Without a doubt, diet is the most confusing aspect of acne for most people. We’ve all read stories of people miraculously getting clear after cutting 1 or 2 foods from their diet. And there’s no doubt that ‘hidden’ food allergies and sensitivities can cause acne. But the real question is how do you know which foods, if any, cause acne for you. Several companies market seemingly scientific (and expensive!) tests that claim to rapidly and accurately uncover the hidden sensitivities that wreck your skin.
In this guest article by Dr. Alexis Shields, we’ll talk why these tests may not do what it says on the can, and she’ll walk you through the only reliable (and free) way to identify your food sensitivities.
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The food that you eat has a direct impact on the health of your body and your skin.
We all know that food allergies can create severe reactions to foods, such as having a peanut allergy. However, there are more common negative reactions to foods called food intolerances.
Unlike food allergies, food intolerances do not typically involve the immune system. Therefore, the methods used to test food allergies are not effective for determining food intolerances.
Many people go their entire lives without knowing that they had a food intolerance at the source of their poor health.
Food intolerance definition
A food allergy is a reaction to a food that involves the immune system, such as a peanut allergy.
A food intolerance is a reaction to a food that does not involve the immune system, but may be from the bodies insufficient production of a particular enzyme, such as lactase in those who are lactose intolerant. The only exception to this rule is gluten intolerance, which can involve the immune system.
Having an intolerance or sensitivity to a food is much more common than a food allergy.
Food intolerance symptoms
The truth is, any symptom can be the cause of or complicated by a food intolerance.
In my clinical experience, I have found that the following symptoms are related to having a food intolerance or food sensitivity:
- Eczema, skin rashes, acne, chronically itchy skin, and psoriasis
- Gas, bloating, diarrhea, constipation, and acid reflux
- Headaches and migraines
- Unexplained fatigue or excessive sleepiness, and insomnia
- Seasonal allergies and asthma
- Brain fog and difficulty concentrating
- Muscle and/or joint pain
- Difficulty gaining and losing weight
- Anxiety and depression
Why you shouldn’t pay for food intolerance tests
It is a widely held myth that you can test for food intolerances using a blood test.
Studies have shown food intolerance blood test are unreliable and often produce false positive results
Many companies offer blood tests that claim to accurately identify your individual food intolerances and sensitivities. In these tests they take little bit of your blood and test it against several hundred foods. More specifically, they measure how your immune system reacts to the antigens in foods. Based on the immune systems reaction to the food, the test claims that certain reactions mean an intolerance to that food.
While seemingly scientific, these tests are not consistent or accurate and they generate many false results. Also, it’s common for different labs to produce completely different results.
It is unclear what these immune reactions really mean and if they suggest a negative reaction to a food, a tolerance to a food, or simply just an individual’s exposure to that particular food.
A study published in December of 2014 assessed 5 different methods for testing food intolerances in a small sample of subjects who had been diagnosed with Irritable Bowel Syndrome (IBS). The study found that the results between the different types of food intolerance tests were not consistent, nor did they correlate to the foods that the subjects self reported as causing an increase in their IBS symptoms.
The study did find that following an elimination diet for 4 weeks, prior to food reintroduction, decreased intestinal permeability (commonly known as leaky gut) and reduced the overall severity of the subjects reported IBS symptoms.
There is currently no consensus on the usefulness of food intolerance testing and what these tests are really telling us. Therefore, the best method for testing if you have a food intolerance or sensitivity is conducting a Food Elimination Challenge (FEC).
How to do a Food Elimination Challenge
If you are suffering from acne, a skin disorder, or any of the symptoms listed above, I highly recommend doing a FEC.
Here are the basics:
- Step 1. Eliminate the foods from your diet that you would like to test for 3 weeks minimum.
- Step 2. Reintroduce only 1 food at a time per 3-day period.
- Step 3. Eat 1 normal serving size of the food you are testing each day for 3 days in a row.
- Step 4. Keep a food diary of the type of food you are testing, serving size, number of days eating the food, energy level, mood, sleep, skin health, and digestive function.
It is important to remember– reactions to foods can happen immediately to 48 hours after eating the food.
If eating the food produces negative effects within the 3 day period, I recommend complete avoidance of that food for an additional 3 months before reintroducing it again. If you are unsure of the effects from the food, give yourself a 3-day break and then reintroduce the food again. If you experience a reaction to a food, wait until symptoms stabilize before introducing another food.
It is important to experiment with food reintroduction when you are feeling healthy, well-rested, and in a low-stress environment.
DO NOT attempt to reintroduce a food that you have a known allergy to.
In my clinical experience, the most common food intolerances or sensitivities are:
- Dairy
- Gluten-containing grains
- All grains
- Soy
- Eggs
- Nightshades
- Legumes
- Alcohol
- Sugar & sweeteners
- Caffeine
- Chocolate
- Nuts & seeds
But do not worry, most people are not intolerant to all of the foods listed above. A FEC can help you to determine which foods may be a problem for you.
Food intolerances that cause acne
It may benefit you to to start with one food or a select list of foods, rather than avoiding the whole list from above. For example, if you struggle with acne or other skin conditions, I commonly observe that the consumption of cow’s milk dairy products can cause or worsen the symptoms.
In summary
Food intolerances commonly cause or aggravate skin conditions, including acne, and can lead to chronic health issues. At this time, food intolerance blood tests are not accurate in determining your food sensitivities.
If you are looking for the single best way to improve your health, I highly recommend that you start with food. Completing a Food Elimination Challenge is the best way to determine which foods you should avoid and which foods will help you to thrive.
Determining if you have a food intolerance can be a challenge without the use of some necessary helpful tools. To make it easier for you, I have created a fill-in-the-blank chart that guides you through the step-by-step process.
Click here to download my free Food Elimination Tracking Chart.
About the author
Dr. Alexis Shields is a board-certified Naturopathic doctor who specializes in the use of functional medicine to treat health problems such as chronic skin conditions and digestive disorders. She currently offers online consultations to patients world-wide.
Website [https://dralexisshields.com/]
Facebook [https://www.facebook.com/DrAlexisShields]
This is a great post and I think people with acne should take food intolerance into high consideration when thinking of treatment. I struggled with extremely bad breakouts for the past year – not knowing what was causing them (and trying A LOT of different things). I ended up doing a food intolerance blood test with my naturopath and discovered I had an intolerant to dairy, egg, almonds and peanuts. I have been off these foods for a full 3 months and my skin is much better. I do not have any active acne, just some red scaring left over which will take a while to heal. I think its also important to note that it took me longer than 4 weeks to see results, so some people may want to stick with the elimination for longer. In regards to the accuracy of the intolerance blood tests – I may not be intolerant to all those 4 listed foods, but there was at least one in there that is the culprit.
Thanks for your comment, Rachel. The problem with those blood tests is that they are profoundly unreliable. Really no better than throwing a dice. They seem to work because the elimination lists almost always contains one or more of the foods that commonly cause problems for people (grains, dairy, soy, etc.). Simply removing some of the common trigger foods most likely gives the same results as these blood tests.
Thank you so much for your comments Rachel. I am so happy to hear that you have seen improvements in your skin and that the testing was helpful. Unfortunately at this time we can not recommend it for everyone, because the results are not yet reliable or consistent. I have run many of these tests over the past 10 years and I am hoping to see some more promising research in the years to come. There have been occasions when a food intolerance blood test has tipped me off to a rare intolerant food that would have taken much longer to identify with the Food Elimination Challenge. So it may make sense in certain situations, however for the majority of people, a FEC with the most common foods is the cheapest and best way to start.
I was wondering,
who would you recomend to see or do if you believe you have a much rarer foor intolerant.
Also, I believe I am sensitive to garlic, dairy, and high gi foods, but i still have moderate to severe acne, and I eat alot of onions, cabbage, tomatos, and peppers. I am not quite sure where to start? Should I continue to add a food one by one for a duriation? How long? I am just so unbelievable stressed out and unhappy with my acne.
I just keep reading Seppo say you shouldn’t self diagnose and should be certain what is going on by going to a doctor, but that was on one of the candida posts.
Thank you for this website.
Sorry about late reply. We are on holiday with my wife and I have limited time to reply.
In the candida posts I advised not to self-test because the self-tests for Candida (spit test and questionnaires) are so unreliable to be completely worthless.
But it’s different for food intolerances because not only there are no good commercial tests but the home test (food elimination challenge) is reliable.
I’m trying to put together a sort of ‘trusted doctors’ list from where people could find doctors (both conventional and natural-oriented) who are open to working with natural methods. But I don’t have anything on hand yet. Your best bet is probably some integrative practitioners. The problem is that many of those practice quackery, so you have to be careful with whom you work with.
Hello seppo what do you think about the insulin index? https://ajcn.nutrition.org/content/66/5/1264.full.pdf
fI this studies show that certain amino acids trigger really high insulin spikes.. things like fish, beef for instance..
Sorry about late reply. We are on holiday with my wife and I have limited time to reply. Insulin index is a valid measure, but aside from showing that dairy products spike insulin as much as sugar, it doesn’t bring that much new information. Insulin increasing effect of protein is one of the reasons I say fat is usually the safest macronutrient for acne-prone skin. Anyway, I wouldn’t stare too much into the various indexes. Just eat moderately carb-restricted and fat-heavy, healthy diet and you should be fine.
Hello seppo i do have a few questions?
So you said that eating fewer carbs would be better for your skin. but i am really into weight lifting and i just love it to have sweaty people around and lifting heavy..
but my skin hasnt got much better since doing it.. so my question whats worse for your skin- eating leucine rich foods like meat,… or eating many carbs? because sience says for building muscle you should eat high protein and if not you have to eat many carbs.. so what would be better?
also do you think that weigth lifting is beneficial for insulin sensivity? i drink 4-6 cups green tee just low gl carbs so no sugar and so..?
and last question what do you think of things like visualisation and healing the body with the mind? i just read a book in the library “how the body heals the mind” or so and it does list literature so it really seems legit to me.. whats your opinion?
Probably varies from person to person but I’d say in general carbs are going to be more damaging to your skin.
Yes, weight lifting will be very good for insulin sensitivity.
If you haven’t noticed improvements after reducing carb intake, exercise and green tea, then you might have some other type of acne. For me, sugar has almost no effect on my skin but anything that aggravates my gut will make a mess of it.
Sounds like quasi-religious nonsense to me. It’s true that stress can damage the body, there’s really no question about that, and reducing stress, relaxing and becoming more mindful will be good for your health. But I have never seen any credible evidence to suggest that ‘the power of the mind’ would go further than that.
There are people, like Drs. Bruce Lipton and Deepak Chopra, that say you can heal your body with your mind using quantum effects/epigenetics, but nobody who actually understands these fields takes such claims seriously.
It’s not impossible that the mind would have some healing power over the body, but I haven’t seen any credible evidence to suggest that – and a lot of evidence to show there’s no such healing power.
Take this seriously! I didn’t for years and it took going on a business trip to convince me to give it a try. I came back from the trip and noticed my skin was almost miraculously clear, even after eating poorly and drinking alcohol daily. I was so unsure of the cause I finally had to admit it may be a food intolerance. I cut out the two foods I hadn’t had on the trip that were common problematic foods, soy and eggs, and my skin has been much improved since.
So far, it seems like an instant trigger for me and only takes about 12 hours after soy for whiteheads to start popping up on my face. Please follow this advice!
Are there any symptoms of a food intolerance? Or, is acne the only symptom. Also, is there another way to identify intolerance? Or, is this the only (reliable) way?
Thank you
Symptoms can very a lot, but they usually involve inflammation. I don’t think that food intolerance are a common cause of acne. Elimination diet is the only reliable way to figure these out. None of the currently available blood tests are specific enough to identify food intolerances.
If we suspect a food intolerance acne connection in grains, can taking digestive enzymes help?? Which enzyme helps break down grains??
They could help. But if you have a problem with gluten, then I suspect digestive enzymes won’t help.
The food elimination is great for some people but I am intolerant to many different foods and it is too difficult to narrow them all down. Due to the advances in technology and methods have you looked into the Mediator Release Test or the Cyrex Array 10 test? Please advise as I am very seriously considering these and would love some advise as the internet is so contradicting on them. Thanks,
I haven’t been able to find any evidence to show these tests are accurate. So the only answer I can tell you is that I don’t know. I would be skeptical.
Are you actually certified to be having these conversations? Food intolerance tests are actually very reliable and work for many, and by putting out FALSE info like this is wrong.
You are starting to get on my nerves. Why don’t you consider writing a post on how to get clear skin instead of trashing down every possible way to get help? I understand that you are basing everything on facts from doctors and so on But it could be a person with acne simple having food intolerance to cucumber or something more odd. And are looking for a way to figure this out but then see your blog that is high on the google searches and don’t do it because you simply say this is not a good idea. Negativity negativity is all i see on this site.
I have written several posts that talk about ways to get over acne. Instead of getting angry at me, don’t you think you should get angry at the people who recommend and profit from these quack methods?
You say it’s negativity, I call it reality. I like to make sure that what I recommend actually works. I know how much it sucks to waste time and money on things that don’t work.
Sensitivity test from a reputable company helped me get rid of multiple issues, so I don’t agree that they are not reliable. They may not be 100% reliable but nothing is. I enjoyed the article.
I recently went to see a naturopathic doctor after struggling with acne and irregular periods. She performed the Carroll Food Intolerance test and informed me that I have an intolerance to eggs and soy with a combination of potato and grain which I cannot eat within 4 hours of one another. I have spent a lot of money and have seen some improvement in my skin within the first month but am still having breakouts. I am taking a high dose probiotic, cell salts and the unda number compounds currently and am about to start my second month of treatment. Do food intoleranaces last forever? Will I have to avoid these foods for the rest of my life? I just want to eat a piece of pizza! Do you think I would be better off going to see someone who practices chinese medicine? I’ve heard that that can help with acne. Or will I just outgrow my acne? I am turning 21 in one month.
That food intolerance test seems highly dubious. I seriously doubt the results.
No, it’s not a good idea to go and see someone who practices Chinese Medicine. Chinese Medicine is based on outdated ideas about how the human body functions – much like the four humors theory of ‘traditional Western medicine’.
I have multiple food intolerance that cause gi symptoms dues to what has been diagnosed as mast cell activation syndrome MCAS. I have been on multiple food elimination trials over several years to identify my worst foods, which are tomatoes, squash, avocados, raw egg whites, and protein powders(esp. Soy). None of these foods cause skin breakouts, but I have identified things that cause my worst skin symptoms: alcohol/vinegar/ferments and Nsaids (aspirin being the worst). I have also had skin flares from other meds tried for migraines, and can quickly identify the reaction now that I avoid alcohol and nsaids 100%. I had minor symptoms from these for many years, only when I got really reactive from massive migraine treatments that I was reacting fast enough after taking to figure out the connection. My symptoms are more cyst-like swollen painful bumps mainly near the mouth and chin than whiteheads, but were treated as acne for many years. I start reacting 2-7 days into dosing on a new med that is a trigger, within 8-12 hours for one I’ve already been exposed to.
Have you looked into histamine intolerance? Based on the foods you react to, you may have histamine issues.
So what do you do if it’s a histamine intolerance?
Avoid high-histamine foods. Taking 1 to 2 grams of vitamin C a day can also help
Really struggling with itching on my face and ears. I’ve had breakouts since my teens and still get cyst like lumps around my chin but put up with it. The itching though is intolerable and as there’s no visible rash at all the docs and derm are suggesting food intolerance or food allergy. Basic patch testing on my arm for the main food groups revealed nothing but as it’s my face itching wouldn’t patch testing there be more effective? I’m about to start elimination diets but as I have no idea of the reaction times it’s going to be difficult to pick which foods could be the culprits!