For the 85 percent of teenagers who experience some form of acne, the condition is embarrassing and uncomfortable. But unwanted pimples popping up before the first day of school or a first date isn’t the only concern. Experts increasingly view this condition, one that also plagues approximately half of women between ages 21 and 30 and many others in their 30s and 40s, as a symptom of other health issues—a poor diet, food intolerance, imbalanced hormones, or too many toxins in your body.

“Acne is an indicator that things are off. If you make the effort to explore what’s off and remedy that, then you become healthier overall,” says Alan Dattner, MD, a holistic dermatologist and Delicious Living advisory board member based in New Rochelle, New York. Clean up your beauty routine by eliminating ingredients such as phthalates, parabens, and synthetic fragrances, which some experts believe can exacerbate acne symptoms. Then address the true problem and make a long-lasting change with these lifestyle tips and research-backed remedies.

Consider nutrition.

The first recommendations Dattner gives any acne sufferer: Eliminate fast foods and fried foods and significantly cut back on white flour and sugar, all of which spur acne-causing inflammation. Although several recent studies have confirmed that a low-glycemic diet can improve acne symptoms, other dietary shifts aren’t so clear-cut.

“You look at what a person’s eating, what they crave, and where they have problems,” says Dattner. Some foods that trigger acne—coffee or chocolate, for example—affect individuals differently. A craving could signal a food allergy or intolerance, which is sometimes linked to acne. “When I’m working with somebody’s condition and getting diet under control, other things start improving that my patient didn’t realize were off.”

Read more on what cravings say about you. 

Start by following a detox diet to quell the buildup of excess toxins that your body eliminates via skin, sometimes as blemishes. Next, focus on a low-glycemic diet containing antioxidant-rich veggies that fight inflammatory free radicals (research has shown people deficient in vitamins A, C, and E may be more likely to develop acne). For supplements, Brent A. Bauer, MD, director of the Mayo Clinic’s Complementary and Integrative Medicine Program, recommends zinc and the plant-based sap guggul, which have the most anti-acne research support.

Load up on probiotics.

Mounting research also supports friendly bacteria, widely used for digestive health and immunity benefits, as an acne remedy. Orally consumed prebiotics and probiotics reduce systemic inflammation that can cause acne. Both probiotics and omega-3 supplements can help manage intestinal bacteria, which may subdue the associated topical inflammation.

New developments even support probiotics’ topical benefits: According to research, Bifidobacterium longum, Lactobacillus paracasei, and Streptococcus thermophilus all show promise for improving acne when applied to skin. Using probiotics also may strengthen skin’s moisture barrier and ceramides, which can help prevent acne.

For best results, Dattner recommends using both external and internal probiotics. “The naturopathic way is to use something from the inside and the outside. It can make a difference if you are trying to get the highest concentration [of an ingredient].”