Why your skin still isn’t improving - even after you’ve changed your diet

You’ve cut out sugar. Swapped your skincare. Said goodbye to dairy and gluten. You’re doing all the right things - but your skin still isn’t improving. 

Does this sound familiar? 

It’s frustrating, exhausting, and quite frankly disheartening. But this doesn’t mean you’ve failed. It just means the root cause of your skin symptoms might lie somewhere else. 

As a nutritional therapist with an interest in skin health, I see this all the time. Clients come to me having tried every cream, supplement, and elimination diet under the sun - but still aren’t getting the results they need.  

That’s because skin issues are often a reflection of internal imbalances that can’t be fixed with topical treatments or food changes alone. 

In this longer read, I explore 5 non-food reasons why your skin might not be healing - and what to do next. 

1. Hormonal imbalances and acne 

One of the most common hidden causes of skin problems, especially adult acne, is hormone imbalance. 

In particular, androgens like testosterone can stimulate oil (sebum) production in the skin. Excess oil clogs pores, feeds acne-causing bacteria, and leads to inflammation. 

Hormonal changes related to: 

• Puberty 

• The menstrual cycle 

• Pregnancy 

• Perimenopause or menopause 

…can all contribute to acne, breakouts, or increased skin sensitivity. 

And it’s not just acne - hormonal shifts can also influence eczema, rosacea, and pigmentation. 

Functional testing for hormones (including free testosterone, DHEA-S, and progesterone) can reveal imbalances contributing to stubborn skin issues.  

2. Insulin resistance and skin inflammation

Insulin resistance is when your body’s cells stop responding properly to insulin, the hormone that helps move glucose from your blood into your cells for energy. 

It’s a major driver of inflammation - and it can wreak havoc on your skin. 

Insulin resistance: 

• Reduces levels of sex hormone-binding globulin (SHBG), increasing free testosterone and worsening acne 

• Is linked to psoriasis, skin tags, and hyperpigmentation like acanthosis nigricans 

• Often goes undiagnosed, especially in people with ‘normal’ blood sugar but high fasting insulin 

Improving insulin sensitivity with diet, strength training, and stress management can support clearer skin. 

3. Low vitamin D and skin repair 

Vitamin D isn’t just for bones - it’s essential for skin healing and immune modulation. 

Low vitamin D has been associated with: 

• Acne 

• Psoriasis 

• Eczema 

• Rosacea 

And it helps regulate: 

• Skin cell turnover 

• Barrier repair 

• Sebum production 

• Inflammatory responses in the skin 

Vitamin D deficiency is extremely common, especially in the UK and northern climates. 

Test your vitamin D levels regularly and supplement accordingly to support skin from the inside out. There’s a longer read about the importance of testing your vitamin D here. 

4. Gut imbalances and the gut-skin axis

There’s a strong two-way relationship between the gut and the skin, known as the gut-skin axis. 

Gut infections and dysbiosis (microbial imbalance) are major contributors to skin conditions. Examples include: 

• Rosacea, linked to H. pylori infection and SIBO (small intestinal bacterial overgrowth) 

• Eczema, associated with overgrowths of Candida, Clostridia, and E. coli 

• Psoriasis, linked to low levels of Akkermansia muciniphila, a beneficial gut microbe that supports the gut lining 

Gut dysfunction can also: 

• Impair nutrient absorption (e.g. zinc, vitamin A, omega-3s) 

• Increase systemic inflammation 

• Disrupt immune responses 

Comprehensive stool testing or SIBO breath tests can help identify what’s going on below the surface. 

5. Chronic stress and skin flare-ups 

Stress is often underestimated when it comes to skin health, but it’s a massive driver of inflammation, immune dysregulation, and gut issues. 

Stress can: 

• Raise cortisol, which increases oil production and slows healing 

• Disrupt gut barrier integrity, leading to ‘leaky gut’ 

• Exacerbate flare-ups in conditions like rosacea, eczema, and psoriasis 

• Trigger itch-scratch cycles, poor sleep, and lower resilience to environmental triggers 

And let’s be honest, having a visible skin condition is stressful in itself. The emotional toll often worsens symptoms, creating a vicious cycle. 

Supporting your nervous system with vagus nerve exercises, restorative movement, breathwork, and stress reduction techniques can be a game-changer. 

Final thoughts: why your skin isn’t healing (yet) 

If you’ve tried eliminating every potential food trigger, switched up your skincare routine, and nothing’s changing - don’t give up. 

It doesn’t mean your skin is beyond help. It just means the answer lies deeper. 

Whether it’s insulin resistance, low vitamin D, hormonal imbalances, gut infections, or stress, your skin is responding to what’s happening internally.

The good news is that these things can be addressed - and when they are, real skin healing becomes possible. 

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Ready to uncover the root cause of your skin issue?  

If you or someone you know is struggling with an ongoing skin issue, please book a free chat with me and let’s get to the root cause of it together.