For three weeks, I've been eating a strict Paleo diet and I've taken anti-inflammatory supplements: fish oil (600 mg EPA, 400 mg DHA) and vitamin D3 (6000 iu/day). I also try to minimize cortisol levels by optimizing sleeping patterns and not doing endurance or chronic cardio but mostly HIIT, weightlifting and static strength holds.
Before this, I was eating nonpaleo foods like grain, diary, fries and soda. Strange but true, my acne was almost gone. After two weeks in Paleo, I started getting some acne again.
How can this be explained?
Is it because before Paleo, my immune system was impaired and didn't even get the chance to respond?
@Matthew: I now eat a mix of the following: 2-4 eggs a day (either boiled or in recipes). I bake in coconut oil, lard or tallow. Grassfed chicken and red meat, if possible from local farmers. Some fish (tuna). Lots of broccoli, cauliflower, mushrooms, brussel sprouts, spinach, pumpkin, celery, asparagus and I probably forgot some vegetables. Raw nuts and seeds in moderation, such as walnuts, almonds, macadamia, brazilnuts. Fruit in moderation, such as apples, oranges, strawberries, blueberries, For snacks I eat organic beef jerky and sometimes pork rind. Some extra-virgin olive oil in salads. Water and green or mint tea.
@all: I forgot to say that I'm a 30 y/o caucasian male and I've been on SED for the last 29 yrs. Also, I'm from The Netherlands, so my english may come across as weird here and there.
Acne can sometimes be a good thing, or at least a marker for good things. Your paleo lifestyle--healthy diet, adequate sleep, interval/weight training--lowers your estrogen levels and raises your testosterone levels. This can make your acne worse. Enjoy your lifestyle, and treat your acne. Since it's only been 3 weeks, the acne flareup may be temporary as your skin adjusts to your new nutritional/hormonal milieu.
The other possibility is that fish oil is suppressing your immune response to the acne infection (After all, acne is not just inflammation, it's a bacterial infection in your skin). Your diet sounds like it's already balanced between O3 and O6 oils, so you probably don't need to take extra O3's. Try stopping the fish oil, and see if that helps.
I have a nagging suspicion that this and other low-grade issues often reported by paleo folks are due to eating too much protein and not nearly enough fat. Fat is needed to properly digest protein and absorb minerals. The recommendation to eat "lean meat" (from, for example, Cordain) is to me among the most obnoxious and misguided pieces of dietary advice in circulation. Fortunately, it does look as though most people here know better, but I think it always merits repeating given the lipophobic conditioning most of us grew up with. In my opinion, if you're not going through a stick of butter or its equivalent at least every two days, you're not eating enough fat. Your meat and vegetables should barely be visible beneath all the butter (or tallow, lard, etc.)!
Due to the high phytic acid (which blocks mineral absorption) and omega-6 content, I'd also go even easier on the nuts, other than macadamias. And what are your chickens eating? If they're fed soy, for example, I wouldn't doubt that it's passing into their meat and eggs, which could be causing you trouble.
Finally, if you can get some grass-fed organ meats and make some fermented foods, these can do nothing but good. What causes acne, exactly? I don't know, but if you try reducing potential problem foods (or problem foods fed to your food), while maximizing nutrient intake and absorption (organ meats+fermented foods=serious nutrient density), and without restricting your calories or fat intake (part of maximizing nutrient intake and absorption!), my guess is your body will resolve the acne soon enough.
I see that there have been many answers to your question now. It seems that people are missing a bit of perspective on your situation as you changed your diet so recently, I don't see that altering small details of your diet at this stage would be useful. Several foods can trigger acne in some poeple, as other answers have mentioned; these include nuts, eggs, fruit and dairy (though you are not eating dairy). However if untill 3 weeks ago you were eating grains, diary, fries and soda without acne I think it is unlikely that things like the fruits, or the ratio between fat, carbs and protein would be the problem.
Remember that this is a radical change to your diet in a short time which can have many effects. I would be cautious of trying to identify possible problem foods for now as it could simply be getting use to the change of diet that is the cause. The diet you are eating sounds good. Keep eating as you are for at least another 3 weeks and see if the acne improves. If you are still getting acne then maybe consider making changes.
Additional points: If you are eating oily fish (like tuna) and grassfed meat regularly and avoiding seed oils you will probably not need the fish oil supplements. Taking acount of where you live and the time of year I would personlly limit the vitamin D3 supplements to 2000iu/day unless you are getting your blood levels tested.
All the above advice so far have been misleading. You actually may HAVE A LOCAL LINOLEIC ACID (Omega 6!!) DEFICIENCY, all acne sufferers do. Local n-6 deficiency causes abnormal desquamation of the skin making it thicker and prevents it from sloughing off, Imagine a corn or callus on your foot, that's what happens.
(BTW, I'm a CPhT. and also had acne so I do have a bit of molecular research. all right now that's out of the way)
By local, I mean, you will not necessarily fix acne systemically (oral administration). You would have to use topicals to increase the "good" Omega-6 (GLA from Borage oil or Evening Primrose) on your skin.
Now before you slather your face with Borage oil, you have to exfoliate the excess skin (Stratum corneum layer) first, brought about by hyperkeratinization and hypercornification (pre-acne stage). Use Salicylic Acid (SA) EVERY SINGLE DAY. Rite-Aid has that cheap orange facial wash with 2% SA for only 4bux I think. Always exfoliate.
Then apply GLA directly to your skin. It's going to be greasy so you might want to use a non-comedogenic base cream like Jason moisturizing cream: http://www.iherb.com/Jason-Natural-Ultra-Comforting-Moisturizing-Creme-Aloe-Vera-84-4-oz-113-g/6234?at=0
BTW, you would need to add in Magnesium and Zinc Monomethionine to your regime to prevent the Omega-6 foods from converting to the inflammatory arachidonic acid Omega-6.
I also get my borage from iHerb (ConsumerLab's #1 online health store)
Let me know if that was too confusing.
EDIT: Taurine powder AND COCONUT OIL (yes, Lauric Acid is COMEDOGENIC) may trigger acne break outs.
Do you have evidence of Candida / fungal infections? Gut bloating, oral thrush, underarm rashes, rosacea?
I have a pet theory that Candida can cause acne. Ketogenic diets promote Candida growth.
I would suggest eating starches, green leafy vegetables, fermented vegetables, and vinegar, as well as spices like turmeric, oregano, thyme. Also practice good oral hygiene.
This could be caused by your fish oil supplements. Fish oil is known to cause breakouts and I have seen people who never had acne break out once they began using it. As I understand it has something to do with the fact that it is not the easiest oil to digest and this causes the skin to react. I am not a fan of fish oil, it is highly processed, stripped of the vitamins and then often has synthetic vit. A and D added back into it. I love my fermented cod liver oil, it is an unprocessed traditional food, it never gives me indigestion (which fish oil has) and it never causes me to break out. If you check out some articles on the WAPF site about the difference between fish oil and real cod liver oil you will be a convert- it is so much better for you. Also, nothing in your diet looks like it could possibly cause breakouts. I have researched this topic exhaustively when I began getting acne in my mid 20's. I have been lacto-paleo (only raw dairy and butter) for about 3 months now and my hormonal acne flare-ups are gone. I really believe this diet is the best for controlling acne and balancing hormones, but most of us were pretty out of whack from the SAD before we started eating this way so it may take a long time to get back in balance.
I read a story recently about some newfangled way of treating acne with gold nanoparticles that released lauric acid. Here's the link.
This got me to thinking about lauric acid. Is there some way to achieve this with out nano-bombs? The article alerted me to coconut oil as the lauric acid powerhouse. I've since started eating more coconut oil everyday. It's been a week, so not really able to say anything about effects one way or another. But if anyone else knows, I'd be interested in hearing about it.
You might want to try a strict elimination diet. This has worked well for me. Cut out the fruit, nuts, olive oil and beef jerky/pork rinds. Eat only meat, low starch veggies and coconut oil or coconut milk. Try to get your body in full blown ketosis with protein staying at a moderate level and plenty of fats. If this works you can try adding things back in one at a time to see how they effect your skin. After experimenting with low carb and paleo eating over the last two years in an attempt to clear my skin and balance hormones, this approach has been the most successful for me.
My intake on this.