Acne and Inflammation: How to Reduce Redness and Swelling

Acne and Inflammation

Poor diet choices stoke the fires of inflammation and lead to painful, swollen acne.

You know the red, swollen pimples you get sometimes?

The ones that really hurt when you touch them?

Sometimes they’re right at the bottom of your nose, and just chewing makes them hurt?

These pimples hurt because they are swollen and inflamed. Good news is, you can reverse this process.

Okay, so what is inflammation, anyway?

Simply put, it’s the body’s natural response to attackers – bacteria, chemicals, or, get this, foods that your body doesn’t like.

When inflammation works like it’s supposed to, it helps your body fight off an attack by bringing in white blood cells and all the warriors of your immune system. When it’s done fighting the infection, it stops. The swelling goes down, the redness disappears, the wound heals.

But when it gets out of control, when it doesn’t stop, it causes your body all sorts of grievous problems – including acne.

How does inflammation make acne worse?

You have red, swollen, painful acne because you have systemic inflammation, an inflammation response that has gone wild, and keeps going, going, going, like an epidemic disease. Systemic inflammation is closely associated with cancer, heart disease, arthritis, irritable bowel syndrome, Parkinson’s, Alzheimer’s, and especially acne. So let’s figure out how to get rid of this systemic inflammation!

But first, I want to tell you why acne isn’t actually caused by bacteria.

The real role of P. acnes bacteria in acne

Contrary to popular belief, P. acnes bacteria do not actually cause acne.

In fact, P. acnes isn’t even required to get really bad inflammatory acne.[1] [2] They simply make the problem worse.

Once your pores get clogged with excess sebum and dead skin cells, an oxygen-deprived environment arises that’s a perfect home for P. acnes bacteria. (P. acnes bacteria are “anaerobic,” meaning “without oxygen” – they die if exposed to oxygen. There’s little oxygen inside clogged pores, so P. acnes can thrive there.)

These bacteria feed on your sebum, and as a thank-you gift, they create highly inflammatory waste products. When your immune system is compromised, as it is when you’re stressed out or when you eat the foods outlined below, you can’t effectively fight off these P. acnes bacteria, and they multiply rapidly inside your clogged hair follicles and cause severe inflammation, redness, and swelling.

Foods that cause inflammation

In a little bit, I’m going to share a bunch of ways to douse the fires of inflammation, but first, I want to talk about which foods contribute the most to this silent killer. You’d do well to stop eating these foods immediately if you want to halt inflammation and see an almost immediate improvement in your acne. (And, if you really follow this list well, permanent clear skin.)

The top 10 worst inflammatory foods

Okay, this is a little misleading, as these are 10 groups of foods, not 10 individual foods. About 90% of what you find in the grocery store falls into one of these categories! Avoid these foods and your acne will start to clear up:

  1. Dairy (especially pasteurized homogenized milk, but also cheese, yogurt, cream, etc., anything that comes out of a cow’s udder)
  2. Gluten (the king of inflammation – gluten damages your intestinal wall and causes systemic inflammation)
  3. Sugar (high glycemic index spikes your blood sugar and leads to glycation and persistent inflammation)
  4. Vegetable oils (canola, sunflower, safflower, soybean, cottonseed, corn oil)
  5. Trans fats (commercial baked goods, margarine, fast foods, deep fried foods)
  6. Feedlot-raised meat (artificial hormones, antibiotics, omega-6 fats)
  7. Processed meats that have nitrites, nitrates, other preservatives
  8. Alcohol (more than one glass of wine per day)
  9. Refined grains and white flour
  10. Food additives, preservatives, artificial flavors, etc.

These foods are found everywhere in our modern food landscape.

Go to your local grocery store, visit any aisle besides the produce and meat sections, and start reading nutrition facts labels. You’ll notice that certain ingredients pop up over and over: vegetable oil, sugar, corn syrup, wheat flour, skim milk powder, sodium nitrite, potassium sorbate, yellow 5, blue 1, red 6… the list goes on and on.

These things are not foods, they are food products. Would your great- grandmother have recognized these things as food? No. (Well, dairy, perhaps, but she would have eaten raw dairy, which is a whole different subject. Still not a good idea if you’ve got acne – avoid dairy at all costs.)

Increasingly, these highly inflammatory “foods” are forming the bulk of the Westerner’s diet. Is it any surprise that diseases of inflammation are so rampant in our society?

Foods that cool inflammation and improve acne

Alright, time for some antidotes. Here’s a list of the most potent foods you can eat to stop inflammation in its tracks:

  • Fish (wild-caught only, not farm-raised) – for the anti-inflammatory omega-3 fats
  • Ginger (especially fresh ginger root)
  • Turmeric (look for fresh turmeric root – it’s great for curries!)
  • Broccoli (and other dark green vegetables)
  • Rosemary
  • Basil
  • Cherries
  • Blueberries (and raspberries, and really all berries)
  • Kelp (kombu, wakame, arame, dulse)
  • Shiitake mushrooms
  • Papaya
  • Extra-virgin olive oil
  • Sweet potato
  • Coconut oil
  • Fermented foods (live sauerkraut, kombucha, kimchi)
  • White tea
  • Free-range eggs

This is just a small sampling of all the great healthy and anti-inflammatory foods out there. By focusing on foods like these, and avoiding the worst inflammatory foods from above, you practically guarantee clear skin.

That’s not an exaggeration.

That’s how powerful of an effect food has on acne.

Not only do the inflammatory foods above cause inflammation (meaning redness and swelling of acne), they also block your pores (especially dairy) and cause your skin to produce excess oil (especially sugar and refined grains/carbohydrates), so you’re really attacking acne from three sides by removing these foods. Together, these diet modifications are the single most effective way to get rid of acne that I’ve ever seen. Better than Proactiv, longer-lasting than laser treatments… better than everything.

What about anti-inflammatory supplements?

You can find a lot of supplements out there that are supposed to help reduce inflammation. However, from personal experience and all the research I have done, I strongly advise against using supplements, with a few key exceptions, because I think they’re a copout at best, and downright dangerous at worst, increasing the toxic load on your body.

The main issue is that taking supplements distracts you from fixing the root cause of acne, which is what you’re putting in your mouth. It just masks the problem, like using topical acne medications. It prevents you from benefiting from the wisdom of your body, which is telling you that you’re doing something very wrong!

People often get obsessed with buying the perfect supplements, and don’t give a moment’s thought to the rest of their diet.

They think they can simply “make up” for all the bad stuff by popping pills: quercetin, resveratrol, fish oil, vitamin E, gamma-linoleic acid, enzymes, echinacea, green tea extract, and CoQ10. What’s the next magic supplement going to be?

Here’s another way to think about it.

Don’t take enzymes; eat the right foods so your body produces its own enzymes. Don’t take curcumin; cook with whole turmeric. Don’t take green tea extract; drink green tea. Whenever you take an extract of something, you’re denying yourself the synergistic power of that nutrient in its original context.

Don’t buy into the marketing hype of supplement companies

Nutrition science has historically been one of the most flawed sciences out there.

Just because some study finds that taking some supplement reduces your chances of getting cancer doesn’t mean you should run out and buy it.

Nutrients like this act in concert with other nutrients when they’re still together in whole foods. Such whole foods have hundreds or thousands of chemicals that interact in extremely complex ways we’re just beginning to understand. These complex interactions will take lifetimes for science to fully understand. When you extract some nutrient from a whole food and bottle it up, what else are you losing in the process?

And remember, nutritional supplements companies are money-making businesses that generally want to grow and sell more and more supplements. So they’re going to do everything they can to make you come back for more, to keep you buying the latest, greatest supplements. (I believe the people running these companies are fundamentally good people and really want to help heal people, but I think that medicating with whole foods is generally more effective than taking isolated supplements, outside of some specific medical conditions and deficiencies.)

These companies jump on the opportunity to create new “breakthrough” supplements whenever a new study comes out, discovering some new chemical in pine needles that promises to add 20 years to your life. Save your money for real food, and support the fine farmers that grow it!

Key Takeaways

  • Excessive inflammation makes acne swollen, red, and painful.
  • Most excessive inflammation is caused by diet.
  • Anti-inflammatory supplements are not a good replacement for fixing your diet (because they don’t actually do anything about the root causes of excessive inflammation).
  • You must stop eating foods that cause excessive inflammation if you want to reduce redness and swelling permanently.
  • Inflammation is only one part of the picture – you also need to prevent acne from forming in the first place.
  • To do that, you need a holistic diet- and lifestyle-based treatment for acne.
  • In sum, you need to fix your diet and lifestyle to really cure excessive inflammation and the root causes of acne (that’s what our book is all about!).

While inflammation is a huge contributor to acne, there’s even more you can do to kickstart your journey to clear skin.

If you’d like to be walked through the whole process of tweaking your diet for clear skin, we (Devin and Sonia) have written an ebook that does just that. It’s called “Clear Skin Forever” (clever title, right? :).

For this complete guide to taking an all-natural, diet-based approach to getting rid of acne and having clear skin for life (no kidding!), go here.

Sources (click to expand)

  1. Zouboulis CC, Eady A, Philpott M, Goldsmith LA, Orfanos C, Cunliffe WC, Rosenfield R. What is the pathogenesis of acne? Exp Dermatol. 2005 Feb;14(2): 143-52. ^
  2. Bowe WP, Logan AC. Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles. Lipids Health Dis. 2010 Dec 9;9:141. ^


  1. Christine says

    I found your website and started reading . I forwarded it to my daughter who is struggling with very painful acne and is in college. Her comment was that all she would be able to eat in the dining hall is carrots. Any suggestions? There are many food options there but I am sure they are all contributing to the acne.

    • Devin Mooers says

      Hey Christine! College dining halls can be a bugger… that said, this is definitely NOT a comprehensive list of foods that do/don’t tend to trigger acne. It’s just meant as a list of strong anti-inflammatory (and inflammatory) foods. We have a comprehensive list of foods in our Food Explorer, which comes for free with our e-book. Here’s a demo of the Food Explorer if you’re curious:

      Book buyers also get access to our members-only forum, where she could definitely get help figuring out which foods would be the best choices to eat for her skin in her dining hall. (I struggled with this a fair amount in college myself but was able to make the best of it.)

      We have a 100% money-back guarantee as well, so if she tried it and still find anything she could eat in her dining hall, we’d be more than happy to issue a refund.

      Not trying to pressure you into picking up the book – just wanted to let you know that that option was available! Let me know if you have any other questions. :)

  2. Irene Odhiambo says

    I am new on this forum. I have been on roaccutane for the last five weeks and the inflamation on my cheeks and jaw line is not getting any better. Should i discard the meds and work on a clear skin forever diet or should i continue with both the meds and the diet. I have changed my diet and cut off the acne devils starting this week, i need quick results. Will combining the roaccutane and diet give me quicker results? Note that i have been on roaccutane for a few months every year and this is the fourth year. (Last year i took it for only 6 weeks and i stopped because the acne cleared. I have never gone beyond 4 months in any of those years). Usually, i start to see results from month 2 but not this time. I am currently on 40mg a day.
    Also, please advise on what to do with the pus filled pimples on my face, should i squeeze out the pus or leave them alone, they really are ugly! My chest and back are totally free of acne.

    • Sonia Carlson says

      Hey Irene – yes, I would definitely suggest getting off the Roaccutane, especially since it doesn’t seem to be working. (If you’re not getting amazing benefits from isotretinoin, it’s totally not worth the nasty side effects.) Take fermented cod liver oil instead, per our recommendations – it’s a natural form of vitamin A.

      As far as quick results – it can take a few months or longer to really transform your inner health so that it shows up on your skin, so stick with it. On the other hand, some people see really fast results – it’s very individual and depends on your overall condition when you start. It sounds like you’ve been on and off isotretinoin for a long time now, so you probably want to get out of that cycle. This is the way to do it!

      Ah, to squeeze or not to squeeze. Generally, we say it’s best not to squeeze – that can cause additional redness, swelling, and trauma under the skin. However, if they’re so ready to pop that you barely need to apply any pressure, then they’re probably fine to squeeze.

      Finally, since you’ve already got the book, you can post further questions and comments on the CSF Forum, where our readers talk to each other (and to us): Hope to see you on there!

  3. Alissa says

    I’m in my mid-30s and have been battling acne issues the last 2 years. To begin, it was just my hairline, chest and back. The doctor put me on an antibiotic to take care of the painful acne, which helped for awhile. Increasingly, over the last 6 months, it has been getting worse, specifically on my face, even while taking the antibiotics. My chest and back are touch and go. The doctor suggested doubling my dose of antibiotics. I haven’t done that yet, I really would prefer to not be on anything at all. Over this past month my face has went crazy with breakouts… worse then when I was in high school. I googled today and found your site, and I am going to cut out dairy and see if that helps at all.

    Thanks for the article and all the free information…. :)

    • Sonia Carlson says

      I’m glad you found us too, Alissa! Cutting out dairy is a powerful first step, and I also highly recommend checking out our probiotics article if you haven’t already, since you’re dealing with antibiotics, too. (BTW, I think you’re absolutely right to second guess your doc’s suggestion to increase your antibiotic…)

      • Alissa says

        Yes, I am taking probiotics and also drink Shakeology daily. I also recently ordered Vitamin D after reading your article… I am in Oregon too (Sublimity … just the other side of the cascades) & I am surely not getting enough. Just trying to figure this all out as I go through my mid-30s. It’s really annoying! lol

        • Sonia Carlson says

          Hey, you’re not so far from here! Yeah, especially starting this time of year, it might be a good idea to supplement D. As far as Shakeology, unless you’re drinking the vegan one, looks like the first ingredient in most flavors is whey protein, which can be a major acne trigger! Glad to hear you’re taking a probiotic; it might help to eat lots of live, fermented veggies, too.

          • Alissa says

            Only drink the Vegan version… I just need to work on cutting out all the dairy that I’ve added back in over the last few months. I don’t eat a TON but I’m not sure the quantity matters if it causes inflammation, any amount may trigger the problem I’m guessing. I generally only have 1 – 6 oz. Oikos Zero greek yogurt and then on my salad, maybe 1/4 fat free Fage greek yogurt…. that’s really about it on a normal day, I do have days that there is more though. Anyway, I’ll be eliminating the dairy completely to see if that helps.

          • Sonia Carlson says

            Great idea, Alissa. Fat-free dairy products are actually *more* associated with acne than full-fat ones, so switching to full-fat, organic dairy products could be an improvement, too. But going totally dairy-free for awhile is most likely to give you the fastest, best results!

  4. Emily G says

    I suffer from ulcerative colitis and acid reflux and I’m not sure if that’s the main source to my acne. My acne also worsens on my period, so it could be a mix of the diseases I have and my hormones. Do you have any advice to someone with ulcerative colitis/crohn’s? I want to eat foods that will be gentle on my stomach and help get rid of acne at the same time. I already bought your book but am struggling to find foods you say should help that also agree with my body. Could you give me some advice on where to start? And also, have you heard of “Reed’s Culture Club Kombucha” drinks? I love these drinks and don’t know if I should continue having them if they aren’t good for my ulcerative colitis.

    • Sonia Carlson says

      Hey Emily, yes, your digestive issues could definitely be related to your acne. Since you have the book, and since this is a pretty detailed question, would you post it (them) on the CSF Forum? If you haven’t checked out the forum already, you can get there by logging into your account on our website. I’ll keep an eye out for your posts!

  5. Helly says

    Great prelude to death.. I don’t agree with this article. I avoided all the food mentioned, still had acne and had my head spinning all the time because of lack of iron and other necessary nutrients.. Follow the instructions in this article if you want to die.

    • Sonia Carlson says

      Hey Helly, sounds like your problem was probably cutting a bunch of foods out of your diet without then adding in healthy, nutrient-dense foods that your skin and body need. I know most processed foods contain veg oil, artificial preservatives, sugar, and antibiotic-laden animal products, but I swear you don’t need these things to live :)

  6. Sam says

    the article is so helpful and i thank you for that :) how do chinese food, steaks, chili, and tortilla chips effect acne?


  7. Eleanor says

    I’m 25 and started experiencing acne last year till now, I’m Indian and eat curries almost every day, could it be my diet? Even though that’s what I’ve always been eating or could it be the depo povera that I stopped taking? Are there any products that I could use to clear my skin, like maybe celltone?

    • Devin Mooers says

      Hey Eleanor, probably the worst diet triggers in typical Indian food are vegetable oil (used to cook many things), and the dairy added to some dishes. Chapati / naan / wheat can be a problem for people with gut issues (especially if it’s fortified with iron – I’m not sure about India, but it often is here in the US).

      Haven’t heard of celltone, sorry! We recommend a holistic, diet-and-lifestyle based approach for curing acne from the inside out, without topical treatments. We’ve found it to be the only effective long-term solution for getting rid of acne. More info in our book.

  8. James says

    Hi, in your articale you say that Gluten is the king of inflammation. I heard there are no studies that prove Gluten to be harmful to people who don’t suffer from celiac disease. So I was wondering what’s your opinion about that.

    • Devin Mooers says

      Hey James, great question! For every study that claims a link between gluten and gut issues, or inflammation, or whatever, there’s another one that disproves it. Nutrition science is one of the most difficult sciences to study in a controlled manner, and there are tons of fatally flawed studies out there that people use to support all kinds of conclusions (i.e. gluten is the king of inflammation, gluten is totally harmless, etc.). We’re moderating our super-strong anti-gluten stance a bit these days. Gluten still is one of the most complex and large food proteins that we eat, so it can present a problem for people with gut issues, leaky gut, etc. And there are enough anecdotal reports of people going gluten-free and finding health improvements that we do think it’s worth talking about. I wouldn’t say it’s the king of inflammation anymore, though, I don’t think. Vegetable oil / PUFA probably takes the cake there, maybe feedlot dairy. It’s hard to measure these things against each other, especially because each individual person reacts so differently.

      Personally, we’re experimenting with things like spelt, sprouted wheat, sourdough whole rye bread, that kind of thing. We’re looking forward to being able to loosen the dietary guidelines in our book a bit in the near future.

      BTW, if you haven’t checked it out, see this post on iron fortification being a hidden issue with wheat/gluten:

      That threw me for a loop. Is iron fortification a more serious problem with wheat products than the gluten itself? Or is it glyphosate residue from pesticides used on non-organic wheat? Wish I knew the answers to all these things…

      • James says

        Hey, yhanks for getting back to me.

        What about gluten free products? I don’t eat much bread but if I do I usually eat gluten free bread. Do you think they are okay or should I switch to whole meal products only?

        • Devin Mooers says

          Yeah it’s a good option. It’s hard to find good gluten-free bread, though, with good taste + texture. A lot of it tastes (and feels) like cardboard. Watch out for veg oil (canola, etc.) used in GF bread, a lot of it has that stuff in it.

        • Devin Mooers says

          When in doubt, not a bad idea to experiment with both. Get some organic whole-grain bread (whole wheat, spelt, rye, etc.) WITHOUT iron fortification, and try that vs. some good gluten-free bread, see if you notice changes in your skin and how you feel. Your body’s going to be better at telling you which food is better for you than some guy on the interwebs. 😀

          • James says

            Hey, sorry for the late reply. Thanks for your suggestions. Maybe it’s a mistake but I think the red spots from old pimples become more red when I eat gluten so I will stop and test it for a while. My biggest problem is that the red spots usually stay for 6 months to over a year until they fade.

          • Devin Mooers says

            Hmm, sounds like there might be some low-lying persistent inflammation going on if the red spots stay around that long until they fade. Eating gluten, when you’re sensitive to it, can definitely have that effect. Worth a try cutting it out for a while! Replacing the gluten with more nutrient-dense foods like veggies, sweet potatoes/yams, grass-fed meats, etc. also can really boost the nutrient density of your diet, which is key for getting rid of acne. I’m becoming more and more convinced that a big general trigger of acne is micronutrient deficiencies.

  9. Kieran says

    Hi I was wondering what you think of raw dairy, like raw milk kefir? I see so many benefits associated with raw dairy. I was also wondering what you think about the Weston a price foundation?

    • Sonia Carlson says

      Hey Kieran – fermented, raw dairy products from grass-fed animals is probably a great food for clear skin for most people, if they tolerate dairy foods well. (Have you seen our post on milk?) We have a lot of respect for WAPF, and there’s some great research coming out of there from folks like Chris Masterjohn. Many of our dietary views align with theirs.

  10. Ben says

    Hello Mr Devin and miss sonia, i started having acne since the start of this year. Like suddenly it just came rushing in, so i started going to a dermatologist last 3 months ago and he prescribed me with acnotin 30mg. So my skin’s basically has this really red dirty blood spots? i don’t know what to call them. Its just some scars i think or inflammation, any idea how to reduce the redness? i’ve read your article and bought Vitamin D 1000mg (the highest my local store sells) and some Vitamin C (recommended by the store). Is there anything else you would suggest that will help reduce the redness and inflammation?

    • Sonia Carlson says

      Hey Ben! So yeah, Acnotin is isotretinoin, also sold as Accutane, Roaccutane, and other brands. Rashes and skin inflammation, cracking, and peeling are fairly common side effects of isotretinoin. I’m not sure what you can do while you’re still on the meds to reduce redness… that’s something that will subside after you stop the pills. You might try soothing your skin with aloe vera, something we recommend for helping scars to heal, and of course, eating an anti-inflammatory diet is always a good thing, but yeah. That’s a powerful drug you’re on.

  11. David says

    I was wondering what part of dairy causes inflammation? I am under the impression that lactose is the cause. For example I am wondering if kefir would be alright since it’s generally considered extremely healthy, but is 99.9% lactose free.

Like what you read? Have something to share? Leave a comment below! Your ideas are much appreciated, though we can't answer every individual question. :)

- Devin and Sonia

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