Acne as a Signal: Understanding Stress, Blood Sugar, and Chronic Breakouts
If you’ve tried just about everything for acne, you’re not alone—and you’re not doing anything wrong. Many people with persistent or adult acne have rotated through cleansers, prescriptions, supplements, diet changes, and “holy grail” routines, only to find their skin still flares unpredictably. That’s often because acne isn’t just a surface problem. For many people, it’s a reflection of deeper internal signaling involving inflammation, hormones, immune activity, and metabolic balance.
One of the most overlooked drivers of chronic acne is stress physiology, even when life doesn’t feel overtly overwhelming. In medical terms, stress is any input that activates the body’s survival response—tight deadlines, poor sleep, emotional load, illness, or constant mental stimulation. When this response stays switched on, the brain releases chemical messengers that communicate directly with the skin. Research has shown the skin has its own stress-response system, meaning stress hormones can increase local inflammation and immune reactivity in acne-prone follicles. Multiple studies have demonstrated that higher perceived stress correlates with greater acne severity, particularly in adults.
Stress also plays a quieter but powerful role in acne through blood sugar regulation. Under stress, hormones like cortisol signal the liver to release glucose into the bloodstream to ensure rapid energy availability. Over time, this can push insulin levels higher and reduce insulin sensitivity. Elevated insulin and related growth signals—especially IGF-1—are well established in acne research as contributors to increased oil production, altered skin cell turnover, and heightened inflammation within pores. A 2024 peer-reviewed review highlighted these insulin and IGF-1 pathways as key mechanisms linking internal metabolic stress to acne, even in people without diagnosed blood sugar disorders.
When these processes overlap, acne becomes harder to control: oil glands become more active, dead skin cells stick together more easily, and inflammation intensifies. This helps explain why acne often worsens during periods of disrupted sleep, high mental demand, or emotional strain—even when skincare and diet remain unchanged. Recent observational studies continue to confirm that acne severity rises alongside physiologic stress load, reinforcing that breakouts are often a downstream signal of internal imbalance rather than poor hygiene or product choice.
This is why a naturopathic approach can be uniquely effective for resolving acne. Instead of treating acne as an isolated skin condition, naturopathic care views it as a systems issue—evaluating stress response, blood sugar patterns, hormone signaling, immune balance, and inflammation together to identify the true drivers in each individual. When those root imbalances are addressed, the skin often improves as a natural consequence rather than a forced outcome. If you’re in Bellevue or Seattle and feel like you’ve exhausted your options, a naturopathic clinician can help you finally understand what your acne is telling you—and how to support lasting change.
To schedule a consultation with Dr. Barnett, contact her office at 425-539-0800 or email staff@drclara.com. Her offices are conveniently located in Seattle and Bellevue, and appointments are also available via telemedicine. Most insurance plans are accepted.