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Clear Skin Starts Within: Acne Q&A With an Acne Nutritionist & Naturopath

  • Writer: Melissa Birch Nutrition
    Melissa Birch Nutrition
  • Aug 18
  • 5 min read

Last month, I joined Afia Kufour, acne activist and founder of Don’t Pop That Spot, for a live Q&A at the Happy Place Festival. The session was all about acne, from adult and hormonal acne to cystic acne, and how to achieve clear skin naturally by understanding the body’s root imbalances.


Below, you’ll find the exact questions Afia asked me and my full answers, expanded from our conversation. This is the same advice I give inside my Clear Skin Complete Programme, an approach that focuses on nutrition, mineral balance, gut health, hormone health, and mindset for lasting skin healing.


If you’ve ever looked in the mirror and thought:


“Why am I STILL breaking out?”


… even though you’re eating healthy, using all the “right” skincare, and well past your teenage years, I’ve been there.


The truth? Adult acne, hormonal acne, and even cystic acne are often driven by hidden root causes that most treatments overlook.


That’s exactly what I cover in my brand new video:


Clear Skin Starts Within: Acne Q&A With An Acne Nutritionist & Naturopath


clear skin starts within acne Q&A


Melissa, experiencing acne yourself makes you the dream guest for a discussion like this. Can you take us through your acne journey and how it led to the work you now do, helping people transform their skin through nutrition?


I had acne as a teenager and, like most people, went straight to the GP. I tried all the conventional options: topical creams, antibiotics, and two separate rounds of Accutane. Each time, my skin cleared for a while but the breakouts eventually returned.


Even as a teenager, I had this instinct that food might be connected to my skin, but at the time my GP told me diet didn’t affect acne. So, I ignored that gut feeling and just did what I was told.


In my twenties, I went through a period of long-term stress. I was vegan at the time, which led to nutrient imbalances, low protein intake, poor gut health, and reduced detox capacity. My skin worsened. I developed not only breakouts but inflammation, itchiness, and irritation.


I tried to fix it myself, green juices, ginger shots, zinc, omega-3 supplements, probiotics, “clear skin” vitamins, switching to all-natural skincare — but nothing worked long-term. I even went back on antibiotics and Accutane.


When the acne came back again, it looked different: less cystic but more like an allergic or inflammatory reaction. My skin was itchy, bumpy, and I started reacting to many foods I’d previously tolerated.


By then, I was already studying to be a naturopath, so I worked 1:1 with another naturopath. We ran functional testing, targeted my gut health, balanced my minerals, worked on my nervous system, and addressed emotional stress. That’s when my skin truly cleared and it’s why I now specialise in acne recovery myself.


You work with so many clients who come to you with skin concerns. What are some common patterns you tend to see?


The same themes come up again and again:


  • Stress and nervous system dysregulation — It’s not always “high cortisol.” Sometimes it’s long-term, chronic stress that leaves the adrenals tired and the body less able to handle daily demands. Cellular stress is also common, showing up as poor mitochondrial function, mineral imbalances, and slow metabolism.

  • Mineral depletion — Many clients have low sodium and potassium, imbalanced magnesium and calcium, and overall nutrient depletion. This can be caused by under-eating, over-exercising, busy minds, old subconscious beliefs, or even past traumas.

  • Gut imbalances — Low stomach acid, low enzyme output, gut dysbiosis (too many harmful bacteria and not enough good ones), high beta-glucuronidase activity affecting hormones, and inflammation.


I’ve had acne for well over a decade, and I’d consider my diet to be pretty ‘good’ as it’s balanced. But for someone like me, what could still be going wrong?


Almost everyone I see already eats “clean.” They avoid sugar, dairy, and processed foods. They focus on vegetables and healthy meals. And yet, the acne is still there.


Often, the missing pieces are about how you eat, not just what you eat:


  • Eating enough food and not under-eating.

  • Eating within an hour of waking.

  • Getting at least 30g of protein per meal.

  • Balancing blood sugar instead of letting it spike and crash.

  • Avoiding fasting or meal skipping when your hormones are already struggling.

  • Including cruciferous vegetables for hormone metabolism.

  • Getting enough omega-3s from food sources like salmon.


It’s a fully holistic approach. We look at nutrition, but also mindset, lifestyle, nervous system support, gut health, and, when needed, targeted supplementation.


A lot of people with acne will have gone down the GP route and been prescribed antibiotics. What are the long-term effects of that on the body?


Antibiotics have their place and can save lives. But long-term use for acne isn’t sustainable.

Over time, they can contribute to:


  • Antibiotic resistance: Not just for acne-causing bacteria but for other bacterial infections in the body.

  • Gut dysbiosis: Antibiotics kill good bacteria like lactobacillus and bifidobacterium along with harmful ones, leading to gut imbalances that can worsen skin issues later.

  • Immune impacts: There’s some research suggesting long-term antibiotic use can affect immune resilience.


We keep hearing about gut health being the key to clear skin. Is ensuring a healthy gut as simple as adding kimchi and sourdough to your plate?


If your gut is already healthy, fermented foods like coconut yoghurt and kimchi can be great. But if you have acne, chances are there’s deeper gut work to do.


A proper gut-healing approach often involves:


  1. Calming the nervous system and improving sleep.

  2. Supporting digestion so you actually absorb your nutrients.

  3. Removing pathogens, overgrowths, or infections.

  4. Restoring the microbiome with targeted probiotics.

  5. Healing the gut lining so it’s not inflamed.

  6. Supporting regular bowel movements and healthy motility.


And if that grocery list existed, what would be your absolute must-haves on it?


  • Coconut water

  • Blueberries

  • Lemons

  • Wild-caught salmon

  • Extra virgin olive oil

  • Organic turkey

  • Green tea

  • Sea salt

  • Broccoli

  • Brazil nuts


Where do vitamins and minerals come into all of this?


Vitamins and minerals are critical for skin health. Deficiencies are common with acne and are often linked to long-term stress, gut health issues, detoxification problems, and hormone imbalances.


It’s not enough to just add zinc or evening primrose oil. We need to know why someone is deficient, choose the right forms and doses, and consider mineral balance (like zinc and copper ratios) to avoid creating new imbalances.


This Q&A shows that acne isn’t just about skincare or diet, it’s about understanding the body as a whole. By working on gut health, hormone balance, minerals, nervous system regulation, and nutrition, you can achieve lasting clear skin naturally.




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