If youre not craving seafood why are you bothering with it? No one is holding a gun to your head. You can paleo with other forms of meat.

VB makes a good point about stress, but personally I think its more upside down : bad diets make you susceptible to stress. I linked to http://thelovevitamin.com because she controls her skin with diet (just to point out that it is possible), but I don't agree with her diet, as some things she eats (like lentils and nuts) cause big problems for me, and I think the only reason she tolerates them is because she does so many lifestyle changes like yoga classes (things I don't have time nor interest for).

Paleo without nuts pretty much reduced my acne to 2-3 small zits, which was kinda okay, way better than it had ever been. Whenever I had an exam, presentation, date, ... I would get a big zit. I wouldn't be able to cope with the stress, even if it was low. So Peat kinda interested me for this.

Right now my sleep is just perfect, I never wake up at night anymore and can finally sleep in a room with light shining in it (and I need less sleep). Last time I had a presentation I didn't get any skin issues, and felt quite okay. I wasn't even very stressed out for it, and managed to improvize during the whole thing which is quite amazing given the fact that I used to be mister ultra-shy-boy.

Some interesting stuff that I found out is that I just get acne on my chin if I don't eat enough sugar. Eating lots of dairy and fruits do not trigger acne when I eat liver and oysters regularly, and I found out I can replace liver and oysters with retinol and not get acne. The biggest change you gotta make is reduce PUFA intake to an absolute minimum though. Some things like coconut oil and butter have PUFA but their saturated fats are protective. But nuts, fatty fish, olive oil should be avoided. If you decide to supplement vitamin A, you can use Nutrisorb-A on your skin itself, it's water-soluble vitamin A. Doses are personal, I've heard of two people that need 70.000iu to get rid of acne, while I personally need around 25.000iu depending on how much milk I use. Cliff also got rid of his acne and he apparently needs 50.000iu.

Ray Peat said that usually, when people supplement thyroid hormone and eat liver, their acne clears up. I can vouch for that, but I think PUFA elimination should be done too.

There is so much to be talked about, but I'm gonna stop here. I'd say give it a try, you can always go back to your old diet if it doesn't work.

EDIT : just wanted to add that a Peatarian diet also enabled me to cut out lots of supplements (magnesium citrate, vitamin C, B-complex, selenium) that initially took care of some of the acne. I still take B3, fat-solubles and eggshell calcium, but I'm slowly transitioning to only topical supplements (the retinol works quite well on the skin for example).

I have never had any severe acne so I cannot speak from the experience. However, I worked with a large body of teenagers and I have encountered many many students with acne. Some of them outgrew it, some not. Most teens who got better cleaned up their diets.

To tell you the truth, I do not even understand why you have to eat seafood? What about fish (if you like it)? Or meat (if you do not like fish)?

This is what I know some people recommended:

Korion posted that he got significantly better on Ray Peat's diet.

He also provided a link to this blog: http://www.thelovevitamin.com/about/

What I found very interesting she points out the amount of stress that contributes to developing acne. It makes perfect sense to me:

stress -> body reacts with producing hormones as a response -> inflammation -> acne as a sign of inflammation

Her observations are supported by some other answers I have seen.

Could be dealing with stress (including nutritional stress) be the answer to acne?

Again, I am in no position to give any advice but here is my take on it:

1. Clean up your diet. Go for nutritionally dense foods.

2. Take care of your gut. Maybe you need fermented foods? Sauerkraut is my favorite choice, but Koreans eat a lot of kimchi and their skin is quite clear. I am yet to see a Korean with a bad acne problem. Maybe you need enzymes or more papaya that acts as a natural enzyme? I do not know. Water kefir? Yogurt? Check with a naturopath if you find a good one. Bone broth does wonders for your stomach. Just make sure your gut flora is healthy. And no gluten, I hope it goes without saying.

3. Reduce stress in your life. Meditation? Friends? Fun? It is your call. If you ever read the book "Why Zebras do not Get Ulcers" you will know that stress kills. If you are in a very stressful situation, brainstorm the ways you can alleviate your stress.

Don't worry. You will get it right one day!

Potatoes are in the solanaceae/nightshade family, along with peppers, tomatoes and eggplants. Many people are sensitive to the alkaloid compounds in nightshades, which create an inflammatory response--such as acne. So the potatoes might be a problem.

If you're eating a lot of fruit, that's a lot of sugar. Sugar is inflammatory, plus it feeds the bacteria that cause acne breakouts. Cut way back on the sugar in your diet by eating green vegetables instead of fruit, and see what happens.

And if you don't like fish, and you know iodine might exacerbate acne, then why the hell are you eating it?

ETA: And, I should add, your diet of potatoes, fruit, and fish seems very limited, as well as low in healthy fats. I strongly suggest eating a wider variety of foods, including different protein sources that you might enjoy more. Paleo's not a weird crash diet, but the way you're eating (as you've described it) almost sounds as if you're treating it as one.

Sadly two of my adult children take acne pills. Nothing else seems to help. I certainly found when I started having babies all skin problems healed up so presumably hormones play a part.

Try lots of sunshine and so get enough vitamin D too. Obviously eat well and clean out unhealthy foods.

I found http://holistichealthherbalist.com/ to be pretty helpful in helping me clear up my acne. She talks about diet, skincare, and diet. At any rate it's worth a try =)