job covering this topic in regards to it looks a lot more bumpy, right? Versus actual, like, cystic acne, where there's pimples and they're whiteheads. It looks just more like real rough skin and little bumps under the skin. That's gonna be kind of at a classic indication that you're looking more at a fungal and a yeast issue than hormonal issue.

9:15 Becca Chilczenkowski: Yeah.

What does jawline and chin acne mean?

9:16 Becca Chilczenkowski: I think in general, what I would say is kind of the big areas is, like, forehead I think is definitely stress, some digestion, but, like, a lot of more so stress. Cheeks are, like, liver, gallbladder detoxification, and jawline and chin are typically more hormonal. I would say, like, that is kind of the general picture. Yes, there's… You can get much more specific with that in terms of, like, the temples and the nose and above the eyebrows and all these different things. But I think in general, it's those three big areas, right?

9:44 Becca Chilczenkowski: And it's that chin, jawline, traditionally this is reproductive. Traditionally, this is what's fluctuating with the menstrual cycle with stress, right? And there's actually a lot of medical, like, modern clinical sources that kind of back this up. And it finds that it flares before the cycle, tends to be deep cystic like you were just talking about and painful rather than surface level and it's frequently tied to PCOS and androgen, you know, excess of androgens relative to estrogen for females. So I think when it comes to facial mapping, those are kind of the three big areas, and we tend to see that pretty consistently.

How does a pimple actually form?

10:20 Becca Chilczenkowski: So let's talk a little bit though on, like, what's happening underneath the skin because we know that any type of skin condition, whether it's acne, whether it's psoriasis, whether it's eczema, whether it's, you know, perioral dermatitis, like all of these things, 80% of it is internal. You know, 20% is gonna be topical, 20% is gonna be what are you being exposed to, what topical products are you using, all of that. But there are really kind of three things that have to happen to form an actual pimple. First, your oil glands have to be producing more oil than normal, and that's driven a lot of times by androgen hormones or testosterone acting on kind of receptors at the skin.

10:56 Becca Chilczenkowski: Second, your skin cells have to be shedding abnormally. So instead of shedding smoothly off the surface, dead skin scales are actually getting sticky, and they clump together inside of your pore, which is what actually impairs what's called desquamation. And then third, once oil and dead skins are trapped together in this clogged pore, that becomes a very good low oxygen environment for bacteria to essentially create overgrowth, trigger the immune system, send inflammation, and then the inflammation is what turns into a swollen red pore that's creating the breakout, right? So it's kinda like a drain.

11:32 Becca Chilczenkowski: Your pore… Think of your pore kinda like a drain, and under normal conditions oil flows, it goes up and out smoothly, dead skin cells shed off your skin at this like a single time and nothing backs up. And then oil production ramps up and those dead skin cells start getting sticky instead of shedding cleanly, and then we end up with like a literal clog forming, right? So acne is never just about the bacteria. It's about like this whole cell turnover situation that's also being impaired. And that's where, you know, we're looking at like how are cells dividing, how is autophagy working in the system?

Does blood sugar or PCOS cause acne?

12:06 Becca Chilczenkowski: And we see a lotta times blood sugar be a big issue with this because guess what? If you're dealing with PCOS, PMOS, whatever we wanna call it, and blood sugar issues, we know you're not getting into autophagy. You're not allowing your cells to be dividing, clearing, dying off, exiting as they should be. So this is where I think of like a big piece of what we just talked about that causes actual acne is the cells are not clearing how they're supposed to. So you know, it comes back to the metabolism yet again — and how well we are, and inflammation.

12:38 Becca Chilczenkowski: And inflammation. And all the root issues that are always there.

Is chronic acne a sign of gut dysfunction?

12:42 Liz Roman: Yeah. And this is always funny when people are like, "I've had rosacea for years. I've had psoriasis for years." And I'm like, "Well, you've had gut dysfunction for years. Tell me what other autoimmune condition that you have." Because I truly look at these skin conditions as autoimmune conditions. And the longest study, we heard Dr. Huberman talk about this, the longest study to date shows chronic skin issues increase all-cause mortality. It's still a study that's ongoing. It's pretty wild. And it's because, as we would say, your skin is a window to the inside.

13:16 Liz Roman: We both love Olivada. Why do we love Olivada? We love Olivada because their mission is beauty within. The first product they ever created was camu camu hydroxytyrosol from the olive leaf extract. High in antioxidants, high anti-inflammatory vitamin C. It supports our immune system, right? And so it's incredible when you really look at what's on the market too with things that people are putting on their skin, all of the nasty ingredients, the preservatives, the additives.

Can your shower water, detergent, or pillowcase cause breakouts?

13:43 Liz Roman: If you even go and you look at, for example, like, other skin issues in different parts of your body, I'm like, "Okay. Well, tell me about the water that you're showering in. Tell me about the laundry detergent that you're using. Tell me about the body wash that you're using." And the same thing would apply here because if we're looking at the face, right, you're laying in your bedsheets, you're laying on your pillow. Maybe you're not cleaning it appropriately or you're reacting to something there. A lot of these toxins, it's like, okay, I just don't think that that's gonna impact me much.

14:11 Liz Roman: But you do that 100 times over, day in and day out, and that toxic burden slowly builds up. And then you're not detoxing it, as we've already talked about several times here. That shit's gonna come out your skin. So this is where we have to say go and look at what's happening with your metabolic health, with your detoxification pathways, with your gut health. You know, if you cannot keep your gut microbiome supported, because I actually have in the Skin Fix guide a lot of different probiotic options that relate to different conditions, and skin conditions specifically.

14:45 Liz Roman: So you can go to my Instagram and comment Skin Fix. It's a free guide. But I poured a lot of things in there that would tell you around rosacea what are some of the underlying causes that we see, right? What is happening with the bacteria in our gut microbiome, and what strains might be helpful? And then, you know, again, always thinking about a low and slow approach. It's both internal and topical when you're dealing with chronic skin issues, and I would say the same thing for acne, especially if it's continuing to come back.

15:14 Liz Roman: And I just don't think a lot of people think about that.

Does dairy cause acne?

15:18 Liz Roman: From a dietary perspective, we do see that dairy is one of the big triggers for acne. I'm gonna tell you though that I've gotten people off of daily allergy medications and done the gut-healing work, and they brought in dairy just fine and never had, you know, the histamine response because it was a lot of sinus issues. It produces a lot of mucus. What does that do? It can produce a lot of that sebum and the, you know, the whiteheads and all of that stuff. So this contains hormones as well as growth factors that could amplify the same androgen pathway that Becca already talked about here, and high-glycemic foods loop right back into that blood sugar and insulin driver as well.

15:57 Liz Roman: So diet alone isn't the only cause for some people. It's the fuel that can absolutely make several other causes worse at the same time. And so this all has to come together under one umbrella for you to assess what's the driver and what are the things that I can be doing to really help the systems that are all at play because again, from a skin perspective, it's your largest surface organ. It is gonna show you what's kind of going on on the inside, and what it's showing you might point you in a different direction as to where you would look at or, you know, where you would you know, start to address things.

16:36 Liz Roman: But most of the time it's always gonna be starting with the gut 'cause if you don't start with the gut, you're not gonna, you know, heal and seal that leaky gut that's allowing things to get to the bloodstream to burden the liver, right? To detox all of those toxins and endocrine disruptors and things that you're exposed to, and then at the same time not absorb the nutrients that you need to combat all the oxidative stress and inflammation because antioxidants — Yeah and B vitamins and all that play a big role here too.

What labs should you get for stubborn acne?

17:02 Becca Chilczenkowski: Yeah, and that's why in acne cases I'm typically at least getting a GI-MAP on top of looking at blood work 'cause we need to look at A1C and insulin and DHEAS and even sometimes, you know, prolactin in these cases and seeing ultimately what's going on with the hormones. If we can get a DUTCH test, I love a DUTCH test in a case like this because then you can get a full androgen picture and a cortisol picture, both of which could be driving acne to their different extents, right? And then, you know, we're getting a full blood panel regardless, an MRT.

17:33 Becca Chilczenkowski: I love MRTs in cases with acne or with any type of major skin issues because sometimes you don't know what's truly irritating your immune system from a food standpoint, and the MRT is a great option to see food sensitivities that could be driving inflammation from the diet side that you might not be having digestive issues with. So like just for example, I just… I have a client that We're in the cleanse and she's struggling a little bit with some headaches and some things. Guess what came back super high on her MRT just now?

18:03 Becca Chilczenkowski: Spinach, which is in all of her smoothies, right? We're seeing wheat and a number of other things that, like, are in some things in small amounts, a lot of the avocado, strawberries, foods that she had been eating that are healthy foods, but are really high on her MRT. Now we know probably why she's dealing with some of the headaches even though she's totally changed diet and we're doing a lot of other good things. So I love the MRT for that. You just, you don't know what you don't know.

What helps acne based on the root cause?

18:29 Becca Chilczenkowski: And then recommendation-wise, if hormones are a driver, we look into ingredients that support healthy androgen metabolism, right? Something like a DIM, saw palmetto potentially. PCOPX is a great product in a case like this. If blood sugar and insulin are a driver, I'm looking at, you know, berberine, chromium, potentially a GLP can be really helpful in PCOS cases. Changing up diet to be lower glycemic, you know, getting rid of refined sugar and dairy for a period of time. If gut is the problem, we kind of have to know what's going on.

18:59 Becca Chilczenkowski: That's why a GI-MAP can be so healthy, but so helpful. But, like, gut lining support, zinc potentially helping with both oil regulation and gut integrity, zinc can be really helpful here. If detox is an issue, milk thistle, NAC, glutathione, high fiber, right?

Is over-exfoliating making your acne worse?

19:15 Becca Chilczenkowski: On top of all of these things, yes, I do think that the topical piece matters. That's obviously not our expertise, but having good skincare and having someone that potentially is doing some topical work for you can be very helpful to keep from scarring, can be helpful with, like, the inflammation side and the actual appearance and frequency of it. So I'm not saying, like, ignore the topical side. I think that the topical side is important, especially in some of these severe cases, and having a really great esthetician can be very helpful.

19:43 Becca Chilczenkowski: So you know, we love the Olivada products. There's a lot of great ones when it comes to acne, when it comes to inflammation of the skin. But I do think sometimes having someone working topically can be kind of just like the icing on the cake and a necessity in some of these cases.

19:58 Liz Roman: Yeah. And then just not going too heavy. I think this is a big thing that I see. I was talking to a client about this yesterday. She buys a lot of things, and then she's overdoing it, and so it's drying her skin out, and you really wanna think about supporting that skin barrier and hydrating the skin barrier, too. And then just not over-exfoliating. Even when I'm working with people and you know, going through the Olivada stuff, I'm like, if you're using the hydroxytyrosol acids, which by the way also work phenomenally for white bumps on the back of your arms or KP, those types of skin conditions, back acne, it's awesome.

20:35 Liz Roman: Don't do it more than, like, twice a week. Do it once every four, five days because you don't want to dry it out. So anyways, with that, we hope that you enjoyed this episode. Don't forget to rate, review, subscribe, share the show. When you rate us, you are going to be entered to win our monthly gift box. And if you're somebody who wants to do a blood work and review or a DUTCH test and review 'cause you're sick and tired of looking like you got pimples coming out all sorts of places, you can check the show notes for links to do that with our team as a standalone or join the FitMom program, which is our Healthy Gut, Happy Hormones.

Frequently asked questions

Can gut problems cause acne?

Yes — and it's one of the most overlooked drivers. FitMom's practitioners routinely see stubborn acne alongside gut dysfunction: constipation, dysbiosis, or a leaky gut lining that lets inflammatory compounds reach the bloodstream and burden the liver. Research on the gut–skin axis links microbiome imbalances with acne through immune and inflammatory pathways. When the gut isn't clearing waste and the liver is overloaded, the skin becomes a backup exit.

Can constipation cause acne even if I poop every day?

It can. Liz Roman of FitMom explains that pooping daily doesn't guarantee you're fully emptying. The liver packages used hormones and toxins into bile and sends them to the gut for elimination; if stool moves slowly or incompletely, that load backs up. Two telltale signs: you're more tired than you should be, and inflammatory skin flares — acne, rosacea, eczema, or psoriasis — keep showing up.

What does acne on my jawline and chin mean?

Jawline and chin breakouts are most often hormonal. Becca Chilczenkowski of FitMom notes they typically flare before your period, run deep, cystic, and painful rather than surface-level, and are frequently tied to PCOS and an excess of androgens relative to estrogen. That pattern is a reason to test hormones — DHEA-S, insulin, and a full androgen picture — instead of just switching creams.

Why am I getting acne in perimenopause when I never had it before?

Because your hormone balance is shifting again. FitMom's Becca Chilczenkowski sees women breaking out in perimenopause — some for the first time ever — as progesterone declines and hormones fluctuate, leaving androgens relatively stronger. Blood sugar, stress, and a sluggish gut and liver can amplify it. Adult-onset acne in your late 30s or 40s is a signal to look inside, not a reason to restart your teenage skincare routine.

How do I know if my acne is fungal or hormonal?

Look at the texture. According to FitMom's Liz Roman, fungal or yeast-driven breakouts tend to look like rough skin with small, uniform bumps under the surface, while hormonal acne shows up as pimples, whiteheads, or deep cysts — often cyclical around ovulation or your period. Fungal patterns point toward candida, sugar, or mold exposure; cyclical patterns point toward hormones and liver detoxification.

What labs should I get for stubborn acne?

More than a skin exam. In acne cases, FitMom's Becca Chilczenkowski typically runs a GI-MAP stool test plus blood work that includes A1C, fasting insulin, DHEA-S, and sometimes prolactin. A DUTCH test adds a full androgen and cortisol picture, and an MRT food sensitivity panel can reveal foods driving inflammation even without digestive symptoms. The goal is finding which driver — gut, blood sugar, hormones, or detox — is actually behind it.

Does dairy cause acne?

It can make acne worse for many people. Meta-analyses of observational studies associate higher dairy intake, especially milk, with higher acne rates. FitMom's practitioners explain why: dairy carries hormones and growth factors that can amplify the androgen pathway behind oil production, and high-glycemic foods push blood sugar and insulin higher. Diet is rarely the only cause, but it's often the fuel that makes other drivers worse.

How does a pimple actually form?

Three things have to go wrong. FitMom's Becca Chilczenkowski explains: first, oil glands overproduce sebum, often driven by androgens. Second, dead skin cells turn sticky and clump inside the pore instead of shedding. Third, that trapped oil and debris creates a low-oxygen pocket where bacteria overgrow and trigger inflammation — the swollen, red breakout you see. Acne is never just about bacteria; it's a cell-turnover problem too.

Key terms

Sebum

The oil your skin's oil glands produce. Overproduction, often androgen-driven, is step one of a pimple.

Androgens

Hormones like testosterone and DHEA-S that women make too. Excess relative to estrogen ramps up oil production and is linked to jawline and chin acne.

Desquamation

The normal shedding of dead skin cells. When it's impaired, cells turn sticky and clog the pore.

Cutibacterium acnes

The skin bacterium that overgrows inside clogged, low-oxygen pores and triggers the inflammation of a breakout.

Autophagy

The body's cellular clean-up and recycling process. Blood sugar dysregulation can impair healthy cell turnover.

PCOS

Polycystic ovary syndrome, a hormonal and metabolic condition tied to androgen excess and insulin resistance. Becca also refers to it as PMOS, a newer proposed name that reflects its metabolic side.

DHEA-S

An adrenal androgen measured in blood. Elevated levels can drive hormonal acne.

DUTCH test

A dried urine hormone test that maps androgen and estrogen metabolism and your daily cortisol rhythm.

GI-MAP

A stool test that uses DNA-based (qPCR) analysis to assess gut bacteria, yeast, parasites, and markers of gut inflammation and function.

MRT (Mediator Release Test)

A blood test that measures immune reactions to foods and food chemicals, used to identify food sensitivities that may drive inflammation.

Mycotoxins

Toxic compounds produced by mold. They're fat-soluble and leave the body largely through bile, which loads the liver and gallbladder.

Candida

A yeast that can overgrow in the gut, often fed by a high-sugar diet.

Migrating motor complex

The wave of muscle contractions that sweeps the small intestine between meals to keep things moving.

Prokinetics

Foods, herbs, or compounds, such as ginger and bitters, that stimulate movement through the gut.

Isotretinoin (Accutane)

A prescription oral retinoid for severe acne. It requires medical monitoring and carries warnings about mood changes.

Sources

• Sánchez-Pellicer P, et al. Acne, Microbiome, and Probiotics: The Gut-Skin Axis. Microorganisms. 2022. https://doi.org/10.3390/microorganisms10071303
• De Pessemier B, et al. Gut–Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021. https://doi.org/10.3390/microorganisms9020353
• Juhl CR, et al. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients. 2018. https://doi.org/10.3390/nu10081049
• Aghasi M, et al. Dairy intake and acne development: A meta-analysis of observational studies. Clinical Nutrition. 2019. https://doi.org/10.1016/j.clnu.2018.04.015
• MedlinePlus (U.S. National Library of Medicine). Isotretinoin drug information. https://medlineplus.gov/druginfo/meds/a681043.html

This content is for education only and is not medical advice. Work with a qualified practitioner before starting supplements or changing any medication.