Learn why finally nailing your nighttime routine, eating foods that fuel your body, and practicing (and sticking with) a stress-management strategy will be your new go-to clear skin treatment in 2025.
Having acne is challenging. Having acne in your late 20s is soul-sucking.
From TikTok trends to unsolicited advice from a colleague, bad information is impossible to hide from. Getting clear is possible, but slapping honey on your face or taking a handful of pricey supplements is not the only answer for clear skin.
We believe that getting clear means doing more good in your world. When you can show up as yourself without hiding from blemishes that make you feel less than, you can contribute more to your work, career, and relationships.
With social media becoming the norm, finding the right clear skin treatment for you can feel frustrating and hopeless. When patients find Natural Skincare Specialist, they have tried everything - from medications to 4-12 step skincare routines. Patients have said that they have tried some version of the following:
Using prescribed medications, such as spironolactone or tretinoin
Wiped their faces with isopropyl alcohol each night
Monthly facials
Elimination diets
Eliminating dairy, gluten, and sugar
Completed comprehensive stool analysis testing
Rotated their pillowcases nightly
Wiped their phones regularly
Using active skincare, like salicylic acid or benzoyl peroxide washes
Beef tallow as a moisturizer
Gone makeup-free for months
While these are viable options, a few interventions are often overlooked, probably because they are simple. These simple yet effective strategies are frequently left out of a comprehensive solution for clear skin treatment.
Nail Your Night-Time Routine
When was the last time you slept a solid 7-8 hours?
Modern-day commitments, such as demanding work schedules, hustle culture, and personal relationships, are increasing. With increasing demand for your time and attention, separating work from personal time is becoming more difficult.
Artificial light fuels the demand to keep up with mainstream culture. With around 80% of the world’s population living in large cities, the line between day and night is blurred. We stay up and work later into the night, wondering why we never hit that coveted eight hours of sweet, sweet shuteye.
This disturbance to the natural day and night rhythms that humans have experienced for generations is disrupting human health and may even contribute to acne.
A 2019 cross-sectional study investigated the relationship between acne severity and sleep quality. Forty healthy adults with acne were asked to rate the severity of their acne using the Global Acne Grading System (GAGS) assessment, and the Pittsburgh Sleep Quality Index (PSQI) assessed the participant’s sleep quality over the past 30 days.
Based on the GAGS assessment, 21 participants had “mild” acne, 17 had “moderate,” and only two had “severe” acne.
An inverse relationship between sleep quality and acne severity was observed. For example, the objective acne severity score increased as participants’ sleep scores decreased (defined as poorer subjective sleep quality).
· Poor sleep may worsen acne.
· More severe acne may lead to poorer sleep.
Adding to these findings, a cohort study from 2022 reports that the participants who were part of the “late bedtime group” experienced several changes to their skin, including:
· Decreased skin hydration
· Decreased skin firmness and elasticity
· Increased transepidermal water loss (TEWL)
· Increased sebum
· Increased wrinkles
My Takeaway: Aiming for 7-8 hours of sleep each night is not as fun as trying a new skincare line or that new TikTok trend, but it has the potential to significantly improve overall skin health. And bonus points because it’s free!
Eat Foods That Feel Good
Raise your hand if you’ve gone through an entire acne-specific elimination diet without stellar results.
From clinical experience, some patients can tolerate triggering foods, such as dairy and refined sugar, while others cannot. While some experts say elimination diets are not worth the time, research suggests time and time again that there is a correlation between an individual’s diet and acne.
---It’s important to note here that a correlation does not translate to causation. This means that there is a relationship between diet and acne; however, there has yet to be a study that shows that certain aspects of the diet, like dairy consumption, cause acne.---
The glycemic load of an individual’s diet and the consumption of dairy products are two characteristics of the diet that have been studied in relation to acne.
A high-glycemic diet consists of a large amount of easily digestible carbohydrates. The concern with these diets is that the body can easily break down the sugar molecules, which activate the release and use of insulin.
Insulin is a hormone messenger within the body. It tells some cells to “grow, grow, grow” and “produce, produce, produce.”
What are the cells producing?
If insulin travels to sebocytes within the skin, it tells those cells to produce more sebum, which contributes to acne formation.
The relationship between dairy consumption and acne is complex, and the research has been equivocal. Within the past decade, research has shown a positive correlation, meaning as dairy consumption increased, so did acne occurrence. This complexity should reassure you that managing your diet for acne is not a one-size-fits-all solution, and you're not alone in navigating it.
My Takeaway: Deciding which foods to include and exclude is a personal choice. Considering one’s dietary preferences, beliefs, and goals will help you choose a diet that best suits one's lifestyle. Adding more nutrient-dense, fiber-rich foods is always better than removing several foods.
Befriending Stress
If you do not structure your life in a way with rest and relaxation built-in, the stresses of life will always overwhelm you.
Tough love? Maybe.
Is it the truth? Absolutely.
I recently read an article that changed the way I thought about self-care.
I had considered self-care as an event, such as scheduling a massage or taking a bath.
While these activities are essential to self-care, it’s not the entire picture.
Self-care is often the ugly part of being a responsible adult.
It’s what we need to do but hate taking the time to do, like not hitting the snooze button in the morning or pushing through another set and rep scheme at the gym.
Self-care includes the often-neglected things that take time, attention, and resources to execute but often lead to enhanced health, wealth, and well-being.
Self-care is parenting yourself in a way that doesn’t always feel good.
How good have you been at parenting yourself?
Do you feel called out?
Good. Now, wipe that sweat off your brow, swallow your pride, and keep reading.
The relationship between stress and acne was investigated in a group of female medical students. A positive relationship was reported: as stress increased, so did acne severity.
The mechanism driving this relationship appears to be the activation of the hypothalamic-pituitary-adrenal (HPA) axis, initiated by corticotropin-releasing hormone (CRH). CRH has been shown to stimulate sebum synthesis, and studies have also demonstrated increased CRH expression in acne skin compared to normal skin.
These findings suggest that stress is a driver of acne formation.
This begs the question: Does managing stress help acne?
In a 2018 randomized, non-blind experimental study, 15 female patients with acne received eight weeks of Pythagorean Self-Awareness Intervention (PSAI). The PSAI was taught to the participants and practiced twice daily. It involved the participants reflecting on the past day’s events and introspecting about their behavior. Based on these reflections, the participants were asked to create specific goals for the next day to ameliorate stress and negative emotions.
Compared to only four patients in the control group, the acne of 14 (93.3%) patients who practiced PSAI improved. The acne stages before and after the intervention were as follows:
Acne Stage | Intervention Group - Before | Intervention Group - After |
Cure | 0 | 5 |
Mild | 6 | 10 |
Moderate | 8 | 0 |
Moderate-Severe | 1 | 0 |
Although these findings are promising, the small sample population used in this study makes generalizing results to the mass population difficult. But, the findings contribute to the larger pool of evidence that suggests a relationship between stress, stress management, and acne severity.
My Takeaway: Stress runs rampant in daily life. If you don’t find ways to control and manage your response to stress, it may continue to harm your health. Finding ways to cope with stress is as important for your clear skin treatment program as a solid skincare routine.
Let us know in the comments how these simple, yet powerful recommendations have helped your skin.
Bri Mesenbring, MS, CNS, LDN
Clincal Science Writer
Integrative Acne Specialist
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