Acne vulgaris is a chronic inflammatory skin disorder involving the pilosebaceous unit, which includes the hair follicle and sebaceous (oil) gland.

Acne develops when several factors interact together, including:

• Increased oil (sebum) production

• Abnormal skin cell shedding

• Inflammation

• Hormonal influences

• Microbiome imbalances

• Immune system activation

Acne can vary from mild congestion and blackheads through to painful cystic acne and widespread inflammatory lesions.

While acne commonly develops during puberty, adult acne is becoming increasingly common, particularly in women experiencing stress, hormonal fluctuations, digestive dysfunction, and chronic inflammation.

At my acne clinic in Gosford, many patients are surprised to learn that gut health, stress, diet, immune function, and inflammation may all contribute to persistent acne breakouts.

Acne most commonly develops on the:

• Face

• Back

• Chest

• Shoulders

• Jawline

• Neck

Adult hormonal acne frequently appears around the jawline, chin, and lower face.

Acne is now understood to be:

• A chronic inflammatory condition

• An innate immune disorder

• Influenced by microbiome balance

• Driven by inflammatory cytokines and immune signalling pathways

Acne is NOT simply caused by:

• Poor hygiene

• Dirty skin

• Excess bacteria alone

• Blocked pores only

At my Central Coast acne clinic, many patients present with multiple contributing factors occurring simultaneously.

Research now shows acne is fundamentally an inflammatory immune condition.

Traditionally, acne was believed to develop in the following order:

1. Excess oil production

2. Blocked pores

3. Bacterial overgrowth

4. Inflammation

However, newer research demonstrates that inflammation may actually begin before visible acne lesions appear.

Studies show:

• Inflammatory markers are present early in acne development

• Microscopic inflammation occurs before visible breakouts

• Immune activation contributes significantly to acne formation

This helps explain why some individuals continue experiencing chronic acne despite using topical skincare products alone.

As a naturopath focusing on inflammatory skin conditions in Gosford, I frequently observe how immune dysfunction, stress, digestive issues, and systemic inflammation may contribute to acne severity.

Acne can significantly impact emotional wellbeing, self-confidence, social interactions, and mental health.

Research into the gut-brain-skin axis now shows psychological stress, gut dysbiosis, and skin inflammation are closely interconnected.

Emerging research highlights the important role the gut microbiome may play in acne development.

The gut-skin axis describes the communication pathway between the digestive system, immune system, and skin.

Gut dysbiosis may contribute to:

• Increased gut permeability

• Systemic inflammation

• Immune dysregulation

• Increased sebum production

• Altered keratinisation

• Skin barrier dysfunction

Research suggests acne patients may have reduced levels of beneficial butyrate-producing bacteria, which are important for maintaining healthy gut and skin barrier function.

At my Gosford skin clinic, many acne patients report digestive symptoms including bloating, food intolerances, constipation, reflux, or irregular bowel habits alongside chronic skin inflammation.