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People who have already given up often end up in my chair. Usually they are young, fifteen, seventeen, twenty years old, and they have tried everything. Expensive serums, acids, facials, antibiotics, ten jars on the shelf. And the skin still breaks out.
The first question I ask at a consultation usually surprises people. I do not ask about creams. I ask about digestion, sleep and stress. Here is why.
In August 2026 a study was published in which facial skin swabs and gut microbiota samples were taken at the same time from people with and without acne. Two groups were compared: 17 people with acne and 14 without.
The difference in the gut was striking. People with acne had an average of 62.7 distinct bacterial groups, compared with 190.9 in the healthy group. The microbiota diversity measure (Shannon index) was 2.46 versus 3.93.
On the skin itself the difference was far smaller: 2.17 versus 2.80. And in the composition of the skin microbiota no statistically significant differences between the groups were found at all.
In other words, the clearest difference showed up where we are not used to looking. Not on the face, but inside.
The skin is the body's border. When the balance of bacteria in the gut is disturbed, quiet inflammation begins, and in time it reaches the skin. That is how stubborn acne appears, along with redness and sensitivity that seems to come out of nowhere.
Picture a boat with a hole in the bottom. You can bail water for a long time, with an expensive bucket, every day. But until the hole is patched, the water keeps coming back. External care during internal inflammation is exactly that bailing. It helps, but it does not solve.
Here I want to be honest. This does not mean that one jar of probiotics will clear acne. The groups in the study were small, 17 and 14 people, and work like this shows a connection, not a ready recipe. Everyone's microbiota is different, and there is no magic pill.
But looking at the skin separately from what is going on inside a person, that is food, sleep and stress, is no longer possible.
If you or your child have been fighting acne for a long time without success, you are not lazy and you are not careless. Perhaps the skin is simply looking deeper than a jar of cream.
Let us start from the cause, calmly and without pressure. You can book a consultation, and see how I work with problem skin on the acne and post-acne treatment page.
Source: Gut and skin dysbiosis in acne vulgaris: a comparative microbiome analysis. Frontiers in Cellular and Infection Microbiology, 6 August 2026.
