Acne Diet – More Than Skin Deep


Think beautiful skin starts in a bottle?  Think again.  Beautiful, clear skin starts in your kitchen and has everything to do with what you put into your body.

Your skin is a direct reflection of what’s happening digestively; I like to tell our clients to think of their skin as their intestines turned inside out.  So when my clients come to me wanting clear skin yet are washing down their Doritos with Diet Coke, well…there’s work to be done in the education process.

A large part of our nutritional practice at the Flagship involves treating people with acne.  And guess what?  90-95% of our clients with acne have either been on the Pill, on antibiotics, or some combination of both.  This causes an overgrowth of unhealthy bacteria, and depletes the good bacteria present.  And acne is the residual after-effect of this imbalance.  The work we do to correct the imbalance is with a yeast-free, sugar-free diet rich in essential fatty acids and protein.  This in effect will rebuild the digestive system and restore luminous, clear skin.

Protein helps repair the skin and supports liver detoxification and hormonal balance (another culprit of acne).  The best choices include: wild Alaskan salmon and other cold-water fatty fish, chicken, turkey, eggs, Greek yogurt, whey protein, and grass-fed meats.  Choose 2-4 ounces per meal.

Since carbohydrates have the greatest impact on blood sugar and inflammation, choose them wisely.  Fruits and vegetables should be the base of your diet; you can incorporate ½ cup cooked of the following per day: barley, beans and legumes, brown rice, rolled or steel-cut oats, winter squash, sweet potato, buckwheat, quinoa, amaranth, and millet.

The right fats can literally make or break your health, and we all need them to survive.  Go for avocados, raw nuts and seeds, nut butters and tahini, olives and olive oil, ground flaxseeds, raw coconut and coconut oil, and grape seed oil.  They’ll correct dry chicken skin and regulate sebum production.  Incorporate at least 2 tsp of fat per meal.

When you’re working hard to eat healthfully, the following can quickly undo all your efforts: white flour and sugar (pasta, bread, muffins, cake, and cookies—and no, whole wheat is not any better), fruit juices and dried fruits, aged cheeses, milk, soy, vinegar, alcohol, and mushrooms.

Cleaning up your act in the kitchen will ultimately help clear up your skin.  Give your body 3-6 months for all the changes to take place.  You’ll be glad you did!

Esther Blum,MS,RD,CDN,CNS
Registered Dietitian
NV Perricone, MD Flagship
791 Madison Avenue
New York, NY 10065

60 thoughts on “Acne Diet – More Than Skin Deep

  1. Which of your products if any , would help with subaceaus hyperplasia? What would you recomend to your patients with this condition? Thanks for any help you can give.

  2. Dr. Perricone,

    I just bought your book, The Acne Prescription, and first I just wanted to thank you for working to dispel the myth that diet and acne aren’t related. I noticed that you mentioned Dr. Cordain’s paper “Acne: A Disease of Western Civilization” in your book. I actually first found out about the diet-acne connection through Dr. Cordain’s website about a year ago. I bought his e-book, followed his advice, and my skin almost immediately cleared up. Recently, however, I’ve started to break out again and have renewed my interest in the subject which is how I found your website and blog. So here are my questions:

    You and Dr. Cordain seem to agree on the basic premise of the diet-acne connection which is that foods that cause a spike in blood sugar and insulin promote systemic inflammation, and in some people, acne. However, he also advises acne sufferers to avoid all dairy and grain products whereas you recommend eating foods like yogurt and oatmeal. He maintains that the former also cause a spike in insulin levels even without the corresponding spike in blood sugar and that the latter contain substances which also promote inflammation and interfere with zinc metabolism. I’m no scientist but I’m sure there is still debate about these things within that community, but I just wanted to know what your opinion on this matter was.

    My second question is what can I do to mitigate the effects of, say, an occasional bowl of pasta on my skin? I know that when I eat pasta, or pizza, or other pro-inflammatory foods I break out, but sometimes they’re just too tempting at the time. Is there any supplement I can take before or after an inflammatory meal that would help? Or anything else I can do? My skin seems to be very sensitive and even though I follow what I think is an anti-inflammatory diet the vast majority of the time, even one slip up seems to cause a breakout and I’d like to know if there’s anything I can do to prevent (or at least reduce) that besides forgo even the occasional indulgence.

    Thank you again for all your work and I look forward to hearing from you!

  3. Dear Kaitlyn,
    In response to your first question, anything having to do with the pros and cons of eating grains is still an evolving science. I am leaning towards recommending that my adult patients eliminate grains and a lot of dairy due to the pro-inflammatory effects I have seen. However, I have not done enough research to reach a final decision.

    As for your second question, before eating the pasta or pizza take the kidney bean extract as found in Natrol’s Carb Intercept® Capsules and a Pycnogenol capsule. After the meal, take the following supplements:
    Alpha lipoic acid
    Chromium Nicotinate
    Omega 3 fish oil capsule

  4. Why are mushrooms bad? I see the reasons behind the others, and I have the book, but it’s at home in the US and I’m here in France for a few more weeks…

  5. Hi Dr Perricone,

    Just bought the acne prescription and started on the 28 day regimen. In the book Mushrooms are on the anti-inflammatory list, and here it says to steer clear from them, same goes for soy, it’s kind of important to me because I drink soy milk almost daily ( 1 cup with my oatmeal) and like to mix mushrooms in my salad.
    Thanks for the clarification

  6. Dear Ellen,

    Thank you for your question. As a service to our clients, we are able to answer very general questions about health and wellness. We unfortunately are not able to provide advice or recommendations pertaining to medical conditions.

    Dr. Perricone unfortunately does not make any products to help with subaceaus hyperplasia. Considering the medical nature of your question, we recommend speaking with your personal physician. Your doctor is most familiar with you and is best equipped to address your concerns.

  7. I am doing the three day diet but am gluten intolerant. Is there an appropriate replacement for oatmeal, or will I just have to forgo having a grain for breakfast?

    Thank you.

  8. Hi,

    This article says to avoid soy. Other articles say it is beneficial. Is it beneficial for bone growth, but promotes acne?? Or, is it not beneficial enough to risk bad skin for? Much of my diet is soy based. Please clarify. Thanks.

  9. Hi Aura,

    Thank you for your inquiry. On behalf of Dr. Perricone I apologize for any confusion created about acceptable foods on the acne diet.

    For optimal results in clearing up your skin, you should avoid the following foods which are either high in yeast, mold, and/or sugar: mushrooms, unfermented soy products (soy milk is included in this group; switch to almond milk instead), wine, beer, cheese, milk (plain yogurt or kefir is acceptable), peanuts and peanut butter, pasta, bread, white rice, sugar, cookies, muffins, soda, and fruit juices.


  10. Hi,

    I take brewer’s yeast every moring for the iron and B-vitamins. I know that it is great for hair and nails. It is also good for the skin? Will it lead to an overgrowth of yeast in the body and cause me to break out? Thanks.

  11. Dear Marie,
    Thanks for your question. According to our registered dietitian at our Flagship store, hot brown rice ceareal can be substituted. Here are some other gluten free substitutions for the 28 day diet as well.

    Lentils and beans
    Sweet potato
    Brown rice
    Buckwheat and soba noodles

    I hope this helps.

  12. 1. is raw milk any better than pasteurized milk for the skin? i belong to a co-op and get raw goat’s milk which i’ve heard is supposed to be beneficial for the skin. what is your expert opinion on this? what about raw goat’s cheddar cheese? or raw cow’s cheese such as swiss?

    2. why is greek yogurt better than others?

    3. what about sprouted ezekial breads and cereals? my research suggests that the sprouting process deactivates the inflammatory factor in the wheat, is this true?

    4. are dry toasted soy nuts bad?

  13. Dear Chris

    Thank you for your inquiry.

    Soy is a really hot topic, and there is a great deal of controversy about the benefits and risks of consuming soy.

    Soy protein and soy flour are toxic, especially in large amounts. The US Food and Drug Administration lists 288 studies on its database showing the toxicity of soy. Numerous studies show that soy consumption leads to nutrient deficiencies, digestive disorders, endocrine disruption, acne and thyroid problems.

    Even the most ardent supporters of soy, such as Dr. Mark Messina, warn against consuming more than about 20 grams of soy protein per day.

    Soy is also very high in oxalic acid; no food is higher in oxalic acid than soy protein isolate, which can contain up to 630 milligrams per serving, at least six times higher than the amount found in typical diets. Oxalic acid is associated with kidney stones, but the sharp crystal deposits can form in almost every tissue in the body–in the heart where they can stop electrical signals; in the bones where they can displace bone marrow cells, leading to anemia or immune deficiency; in the brain where they can impair the transmission of signals; and in the skin where they can cause fibromyalgia.

    The estrogen-like compounds in soy are known to depress thyroid function and contribute to lethargy and weight gain. In my 16 years of practice I have yet to treat a patient with an autoimmune disease or thyroid problem who was not consuming soy.

    If you must consume soy, consume it only in its fermented form, such as miso, natto, tempeh, or soy sauce. But only use it as a condiment, in very small quantities.

    You can also visit to learn more about the Soy Alert! Campaign, and to see further research done on soy.


    Esther Blum,MS,RD,CDN,CNS
    Registered Dietitian
    NV Perricone, MD Flagship
    791 Madison Avenue
    New York, NY 10065

  14. Hi,
    I found the Perricone Acne Diet way too low in calories. As a man, I should be eating 2500 calories but the diet plans seem way too low. If I can’t eat any starches, how can I make up for this?

  15. Dear Meesh,

    Thank you for your inquiry.

    To answer your questions:

    1. Raw milk is absolutely better for your skin than pasteurized milk. Raw milk contains all the live active enzymes and cultures to help boost your immune system and digest milk properly. Plus, it contains absorbable calcium and vitamin D. Once milk is pasteurized, it becomes much harder to digest because the digestive enzymes present are no longer functional. Also, the calcium in milk gets ionized under the pasteurization process and is no longer absorbed or assimilated. You can visit for sources of raw milk.

    As for cheese, raw milk cheese is a much healthier option than pasteurized cheese for all the reasons mentioned above. However, cheeses that are aged contain mold and yeast and can worsen your acne. You’ll have to incorporate it into your diet on a trial basis and see if whether or not it agrees with you.

    2. Greek yogurt is better than others because it contains 2 ounces of protein and only 7 grams of sugar in 8oz of plain, full-fat yogurt (compared to 13 grams in the Stonyfield Farm plain yogurt). It also contains live active cultures and the cows are not fed any antibiotics or hormones.

    If you’re a true purist, you can have a ball making your own yogurt: visit for complete instructions.

    3. Of all the breads you can eat, sprouted Ezekial breads are certainly the best choice and are the least allergenic. The Ezekial cereals are less favorable; although they contain 6gms of fiber, they also contain 40gms of carbs and have only 1 gram of protein. You’d be better off with an omelet with fruit for breakfast.

    4. I also recommend that people steer clear of soy in general. Not only is it hard to digest, but it will cause all sorts of hormonal disruptions and is linked to autoimmune diseases. Here are some credible articles based on medical research for you:

    Best of luck!

    Esther Blum,MS,RD,CDN,CNS
    Registered Dietitian
    NV Perricone, MD Flagship
    791 Madison Avenue
    New York, NY 10065

  16. Dear Dan,

    Thank you for your inquiry.

    On behalf of Dr. Perricone, please allow me to apologize if you’ve experienced any unwanted weight loss on the diet. I’d like to help you sustain your usual weight, so please allow me to make some suggestions for you:

    Eat the recommended types of foods on the diet, but increase your portion sizes. Eat until you are satisfied according to what your body needs. Most people who follow the diet are trying to lose weight, and that is why Dr. Perricone regulates the portion sizes in his book. But for you, this is clearly not an issue, so feel free to increase the amounts you are eating. Your skin will still reap the benefits of high-quality foods.
    Often for those folks who are naturally thin and have a harder time gaining/sustaining weight, it is beneficial to add in healthy carbohydrates at each meal: steel-cut oats, beans, lentils, hummus, sweet potatoes, barley, amaranth, quinoa, millet, and buckwheat. Enjoy soba noodles on occasion, as well as brown rice and sweet potatoes.

    Best of luck to you as you continue your journey towards optimal health.



    Esther Blum,MS,RD,CDN,CNS
    Registered Dietitian
    NV Perricone, MD Flagship
    791 Madison Avenue
    New York, NY 10065

  17. I am 7 months pregnant and have had terrible acne (face and body) since day 1 of the pregnancy. I’ve already incorporated most of the dietary suggestions listed above (for health of baby and me) and plan to incorporate some of the additional items in the article (like cutting down on mushrooms,etc). I am well hydrated, get enough rest, swim and practice yoga for exercise and stress management, etc. I know that most acne treatments are off-limits during pregnancy. Are there any additional suggestions you have (skin care products, diet, lifestyle) that may help?

  18. Hi.

    I have moderate to severe acne right now. I’m trying to go the natural route. I was wondering if bread (carbs) in general are bad? and what other foods should i eat and avoid to help this problem?

    I’ve been on everything under the soon. Antibiotics, the pill, accutane, everything.

    Any advice you have is appreciated.

  19. I have read all of your books and i feel great after learning how to eat correctly. I lost 15 pounds in a year. I was already thin and i was comfortable with my weight. I wanted to ask you advice about how to gain the weight back withou…t eating the inflammatary foods. I wasn’t planning on loosing the weight but it just happened by avoiding the inflammatory foods. How can i gain the weight back without eating starchy foods like potatoes, pasta , and rice. This is what my diet consisted of before reading your book. I am 4’11 and i weighed 90 pounds last year and now i am 76 pounds. I still feel great and i am healthy but i think i would feel better by going back to my usual weight. I have a very active lifestyle. I am working as a teacher so i am always walking around the classroom or taking walks in the park. I enjoy having this lifestyle so what do you reccomend for me to eat to gain weight?

  20. Pingback: Acne Solutions: Solve the Problem of Irritating Acne

  21. Pingback: Losing the Acne Battle? Try the Dr Perricone Diet for Clear Skin

  22. Hi,

    When you say to stay clear of fruit juices, do you mean freshly squeezed fruit juices as well? I squeeze oranges and grapefruits daily and I thought this may be a benefit for my breakouts since I’m getting readily available minerals and vitamins from fresh fruit. Can you please clarify? Thanks very much!

    • We recommend you opt for the whole version of fruits, because, unlike even freshly squeezed juices, whole fruits provide more fiber and are much more filling than a glass of juice.

  23. Hello, I am looking for some advice. I had acne (moderate-severe) from the age of 12 until I was about 27. Off an on during that time, I took various antibiotics/accutane/differen, etc. Suddenly, for no apparent reason, after 3 years of clear skin with NO MEDS during that time I am breaking out terribly. It’s been going on 5 months. What is going on here?!

  24. Hi Dr. Perricone,
    I just read your book and am planning to start a diet to clear up my acne.

    However, as a hobby, I bodybuild.

    You mentioned above that whey protein is a good source of protein while milk is not. Isn’t whey protein made out of milk?

    Additionally what other protein sources should I consider to meet the recommended daily needs.

    Thank you,

    • Organic, low-fat milk and dairy products can be an excellent source of protein. We also recommend skinless and boneless chicken breasts, lentils, chickpeas, almonds, and walnuts.

  25. Hello Dr. Perricone,

    I am a chocolate addict so please let me know if eating chocolate (85% cocoa – Lindt) can be harmful for acne diet?

    Thank you very much!

    • It is a long-held myth that chocolate causes acne. If you choose chocolates that contain 85% cocoa (like the one you mentioned), you will be getting the supremely sweet benefits of chocolate (like powerful antioxidants and boosts to serotonin and endorphin levels) without ingesting too much sugar, a substance that can aggravate acne.

    • It is always better to eat the fruit rather than the juice alone. When the juice is separated from the fiber of the fruit it causes blood sugar to spike more quickly. Cranberry is a relatively low-sugar berry. Make sure the juice is unsweetened.

    • Soy should be eaten in moderation as it does contain hormones. There are conventional dairy alternatives like coconut milk yogurt and even some varieties that are made from almonds and other nuts.

  26. Hello,

    I have type 1 diabetes, so I’m not sure whether trying to avoid blood sugar spikes has the same effect on me as on non-diabetics. While I eat healthily, is the effect of the Perricone diet on my skin negated by my autoimmune disease?

    Thank you!

    • Not at all! The Perricone lifestyle is a perfect choice for people with blood sugar issues as its entire aim is to maintain stable blood sugar levels. The anti inflammatory lifestyle has been demonstrated to be beneficial for a number of systemic and age related diseases.

  27. Hi!
    I was wondering if there is a direct link between iodine and acne. At the moment I am taking a multivitamin supplement and I just saw that it contains small amounts of iodine. I have heard from before that if one is suffering from acne one should stay clear from iodine. But isn’t iodine good for the Thyroid gland and such?
    I don’t have severe acne, but I often get tiny red blemishes that can look a bit like a rash except they don’t itch. So I susspect they are small blemishes that just contain “clear fluid” that looks like water and some blood.

    • The U.S. RDA of iodine is 150 micrograms (mcg) for adults per day. If your multi has a concentrated dosage of it, its possible that it could be causing some of your acne. Consult with a physician and dermatologist to make sure you are getting levels adequate for your body.

  28. Hi, I am currently following the Perricone diet, I have only been on it one week and my skin has already begun to glow.
    One thing – I am currently on accutane (for persistently occurring acne, although not very severe).
    I have read a LOT about dairy causing / making acne worse.
    Is unsweetened/greek yogurt okay for acne? I love yogurt but am afraid to start eating it for breakfast because of all the horror stories I’ve heard about dairy and acne. (I don’t like eggs and not a big fan of oats, so at the moment all I am eating for breakfast is grapefruit!)

    • Hi Isabel. You should be fine with unsweetened Greek yogurt. Opt for low-fat as opposed to non-fat options, since the fat will help slow the rise in blood sugar. Also, think about adding raw pumpkin seeds which are high in zinc and beneficial for controlling breakouts as well as cinnamon to further help control blood sugar.

  29. hi dr i would like to know what gelatin is used to make coats for alpha lipoic acid capsules…id be very grateful for ur reponse its very hard to drink it without its coat…

  30. My acne has become cystic. The cysts take months to go away and appear more like absesses than acne. Will the diet resolve this? I eat pretty well as it is and cannot understand why my acne should be so severe! Would this type of acne be cured by this type of diet?

    • Hi CeeCee. Following the anti inflammatory diet can make a tremendous difference, however, you should check with your dermatologist.

  31. Hi does oatmeal really aggregate acne?

    I eat it every morning and I dont think its possible for me to cut it out of my diet because im usually in a huge rush and oatmeal are quick to make and really filling

  32. Hi. I am allergic to soy protein. It causes atypical acne breakouts on my face; atypical because they occur in strange places on my face that they do not occur if I do not take soy. I am amazed at the amount of products that contain soy and soy protein. Recently, I emailed Campbell’s Soup to ask them to reconsider the use of soy protein in their soup products. Their response was that it improves the texture of their soups. I am interested in starting an awareness campaign on regarding the use of soy protein in foods. Do you have any data on how prevalent adverse reactions to soy protein actually are? I could really use the data. Thanks!

  33. Hi,
    What to eat for breakfast on an anti-inflammatory diet?
    Is it ok a sandwich of roasted turkey breast on 1 slice of toasted whole wheat bread?

    Thank you so much.

    • Dr. Perricone recommends eating 1 egg with two egg whites, plus steel cut old fashioned oatmeal and fresh berries with green tea and spring water. You can also have fresh grilled salmon instead of eggs. Try adding the turkey to an egg scramble, but omit the bread as it is not recommended on the anti inflammatory diet.

  34. I know regular pasta is an inflammatory food, but I was wondering about barilla plus which is made of Ingredients
    Semolina, grain and legume flour blend, [grains and legumes (lentils, chickpeas, flaxseed, spelt, barley, oats), egg whites, oat fiber], durum flour, niacin, iron (ferrous sulfate), thiamine mononitrate, riboflavin, folic acid.

    it contains 4g of fiber per serving 10g of protein per serving and is high in omega 3’s

    I really like it for the protein content (I workout alot) so i was wondering if it would be ok to eat

    • Hi Rob. Try instead for eating a quinoa-based or buckwheat noodle. Even whole wheat pasta is still inflammatory, although better than just white pasta.

  35. Funny, I eat healthy all the time and I rarely if ever have any junk food/pop/coffee/ or anything of that stuff.

    My diet strictly consist of fruits, strawberry, raspberry, blueberry, blackberry, apples, bananas. Also yogurt, mushrooms, spinach, chicken. Milk and water. The list could go on. I will get off apple juice that I usually drink and the mushrooms

    Funny thing is, I still have Pustules on my face and they never go away, they come and go and it seems as though once one is gone, another pops up. I clean my face daily as well and have tried BP, salycic acid, tea tree oil, nothing works.

    I don’t know what the heck I am doing wrong I am on (I believe) a fairly healthy diet.

    • FYI, Bananas are supposed to be bad according to the book. Make sure that you’re eating the right fruits and vegetables. Also, what I did that really helped was adding stuff like apple cider vinegar and garlic to my diet, since they are natural antibiotics (look it up!). I think in that sense, for people like us who would tend to get the moderate type of acne, it’s essential to fight it with something extra.
      For me, it’s been 5 months and I couldn’t be happier with the results.

  36. Just wanted to pass along something I’ve been doing to help me consume more healthy fats: I put a scant tablespoon of coconut oil into my tea in the morning. Not only does it add a nice flavor, the oil keeps my lips moisturized.

  37. Dr. Perricone,

    I have been following your book “The Acne Prescription” for the past 2 months and all I can say is that IT WORKS!!!
    I began seeing results within the first week. I stuck to it, and now, not only have I lost weight because I’m eating a lot healthier than before, my skin hasn’t been this clear in a very long time! It’s amazing! I suffered from severe acne for years. This book was truly god sent!

    Thank you so much!


  38. Is there any certain vegetables or fruits I should avoid for my acne?

    I Also not only have a problem with acne, but i have a HUGE HUGE problem with scarring. I have such a pretty face but the scars really out do the acne. Is there any particular foods I should eat? Maybe im lacking cellular regeneration or something. I cant go through life with make up.

  39. Typical features of acne include: seborrhea (increased oil-sebum secretion), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), nodules (large papules) and, possibly scarring.The appearance of acne varies with skin color. It may result in psychological and social problems.

  40. Hi not sure if this is the correct place to write this, but I am curious if you are mostly raw /vegan and do not eat soy how can you make this diet work? More beans and nuts or take more? supplements .

  41. Hi
    I find this website very useful and spot on in terms of advices for healthy skin. However, I have a couple of questions with regards to nuts and nut oil. I just discovered recently that macadamia oil is one of the healthiest oils around due to the reasonably high omega 3 to 6 ratio (compared to other oils other than flaxseed) and pretty good MUFA content. However unsure if it’s good for people who are prone to acne and on acne diet.
    Another one is on pistachio nut. I read somewhere that it is good for those on acne diet since it can help keep acne at bay rather than aggravate it.
    My skin is acne-prone, and am very sensitive to most nuts (breakout within hours after consuming peanuts, cashews, almonds etc) and wonder if the two above are the exceptions. Thanks for helping!


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