Your liver, your lungs, your intestines. If you want to solve this problem without a dermatologist, read on.

There are a number of factors that could be contributing to your acne, and they will need to be addressed differently. “Good skin comes from within” is 90% true, meaning you mostly have to look at your inner ecology and what you are eating; and the last 10% of the solution relates to how you care for your skin on the surface.

Let us start with your liver, which filters toxins and excess hormones from your blood in two directions, both upwards and downwards. It takes toxins and excess hormones pulled from your blood and stores them in bile in the gallbladder. Your hormones do play a role in acne for sure, so to make sure that your liver is not compromised in its filtration process you may need to supplement with some liver tonifying herbs and supplements: schizandra is delicious, and has been revered for its beautifying and adaptogenic properties for thousands of years by TCM. Add 1/2 tsp to your daily diet and see what happens. Other liver stimulators include sour foods like fresh lemon, lime and grapefruit juice. Curcumin extract is also excellent for boosting liver function, as is simply adding an abundance of turmeric to your diet. Dandelion and nettle also support your liver in dramatic ways and can bring brightness and clarity not just to your skin but to your eyes as well. Cruciferous vegetables will boost liver function, but should probably be avoided if you have thyroid issues because they contain goiterogens.

And lastly, simply eating more fresh fibrous vegetables will help your liver too, because their fiber will bind with old bile when it is utilized in the digestion process, giving it an escort out of your body via your intestines. If you are not eating enough fiber, your toxin laden bile will be reabsorbed through the walls of your intestines and recycled by your liver. Eating extra fresh veggies and green leafy veggies is one of the fastest ways to reduce your overall toxin load. Pulling old bile out of your system will also help compel the manufacturing of fresh new bile (and also, more blood detoxification).

Another great herb for lowering your cortisol and balancing your hormones is ashwanganda, which is also adaptogenic and will help you deal with stress and prevent acne.

Moving on to your intestines, this is where a few different things could be contributing to break outs. How much sugar do you eat? This is a great question to ask oneself because acne, along with rashes, bloating, weight gain, and sugar cravings, are all symptoms of a yeast overgrowth. Do you eat a lot of carbohydrates from processed grain? Bread, crackers, pasta, anyone? Things that you wouldn’t necessarily consider “unhealthy,” like dried fruit, bananas, dates, and potatoes are all sources of sugar in the gut which can feed the yeast fungus, which in turn will throw off spores that can travel all through your blood stream and tissues causing trouble.

A candida elimination diet often results in clearing up acne. Constipation, however, can also contribute to acne because whatever is in your intestines is essentially feeding your bloodstream. This is all related. Eating foods that “boost your metabolism” essentially means eating foods that naturally increase your elimination (how frequently you go to the bathroom) — fresh veggies are your best friend when it comes to accomplishing this goal. Probiotics are also crucial for creating an environment in your gut that is inhospitable to the overgrowth of candida and encouraging healthy elimination and a strong immune system.

And then there are your lungs — there is a connection between your lungs and your gut, and TCM has known about this for a long time. You start cleaning house in your gut, don’t be surprised if some congestion in your lungs appears. Spicy foods are great for keeping things open and clear. However, if you are a smoker or breathing other airborne pollutants, this could be contributing to acne on your cheeks — as this is where the lungs will reference. In fact, depending on what is happening inside your body, acne can provide a sort of road map on your face in terms of where you should focus your internal efforts.

To bring things full circle, smoking is something that actually hinders liver function by giving it more work to do in terms of filtering those toxins from your blood.

And finally, there’s the last 10% — how you care for your skin and what you put on it. Your skin absorbs or “eats” whatever it touches. If you are a sensitive person, your skin may react to things that not everyone else does, so you may need to be extra careful with added oils and parabens, fillers, and preservatives. If you’ve had acne for years and have enlarged pores, it is essential that you perform some form of weekly exfoliation. Too much exfoliation will only make things worse, as it will strip away precious protective oils. Here’s a skincare routine for adult acne:

1. Cleanse with an enzymatic cleanser, or something like “take the day off” by Clinique — which rinses clean and doesn’t strip your skin, and leaves no residue.
2. One to two times a week, scrub with something more abrasive — like a Clarisonic or scrub cleanser (Acure makes a good one).
3. After cleansing your face, spot treat with tea tree oil, followed by a hyraluronic acid serum which helps draw the tea tree oil deeper into the layers of your skin.
4. Lastly, a retinol moisturizer can work wonders. 

If you’re able to apply some sort of tinted sunscreen to give you a better view of yourself throughout the day, do so. Leaving your skin alone and not picking at it is just as important for the healing process as the psychological benefit of feeling confidant in your appearance.

Good luck! You’re not alone!