Got acne? Go primal

Acne is unheard of in populations eating a ‘primal’ or ‘paleolithic’ diet. This has caused some researchers, for example Loren Cordain (author of The Paleo Diet), to question what factors might be at play here. One prominent theory concerns the impact of eating carbohydrates that tend to be disruptive for blood sugar levels. These foods stimulate, among other things, the secretion of insulin and something known as insulin-like growth factor-1 (IGF-1) that induce changes in the skin that are conducive to the development of acne. Not only that, but a low glycaemic load (GL) diet (one which will tend to lower insulin and IGF-1 levels) was found to brings benefits to people with acne. You can read more about this in a previous post from 2007.

Very recently, the journal Acta Dermato-Venereologica published a study which again tested the potential of a low GL diet as a treatment for acne [1]. According to the summary of this study, eating a low-GL diet led to a significant reduction in acne, as well as evidence under the microscope of reduced sebaceous gland size and lower levels of inflammation.

This study is accompanied by a commentary [2] which talks about the role of diet in acne, and it inevitably focuses on the role of carbohydrate here, making reference to this recent study as well as the one I wrote about in 2007 that I link to above.

The author of the commentary also focuses on the potential role of milk in the development of acne. This is something that has been mooted before (see a previous post here from a couple of years back for example).

Cereal and milk - essential food or recipe for acne?

Again, insulin and IGF-1 are implicated. The author of the commentary makes the point that insulin and IGF-1 end up stimulating a process (mammalian target of rapamycin complex 1) which are similar to the hormonal changes seen in puberty. The author makes the point that a drive in this direction may also add to the burden of health issues such as obesity, type 2 diabetes and cancer later in life.

All in all, the author is down on Western diets, and urges dermatologists to counsel their acne patients about its hazards. And while he does not make this claim, it’s clear that what would be generally better for these patients (and, in my view, lots of other people) is a diet which is more ‘primal’ in nature. This can be a tough thing for some to accept, given just how much we’re told that children ‘need’ grains (energy) and milk for healthy bones – neither of which are true, by the way.


1. Kwon HH, et al. Preview of article: Clinical and Histological Effect of a Low Glycaemic Load Diet in Treatment of Acne Vulgaris in Korean Patients: A Randomized, Controlled Trial Acta Dermato-Venereologica 2012. DOI: 10.2340/00015555-1346

2. Melink BC. Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Acta Dermato-Venereologica 2012. DOI: 10.2340/00015555-1358

10 Responses to Got acne? Go primal

  1. James 21 March 2012 at 1:40 am #

    What about the kitavans, who eat a high carb diet and have no acne?

  2. Dr John Briffa 21 March 2012 at 10:27 am #


    Yes, and most smokers don’t get lung cancer, but when someone has lung cancer, smoking has usually played a part.

  3. simona 21 March 2012 at 2:17 pm #

    Dr. Briffa,
    could you look into the link between damaged gut flora (due to antibiotics) and acne?
    Dr. Ayers believes it’s an important cause. I wonder if insulin resistance adds to it or is another mechanism.

  4. steph 21 March 2012 at 3:13 pm #

    I absolutely agree with this, I’ve had acne for over 12 years and it has gotten severe in the last few. The only thing that has ever worked other than hormonal birth control has been a very strict paleo diet. I should warn people that it may take 3 months to see results (I speed up the process by taking saw palmetto) But after 3 months your skin will be smooth and perfect. My skin feels different now too, well mosturized and soft. People can not believe the difference. I have them asking me what dose of accutane I took, that is how dramatic the difference is. I have gone on the diet once before and lost the results due to travelling for three months. The key is that you have to be strict. I actually enjoy the diet and don’t feel I’m missing out at all, although the first month is the hardest. If you suffer from acne please try this (and give it at least 6 weeks) You will at least feel that your skin is changing, even if it is hard to see results. Good luck!

  5. Joe 22 March 2012 at 12:14 am #

    @james Kitavans also solely eat coconut oil which contains lauric and myristic acid, both of which have been shown to inhibit the conversion of testosterone to dht by 5a reductase and so possibly prevent dht induced hyperseborrhea associated with acne

  6. Mary Roe 25 March 2012 at 7:30 pm #

    I am a specialist nurse testing clients to see which foods they are intolerant of, and I get very good results with adult acne…..average 85% improvement. The most common food cause that I observe is cheese. To supplement with beta carotene also helps.

  7. Erica-Rose 26 March 2012 at 11:55 am #

    I totally agree – go primal and MOST importantly dairy free!! I agree that you have to be very strict though. I have had acne for almost 15 years and it only started when I was 21 years old. I tried everything from several doctors, saw dermatologists and took roaccutane (which is evil evil stuff with many side effects in my view now), but it just came back with a vengeance a few months later….the only option I was offered then was ‘take more again’ !!!! So I went Primal and to be honest didn’t notice any difference, but when I combined this with being strictly dairy free I got amazing results. I have NEVER had improvements like this! I had full on cystic acne and tried everything and anything. My skin is now softer, clearer and no more cysts. I have been doing it for just over two months and it has been hard not to get disheartened (my paleo convert husband has kept my morale up!) but I am confident that by three months it will be completely clear and it’s just the scars that are taking a little longer to repair. I was a strong sceptic to say the least at first but now am telling everyone I can!! Giving up dairy WORKS with a low carb, low sugar pales diet. In summary, if you have acne.,,, do it, do it, flipping do it!

  8. Leslie 4 May 2012 at 1:47 am #

    If I’m not mistaken the kitivans also don’t eat sugar. I find dairy and sugar to be triggers for acne, and after eating paleo for over a year, clear skin I only dreamed of in my youth, this is the way to go. Honestly, worth it. When I first started paleo, I kept yogurt in my diet for about three months and after removing that, my sinuses drained and seemed to be the final piece of the puzzle for me. Love eating this way, not ravenous in the afternoon anymore, lost weight and belly, and feel amazing.

  9. Diane Smith 14 August 2012 at 8:39 pm #

    Going low carb, grain and diary free and primal has improved my life long acne (I am now 42). I even had accutane in my 20’s and it only kept the acne away for a few years.

    However, just going primal hasn’t been enough to completely cure the acne though it’s much improved. I am working on more changes to make more improvement. I also always suffered from gum disease and I suspected that bacteria in my gums were getting into my bloodstream and causing the deep acne cysts. I have been using oil pulling with coconut oil for several months now and the gum disease has gone and there is a further improvement in the acne but still not 100% improvement. I have also been taking Cod Liver Oil capsules daily.

    My next step in the fight for skin health is to supplement with Vitamin C & Vitamin D as I have been reading about the adverse effects on skin and bone caused by deficiency in these two vitamins and also that the recommended daily levels are set way too low. I am hopeful that these steps might help me to see the end to the acne once and for all.


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