If you’re struggling with acne, I know how frustrating it can be. I see patients at my functional medicine center all the time that have tried everything — even medications like antibiotics, Accutane, and birth control pills. Unlike teenage acne that usually resolves on its own after a few years, adult acne can be persistent, stubborn, and start to hurt your confidence and your relationship with your body. 

When I approach acne, I always recommend that my patients do a few important things, like an elimination diet, a microbiome test, and a hormone test. Then, I set them up with a personalized lifestyle plan that aims to tackle the underlying causes of their issue. Why? Because in order to kick acne for good, you have to address the underlying cause, whether that hormones, stress, inflammation, or bacterial issues — or all four! 

Once you’ve established daily habits, supplements come into play. Supplements aren’t the only important part of a functional medicine approach to acne — but they are still a big piece of the puzzle. 

If you’re struggling with acne, you’re in the right place. Let’s dive into the root causes and best supplements for hormonal acne, stress acne, bacterial acne, and inflammatory acne.

Hormonal Acne: 

If you’ve got acne — especially on the lower half of the face, jawline, or chin — that seems to fluctuate based on your monthly cycle, you’re most likely experiencing hormonal acne. I recommend focusing on balancing your hormones above all else. The following supplements can help: 

• NAC

N-acetyl cysteine (NAC) is a powerful antioxidant that can promote cellular health and help fend off oxidative stress. But why does that make it one of the best supplements for hormonal acne? Studies have shown that oxidative stress plays a role in acne (1) meaning NAC benefits skin health. It is also being studied for its potential benefits for endometriosis and PCOS, both being hormonal conditions. So, if your acne is rooted in an issue with hormones, NAC will target that root cause and provide relief. 

How to take NAC: I recommend taking 600 mg of NAC daily. 

• DIM 

DIM, which stands for diindolylmethane, is a compound found in cruciferous vegetables like broccoli, cauliflower, and Brussel’s sprouts. DIM has shown an ability to metabolize excess estrogen, which can be helpful for people with estrogen dominance or other hormone imbalances making it one of the best vitamins for hormonal acne. 

How to take DIM: I recommend taking about 200 mg of DIM for acne each day. 

Inflammatory Acne: 

My book the Inflammation Spectrum is all about tackling chronic inflammatory issues — and acne is no different than any of the other inflammation-related conditions we deal with! If you suspect your acne is related to inflammation, consider supplementing with the following: 

• Vitamin D  

Studies have shown that people struggling with acne have lower levels of vitamin D. (2) And ideally, you’d get your daily dose of vitamin D through at least 20 minutes of direct sun exposure these days. Unfortunately, if you’re like me with a home base in the Northeast, in the winter, I’m lucky if I get 20 minutes of sun exposure in a whole week! The good news is that vitamin D supplements are inexpensive and a breeze to take. Plus, if you take vitamin D, you reap a bunch of other benefits like immune system and mood support. For a full picture of the importance of vitamin D click here.  

How to take vitamin D: I recommend taking at least 2000 IUs of vitamin D3 every day and more if you get a blood test and it shows that your vitamin D levels are low. 

• Omega-3s

If you suspect that might be contributing to your acne, omega-3s are a great anti-inflammatory supplement to add to your routine. One study tested 13 individuals with inflammatory acne who were given three grams of fish oil containing 930 mg of EPA to their unchanged diet and existing acne remedies for 12 weeks. The results showed significant improvements in 8 of the 14 participants and that improvement was most notable for those with severe acne. (3) 

How to take omega-3s: I recommend taking a mixture containing ~800 mg of EPA and DHA daily. 

Bacterial Acne 

If you’ve got acne accompanied by gut health issues like bloating, diarrhea, constipation, or leaky gut, I recommend focusing on healing the gut before you spend hundreds of dollars on creams, lasers, and peels. Why? Because there’s an established connection between gut bacteria and acne, meaning supplements for gut health might just be the best supplements for acne too.

• Probiotics 

It might seem crazy that restoring gut bacteria could help with the skin, but studies have shown that acne sufferers have decreased bacterial diversity in their guts. (4) Not to mention, issues like leaky gut can cause chronic systemic inflammation that winds up causing inflammatory issues like acne in far-away areas of the body. 

How to take probiotics: I recommend taking a shelf-stable probiotic with at least 100 billion CFUs per capsule once a day with food. 

• Zinc 

Zinc is famous for its beneficial effects on the immune system, but it also seems to be important for acne prevention. In fact, a review that analyzed 14 studies revealed that 10 of them showed a beneficial effect of supplementing with zinc for acne. (5) Just be aware that zinc can sometimes cause nausea, so make sure you take it with food and pay attention to any side effects you notice. 

How to take zinc: I recommend supplementing with 15 mg of zinc daily. Taking Zinc supplements for acne should be done with caution and at appropriate doses because taking too much can be dangerous and cause symptoms like nausea, vomiting, and digestive distress. 

Stress Acne 

There’s a well-established link between stress and acne severity. If you’ve noticed that your acne tends to flare before a big work deadline, final exams, or after a breakup, I’d consider making managing stress your number one goal for acne treatment. Luckily, the following supplements can help: 

• Ashwagandha 

Ashwagandha is an herb that’s been used for stress and anxiety for centuries. It’s part of the “adaptogen” family, which is a group of plant medicines that are known for helping you handle stress and anxiety. In fact, ashwagandha has been shown to reduce anxiety by up to 44%, which is pretty out of this world. (6) Using ashwagandha for acne caused by stress is a no-brainer with results like that.

How to take ashwagandha: I recommended taking 500 to 600 mg of ashwagandha for acne daily for at least 3 months to see an effect.  

• Magnesium 

Magnesium is well-known as the “relaxation mineral” making it a great option if your acne is caused by chronic underlying stress. As an added bonus, the list of magnesium’s benefits also includes better hormone balance, blood sugar balance, and lower inflammation levels. 

How to take magnesium: I recommend supplementing with 300 to 400 mg of magnesium glycinate daily. 

If you’re trying to kick acne to the curb for good, make sure you’re addressing the underlying cause of the problem — not just treating the symptoms like excess oil, cysts, whiteheads, and blackheads.

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