Episode 149

Published April 14, 2026

In this episode, Dr. Jaclyn Smeaton sits down with Dr. Bryant Esquejo to unpack acne through a functional medicine lens, moving far beyond the surface to explore what’s really happening inside the body. 

Dr. Esquejo and Dr. Smeaton also discuss: 

• Acne as not just a skin condition, but a reflection of imbalances involving hormones, blood sugar, inflammation, and the gut microbiome
• The science behind acne development, from bacterial activity and oil production to deeper drivers like insulin resistance, androgen metabolism, and chronic inflammation
• The influence of diet, stress, sleep, and gut health
• How advanced testing, like hormone metabolite analysis, can reveal hidden imbalances in the body
• Treating acne as an opportunity to better understand and optimize whole-body health

Key Moments

0:06 Episode Introduction

2:25 Introduction to Acne and Functional Medicine

5:38 Understanding Internal Drivers of Acne

8:43 The Role of Blood Sugar in Acne

11:49 Inflammation and Its Connection to Acne

17:34 Identifying Metabolic Health Issues

20:55 Become A DUTCH Provider

21:36 Lab Testing for Acne and Metabolic Health

25:54 The Balance of Skin Microbiome and Antibiotic Treatments

28:26 The Connection Between Gut Health and Acne

31:02 Stress and Androgens: Their Role in Acne

34:33 Utilizing DUTCH Testing for Hormonal Insights

40:20 Future Research Directions in Acne Treatment

45:24 Seeing Acne as a Systemic Indicator

About our speaker

Bryant Esquejo, ND is a California-licensed Naturopathic Doctor who specializes in complex acne, eczema, and integrative care for hormone imbalances, gut health, and thyroid concerns. Rooted in the belief that skin health is a reflection of inner health, his whole-person approach to healing has earned him features in Vogue, Mindbodygreen, Who What Wear, and The Daily Beast. He holds a Bachelor of Science in Biology from San Diego State University and earned his naturopathic medical degree from the National University of Natural Medicine in Portland, Oregon. 

Show Notes

Learn more about Dr. Esquejo and follow him on Instagram @dr.bryant!

Check out Dr. Esquejo’s blog post on blood sugar, insulin, and acne, and read our whitepaper on 5a-Androstanediol as a marker of androgen status in women.

Become a DUTCH Provider to get access to free educational resources, expert clinical support, comprehensive patient reports, and peer-reviewed and validated research.

Disclaimer: Special offer of 50% OFF first five kits is invalid 60 days after new provider registration.