Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
16 Jun

Primal Advice for Acne Sufferers

Included among last week’s “Ask Me Anything” responses were several requests for a Primal commentary on acne. A lot of people have asked for this kind of post over the years. The fact is, it’s a great question. Acne is a common problem that gives too many people too much grief. Our medical establishment’s prescription for acne generally involves dehydrating the skin into oblivion, sandblasting it with chemicals, or pumping hormones, antibiotics and potentially toxic meds into the patient. (If any of these methods have worked for you, I mean no offense. I just think people deserve better options than these.) Is there a healthier, more Primal method to a clear complexion? In a nutshell, yes. I’m not talking rabbit-in-a-hat trick but a lifestyle approach with natural options that minimize the systemic and external conditions associated with acne. Let’s look at the full picture.

The Systemic Root

Acne doesn’t have a single definitive cause but can be set in motion by internal and external conditions, all of which have some root in systemic functioning: inflammation, “excessive” sebum (oil) production, pore blockage and “bad” bacterial presence/infection. In large part, the condition of the skin is part and parcel of the body’s overall health. Systemically speaking, hormonal balance (or lack thereof) and associated nutrient levels strongly influence the production of oil, the skin’s vulnerability to invasive bacteria (and presence of “good” defensive bacteria), the natural production and turnover of skin cells, and (of course) underlying inflammation. As hard as it is to believe, the medical community is only this decade beginning to recognize the systemic roots of acne. (Then again, should we really be surprised?)

Now, we all know those folks who eat junk food, exercise once in a blue moon and keep a ridiculous sleep schedule – and yet by some bizarre miracle always have perfect skin. It can seem like a slap in the face to the earnest person who has to work for his/her complexion and still comes up short. (All I can say to this irony is the chickens come home to roost eventually. It’s not metaphysical karma but biological fact. Live a hard and sloppy life, and it will catch up with you at some point, in some way.)

I always say that we’re all cut from the same physiological cloth, and basic biological patterns hold. Nonetheless, subtle differences seem to exist from person to person. Some folks appear to be more vulnerable to acne – hormonal “stages” are a big part of that susceptibility – the teenage years being the most infamous example and early pregnancy or post-pregnancy/nursing being another. Hormonal shifts brought on by stress, exhaustive exercise or medication side effects can also figure into our skin’s condition.

I don’t believe we’re 100% destined to have acne or not, but our susceptibility does appear to vary, and our modern Westernized environment seems to set the stage for that risk. As Loren Cordain’s (and others’) research have shown, acne is ubiquitous in the Western world but limited in other parts of the world and practically unseen in traditional societies. Yet, even Primal folks are subject to acne. What gives exactly? I’d suggest it’s a constellation of influences in modern living that come back to taunt us in the mirror. We live a modern existence full of systemic traps: pollution, personal care products, stress, lack of sleep, and climate controlled living to name a few. Nonetheless, we needn’t sit home on a Friday night.

Systemic Strategies

Let’s get down to the nitty gritty. What lifestyle factors actually make for healthy, clear skin? (We’ll get to other strategies later.) I’m sure you can guess what I’ll say first, and there’s good reason for this suggestion of course. Go Primal! First, the obvious and then some additional tips.


Ding, ding! Eat an anti-inflammatory diet. As research has shown, even conventional low glycemic diets make for better skin. Understand also that acne can be a manifestation of food related allergies or sensitivities (e.g. yeast, eggs, gluten, lectins). Dairy is a common culprit(I’ve always said that milk is meant for baby cows.) Women in one study who reported high dairy intake in teenage years were 44% more likely to have experienced severe acne. (Incidentally, full fat dairy isn’t as strongly implicated as lower fat dairy foods.)

Speaking of fat, I suggest that those vulnerable to acne eat plenty of clean fats, and do you can to avoid livestock hormones (the basic reason to avoid milk, which is full of them regardless of organic status). Enjoy clean animal fat and safe, non-oxidized plant-based fats like olive oil, coconut oil, etc. And be sure to load up on antioxidant-rich produce items as well, like garlic, onions, greens and broccoli that support cellular production and repair.


Beyond the power of a clean, anti-inflammatory diet, I suggest adding a good comprehensive supplement as well as extra zinc, vitamin B complex (especially vitamin B3), vitamin A and vitamin D for added help in regulating oil production and further boosting the skin’s natural repair abilities. Research has especially supported the role of zinc deficiency in acne. Women who are pregnant, nursing or have recently weaned are particularly at risk because of higher need for zinc. Of course, make sure you get plenty of omega-3s for extra anti-inflammatory effect. Some folks report good experiences with adding evening primrose, an anti-inflammatory omega-6 as well. Finally, a good probiotic can help your body (and skin) balance its own “good” bacterial defenses.

Environmental Toxins

Chemicals like flame retardants, parabens, phthalates and other plastic-related chemicals are hormone disruptors, which can throw off even the best lifestyle efforts. Eliminate them as much as you practically can (including the paraben-loaded conventional acne creams!).

Stress and Sleep

Stress causes a cascade of hormonal actions that over time deplete essential nutrient stores, especially minerals like zinc. They don’t call it beauty sleep for nothing! Consider it an investment in your appearance as well as overall health. Additionally, take up stress management methods that support the relaxation response to further support hormonal balance.

Topical, Hygienic and Commonsensical Ideas

Beyond systemic strategies, there are plenty of topical options that are effective for many but tend to be more hit and miss overall. I think it’s important to view their role as supplementary to systemic efforts. From a personal perspective, I understand people being willing to try anything and everything they find – at the doctor’s office, at the drug store, on the infomercials. From a Primal perspective, however, I’d suggest otherwise. The idea shouldn’t be to beat your skin into submission. Most people who have acne actually have very sensitive skin. Rather than looking for products that strip and dry the skin, I’d recommend choices that enhance the integrity of the skin and its natural defenses. There are plenty of natural options that won’t clean out your wallet and that promise fewer side effects to boot. Here are a few of Primal note….

  • Manuka honey: All honey has antibacterial properties, but research shows this New Zealand variety appears to pack more of a punch for acne and other skin conditions.
  • Nicotinamide: A topical form of vitamin B3 can reduce inflammation and help acne and improve skin’s overall condition.
  • Willow bark: It packs an anti-inflammatory wallop.
  • Tea tree oil: Consider it a more natural astringent that has a powerful antibacterial impact.
  • Other botanicals like calendula and feverfew can be soaked and spread over the face with a cotton ball after washing in order to calm skin.
  • Steaming: Visit the steam room at the gym or lean over a pot of hot water with a towel draped around your face to open pores for a good cleansing, natural oil extraction or absorption of botanical agents.
  • Light exfoliants: Use baking soda or oatmeal to exfoliate and encourage skin turnover, but go gentle.
  • Pure water: Those with the worst skin conditions like severe acne or rosacea can benefit from rinsing with distilled rather than tap water.
  • Practical prevention: Minimize bacteria exposure to the face by keeping hands away from the face, cleaning phones, helmets, etc., and using fresh pillowcases (thanks, Shastagirl!)

The idea here is a holistic approach to supporting healthy skin. Although these suggestions might not serve as a magic bullet, they are the best way to get at the root causes of the physiological imbalances behind acne. Furthermore, the natural topical options can support your lifestyle efforts without depleting skin of its natural moisture or defenses and without creating product dependence. Finally, these suggestions can support the overall health and condition of your skin whether or not you have complexion issues. I hope the overview offers those with acne good food for thought and encouragement in their personal Primal regimens.

What say you, MDA community? How did going Primal change your skin? What other strategies and products (natural or otherwise) do you use that complement your Primal efforts? Thanks for reading and sharing your thoughts today.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Attractive portion of content. I simply stumbled upon your web site and in accession capital to claim that I get in fact
    loved account your blog posts. Any way I will be subscribing to your
    augment and even I achievement you get right of entry to
    constantly rapidly.

    retinol acne wrote on September 8th, 2012
  2. I am 37. I’ve always had some acne but 2 years ago my skin got really bad. I had painful cysts on my face and breakouts on my chest and back. I tried ziana, antibiotics, apple cider, tea tree oil, facials – nothing really worked. Recently, I had stopped coffee, sugar and alcohol. It was a little better but far from good. I was recently tested for gluten and I came up just a tiny bit gluten sensitive. I stopped gluten and my skin completely cleared up.

    clearnow wrote on December 4th, 2012
  3. I never had acne until I went primal. Connection? Not sure, but I do know that I am having the worse acne of my life right now (I’m 27) and although I feel great from eating many months of primal foods, I think I am at my whits end with this sudden problem with acne. Any suggestions for some one who actually develops acne after going primal rather than it being cleared up as it supposedly should do? I have tried giving up dairy and nuts and even nightshades to no avail.

    Mindy wrote on January 26th, 2013
    • I am with you, Mindy. I had some break outs before I went Primal, enough to go on Proactiv, and that worked very well. Since going Primal, I slowly cut it out, but my face exploded. I tried natural, organic options, but that made me worse.

      It’s been a few months and even restarting the Proactiv is not working (that scares me). I’m trying to cut out dairy (slowly because I still eat a lot of it) to see what happens. I wish expermintation did not have to be written all over my face.

      So, I add my voice to yours: Anyone out there have any thoughts for post-Primal acne?

      Nicole wrote on February 20th, 2013
    • Hi Mindy- Any luck with the acne? I am having the same issue. I felt great for 2 months, clearest skin Ive ever had- but then I had a slow to complete eruption all over my jawline and neck. Its now creaping up my right cheek this week. I wasnt eating many grains to begin with so it wasnt a huge transistion- not sure if it was too much protein, not enough carbs or added one of the 20new things into my diet again I wasnt used to. My hormones have gone completely nuts Ive always gotten the occasional pimple, this is very hard to handle.

      Allison wrote on May 6th, 2013
      • This is just an idea – maybe when beginning to eat healthy, your body starts to clear out the old stored toxins from fat cells and this is the cause of acne after going Primal.

        If hormones are going crazy, do some research on iodine supplementation and look up Dr. Berg on youtube and his site. He may have some other info that will help.

        Wenona wrote on December 4th, 2013
  4. Hi Mark, do you think acne sufferers should avoid whey as well? Would plant proteins such as rice and pea be less offensive?

    Alan wrote on February 20th, 2013
  5. For me I find dairy is the worst thing, I also wash with hot water the hotter the better. I guess it helps remove oil and drys out the acne temporarily. I’m scared to use creams in case it makes it even worse.

    Jes wrote on March 28th, 2013
  6. Hey, just wanted to update you all! I finally found out what was causing my acne! It was soy lecithin! I already knew soy messed up my hormones, but figured that beause the lecithin was seperated out from the soy, it wouldn’t cause me problems. I often ate dark chocolate and other things containing it, but never made the connection. But then my husband bought me a huge belgian dark chocolate bar, which I munched daily for a couple of weeks until it was gone. I subsequently broke out in horrible deep acne cysts all over my face! I immediately suspected the soy lecithin in it, as nothing else in my diet had changed. Once I figured it out, I started reading labels and avoiding anything with soy lecithin. Now, 2 months later, for the first time in 40 years, my skin is acne free! YAY!!!!

    Ailu wrote on April 3rd, 2013
    • That’s wonderful! Congratulations! I am still fighting the acne battle and you must be so happy! Thank you for sharing. I am going to add that to my list of foods to avoid — maybe that will help!

      Nicole wrote on April 3rd, 2013
  7. I also should add, at first I thought it was flouride, so I was avoiding it. But then my acne got worse! That was when I figured out it was soy.

    Ailu wrote on April 3rd, 2013
    • Oh, and avoid flouride, anyway!

      Nicole wrote on April 3rd, 2013
  8. For whatever reason, my son developed acne on his back. Maybe it’s from from lack of sleep and stress from school? …

    Anyhow, I bought the Citrus Clear Acne Wash online and it was excellent at treating any acne and even helped to prevent most of it. My son washed with this Citrus Clear wash at night before bed – and it works great!! He has had no body acne since he started using this product.

    Maria Giz wrote on June 19th, 2013
  9. My daughter is already having problems with acne and our dermatologist recommended Citrus Clear – so I tried this and it worked immediately. She is washing her face and using it daily and is a much kinder and gentler than other acne products. She loves it !

    Jessica P wrote on June 28th, 2013
  10. Excellent post and one of the best I have read recently. Acne is a treatable condition and before resorting to powerful medications folks would be wise to follow much of the advice given above.

    In particular diet, most of us are aware they is no scientific link between diet and acne, but there is one between diet and a healthy skin, without the vital nutrients and minerals it needs the skin will not be best able to repair itself, nor will the immune system be in a good position to fight infections.

    Cows milk and anything made from proteins of it is a big enemy of acne, especially for teenagers, it is usually full of hormones that can play havoc with the hormone balance in the body, for this reason it is best to use goats milk or perhaps soya milk as alternatives.

    Anna wrote on July 21st, 2013
    • Soy milk has an extremely high level of estrogen, comparable to birth control pills. Please don’t drink soy milk ever.

      Wenona wrote on December 4th, 2013
      • This is a commonly held beleif by many…and perpetuated by the wild west internet…It is is true that soy is a “phyto-estrogen” food, which means it contains substances that have hormone-like components. However, their estrogen strength is 1/1000th that of the body’s own stronger estrogen’s. therefore, you want to load your digestive system with quality controlled raw soy powder, because these weaker estrogens will block the estrogen receptor sites from receiving your body’s own stronger estrogen s and therefore be very protective against estrogen fed cancer

        Caroline wrote on December 4th, 2013
  11. A combination of 3:1 water and apple cider vinegar has been a blessing for my acne.

    Sarah wrote on July 29th, 2013
  12. I suggest anyone who wants to clear up their acne to go to the person ”Seppo pussa” Has uploaded a lot of studies regarding acne treatments and what works and what not. And he is a fan of Primal diet.

    I’m not clear yet, I still have to manage my stress level and get tested for food allergi + fix my gut health. But I believe that I’ll be able to clear up very soon. :)

    Adel-Alexander Aldilemi wrote on September 24th, 2013
  13. What does OCM stand for? I thought it was “Over the Counter Meds” but I can’t tell by the way it’s been used in the comments.

    Mandy wrote on February 1st, 2014
  14. I would highly recommend Jojoba Oil (actually it is natural wax)! it is meant to be the most similar oil to the humans’ skin oil(sebum).

    Jojoba Oil is basically tricks the body into thinking that there’s enough oil on the skin (moisture) and there’s no need to produce more. With time it does a great job of balancing oil production and it helps clear acne. Some people were able to completely clear their skin with Jojoba Oil. It works great for all skin types (yes even the very oily type).
    It is a superb moisturizer and you don’t have to use much of it, so little goes a long way 😉 I’d say give it a go and see how it works for you after 2-3 weeks =)

    Valerie wrote on March 18th, 2014
  15. For me:

    1) HEAL GUT and reverse food sensitivities. Probiotics, bone broth, elimination/reintroduction diet. This took care of the cystic nightmare. Then…

    2) Supplement – Fermented Cod Liver Oil/Butter Oil Blend from Green Pasture website.

    3) Topical: Use a simple wash with a similar pH to that of my skin. Stop changing/adding products. Turn down heat to cool/cold in sink/shower when washing face.

    Kat wrote on June 2nd, 2014
  16. After 40 years of fighting acne, I seem to have finally figured out a diet that keeps me acne free. I eat a high-fat, low-carb diet consisting of ONLY these things:
    Meat / fish
    Olive oil
    Coconut oil
    Lemon juice
    Salad greens
    Heavy cream
    Bone broth
    Dijon mustard
    Macadamia nuts
    Lemon Juice
    Sauerkraut with live cultures

    Keep in mind, that because I do not eat more than about 80 to 100 grams of protein per day, so I am not eating high-protein. I don’t know if the high protein might give me acne, but I am sure I will find out in the future.

    I have been acne free for 2 weeks for the first time in my life. I will begin experimenting with things to see what my acne triggers are, but I believe that milk products other than heavy cream and butter (milk, cheese, yogurt), honey, peanut butter and grains are the major culprits. Veg. oils (such as those in almost every salad dressing) may be a problem, also. I make my own salad dressing with some of the items listed above.

    My diet looks like this:
    Breakfast: Eggs cooked in lots of butter, sausage or bacon, lemon water, coffee with heavy cream, 8 oz bone broth, probitiotics (soil-based)
    Lunch: salad with greens, avocado, sauerkraut, meat, blueberries (1/4 cup), home-made dressing (high-fat).
    afternoon: bulletproof coffee
    Dinner: repeat lunch

    I had many times gotten very close to this diet and had reduced my acne quite a bit, but I was still ingesting processed foods, peanut butter, cheese, sweeteners and other things outside of the list above, and was constantly frustrated that I couldn’t quite eliminate it.

    Ray wrote on February 5th, 2015
  17. Hi, I want to subscribe for this web site to take hottest updates, thus where can i do it please help.

    Regula RX wrote on February 10th, 2015

Leave a Reply

If you'd like to add an avatar to all of your comments click here!

© 2016 Mark's Daily Apple

Subscribe to the Newsletter and Get a Free Copy
of Mark Sisson's Fitness eBook and more!