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Too paranoid with acne diet? UPDATE

by (1198)
Updated about 2 hours ago
Created August 24, 2011 at 6:28 PM

I know this is a typical acne hack, but if I don't get some answers this paranoid whodunnit with food is going to get out of hand into orthorexia territory. I've been eating paleo for roughly 5 months in an attempt to cure my acne. I did notice a change in skin texture (much smoother) within a few weeks, but have still been having the inflamed pimple here or there, plus a new strange symptom of facial flushing, or rather, what looked like a sunburn across my nose most days. There were simply too many variables to start identifying culprits, so I started wittling down my diet just to be safe:

Paleo + no dairy/nuts of course, from the get-go. Over the next few months these met the chopping block: pork, chicken, avocados, eggs, nightshades, starchy vegetables, corn-fed meat, fruit. For the past two weeks, I essentially eat beef/lamb/goat, offal, fish, coconut oil, grass-fed tallow, preservative-free coconut milk and various low-carb vegetables. Is this not an airtight diet? The only supplement I take is zinc, 30 mg/day. I toyed around with other supps but really didn't want to confuse myself with more variables, as something is causing systemic inflamation with or without them.

I'm still experiencing flushing, faux sunburn, digestive issues (constipation followed by loose BMs), and in the morning i feel very bloated, headachy, with bloodshot eyes. My skin texture has recently gone from improved to tons of tiny non-inflamed clogged pores all over my forehead. I have a good sleep schedule, not a lot of stress...

Am I missing something? Do I just need more time on the stricter diet? Perhaps this is a gut flora problem? Probiotics? Anything I should just add back in without worrying about it?

Update: I was way too stressed out when I first wrote this months ago! Part of my problem was that I was trying to address about a dozen different things at the same time, with a dozen different overlapping diets. I was scared of everything. A few things:

1) I definitely needed more carbs; that was one of the most helpful answers here, just as far as mood and my relationship to food. No idea why I was so fixated on low-carb. It never ever felt intuitive to me, my body didn't want it. Felt like my cortisol was spinning out of control.

2 All digestive issues were resolves by adding some starch (and thus lowering my meat/fat intake), limiting brassicas like cabbage, and a probiotic.

3) I still haven't figured out the flushing/puffiness. It comes and goes. I'm getting some autoimmunity and thyroid blood tests for that. Still snooping around the idea of salicylate sensitivity or histamine intolerance, but it doesn't seem to correlate to specific foods. I either react a lot that week or I'm totally asymptomatic.

4) As far as acne, I'm eating pretty standard paleo while supplementing fat soluble vitamins with FCLO/HVBO, a strong probiotic, selenium, occasional zinc. It's doable, but not miraculous.

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156 · February 23, 2012 at 8:18 AM

ESR=1 on my last test and never higher than 8 making lupus a somewhat unlikely diagnosis... There is a doctor in London who specialises in treating flushing problems and rosacea with drugs, so I'll probably end up seeing him if I can't figure anything else out.

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156 · February 23, 2012 at 8:12 AM

Not really, except for some hypertension and anxiety, which probably predates the weird flushing. I showed my doctor a photo earlier this week and he said it was a 'proper butterfly rash' and ordered a ton of immunological testing. He says it's either lupus or 'idiopathic flushing'. I'm going to keep testing and do 30 days of paleo autoimmune, then 30 days of no meat/dairy/eggs if it doesn't clear.

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1198 · February 23, 2012 at 4:25 AM

The ANA seems to be a weaker positive than I thought. My full blood count was fine. I indeed took an organic acids test. From Metamatrix. It identifies metabolism abnormalities, but I passed with flying colors. The idea of histamine/amine/salicylates/obscure intolerance is always in the back of my head. They always say allergies and intolerances can pop up at any time. Do you have any other symptoms associated with this?

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156 · February 19, 2012 at 10:01 PM

Yeah the histamine thing doesn't seem to make much sense I ate tons of those things every day for 30 years without this problem. Chris Kresser mentioned that he puts his patients with migraines or skin problems on it, so I guess there must be something to it for many people. He also mentioned that the results of an 'organic acids test' (I'm guessing the one that Great Plains Laboratory does) might be relevant.

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1198 · February 19, 2012 at 9:09 AM

I think those other markers were fine, but I'd have to look through encyclopedic amount of bloodwork. That looks similar to my flushing, except milder, and mine is lower on the bridge of my nose, but that same sloping top border. I hear you on the histamine diet. I actually started it for acne, but it's wearing on me. No mushrooms, avocado, tomatoes, vinegar, chocolate, cinnamon...the list goes on, and you never know the histamine level in things like leftover meat. I've had weeks where all symptoms just vanished, and I was still eating all of these foods so the connection is dubious.

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156 · February 18, 2012 at 10:31 AM

Sorry, that's http://bit.ly/vZsi99

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156 · February 18, 2012 at 10:25 AM

Sorry to hear about that, but I guess it's good that you found a probable cause. Do you have other biomarkers of some autoimmune problems like low lymphocytes or low platelets? I do. Going to ask about ANA test when I see my doctor on Monday. Here is what the flushing looks like, except it's often bilateral and was worse before I started the beta blockers: https://dl-web.dropbox.com/get/Photos/me/me_again.jpg I dumped the low hist/tyramine diet for now because I was getting too stressed out/restrictive about food.

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1198 · February 18, 2012 at 1:06 AM

Not_James, I just got my tests back. My ANA came back positive, indicating a systemic autoimmune reaction. That's as far as I've gotten. I'll be taking a glutathione recycler to help. I'm still having some reactions despite a low histamine diet.

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1198 · February 10, 2012 at 12:36 AM

One thing I've found that stops it dead in it's tracks every time is ice cream. I don't know if it's the sugar, the cold, the dairy (I don't eat dairy besides ghee) or what, but it's like it just snaps my body right out of it. I look like I did pre-paleo. I'll let you know if I find anything with the tests.

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1198 · February 10, 2012 at 12:34 AM

I have the same triggers as you. I went throuthe gamut of suspicions too: autoimmune, cortisol issues, histamine (even did a 24 hr histamine urine test, nothing), allergy, leaky gut, salicylates. Histamine and salicylates seems unlikely because I never had this before. The longest I had with no symptoms was a few weeks, and I was eating moderate carb paleo, taking Jarrow probiotic, FCLO, selenium, and zinc. But then it came back, so I can't put too much wight in the supplementation.

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156 · February 09, 2012 at 9:50 PM

Various ideas I've had: lupus (going to get ANA test for this I think), elevated histamine levels, some type of infection, some type of poisoning from something I ate while traveling.

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156 · February 09, 2012 at 9:48 PM

Basically the same as yours. Long-term vegan who moved to a moderate-carb paleo diet. Few months later my face started getting really red and swollen on and off all day. Temperature changes, stress, concentration, and eating warm food seem to set it off. My MD suspected pheochromocytoma because of hypertension+anxiety+flushing, but tests were negative. Taking beta blockers now and that seems to help somewhat. I've only tried the low hist/tyramine diet for a couple days, so I can't say whether it helps. Have you found anything that helped you?

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1198 · February 09, 2012 at 7:34 PM

What has been your experience?

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1198 · February 09, 2012 at 7:34 PM

Not really! But I'm on my way. Very funny, I JUST started a low histamine/tyramine diet. I'm still not sure that histamine-rich foods are triggers because it's never had a specific trigger; I would have figured it out by now. It's either on or off, the puffiness, flushing etc.. I'll have asymptomatic weeks where I'm impervious and look like I used to look, but once the switch is flipped, everything will start causing a reaction, if that makes sense. I'm seeing a practitioner and getting some blood tests for autoimmunity, thyroid etc.

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1026 · February 09, 2012 at 1:54 PM

Starch exacerbates my acne. I got rid of my LC side effects by eating lots of fruit (I eat 6 apples daily now) and veggies instead.

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814 · February 09, 2012 at 1:42 PM

a very thoughtful and thorough answer. Nice Job!

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1198 · November 07, 2011 at 9:02 PM

@EvolvedHealth: I started supplementing FCLO Butter Oil blend for D and A, it seems to be helping. I don't supplement with B. I stopped with the elimination diets as well and started just treating my acne topically, which I've done in the past with totally acceptable results. It got to the point where I had to compromise: if this is the diet I must strictly adhere to in order to cure acne, then I'm going a different route. I had taken all of the fun out of paleo. I might try selenium for the other symptoms, which come and go.

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215 · November 07, 2011 at 1:26 PM

Might want to look into supplementing with Vitamin A which helps with skin proliferation. Also curious about your B vitamins - niacin flush can cause redness as well. Rosacea is a possibility, but remember that diagnosis is just putting a name on your symptoms - you still need to figure out what is causing this. I would also try some vitamin D and selenium together - they have been shown to be correlated with autoimmune symptom severity and could be related to your problems.

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7967 · November 07, 2011 at 6:17 AM

I agree that starch would surely solve all the issues you are having; except perhaps acne.

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1515 · November 06, 2011 at 11:48 PM

That's a lot of kefir. In theory it could contribute to bacterial overgrowth in the small intestine, where coconut oil's antimicrobial effects could then contribute to die-off which could manifest on the skin. There's a connection between dairy and acne, so you can't make an accurate guess while it's part of your diet.

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569 · November 06, 2011 at 11:02 PM

@cliff so you take artificial vitamin A? what makes you think that it is the vitamin A that help and not the zinc or K2?

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1198 · November 02, 2011 at 3:53 PM

Haven't resolved the problem. It actually got to a breaking point where I was too stressed out about eating, binged on SAD for a week, then had to start eating what i enjoy (anything paleo + starch). I had tried eliminating all coconut, didn't work. I'm not so much concerned about the acne now (which I've dealt with before topically), but the puffiness in hands and face, redness etc. I wake up every morning looking like I was on a bender.

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1198 · August 27, 2011 at 6:04 PM

Travis, I know. The C was just 1/2 of what I consumed before an unexpected (and temporary) disappearance of symptoms. I think I'm going to up the vegetables and not worry about food sensitivities for now, but still hold on starches/tubers, as most acne-oriented anti-inflammatory diet restrict them.

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1198 · August 27, 2011 at 6:03 PM

Travis, I know. The C was just 1/2 of what I consumed before a unexpected disappearance of symptoms. I think I'm going to up the vegetables and not worry about food sensitivities for now, but still hold on starches/tubers, as most acne-oriented anti-inflammatory diet restrict them.

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12847 · August 27, 2011 at 12:07 AM

I take vitamin A alone, I also take 5000mcg k2 every other day and 10-20mg zinc

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39841 · August 26, 2011 at 11:55 PM

The vitamin C wasn't for the facial issue, it was because your diet lacks it.

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1198 · August 25, 2011 at 4:05 PM

cliff, that's really interesting. Do you take vit A alone or in high-vitamin CLO? Any K2?

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1198 · August 25, 2011 at 3:54 PM

I'm male, and I should mention my apparent LOW testosterone since going on paleo. Hardly any libido at all. I suspected zinc, it's the only supplement taken consistently the entire time, and commonly implicated in testosterone regulation. However, I think have low testosterone to begin with: 26 y.o. and really no facial hair to speak of. I've always read about Zinc optimizing one's testosterone levels though, bringing down when excessive and boosting when low. Could it be that I have extremely low baseline T and removing all of the food-source binders/exacerbaters has revealed this?

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1198 · August 25, 2011 at 3:50 PM

No long term antibiotics for acne, took Biaxin for pneumonia briefly years and years ago. I can't pin bloating on anything specifically besides fruit and perhaps too much coconut oil taken at a time. The first week of paleo I'd eat a big bowl full of fruit in the morning (i know) and be doubled over in pain by lunchtime. Haven't tried any dairy besides ghee for 4-5 mo.

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8933 · August 25, 2011 at 2:36 PM

I don't know for sure, but I heard quite some people saying salmon made their skin worse. For example, the woman who created this page : http://www.ctds.info/acne-diets.html.

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12847 · August 25, 2011 at 2:36 PM

Milk and cheese gave me acne before I started supplementing with vit A at around 10-20k iu daily. I can literally drink gallons of milk with no problems now. Other food induced acne has gone away as well. Might be worth a try, I know it has allowed me a lot more dietary freedom without having to worry about breakouts.

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960 · August 25, 2011 at 1:45 PM

why watch out with salmon?

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2399 · August 25, 2011 at 9:36 AM

Antibiotics usage ? Any problems (bloating, digestive issues) with certain foods (like milk or kefir) ? If so, which ? Dental health ?

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1198 · August 25, 2011 at 8:45 AM

grenadine, I'm 26, which is kind of prime time for lupus or rosacea, though I'd think it odd for rosacea to develop after adapting a diet which commonly reduces its symptoms. I have a Dr.'s appointment next week, and I'm sure he's going to be mighty annoyed with all my ideas.

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1198 · August 25, 2011 at 8:36 AM

I've definitely outgrown acne.org to an extent. Kids claiming they've cured their acne by eating massive amounts of raisins or smothering honey all over their face. But I swear I owe Daniel Kern my young adulthood; his regimen made it at least manageable for years.

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8933 · August 25, 2011 at 8:30 AM

You know what would be funny? If you had the same thing as me : a mold allergy. Vitamin C helps a lot against allergies (it's an antihistamine). I noticed a huge difference in appearance overnight too, a couple of months ago.

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1198 · August 25, 2011 at 8:20 AM

I drink plenty of water and eat plenty of fat (60-70%). I think magnesium is a logical choice and happens to be a short-term solution to the constipation. I tried Carlson's CLO as my latest supplement and I, of course, blamed some new pimple on it two days in, which I know was absurd.

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8933 · August 25, 2011 at 8:01 AM

I strongly advice against acne.org. That is the single most annoying website on the internet : tons of annoyed teens moaning about their acne but they don't have the gut to test things out. Most of the people who go there end up starving themselves because they believe every food causes acne. It's been months since I visited the website, especially because it promotes the use of chemicals against acne and doesn't believe in a natural cure.

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8933 · August 25, 2011 at 7:01 AM

Oh, my diet is just eggs or cod in the morning with spinach, beef at lunch and at dinner (not more than 300g in total) with random vegetables. I eat 3 tablespoons of coconut oil with every meal.

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8933 · August 25, 2011 at 6:55 AM

Couldn't the redness be the niacin in meat? If that is the case, I wouldn't worry : that goes away after a while (I even supplement niacin now) and it helps your skin. It's important to know the vitamins, really!

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8933 · August 25, 2011 at 6:50 AM

I came from vegan, my skin had not that much acne but was quite inflamed. I then went paleo vlc (like you now) in 4 days, but never tried butter (I hate dairy for some reason). My skin improved, improved, improved, though my chin is still not clear. I gotta admit though : this week I started to have loose stools. Really loose. I don't know what it is, gonna ask the question somewhere. Anyways, one thing is for sure : keep up with the diet. It takes a long time to heal. I'd say it takes up to 5 months. I do not take zinc, I find vitamin D and vitamin A (and C) to be way more important.

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39841 · August 24, 2011 at 11:28 PM

The digestive issues sure sound like LC side effects to me. Supposedly the flushing is as well. I'd be really surprised if starch would exacerbate acne, but I wouldn't be surprised at all if sugar/dairy would.

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3631 · August 24, 2011 at 11:22 PM

diet sounds pretty effing airtight. how old are you? that faux sunburn thing... it makes me think of the "butterfly rash" of lupus. not to be alarmist or anything.. just throwing it out there. i had a really good friend that was diagnosed with lupus when he was in his early 20s. he had the sunburny thing for prolly a year before he finally went to the Dr.

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1198 · August 24, 2011 at 8:36 PM

I've done the same, and since starting the diet approach I am treating acne more as a symptom rather than a cosmetic annoyance. I've been reading the forums on acne.org on-and-off for years as well, and I'm a firm believer in a diet solution, but insidious little variables like shaving or SLS/flouride toothpaste can make me question any stigmas I've given to certain foods that week. I've hesitated to jump into the GAPS/FODMAPS world. I never had IBS on the SAD, and the digestive issues have only arisen since eating paleo/primal, even before getting strict and lowering the carbs.

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1198 · August 24, 2011 at 8:13 PM

Also, I'm not sure that any of these eliminated foods (avocado, eggs, tubers...) are, in fact, triggers for what feels like generalized inflammation. I did a the diet ass-backwards in that I was most inclusive at the beginning, and am now scaling down. What bothers me most is the redness, because it never happened before and correlated strongly with the beginning of the diet 4-5 months ago when it was more of a primal deal, but it still comes and goes. I'll start taking vitamin C again today and perhaps add in some more starch.

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1198 · August 24, 2011 at 8:13 PM

Also, Korion, what did your acne look like before you started eating this way, and what does your diet typically consist of?

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1198 · August 24, 2011 at 7:53 PM

I do think too much about my acne, that's partly why I'm asking for help. When I leave it to my own depressive-biased mind and meandering through online forums, picking and choosing my symptoms I identify with and a million different anecdotal solutions, it leads to "I can't do this anymore" apathy. I try to eat high fat, tallow/coconut mostly, everything is cooked or dressed in it. I actually should have ACV as one of the few non-strict foods I do eat, sometimes to deglaze for for dressing. Haven't tried K2, is butter oil worth a shot?

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8868 · August 24, 2011 at 7:38 PM

I'm not sure this is a low-carb side effect.

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8933 · August 24, 2011 at 7:30 PM

How long have you actually been on a diet with no fruit? Also, are you sure avocado's aren't a bigger problem than eggs? They were for me... I eat eggs with no acne (I get an occasional pimple, like once every 2 weeks, and I've only been 2 months on the diet).

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16131 · August 24, 2011 at 7:08 PM

This sounds like rosacea.

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8933 · August 24, 2011 at 6:39 PM

1 - You think too much about your acne. 2 - Do you eat enough fat? 3 - Do you drink enough water? 4 - Have you tried apple cider vinegar? 5 - Supplement vitamin K2 6 - How long have you been doing this?

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16 Answers

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960 · August 25, 2011 at 2:23 PM

I've been troubleshooting my acne for about 13 months now. I went paleo in March of 2010, started getting forehead bumps in June 2010, and then cystic acne around my mouth starting in August of 2010. It's been horrible-- up to dozens of cysts at a time sometimes. But I've done a ton of research, learned a lot about acne, and also experienced a ton of n = 1 self experimentation stuff. Only in the past few weeks have I found all (most?) of the answers I needed, so while I know that everyone responds to foods differently, I'll share the most pertinent of my experiences with you to see if it helps.

There are a lot of causes of acne. One apparently common one is face washing. I have found that all the redness that used to be "just a part of my face" is now completely gone that I don't wash with soap. Just water a few times per day, and, incredibly, I'm doing really well with that. Also, re: non-diet treatment: do NOT touch your face, do NOT pick your acne, no matter how horrific it looks. Trust me. Ack. It's not worth it.

Another prominent cause is an inflammatory diet. This just makes sense. If you're inflamed, your body is going to be sending all sort of inflammatory cytokines to sites needing repair, so you'll just keep getting more and more obviously inflamed. Up the omega 3s. I have gone up to eating a pound of salmon per day without ill effect (so far as I can tell-- I know that I probably exhibit some oxidative damage as a result).

Inflammation, so far as I can tell, is why food allergies can contribute to acne. If you're allergic/sensitive to foods, they can upregulate your immune response, and they can contribute to your general inflammation.

The final and, so it seems from my research and my own experience, largest cause of acne is hormone imbalance. Testosterone, particularly in females but also in males, if too prominent in the body relative to other hormones, will cause cystic type acne, mostly around the mouth but also on the cheeks and forehead. Our testosterone can get messed up for a number of reasons, but this is how various foods can affect our testosterone levels:

Dairy: I just read on a link from Seth Roberts blog (I know, helpful... sorry) that pregnant cows produce a protein that binds with another protein in our bodies which is responsible for binding with excesss testosterone and clearing it out of our systems... basically, it steals one of our testosterone "receptors" and this is how dairy makes such a big impact on people (other than gut issues and food sensitivities). This is HUGE for me. If I have just a sip of milk, a bite of cheese, I can immediately feel my face start burning, etc.

Soy: Soy acts as an estrogen in our bodies. If we continue to eat external estrogen, our bodies "forget" how to produce it themselves, and therefore including high amounts of soy in our diet will mess up our testosterone/estrogen balance. Best to leave it out altogether.

Industrial meat, chicken, eggs: Despite what the industry will tell you about "minimal" hormone levels in the animals, it's lies! all lies! Honest, though. I knew that testosterone was my problem from the get-go, since I have poly cystic ovarian syndrome, but I didn't understand why just about every paleo food made my acne worse until I found out that small amounts of hormones over large amounts of time can make a big difference. Eat local, grass fed, etc. I really do experience problems after just one meal of an industrial animal, and it was hugely frustrating to think it was the paleo diet or some macro nutrient ratio or something effecting me when it was in fact testosterone levels. I must confess, however, that I haven't tested grassfed beef. I have no idea if that would give me problems. There is a well-known correlation out there between high testosterone levels and high meat consumption, but that could be for a variety of confounding factors. It is possible that meat has an inherent testosterone increasing component that is outside of grass/grain fed cows. For right now, I'm avoiding all meat, just to be safe.

Oddly, pork in my experience seems to be better than both meat and chicken.

Sugars, high GI foods, etc: Insulin spikes and hyperinsulinemia both lead to increased testosterone production. For this reason, intermittent fasting has helped me, to a degree, mitigate my acne and other hormone problems.

Stress: increases testosterone.


Some more results of my self-experimentation and reading anecdotes:

It takes longer than two weeks to see the full effect of removing a food. I "removed" dairy a number of times to test my sensitivity, but only for a week or so. Because my acne was so bad, it decreased a little bit with removal, but not significantly for months. Loren Cordain recommends waiting 3 months to see real changes in your acne from food changes. Sometimes I get effects overnight, but in general, overall, my experience lines up with Cordain's recommendation.

Dairy includes butter. Don't let yourself just think it's lactose or casein effecting you. It could be an inherent part of the dairy itself, such as the proteins I described briefly above.

Rosacea is different from acne and should be treated more as an autoimmune condition.

If you're going to experiment with macronutrient ratios, give yourself a lot of time and try to set up the cleanest experiment. I've been wondering about whether or not I need more carbs in my diet for a year and kept thinking "maybe" after my experiments. However, it seems from this point (where all I have left is the scars of my acne) that macronutrient ratios aren't important (for me) at all.


Just to wrap it up with my experience:

I have Poly Cystic Ovarian Syndrome, which is a condition in the ovaries caused by male-hormone excess in a female body. I went paleo after my diagnosis but nothing really improved. I added dairy in huge quantities, plus meat and eggs into my diet (I had been a vegetarian). Slowly the acne came on, and then I became experimenting with eliminations with very little success. It took me a very, very long time to figure things out. It sounds obvious in hind sight, but the acne really could have been from anything. Or so I thought. In any case, I know a lot of women who started getting acne once going on a paleo diet, and I think this may be an (the?) answer. My acne got worse and worse over time, and as I eliminating the right foods, from dairy and then butter, then meat, then chicken, then soy, then eggs, it has very slowly abated. Now that I am on a diet that doesn't actively create new cysts and keeps my testosterone in check, the acne is going away, but, again, slowly. The lesson here is that it really can take a long time for our bodies to heal. I imagine that once I "reset" and get everything more in balance in a few months or so I will be able to eat these foods in smaller doses. I really just overdid it when I went paleo, sometimes eating 75 percent of my calories in a day from dairy.

Today, I eat vegetables (all vegetables, including nightshades, which I had feared for a long time for apparently no good reason), macadamia oil, coconut oil, avocadoes, and seafood. It's not much, but it's the "cleanest" diet I have found and, for me, it works. I know that this diet and these problems aren't quite the problem discussed in this thread, re: the rosacea, but it seems as though some commenters may be able to relate to my experience and others who read it.

My thoughts and opinions about acne are informed by my experience, as well as the vast volume of acne literature out there. There's not a lot, but if you dig around you can find SOME good stuff. There's a lot of appealing ideas out there that may in fact not have any merit, such as attributing acne to "unclean" proteins, improperly cooked foods, nightshades (the only anti-nightshade information I've ever found is anecdotal), lack of sleep.... it's important, I believe, to think about all of the things that cause acne on that particular spot of your face (it's true that different areas have different causes, though hormones play a role in all of them, and usually testosterone), and then think about how you might be affecting those causes in your life.

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1198 · August 25, 2011 at 4:05 PM

cliff, that's really interesting. Do you take vit A alone or in high-vitamin CLO? Any K2?

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12847 · August 25, 2011 at 2:36 PM

Milk and cheese gave me acne before I started supplementing with vit A at around 10-20k iu daily. I can literally drink gallons of milk with no problems now. Other food induced acne has gone away as well. Might be worth a try, I know it has allowed me a lot more dietary freedom without having to worry about breakouts.

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1198 · August 25, 2011 at 3:54 PM

I'm male, and I should mention my apparent LOW testosterone since going on paleo. Hardly any libido at all. I suspected zinc, it's the only supplement taken consistently the entire time, and commonly implicated in testosterone regulation. However, I think have low testosterone to begin with: 26 y.o. and really no facial hair to speak of. I've always read about Zinc optimizing one's testosterone levels though, bringing down when excessive and boosting when low. Could it be that I have extremely low baseline T and removing all of the food-source binders/exacerbaters has revealed this?

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12847 · August 27, 2011 at 12:07 AM

I take vitamin A alone, I also take 5000mcg k2 every other day and 10-20mg zinc

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569 · November 06, 2011 at 11:02 PM

@cliff so you take artificial vitamin A? what makes you think that it is the vitamin A that help and not the zinc or K2?

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814 · February 09, 2012 at 1:42 PM

a very thoughtful and thorough answer. Nice Job!

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8868 · August 24, 2011 at 8:04 PM

I've recently read all the acne questions and answers trying to find an all-encompassing universal theory of acne. Doesn't exist. One idea is that oxidized vegetable oils are the culprit. Not so if we are to take you at your word that you're not getting any in your diet. At least I don't see any evidence of this. Then dairy, fructose, intolerances of other allergens--all these get implicated. An elimination diet gets complicated when you eliminate (almost) everything, as you have described.

Recently I've had a flare-up of acne, and acne is not a problem I have had, at least not for a long time and not with this kind of severity. I think there are several classes of acne and they most likely have multiple, different causes. My acne is completely confined to the head and neck, which is odd to me. Could it be that this is not a dietary thing at all? I'm deeply skeptical, but at the moment I'm more inclined to implicate my razor than my diet. The zits follow an interesting pattern. They are all on the edge of where I shave.

I have not completely eliminated chicken, eggs, fish, and pork but I've much reduced my intake. (I've been clearing my fridge and freezer. Don't want to waste food.) But the most striking thing to me was the elimination of dairy. Striking in that I've read many accounts of how terrible it is for acne; yet a two week dairy elimination diet (strict) produced no reduction in my acne AT ALL. And it was not an easy thing to give up that heavy cream in my coffee, or the parmesan cheese, or the butter. All staples. I suppose it's possible that vegetable fats in my chicken (pastured, but supplemented with feed I'm sure), soy proteins in my eggs (WAPF says it ends up in the eggs and even the best pastured eggs get soy), or pork or fish allergens are causing this. My digestion is excellent so in my case I would conclude nothing, only note that there are too many confounding accounts. And dairy is not the cause (in my case, and it seems in yours, too).

Still, I will continue to eliminate the pork, chicken, eggs and the like, at least for now, as an experiment. And I'm buying an electric razor.

I did want to address the digestive issues. These should be addressed, perhaps with a GAPS/SCD/FODMAPS-type diet. If you can resolve the digestive issues and the acne is still a problem I'd be interested to know the outcome. For what it's worth, as a reformed IBS sufferer, fiber and probiotics were awful for me. Just awful. Getting rid of the lethal combo of plant matter and sugar for many months is what cured me. Now I can tolerate them increasingly. But it took about six months of an all meat diet before I got better.

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1198 · August 24, 2011 at 8:36 PM

I've done the same, and since starting the diet approach I am treating acne more as a symptom rather than a cosmetic annoyance. I've been reading the forums on acne.org on-and-off for years as well, and I'm a firm believer in a diet solution, but insidious little variables like shaving or SLS/flouride toothpaste can make me question any stigmas I've given to certain foods that week. I've hesitated to jump into the GAPS/FODMAPS world. I never had IBS on the SAD, and the digestive issues have only arisen since eating paleo/primal, even before getting strict and lowering the carbs.

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8933 · August 25, 2011 at 8:01 AM

I strongly advice against acne.org. That is the single most annoying website on the internet : tons of annoyed teens moaning about their acne but they don't have the gut to test things out. Most of the people who go there end up starving themselves because they believe every food causes acne. It's been months since I visited the website, especially because it promotes the use of chemicals against acne and doesn't believe in a natural cure.

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1198 · August 25, 2011 at 8:36 AM

I've definitely outgrown acne.org to an extent. Kids claiming they've cured their acne by eating massive amounts of raisins or smothering honey all over their face. But I swear I owe Daniel Kern my young adulthood; his regimen made it at least manageable for years.

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39841 · August 24, 2011 at 6:37 PM

How sure are you that starchy tubers aggravate it? Adding them back in would likely correct all of the other side effects of low-carb that you're experiencing. It may be worth it to add back in a few sweet potatoes per day and give it a week to see how you feel. Even if what you're doing now cleared your skin perfectly (which it has not) it would obviously be at the expense of your overall health.

At the very least, you ought to supplement with vitamin C, since you're very likely deficient.

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8868 · August 24, 2011 at 7:38 PM

I'm not sure this is a low-carb side effect.

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39841 · August 24, 2011 at 11:28 PM

The digestive issues sure sound like LC side effects to me. Supposedly the flushing is as well. I'd be really surprised if starch would exacerbate acne, but I wouldn't be surprised at all if sugar/dairy would.

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1198 · August 24, 2011 at 8:13 PM

Also, I'm not sure that any of these eliminated foods (avocado, eggs, tubers...) are, in fact, triggers for what feels like generalized inflammation. I did a the diet ass-backwards in that I was most inclusive at the beginning, and am now scaling down. What bothers me most is the redness, because it never happened before and correlated strongly with the beginning of the diet 4-5 months ago when it was more of a primal deal, but it still comes and goes. I'll start taking vitamin C again today and perhaps add in some more starch.

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8933 · August 25, 2011 at 6:55 AM

Couldn't the redness be the niacin in meat? If that is the case, I wouldn't worry : that goes away after a while (I even supplement niacin now) and it helps your skin. It's important to know the vitamins, really!

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7967 · November 07, 2011 at 6:17 AM

I agree that starch would surely solve all the issues you are having; except perhaps acne.

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1026 · February 09, 2012 at 1:54 PM

Starch exacerbates my acne. I got rid of my LC side effects by eating lots of fruit (I eat 6 apples daily now) and veggies instead.

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20 · September 05, 2012 at 12:11 PM

If these steps do not clear up the blemishes, try over acne medications counter. These products are applied directly to the skin.

 They may contain benzoyl [acne no more][1] peroxide, sulfur, resorcinol or salicylic acid.
 They function by destroying bacteria, and by drying the oil descamar upper layer of the skin.
 They may cause redness or skin peeling.

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156 · February 09, 2012 at 12:46 PM

I'm having a similar problem with unexplained facial redness and flushing and am trying a low tyramine/histamine diet for a while to see if makes a difference. Did you ever figure out what was causing this?

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1198 · February 10, 2012 at 12:34 AM

I have the same triggers as you. I went throuthe gamut of suspicions too: autoimmune, cortisol issues, histamine (even did a 24 hr histamine urine test, nothing), allergy, leaky gut, salicylates. Histamine and salicylates seems unlikely because I never had this before. The longest I had with no symptoms was a few weeks, and I was eating moderate carb paleo, taking Jarrow probiotic, FCLO, selenium, and zinc. But then it came back, so I can't put too much wight in the supplementation.

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1198 · February 09, 2012 at 7:34 PM

What has been your experience?

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156 · February 09, 2012 at 9:50 PM

Various ideas I've had: lupus (going to get ANA test for this I think), elevated histamine levels, some type of infection, some type of poisoning from something I ate while traveling.

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1198 · February 10, 2012 at 12:36 AM

One thing I've found that stops it dead in it's tracks every time is ice cream. I don't know if it's the sugar, the cold, the dairy (I don't eat dairy besides ghee) or what, but it's like it just snaps my body right out of it. I look like I did pre-paleo. I'll let you know if I find anything with the tests.

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156 · February 09, 2012 at 9:48 PM

Basically the same as yours. Long-term vegan who moved to a moderate-carb paleo diet. Few months later my face started getting really red and swollen on and off all day. Temperature changes, stress, concentration, and eating warm food seem to set it off. My MD suspected pheochromocytoma because of hypertension+anxiety+flushing, but tests were negative. Taking beta blockers now and that seems to help somewhat. I've only tried the low hist/tyramine diet for a couple days, so I can't say whether it helps. Have you found anything that helped you?

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1198 · February 09, 2012 at 7:34 PM

Not really! But I'm on my way. Very funny, I JUST started a low histamine/tyramine diet. I'm still not sure that histamine-rich foods are triggers because it's never had a specific trigger; I would have figured it out by now. It's either on or off, the puffiness, flushing etc.. I'll have asymptomatic weeks where I'm impervious and look like I used to look, but once the switch is flipped, everything will start causing a reaction, if that makes sense. I'm seeing a practitioner and getting some blood tests for autoimmunity, thyroid etc.

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156 · February 18, 2012 at 10:25 AM

Sorry to hear about that, but I guess it's good that you found a probable cause. Do you have other biomarkers of some autoimmune problems like low lymphocytes or low platelets? I do. Going to ask about ANA test when I see my doctor on Monday. Here is what the flushing looks like, except it's often bilateral and was worse before I started the beta blockers: https://dl-web.dropbox.com/get/Photos/me/me_again.jpg I dumped the low hist/tyramine diet for now because I was getting too stressed out/restrictive about food.

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1198 · February 18, 2012 at 1:06 AM

Not_James, I just got my tests back. My ANA came back positive, indicating a systemic autoimmune reaction. That's as far as I've gotten. I'll be taking a glutathione recycler to help. I'm still having some reactions despite a low histamine diet.

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156 · February 19, 2012 at 10:01 PM

Yeah the histamine thing doesn't seem to make much sense I ate tons of those things every day for 30 years without this problem. Chris Kresser mentioned that he puts his patients with migraines or skin problems on it, so I guess there must be something to it for many people. He also mentioned that the results of an 'organic acids test' (I'm guessing the one that Great Plains Laboratory does) might be relevant.

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156 · February 18, 2012 at 10:31 AM

Sorry, that's http://bit.ly/vZsi99

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1198 · February 19, 2012 at 9:09 AM

I think those other markers were fine, but I'd have to look through encyclopedic amount of bloodwork. That looks similar to my flushing, except milder, and mine is lower on the bridge of my nose, but that same sloping top border. I hear you on the histamine diet. I actually started it for acne, but it's wearing on me. No mushrooms, avocado, tomatoes, vinegar, chocolate, cinnamon...the list goes on, and you never know the histamine level in things like leftover meat. I've had weeks where all symptoms just vanished, and I was still eating all of these foods so the connection is dubious.

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1198 · February 23, 2012 at 4:25 AM

The ANA seems to be a weaker positive than I thought. My full blood count was fine. I indeed took an organic acids test. From Metamatrix. It identifies metabolism abnormalities, but I passed with flying colors. The idea of histamine/amine/salicylates/obscure intolerance is always in the back of my head. They always say allergies and intolerances can pop up at any time. Do you have any other symptoms associated with this?

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156 · February 23, 2012 at 8:12 AM

Not really, except for some hypertension and anxiety, which probably predates the weird flushing. I showed my doctor a photo earlier this week and he said it was a 'proper butterfly rash' and ordered a ton of immunological testing. He says it's either lupus or 'idiopathic flushing'. I'm going to keep testing and do 30 days of paleo autoimmune, then 30 days of no meat/dairy/eggs if it doesn't clear.

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156 · February 23, 2012 at 8:18 AM

ESR=1 on my last test and never higher than 8 making lupus a somewhat unlikely diagnosis... There is a doctor in London who specialises in treating flushing problems and rosacea with drugs, so I'll probably end up seeing him if I can't figure anything else out.

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2291 · November 07, 2011 at 2:55 AM

Try an anti inflammatory.. like turmeric? I always wake up feeling less inflamed all around when I take it.

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0 · July 13, 2013 at 3:09 AM

Mate try palio with low fodmap, fructose and lactose intolerance is a big hidden problem we don't look into. Give it go for few weeks and see. I am already improving.

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0 · June 20, 2013 at 11:24 PM

I have read with interest how you are on the Paleo diet but have not had the anticipated success for your acne condition.

Firstly none of us must abdicate the responsibility to reason and/or think for ourselves, We, humans are a complex specie, so that what works for one may not at all work for the other.

Therefore we do need to follow best practices and see what works best especially when dealing with acne.

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1523 · April 22, 2013 at 11:55 PM

do you eat any seaweeds? have you looked into supplementing with iodine?

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0 · April 22, 2013 at 7:36 PM

As someone who suffered with acne throughout my teen years, I wish I would have known there was a real scientific connection between diet and acne then. Yes I had heard that greasy fried foods and chocolate caused acne but I found out those were myths so didn't think diet had any impact on acne. Once I started getting to the paleo diet I found out that a lot of the things I was going to be be cutting out could have actually been the cause or aggravater of my acne!

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0 · April 10, 2013 at 2:43 AM

GAPS is the answer in my opinion.

I am documenting my journey with GAPS to fix Acne on my online blog. http://ashnand.blogspot.com/

I am 3 weeks in and already seeing progress.

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0 · January 19, 2013 at 8:37 PM

the red flushes you describe as well as the bumpy rash sounds like it might be demodex - a parasite on the skin that can look like acne. consider a parasite cleanse internally (humaworm ships to UK and is v good), then a liver flush - should also help with the digestive problems, etc. topically, apply diluted tea tree oil. good luck.

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0 · August 27, 2012 at 3:00 AM

I am struggling so much with diet and acne. One doctor i visited told me to remove all dietary lectins and it would clear my acne.

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0 · November 06, 2011 at 8:32 PM

I follow gaps and i find out that cocunut and cocunut oil especially contributes to eczema or acne. It is not cleanse effect because just removed I have the clearest skin ever. I find a lot of people in paelo community as well. For some people it is healing because of good amount of fat but for others it is definetly not. The best source of fat should b meat not plant sources. I eat lot of raw dariy 2liters of kefir, red meat 1kg a day. 6 eggs 1kg veggies fish oil and primose oil.

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1515 · November 06, 2011 at 11:48 PM

That's a lot of kefir. In theory it could contribute to bacterial overgrowth in the small intestine, where coconut oil's antimicrobial effects could then contribute to die-off which could manifest on the skin. There's a connection between dairy and acne, so you can't make an accurate guess while it's part of your diet.

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0 · November 02, 2011 at 2:40 PM

You may not see this or may have already resolved your problem, but I thought I'd give it a shot. Are you familiar with Fructose Malabsorption? Researchers think that nearly a third of the population in the US is afflicted with it. That bloating and IBS-like stuff are signs you might have it. If so, all that coconut milk you've been drowning in could very well be your culprit. Coconut products can be a real problem for people with FM, due to their fructose content. If I were you, I'd leave off the coconut stuff (aside from coconut oil, which doesn't have fructose) for a few weeks and see what happens. You've tried just about everything else, right? Also interestingly, FM is associated with zinc deficiency, which causes acne, etc.

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1198 · November 02, 2011 at 3:53 PM

Haven't resolved the problem. It actually got to a breaking point where I was too stressed out about eating, binged on SAD for a week, then had to start eating what i enjoy (anything paleo + starch). I had tried eliminating all coconut, didn't work. I'm not so much concerned about the acne now (which I've dealt with before topically), but the puffiness in hands and face, redness etc. I wake up every morning looking like I was on a bender.

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8933 · August 25, 2011 at 6:59 AM

After months of looking at the effects on nutrition on acne (by testing it out on myself), I find the most important part of acne to be face mapping Basically the theory is that your acne shows you what's wrong with your body. I was skeptical at first, but every time I have digestion issues I get chin acne. When eating raw meat/eggs, I get inflamed skin between my eyes. When my allergies are bad, I get cheek acne. When I don't sleep enough or get angry at someone (bad emotions) I get acne on the sides of my chin. The nose would show you what's wrong with your heart. That's what I use to understand my acne.

The problem is : everywhere, my acne is practically gone (compared to what it used to be). There's only one place that just doesn't want to clear up : my chin. For some reason, I have constipation from time to time, and right now my stools are ridiculously loose (they're basically water). I'll post a separate question for this and will update here.

Some important questions you left unanswered :

  1. How much water do you drink? It should be 2-3 liters.
  2. How much fat do you eat?

Some more thoughts :

  1. Watch out with salmon
  2. Eat anti-inflammatory
  3. Get Pau d'Arco tea
  4. I'm not sure, but that is one of the things I'm yet to try out : I believe salt helps digestion a LOT.
  5. Supplement more. Our world has changed a lot due to pollution etc., you HAVE to make up for that. Grok's diet might have been perfect, it's almost impossible for most of us to achieve that without supplements. I'm thinking about cod liver oil, magnesium/calcium, b complex, ...
  6. Check out http://www.healingnaturallybybee.com/ . I followed her advice, my acne improved a lot, and I'm not the only one who had success with her diet (it's basically your diet with a supplement list).
  7. Drink rooibos tea, it helps the skin texture a lot
  8. While a probiotic supplement might help a lot, it shouldn't really be necessary. Those things cost a lot of money. Eating quality salt is more important IMO

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1198 · August 25, 2011 at 8:20 AM

I drink plenty of water and eat plenty of fat (60-70%). I think magnesium is a logical choice and happens to be a short-term solution to the constipation. I tried Carlson's CLO as my latest supplement and I, of course, blamed some new pimple on it two days in, which I know was absurd.

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960 · August 25, 2011 at 1:45 PM

why watch out with salmon?

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8933 · August 25, 2011 at 2:36 PM

I don't know for sure, but I heard quite some people saying salmon made their skin worse. For example, the woman who created this page : http://www.ctds.info/acne-diets.html.

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