Acne, Eczema & Psoriasis: Natural Treatment Approaches

The Skin as a Window to Internal Health

The skin is the largest organ of the body, weighing between 6 to 9 pounds with a surface area of approximately 20 square feet. Beyond its role as a protective barrier between our bodies and the external environment, the skin serves as a mirror reflecting our internal health.

Skin conditions like acne, eczema and psoriasis are rarely just “skin problems.” They often indicate underlying imbalances in gut health, immune function, hormonal regulation or systemic inflammation. This understanding shapes the naturopathic approach: rather than simply suppressing symptoms, we work to identify and address the root causes driving skin conditions.

The Gut-Skin Connection

One of the most important advances in dermatology research has been recognizing the profound connection between gut health and skin conditions. The gut microbiome, the trillions of bacteria living in our digestive tract, influences skin health through several mechanisms.

Intestinal Permeability (“leaky gut”) allows partially digested food proteins and bacterial products to enter the bloodstream, triggering immune responses that can manifest as skin inflammation. Research has linked increased intestinal permeability to eczema, psoriasis and acne¹.

Microbiome Composition affects systemic inflammation. An imbalanced gut microbiome (dysbiosis) promotes inflammatory processes throughout the body, including in the skin. Conversely, a healthy, diverse microbiome supports immune regulation and reduces inflammation².

Nutrient Absorption depends on gut health. Deficiencies in zinc, vitamin A, essential fatty acids and other nutrients important for skin health can result from poor gut function, even with adequate dietary intake.

This gut-skin axis explains why dietary changes and gut-healing protocols are often effective for skin conditions that seem unrelated to digestion.

Acne: Beyond Surface-Level Treatment

Understanding Acne Development

Acne develops through a sequence of events. Excess sebum (oil) production provides a medium for bacterial growth. Follicular hyperkeratinization occurs when skin cells don’t shed properly and clog pores. Bacterial colonization follows as Cutibacterium acnes (formerly Propionibacterium acnes) multiplies in clogged pores. Finally, inflammation results as the immune system responds to bacterial products.

While acne is often thought of as a teenage problem, adult acne is increasingly common, particularly among women. Different factors predominate at different life stages, hormones play a larger role in some cases, while diet and gut health may be more significant in others.

Hormonal Influences

Androgens (including testosterone and its more potent metabolite DHT) increase sebum production and influence acne development. This explains why acne often worsens around puberty and why it commonly flares with menstrual cycles in women.

For an in-depth exploration of hormonally-driven acne and targeted treatment approaches, see our dedicated article on hormonal acne natural treatment.

Dietary Factors in Acne

Research has established several dietary connections to acne.

High Glycemic Index Foods spike blood sugar and insulin, which increases androgens and sebum production. Studies show that low-glycemic diets improve acne³. Reducing refined carbohydrates, sugary foods and processed snacks often helps acne-prone skin.

Dairy Products have been associated with increased acne, particularly skim milk⁴. Dairy contains hormones and growth factors that may influence sebum production and skin cell growth. Many patients see improvement when reducing or eliminating dairy.

Chocolate has been debated for decades. Recent research suggests that while pure cocoa may not cause acne, the sugar and milk in most chocolate products likely contribute⁵.

Whey Protein supplements can trigger or worsen acne in some individuals, likely due to their effects on insulin and IGF-1 levels.

Naturopathic Acne Treatment

Dietary Modification: Reducing high-glycemic foods, eliminating or reducing dairy and emphasizing whole foods forms the foundation of naturopathic acne treatment.

Gut Health Support: Addressing dysbiosis with probiotics, particularly strains like Lactobacillus rhamnosus that have been studied for skin health⁶. Healing intestinal permeability with nutrients like L-glutamine and zinc.

Targeted Nutrients: Zinc has extensive evidence for acne treatment, with some studies showing effectiveness comparable to antibiotics⁷. Typical doses range from 30-50mg daily of zinc picolinate or citrate. Vitamin A supports healthy skin cell turnover. Omega-3 fatty acids reduce inflammation.

Topical Support: Topical niacinamide (vitamin B3) gel has research supporting its effectiveness for inflammatory acne, with one study showing comparable results to topical clindamycin antibiotic without the downsides of antibiotic resistance⁸. Tea tree oil has antimicrobial properties against acne-causing bacteria.

Herbal Support: Saw palmetto may help hormonally-driven acne by reducing DHT. Berberine-containing herbs support gut health and may help reduce insulin’s effects on acne.

Conventional Acne Treatments: Considerations

While naturopathic approaches address underlying causes, some patients may also use or consider conventional treatments.

Topical Antibiotics (clindamycin, erythromycin) can contribute to antibiotic resistance with prolonged use and disrupt skin microbiome balance.

Benzoyl Peroxide is effective but can cause significant drying and irritation in some individuals.

Oral Antibiotics provide temporary improvement but acne typically returns when stopped, and prolonged use affects gut microbiome health.

Isotretinoin (Accutane) is effective for severe acne but carries significant risks including liver toxicity, mood changes and severe birth defects if taken during pregnancy^9,10. It remains an option for severe, treatment-resistant cases but should be approached with full understanding of risks.

Eczema (Atopic Dermatitis)

Understanding Eczema

Atopic dermatitis is a chronic inflammatory skin condition characterized by dry, itchy, inflamed skin. It’s part of the “atopic triad” along with asthma and allergic rhinitis, many eczema patients have or will develop these related conditions.

Eczema typically begins in early childhood. Approximately 85% of cases develop before age 5, and about half of childhood eczema cases resolve, while the other half experience symptoms into adulthood¹¹. Adult-onset eczema also occurs.

The primary symptom is intense itching, which leads to scratching, further skin damage and a worsening cycle of inflammation. Other symptoms include redness, dryness, cracking, weeping, crusting and scaling of the skin.

What Causes Eczema?

Eczema involves a combination of genetic factors, immune dysregulation and environmental triggers.

Skin Barrier Dysfunction: Many eczema patients have mutations affecting filaggrin, a protein crucial for skin barrier function. A compromised skin barrier allows increased water loss (dry skin) and entry of irritants and allergens¹².

Immune Imbalance: Eczema involves T-helper 2 (Th2) dominant immune responses, similar to allergic conditions. This explains the connection to asthma and allergies.

Gut-Skin Axis: Alterations in gut microbiome composition are associated with eczema risk and severity. Early-life factors affecting gut microbiome development influence eczema likelihood¹³.

Environmental Factors: Triggers include contact with irritants (soaps, detergents, wool), temperature extremes, low humidity, stress and infections.

Food Sensitivities and Eczema

Food sensitivities play a significant role in many eczema cases, particularly in children. Common triggers include cow’s milk, eggs, wheat, soy, peanuts and tree nuts. However, the specific triggers vary considerably between individuals.

Unlike immediate allergic reactions (IgE-mediated), food sensitivities causing eczema may be delayed (IgG-mediated or other mechanisms), making identification challenging. Symptoms may appear hours to days after consuming the trigger food.

Elimination diets, removing suspected foods for a period and systematically reintroducing them, remain the gold standard for identifying food triggers. Food sensitivity testing can provide guidance but should be interpreted carefully and confirmed with elimination/reintroduction.

Research shows that identifying and avoiding food triggers significantly improves eczema in affected individuals¹⁴.

Naturopathic Eczema Treatment

Identify and Remove Triggers: Working to identify food sensitivities, environmental irritants and other triggers is foundational. This may involve elimination diets, keeping a symptom diary and possibly food sensitivity testing.

Heal the Gut: Supporting gut health addresses a root cause of eczema for many patients. This includes probiotics (specific strains like Lactobacillus rhamnosus GG and Bifidobacterium lactis have the best evidence for eczema)¹⁵, gut-healing nutrients (L-glutamine, zinc, vitamin A), addressing dysbiosis if present and supporting digestive function.

Support Skin Barrier: Essential fatty acids (omega-3s from fish oil, GLA from evening primrose or borage oil) support skin lipid composition. Topical emollients and moisturizers protect the skin barrier and reduce water loss. Vitamin D supports both immune function and skin barrier integrity.

Reduce Inflammation: Anti-inflammatory diet emphasizing omega-3 fatty acids and colorful plant foods. Quercetin and other flavonoids have natural antihistamine effects. Managing stress, which can trigger flares.

Address Immune Imbalance: Supporting regulatory T-cells helps balance the Th2-dominant pattern seen in eczema. This involves vitamin D optimization, adequate omega-3 intake and gut microbiome support.

Conventional Eczema Treatments

Topical Corticosteroids reduce inflammation effectively but long-term use can thin skin and cause other local effects. They’re useful for flares but don’t address underlying causes.

Calcineurin Inhibitors (tacrolimus, pimecrolimus) are steroid-sparing alternatives for sensitive areas.

Antihistamines may help with itching, though they don’t affect the underlying condition.

Oral Corticosteroids may be used for severe flares but have significant systemic side effects with prolonged use.

Biologics (dupilumab) represent newer options for severe eczema, targeting specific immune pathways.

These treatments have a place in managing symptoms, but ideally are combined with approaches addressing underlying causes.

Psoriasis

Understanding Psoriasis

Psoriasis is an immune-mediated inflammatory condition affecting 1-3% of the population. While it primarily manifests as skin symptoms, psoriasis is increasingly recognized as a systemic inflammatory condition with implications beyond the skin.

In psoriasis, immune dysfunction causes skin cells to proliferate much faster than normal, skin cells that normally mature over about a month do so in just days. This results in the characteristic thick, silvery-white, scaly plaques.

Common sites include elbows, knees, scalp, lower back and nails, though any area can be affected. Psoriatic arthritis, joint inflammation associated with psoriasis, affects approximately 30% of psoriasis patients and can cause permanent joint damage if untreated¹⁶.

Psoriasis and Systemic Health

Psoriasis is associated with increased risk of metabolic syndrome, cardiovascular disease and other inflammatory conditions. The chronic inflammation driving psoriasis affects the entire body, not just the skin. This makes addressing systemic inflammation particularly important in psoriasis management.

Types of Psoriasis

Plaque Psoriasis (most common) presents as raised, red patches covered with silvery scales.

Guttate Psoriasis appears as small, drop-shaped spots, often triggered by streptococcal infections.

Inverse Psoriasis affects skin folds (armpits, groin, under breasts) and appears as smooth, red patches.

Pustular Psoriasis presents as pus-filled blisters surrounded by red skin.

Erythrodermic Psoriasis is a severe form covering most of the body surface, requires medical attention.

Psoriasis Triggers

Psoriasis tends to follow a pattern of remissions and flares. Common triggers include stress (a major trigger for many), infections (especially streptococcal), skin injury (Koebner phenomenon), certain medications (beta-blockers, lithium, antimalarials), alcohol consumption and smoking.

Food and Psoriasis

Dietary factors influence psoriasis through effects on inflammation and gut health.

Gluten Sensitivity: A subset of psoriasis patients has antibodies to gliadin (a gluten protein), and these patients often improve significantly on gluten-free diets¹⁷. Testing for anti-gliadin antibodies can identify those most likely to benefit.

Alcohol: Even moderate alcohol consumption worsens psoriasis in many patients, both through direct inflammatory effects and by increasing intestinal permeability.

Inflammatory Foods: Processed foods, refined sugars and excessive omega-6 fatty acids promote inflammation.

Anti-Inflammatory Foods: Mediterranean-style diets rich in olive oil, fish, vegetables and fruits are associated with better psoriasis outcomes¹⁸.

Naturopathic Psoriasis Treatment

Dietary Intervention: Consider gluten elimination trial, especially with positive anti-gliadin antibodies. Eliminate or minimize alcohol. Adopt an anti-inflammatory, Mediterranean-style diet. Ensure adequate omega-3 intake.

Gut Health: Address intestinal permeability (“leaky gut”), support healthy gut microbiome, address any dysbiosis or SIBO if present, consider digestive support if needed.

Reduce Systemic Inflammation: Fish oil (2-4 grams EPA/DHA daily) has evidence for psoriasis improvement¹⁹. Curcumin (turmeric extract) has anti-inflammatory effects. Vitamin D optimization, deficiency is common in psoriasis and supplementation may help.

Stress Management: Given stress as a major trigger, stress management is therapeutic, not optional. Practices like meditation, yoga and adequate sleep support psoriasis management.

Topical Support: Topical vitamin D analogues have good evidence. Aloe vera may provide symptomatic relief. Coal tar preparations remain useful for some patients.

Address Metabolic Health: Given the metabolic syndrome association, addressing insulin resistance, maintaining healthy weight and supporting cardiovascular health benefits psoriasis.

Conventional Psoriasis Treatments

Topical Treatments include corticosteroids, vitamin D analogues, retinoids and coal tar preparations for mild-to-moderate disease.

Phototherapy (UVB light therapy) can be effective, particularly for widespread psoriasis.

Systemic Treatments for moderate-to-severe psoriasis include methotrexate, cyclosporine, acitretin and newer biologics targeting specific inflammatory pathways (TNF-alpha inhibitors, IL-17 inhibitors, IL-23 inhibitors).

Biologics have transformed severe psoriasis treatment but come with significant costs and potential risks including immunosuppression.

General Principles for Skin Health

Regardless of the specific condition, several principles support healthy skin.

Anti-Inflammatory Foundation

• Emphasize whole, unprocessed foods
• Include fatty fish, olive oil, colorful vegetables and fruits
• Minimize refined sugars, processed foods and excess omega-6 fatty acids
• Consider anti-inflammatory supplements like fish oil and curcumin

Gut Health Support

• Include fermented foods or probiotics
• Eat adequate fiber to support microbiome diversity
• Address any digestive symptoms or suspected food sensitivities
• Consider gut healing protocols when indicated

Key Nutrients for Skin

• Zinc: Supports skin healing and immune function
• Vitamin A: Essential for skin cell development
• Vitamin D: Supports immune regulation and skin barrier
• Essential Fatty Acids: Component of healthy skin cell membranes
• Vitamin C: Necessary for collagen production

Lifestyle Factors

• Manage stress through regular practices
• Prioritize adequate sleep
• Avoid harsh skin products and known irritants
• Stay hydrated
• Avoid smoking and minimize alcohol

Finding the Right Approach

Skin conditions vary significantly between individuals. What works for one person may not work for another. This is why a personalized approach, identifying your specific triggers, imbalances and needs, is more effective than generic advice.

The timeline for improvement also varies. While some patients see rapid improvement with dietary changes, others require longer-term gut healing or multiple interventions. Patience and consistency are important.

Skin Health Support in Halifax

Chronic skin conditions like acne, eczema and psoriasis often reflect internal imbalances that can be addressed naturally. By identifying triggers, supporting gut health, reducing inflammation and optimizing nutrition, many patients achieve significant improvement in their skin and overall health.

If you’re dealing with chronic skin issues and are interested in addressing root causes rather than just suppressing symptoms, please contact Dr. Colin MacLeod ND to book an initial consultation. Dr. MacLeod provides comprehensive assessments, appropriate testing (including food sensitivity testing when indicated) and personalized treatment plans. Learn more about our clinical nutrition services and lab testing options.

References

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