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This article is part of a series on whole food, plant-based (WFPB) nutrition. To view more topics, see Discovering the Word of Wisdom Topics A-Z.
Acne is a common scourge, particularly among teenagers and young adults. Many assume it is an inevitable part of life. Interestingly, although it is widespread in Western developed countries, it is almost non-existent in areas of the world that eat a more unprocessed, plant-based, low-fat diet.
One study examined the prevalence of acne in two non-westernized populations: the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay. Surprisingly, among this population, not a single case of even mild acne was found, even among the 15-25 year olds. In particular, “Of 1200 Kitavan subjects examined (including 300 aged 15-25 years), no case of acne . . . was observed. Of 115 Aché subjects examined (including 15 aged 15-25 years) over 843 days, no case of active acne . . . was observed.” These populations were consuming a high carbohydrate, low fat diet of minimally processed plant and animal foods.
Why Should We Care?
Anyone who has suffered from acne (or had teenagers who did) understands something about why this disease can be so distressful. Being a teenager is hard enough without your face becoming disfigured. Most of us have experienced this unpleasant condition and know how powerfully it can affect one’s self-esteem. Of course, it goes beyond emotional suffering as severe acne can be physically painful and leave permanent skin scars and dark spots.
Acne is the most common skin condition in the US. It can affect people of all races and all ages, though it most commonly affects adolescents and young adults. Over 85% of adolescents get acne, and many people in their 30’s, 40’s and older still get acne. Approximately 17 million Americans are estimated to have acne at any one time.
For many people, acne is very different from the medical conditions where we can separate our sense of self and self-esteem from our disease. Because acne strikes at a vulnerable age and in such a public place as our own face, even a relatively small outbreak can be emotionally and even psychologically devastating.
Fortunately, there is something we can do to prevent and even cure acne and enjoy beautiful clear healthy skin. It has to do with the foods we eat.
What’s the Cause?
Each hair follicle (pore) in our skin is connected to an oil gland which secretes an oily substance called sebum, which is an important lubricant for our hair and skin. When working properly, sebum carries dead skin cells through the follicles to the surface of the skin. Acne can develop when excess sebum mixes with dead skin cells. The oil and dead skin cells stick together and instead of exiting out the surface of the skin, the mixture blocks the pores. This blockage creates an anaerobic (“without oxygen”) environment that is conducive to the growth of bacteria, which may lead to infection and inflammation. This toxic mixture can rise to the surface of the skin where we then see the symptoms of acne: swelling, redness, and pus.
What stimulates the production of excess oil (sebum) and skin cells in our pores? Part of this is of course age-related, as it occurs more often at times when hormones in the body are changing, and hormones have an impact on excess oil and skin cells. Beyond age, many things impact both our hormone levels and the development of acne, including stress and medications, but the most important factor is the food we put into our body. Here are three of the most significant dietary triggers:
(1) Excess fat
A high fat diet contributes to the amount of fat (sebum) in and on the skin. Experiments show that dramatically altering the amount of fat in the diet dramatically alters the amount of sebum production. Even a relatively small amount of fat (either animal fat or vegetable oils) can plug the pores, feed skin bacteria, and cause acne in susceptible people. Note also that touching fat/oil with one’s fingers and then touching one’s face can transfer enough oil to block pores and may increase likelihood of acne.
(2) Meat, poultry, and dairy
Growth hormones, such as insulin-like growth hormone-1 (IGF-1), can adversely affect sebaceous glands and cause them to become easily plugged. IGF-1 is known to be increased by dietary protein (meat, poultry, etc.), and especially by dairy products. A large number of studies link dairy consumption and acne in adolescent boys and girls. Surprisingly, skim milk is even more associated with acne than whole milk, even though whole milk is higher in fat. This may be due to higher levels of estrogen in skim milk.. Cow’s milk is filled with growth hormones as it is specifically designed to make calves grow. As compared to breast milk, cow’s milk also has three times more leucine, the primary activator of the enzyme TOR, which is associated with not only acne but many chronic diseases which manifest later in life, like obesity, diabetes, and heart disease. Note that since growth hormones are a natural part of milk, even raw and organic milk contain an abundance of growth-stimulating hormones.
It is well known that children in developed countries are reaching puberty at earlier and earlier ages. A large part of this early maturation process is a consequence of the animal-protein rich Western diet, which increases sex hormones leading to precocious puberty. Both girls and boys are maturing at much younger ages, 12 rather than 16, for example. Studies show that “Earlier maturation of women is known to be associated with more severe acne. Excess male hormones (androgens) in men and women are well known to cause acne and increase production of sebum.”
(3) Refined carbohydrates
Refined carbohydrates (white flour, sugar, processed foods) are high glycemic foods which cause our blood sugar to rise quickly. When blood sugar spikes, it can lead to inflammation, which plays a role in acne. These high-glycemic index foods can also elevate hormones that increase sebum and contribute to the formation of acne.
Likewise, scientific studies show that a low glycemic load diet reduces the size of sebaceous glands, decreases inflammation, and diminishes the expression of key factors of lipid (fat) biosynthesis. 
What’s the Cure?
The impact of diet on acne is so powerful that a radical change in diet is typically all that is required for a dramatic decrease (if not elimination) of acne. Because it addresses the root of the problem, changing one’s diet can cure acne rather than simply address the symptoms. Unlike acne medications which run the risk of serious complications (including blindness) and can even be life-threatening, eating a healthier diet has no negative health consequences, so at the very least, there is no harm in giving it a try.
Here are the key dietary changes to make:
- Eliminate dairy. Many good scientific studies link consumption of dairy (especially low-fat dairy) with acne (and many other chronic diseases).
- Eliminate excess fats and all oils. Our bodies require essential fats, but the amount needed is extremely small. It is best to get them from natural whole foods. The elimination of excess fat, including pure vegetable oils, can make a dramatic difference in acne elimination.
- Eliminate meat and eggs. Animal foods all contain excess fats. They also contain a range of growth hormones that can stimulate acne production.
- Eliminate processed foods. Highly processed foods increase glycemic load, which can lead to increased inflammation and acne.
- Add whole fruits, vegetables, legumes, and grains. These whole plant foods are rich in antioxidants and other important nutrients that keep the skin healthy.
The same diet that manifests as acne in the teen years manifests as obesity, diabetes, and heart disease as we grow older. Eating a healthy whole food, plant-based diet not only prevents acne, it also prevents these deadly diseases later in life.
It can be hard, especially for teenagers and young adults, to change one’s diet, but having beautiful skin and a healthy body make it well worth it. Some people see results in a week or less. For others, it may take a full month. Follow the above recommendations for 30 days to see what it does for you!
Top Resources for Learning More
- “Acne Has Nothing to Do with Diet – Wrong!” by John McDougall, MD. In this introductory article, Dr. McDougall discusses the link between diet and acne and describes both the cause and cure for this disease.
- “The Dietary Link Between Acne & Cancer” by Michael Greger, MD. This article summarizes important studies on acne from the scientific literature and links to short videos that illustrate many of the key points.
- “Preventing Acne With Diet” by Joel Fuhrman, MD. This article also covers the cause and cure of acne.
For more resources, see the topic guide for acne on Discovering the Word of Wisdom Topics A-Z.
- “How We CURED Our ACNE – Nina and Randa” (video). The Nelson twins grew up vegan, but ended up with severe acne because they had not been careful to eliminate oil and excess fat from their diet. See the video to witness the difference once they switched to a healthy low-fat whole food, plant-based diet. See also this printed version, “How We Cured Cystic Acne With One Simple Diet Change.”
- “How I Cured My Acne With An Unprocessed Alkaline Vegan Diet” by Lucie McAdams. Lucie lost her beautiful complexion at age 21. She was desperate and tried everything to restore it. The answer was an unprocessed plant-food diet.
- Personal Story Posted on Facebook (Used with Permission) by Michelle Jones. “One of our sons tried Accutane as a teenager. While on it, his skin dried out, his lips cracked and peeled, and the acne—while somewhat better—was still there and returned upon completion of the treatment. We didn’t like the risks associated and decided to wait and see if the acne would clear up with age. It didn’t. In the meantime, his younger brother was experiencing his own acne problems. At Christmas two years ago, I remember sitting at the dinner table with them and wondering WHAT to do about it! Fast forward to the following March when we watched “Forks Over Knives” and decided to adopt a whole food, plant-based (WFPB) diet. The younger brother was absolutely convinced and adopted the diet whole-heartedly. The older brother ate the WFPB foods I offered but wasn’t opposed to an occasional taste of the SAD diet. Within a few months, the younger brother’s skin was clear. The older brother noticed and started eating cleaner. It took months for his skin to clear up, but it did! Since then, they have both moved on to college. The younger brother still tries to eat strictly WFPB, but every now and then he eats something he would rather not (out of politeness). The acne breaks out every time. Thinking back, I remembered that both boys had a terrible time digesting milk as infants, and now dairy products definitely set off their acne. But meat and oils also seem to affect them.”
For help getting started on a healthy whole food, plant-based diet, see: “Getting Started on a WFPB Word of Wisdom Diet.”
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Jane Birch is the author of Discovering the Word of Wisdom: Surprising Insights from a Whole Food, Plant-based Perspective and many articles on the Word of Wisdom. She can be contacted on her website, Discovering the Word of Wisdom. Watch the video “Discovering the Word of Wisdom: A Short Film.”
 Cordain Loren, et al., “Acne Vulgaris: A Disease of Western Civilization,” Archives of Dermatology 138 (2002):1584-1590.
 American Academy of Dermatology, “Acne: Overview,” aad.org (accessed May 27, 2017).
 CN Collier et al., “The Prevalence of Acne in Adults 20 Years and Older,” Journal of the American Academy of Dermatology, 2008 Jan; 58(1):56-9. (See also several related references in Note 1 above.)
 Christian Nordqvist, “Acne: Causes, Diagnosis and How to Get Rid of Acne,” Medical News Today (August 3, 2015).
 Mayo Clinic Staff, “Acne: Causes,” MayoClinic.org (accessed May 27, 2017).
 John A. McDougall, “Acne Has Nothing to Do with Diet – Wrong!” McDougall Newsletter (November 2003).
 See Note 6.
 “The Link Between Skim Milk and Acne,” ForksOverKnives.com (May 11, 2012).
 Michael Greger, “The Dietary Link Between Acne & Cancer,” NutritionFacts.org (January 7, 2016).
 Robin McKie, “Onset of Puberty in Girls Has Fallen by Five Years Since 1920,” The Guardian (October 20, 2012).
 See Note 6.
 University of Wisconsin-Madison School of Medicine and Public Health, “Acne and Your Diet: How the Glycemic Index Affects Your Skin,” UW Health (September 11, 2015).
 Bodo C. Melnik, “Diet in Acne: Further Evidence for the Role of Nutrient Signalling in Acne Pathogenesis,” Acta Dermato-Venereologica 2012; 92(3): 228–231.
 Bodo C. Melnik, “Evidence For Acne-Promoting Effects Of Milk and Other Insulinotropic Dairy Products.” Nestle Nutr Workshop Ser Pediatr Program (2011).
 For a good demonstration of this principle, see, “How We CURED Our ACNE – Nina and Randa,” YouTube (October 24, 2014).
 See Note 9.
 See Note 12.
 Mary Jo DiLonardo, “Clear Skin Diet: Foods That Bring Acne Relief,” Mother Earth Network (November 5, 2015).