Psychosocial Stressors, Gut–Skin Axis and Acne Vulgaris: Understanding Constitutional Remedy Selection in Homoeopathic Practice

Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [NovDec] Year 2025 133 © 2025 Dr. Aarti Gorakhnath Kanchar, Dr. Meghana Balaji Shewalkar. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ Research Article Psychosocial Stressors, Gut–Skin Axis and Acne Vulgaris: Understanding Constitutional Remedy Selection in Homoeopathic Practice Dr. Aarti Gorakhnath Kanchar 1*, Dr. Meghana Balaji Shewalkar 2 1 BHMS, MD (Homoeopathy, Practice of Medicine), Associate Professor, Department of Community Medicine Sayli Charitable Trust’s Homoeopathic College, Chh. Sambhajinagar, Maharashtra, India 2 BHMS, MD Homoeopathy, Paediatrics, Consultant Homoeopath Corresponding Author: *Dr. Aarti Gorakhnath Kanchar DOI: https://doi.org/10.5281/zenodo.17586305 Abstract Manuscript Information Background: Acne vulgaris is increasingly recognised as a condition influenced by psychosocial stress and dysregulation of the gut–skin axis. Emotional stress alters gut microbiota composition and neuro-endocrine immune responses, contributing to inflammatory acne. Homoeopathy, with its emphasis on mental state, individuality, and constitutional makeup, may offer therapeutic benefit by addressing psychophysiological contributors. Objective: To explore the interconnected roles of psychosocial stressors and gut–skin axis dysregulation in acne vulgaris, and to discuss how constitutional Homoeopathic remedy selection aligns with these mechanisms. Method: A narrative literature review was conducted using publications from dermatology, psychoneuroimmunology, gastroenterology, and Homoeopathic clinical literature (2010– 2024). Theoretical synthesis was carried out linking stress response, intestinal dysbiosis, and inflammatory acne expression to individualised remedy selection principles. Results: Evidence suggests that chronic psychological stress impacts intestinal permeability and systemic inflammation, leading to acne exacerbation. Homoeopathic case analysis that integrates personality structure, stress triggers, coping mechanisms, and gastrointestinal symptoms enhances constitutional remedy accuracy. Key constitutional remedies, including Pulsatilla, Natrum muriaticum, Lycopodium, Sulphur, and Ignatia amara, demonstrated clinical relevance in bridging gut–skin and emotional dynamics. Conclusion: Understanding the mind–gut–skin axis provides a strong scientific framework supporting constitutional Homoeopathic prescribing. Future clinical studies correlating psychometric and microbiome markers with remedy response are warranted. ▪ ISSN No: 2583-7397 ▪ Received: 13-09-2025 ▪ Accepted: 25-10-2025 ▪ Published: 12-11-2025 ▪ IJCRM:4(6); 2025: 133-135 ▪ ©2025, All Rights Reserved ▪ Plagiarism Checked: Yes ▪ Peer Review Process: Yes How to Cite this Article Kanchar AG, Shewalkar MB. Psychosocial stressors, gut–skin axis and acne vulgaris: understanding constitutional remedy selection in homoeopathic practice. Int J Contemp Res Multidiscip. 2025;4(6):133-135. Access this Article Online www.multiarticlesjournal.com KEYWORDS: Acne vulgaris, psychosocial stress, gut–skin axis, homoeopathy, constitutional prescribing. Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [NovDec] Year 2025 134 © 2025 Dr. Aarti Gorakhnath Kanchar, Dr. Meghana Balaji Shewalkar. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ 1. INTRODUCTION Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit influenced not only by hormones and microbial presence but also by emotional and digestive health. Recent biomedical research has highlighted the gut–skin axis, a bidirectional communication network linking gastrointestinal microbiota, immune response, and dermatological expressions. Psychosocial stress alters intestinal permeability, stimulates hypothalamic–pituitary–adrenal (HPA) axis activity, and increases inflammatory cytokine production. These systemic effects contribute to inflammatory acne lesions, heightened sebum secretion, and delayed skin repair. Homoeopathy considers emotional state, digestive patterns, food cravings, and constitutional temperament, making it well-positioned to address this multidimensional pathology. 2. Psychosocial Stress and Acne Expression Stress activates corticotropin-releasing hormone (CRH), increasing sebaceous gland activity and stimulating keratinocyte proliferation. Persistent emotional strain leads to: • Increased cortisol levels • Dysregulated inflammatory signalling • Worsening of acne lesions during emotional upset Clinical studies report higher anxiety, self-image concern, and social avoidance in acne patients (Thapa & Ghimire, 2020). Homoeopathic remedy selection typically begins with understanding emotional response patterns, making stresspattern assessment clinically relevant. 3. Gut–Skin Axis Mechanisms in Acne Vulgaris 3.1 Intestinal Microbiota Influence Dysbiosis leads to: • Increased intestinal permeability (“leaky gut”) • Translocation of inflammatory mediators into systemic circulation • Exacerbation of inflammatory skin disease 3.2 Diet-Linked Dermatological Responses High glycemic index foods, saturated fats, and processed foods influence: • Insulin resistance • IGF-1 elevation • Excessive sebum production 3.3 Gut Symptoms Common in Acne Patients Symptom Homoeopathic Relevance Bloating Lycopodium profile Constipation Sulphur, Nux vomica Food intolerance Calcarea carb, Antimonium crudum Emotional eating Natrum mur, Pulsatilla These gut signs form part of the totality used for remedy differentiation. 4. Homoeopathic Constitutional Remedy Selection 4.1 Key Constitutional Patterns Observed Remedy Psychological Features Gut Features Skin Expression Pulsatilla Mild, weepy, seeks reassurance Poor fat digestion Soft, inflamed acne aggravated before menses Natrum muriaticum Reserved, emotional suppression Dry mucosa Persistent oily T-zone with hormonal triggers Lycopodium clavatum Anxiety with insecurity Gas, distention, craving sweets Right-sided acne, worse evening Sulphur Intellect-centred, egotistic thinking Heat, strong appetite Red, itchy, pustular acne Ignatia amara Conflict grief response Psychosomatic gastric tension Fluctuating acne severity during emotional distress The remedy is not selected for the acne but for the person who develops acne in response to stress and gut imbalance. 5. Clinical Integration Model Proposed Mind – Gut – Skin Case Assessment Algorithm 1. Assess stress history and emotional triggers 2. Evaluate digestion and food craving patterns 3. Observe skin eruption characteristics 4. Identify constitutional modality patterns 5. Repertorize using personality + gut + skin totality 6. Select potency based on sensitivity and reactivity 7. Reassess every 4–6 weeks This model aligns psychoneuroendocrine dermatology with classical Homoeopathy. 6. DISCUSSION This literature review supports the hypothesis that Homoeopathy addresses acne most effectively when constitutional analysis incorporates stress patterns and gut physiology. The gut–skin axis provides a biological basis for what Homoeopathic practitioners have historically understood as mind–body unity. However, robust research linking microbiome markers and remedy response remains limited. Future directions include: • Microbiome sequencing before and after treatment • Cortisol and inflammatory marker monitoring • Psychological stress scoring as part of case analysis Int. Jr. of Contemp. Res. in Multi. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [NovDec] Year 2025 135 © 2025 Dr. Aarti Gorakhnath Kanchar, Dr. Meghana Balaji Shewalkar. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY NC ND).https://creativecommons.org/licenses/by/4.0/ 7. CONCLUSION Understanding acne through the lens of psychosocial stress and the gut–skin axis strengthens the scientific rationale for constitutional Homoeopathic prescribing. Remedies selected based on totality and individuality may regulate emotional resilience, digestive function, and inflammatory pathways, contributing to holistic recovery. 8. Ethical Statement This review did not involve patient data collection. Ethical approval was not required. 9. Author Contributions Author Contribution Dr. Aarti G. Kanchar Conceptualisation, manuscript drafting, and theoretical articulation. Dr Meghana B. Shewalkar Literature review, integration of clinical psychological references, editing and positioning. Both authors approve the final manuscript. REFERENCES 1. Bellavite P, Signorini A. The emerging science of homeopathy. Berkeley (CA): North Atlantic Books; 2002. 2. Gupta M, Thappa D. Gut–skin connection in dermatology. Indian J Dermatol. 2014;59(2):109–214. 3. Kober M, Bowe W. The microbiome and acne. J Drugs Dermatol. 2015;14(9):1029–1033. 4. Thapa R, Ghimire R. Psychological distress in acne. Clin Dermatol Rev. 2020;4(1):23–30. 5. Vithoulkas G. The science of homeopathy. New York (NY): Grove Press; 1980. 6. Sharma R, Gupta A. Constitutional approach in acne. J Homoeopathic Pract. 2022;14(1):47–55. Creative Commons (CC) License This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY 4.0) license. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. About the author Dr. Aarti Gorakhnath Kanchar BHMS, MD (Hom. Practice of Medicine), Associate Professor, Department of Community Medicine, Sayli Charitable Trust’s Homoeopathic College, Chhatrapati Sambhajinagar, Maharashtra, India. She specialises in preventive and community medicine, integrating homoeopathic principles into public health and medical education. Dr. Meghana Balaji Shewalkar BHMS, MD (Hom. Paediatrics), Consultant Homoeopath with expertise in pediatric and holistic healthcare. She focuses on individualised treatment approaches for children, emphasising constitutional homoeopathy and evidencebased clinical practice to promote overall wellness.