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.

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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. Fortified wheat products sprayed with pesticides (may wreak havoc on your gut and disrupt hormone levels)
  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.

About Devin Mooers

Devin MooersHey! Over the past 10 years, I've developed a powerful system for clearing acne with a little-known diet- and lifestyle-based method, and I want to spread the love. That's why I started Clear Skin Forever back in 2011. I studied engineering and product design at Stanford University, and graduated in the top 5% of my class, but afterward, I decided to focus on writing about health, since I found it so fulfilling to help people clear their acne for good. Thanks for reading, and sign up for email updates to stay in the loop with clear skin tips! Also, be sure to check out our book if you haven't yet, all about how to fix acne permanently with diet and lifestyle changes. We've helped thousands of people get clear skin this way!

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. ^

{ 36 Comments }

  1. Idara says

    Awesome post! I love adding coconut oil to my steamed vegetables and my smoothies. I tried it on my face and found out the hard way that it breaks me out. But I haven’t had that issue with hemp and grapeseed oil.

  2. Idara Hampton says

    Thank you for explaining epigenetics so clearly. It’s very easy to follow. Congrats on clearing your skin. Your story is inspiring.

  3. Idara says

    This is such a well researched and well written article. B5 is great for the skin. I also love B6 and B12 for boosting energy, promoting a healthy luteal phase, and stopping PMS.

  4. Idara says

    Great post! Understanding hormonal imbalances isn’t always easy, so thank you for writing an informative and easy to follow article with helpful tips.

  5. wendy says

    There is no official link between iron and acne in science research but antidotally I believe there is. My daughter used prescription acne creams for a couple of years with only modest improvements to her skin. She recently was prescribed an iron supplement, her iron levels were on the low side of normal, because of her low energy state and, voila, Not only does she feel more energetic, her face is very noticeably improved and much smoother in, just days. She is a big meat eater. Who knew iron can be hard to absorb?

  6. Srey says

    I love this post! I recommend this book “inheritance” by Sharon D Moalem. It talks a lot about genetics, and could be helpful to understand more about epi genetics, and our human genome.

  7. Mike says

    Why do you say that coffee negatively affects muscle since there is like a bunch of evidence that shows the caffeine from the coffee actually helps build muscle and burn fat. Of course this is when you take black coffee without any sweeteners. I have read so many articles that talk about consuming coffee in a fasted state leading to positive muscle gains you can find them easily too

    • Devin Mooers says

      Hey Mike! Interesting point here. I found this study:

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/

      …Which says that you habituate to the caffeine in a few days’ time, meaning your morning coffee no longer stimulates over-production of cortisol once you adapt to drinking coffee daily. However, the study still found that a 1:00 PM cup of coffee boosted cortisol levels higher than normal (though the study only ran for 5 days of caffeine habituation). My personal experience is that coffee just makes me more stressed out in response to stressful events, which includes cortisol release. But I haven’t read the articles you have about fasted-state coffee drinking leading to muscle gains – I wonder if this is just due to metabolic rate increase from the caffeine? In any case, if coffee floats your boat and treats you well, go for it!

    • Devin Mooers says

      Hey Julie! I’m not totally sure on this. That still sounds like a good range. I was going based on a Dr. Mercola article, which I can no longer find (the link is broken). I am far from an expert on what ideal ferritin levels should be!

    • Rhonda says

      I will interject with a personal anecdote about Ferritin levels. I have a genetic disorder called Hemachromatosis. It causes iron from the food I eat to get into my organs and my body can only release it through phlebotomy (donating blood). My Dr noticed a high ferritin level and high liver enzymes on a blood panel and on a hunch she ordered a DNA test for this. If you are suspicious that your ferritin levels are out of whack, ask for this test. This condition is very common especially if you are of Irish or Scottish descent. It’s a lifelong condition but the remedy is easy because you just have to have your levels checked regularly and donate a pint of blood to balance your levels. I am so grateful my doc was smart enough to call for this test. Having this disorder and not taking care of it can lead to liver damage and heart attack. It’s hereditary and if you do have it, all of your nearest relatives should test for it too. Hoping it’s not the case for you, and wishing you all the best!

      • Devin Mooers says

        Kudos to your doc for finding this!! I’m so glad you know now. I had a genetic test done a few years ago, and ruled out hemachromatosis (at least current knowledge of it). So I guess it was just from my diet. And I do have a fair amount of Irish + Scottish in me. Go figure! Great thing to check for, though, as you just found out!

  8. Katy says

    I’m 25 and I have very irregular periods (which have never been regular) and acne since puberty. I got literally all my hormones checked and everything came out normal. Does anyone have an explanation for this?

    • Devin Mooers says

      Hey Katy! I don’t put much stock in hormonal tests, blood tests, saliva tests, or related “snapshot” health tests. I don’t think they’re a very accurate reflection of long-term reality, and don’t often give very useful information for clearing acne (in my experience). The fact that you have irregular periods right away shows that something’s up with your hormone levels, and/or some basic nutrient levels like vitamin A, utilizable iron (don’t go taking iron pills though!), and/or maybe some toxin overload issues. There are lots of things that feed into having a normal cycle, and a hormone test isn’t going to tell you what needs to be fixed.

      Are you drinking fluoridated water, do you know?

      Also, do you want to give an overview of what your current diet is – the more detail the better! – and any pills/supplements you’re taking? I can see if anything jumps out!

  9. Johnny Cox says

    Hi. Im going to say that Im afraid to eat coconut because of acne. Chocolate of any kind gives me acne too. Even fish oil. All these oils do it to me. I used to suspect leaky gut causing me breakouts. All these oils ruin my skin. Whey concentrate and isolate too! Someone said “keep eating the Extra Virgin Coconut oil, It’s just die-off!! It will stop soon” But it does not stop. I get brutal acne from it. Tempted to try again after reading this, but it scares me. My acne is so painful..

    • Devin Mooers says

      Hey Johnny! Really sorry to hear about your experience with so many oils/fats giving you acne. Huge bummer! Frustrating not to know whether it’s from die-off or detox, or just an adverse reaction. (I will say that whey isolate/concentrate both give me acne as well!)

      Couple questions… are you using organic coconut oil, or non-organic?

      Also, do you want to post a mini diet overview right here? I can see if any major red flags come up.

      Finally, are you drinking fluoridated tap water? (And/or using fluoride toothpaste?) Wondering if these fats/oils might be causing a detoxification of fluoride, causing transient acne.

    • Devin Mooers says

      Hey Ashley! I think it’s okay in really small amounts as a garnish or flavoring, but it’s very high in PUFA so I wouldn’t make it a main cooking or salad oil. Toasted sesame seed oil is even a bit more risky because of the toasting process damaging more of the PUFA (and the protective vitamin E found in raw sesame oil).

      What are you wanting to use sesame oil for? Maybe I can suggest a skin-friendly alternative!

  10. Kris says

    Hi Devin,
    Great research, thank you for linking the sources. I’ve suffered with back acne for years. I eat a mostly plant based diet, so I’d call myself a flexitarian (95% plants, 5% grass fed-organic animal). Before that I did mostly Paleo, therefore lots of fresh plants, but still a lot of organic meat/poultry.
    From recent testing, I have low iron stores (ferritin), normal iron (since I suppliment), and low iodine (I now supplement—-boyfriend has shellfish allergy…). I take vitamine A and Magnesium as well.
    I’m game to try anything thats humane and organic even if its not a plant based suppliment, but I would be interested in the Frankin-rice you mentioned since I try to avoid dairy due to an intolerance (causes me inflammation and IgG testing shows markers). If the colostrum is derived from cows or colostrum is from humans, wouldn’t in theory the human one be closer to what we need? Albeit odd to consider!!
    I’ve also looked for a non-bovine ferritin supplement, but it seems I may need to take the bovine one as the plant ones are just more iron (leading to excess). I just want to be humane in my choices, with no added hormones from the cows, etc. With all that said—I’m open to anything—as my skin and other health issues are the number one priority! Any product tips would be greatly appreciated. I use Pure Encapsulations too. 😊 Thank you!

    • Devin Mooers says

      Hey Kris! Sorry for the epic delay on this, I haven’t checked blog comments in a long time. My fault!

      How low is your ferritin? Did you get liver enzymes checked? It’s quite possible to have low ferritin, but also have an overload of unusable iron stored up in your liver. Taking additional iron supplements on top of that, if that’s the case, isn’t a very good idea. Liver enzymes (and/or GGT) can help point to iron overload in the liver. (See my iron article for more info on tests.)

      What kind of iron are you supplementing with?

      Doubt you’ll find human-sourced colostrum, though it’s an interesting idea! 🙂

      Are you interested in lactoferrin for reducing your iron levels, or for boosting your ferritin? There are definitely other, more effective ways of modulating ferritin, I think (see the iron article linked above for way more info on all the iron stuff, including why I think many people may have an iron overload problem even if ferritin levels don’t show it). I’d target the iron-utilization-boosting nutrients listed in the iron article, personally.

      Also, how much iodine are you taking? What form?

      Finally, have you thought about A2 milk as a skin-safe dairy option, that would give you some lactoferrin in a whole food form?

  11. Donna says

    I actually test low for iron. My Tibc, Total Iron, Iron Saturation, and Ferritin are all low.
    It was recommended for me to take Lactoferrin with an iron supplement to properly increase my iron.
    I’m confused about your article because it makes me second guess my situation. You don’t believe ANYONE is actually low in iron?

    • Devin Mooers says

      Hey Donna! How low are we talking on these numbers?

      I definitely think there are a small number of people who are actually low in iron, but I think it’s probably a lot fewer people than most doctors think. Often, if you have iron dysregulation, excess iron gets stored up in your liver, which doesn’t show up one these blood tests. If you’re lacking in one of the co-factors necessary to use iron properly (vitamin A, molybdenum, vitamin C, copper, ceruloplasmin, vitamin B12, etc.), you can get excess iron deposits in the liver combined with low circulating iron. When you add a plain iron supplement on top of that, without addressing the deficient co-factors, you can worsen the problem. Did you happen to get your liver enzymes and/or GGT tested? That can sometimes indicate excess iron storage in the liver. But keep in mind I have zero clinical experience in all this and just going based on the all the research I’ve read (and my own iron overload problem).

  12. jay,s says

    hi, suffering from acne for 20 years and a rediculolus amount of money spent on “solutions”i tried a newer supplement that’s called acne block that contains lactoferrin,found it on amazon.. it actually was/is one of the only supplements I have tried that actually helped..

    • Devin Mooers says

      Great to hear you got good results from lactoferrin! The science is sound behind why it works, helping to reduce iron overload. Good stuff.

  13. Sara says

    Would eating liver or taking a dessicated liver supplement cause iron overload? I would like to get more vitamin A, but am concerned about the extra iron I would be getting.

    • Devin Mooers says

      Hey Sara! Wise to be cautious about this. Do you have reason to suspect you have existing iron overload? Curious about that, I’ve suspected that in myself for a while now, and have been avoiding liver for that reason. I’m taking Pure Encapsulations vitamin A instead.

    • Sarah says

      Suggesting vegans/Vegetarians have a greater risk of iron deficiency is incorrect. There are at least as many meat-eaters as vege people deficient in Iron. Meat is not an efficient source of iron for human beings. Cutting out animal products goes along way in clearing up acne.

      • Devin Mooers says

        Hey Sarah! I actually agree with your first point now, but differ in the second. I think many people, vegeterians and meat-eaters, have an iron overload problem. This is pretty new to me, but the research seems sound. Turns out you can have anemia AND iron overload, due to iron getting deposited in your liver, but a lack of nutrients that are required to put iron into hemoglobin, like vitamin C, vitamin A, molybdenum, and copper. I also think the research strongly points to heme iron from meat being an excellent source of iron – much more absorbable than plant iron – but I now think eating too much meat leads to iron overload, because your body can’t shut off absorption from heme iron like it can from plant iron. If you’re curious to learn more, I just posted a huge article on iron and acne two days ago:

        Iron and Acne

        I think this is really an unusual perspective, and the opposite of what most people will tell you! Curious to hear your thoughts! 🙂 (I’m actually eating mostly vegetarian these days, due to trying to reverse my iron overload problem, and, yes, the environmental impact.)

  14. Taylor says

    So if I maintain a Paleo/Whole 30 diet that includes high quality meats and seafoods and I do not eat any of the iron-fortified foods or foods that inhibit lactoferrin – my body should be creating lactoferrin on it’s own in a healthy manner and I likely do not need to supplement it, correct?

    • Devin Mooers says

      Yep, exactly! Historical iron overload can be an issue, less so for menstruating women due to the continual iron dumping outlet. Bloodletting was effective back in the day for many diseases due to iron removal! Men don’t have such a built-in iron removal system (perhaps explaining why men tend to live shorter lives than women – iron buildup!). I’m not 100% sure how effective lactoferrin supplementation is for addressing built-up iron overload. Morley Robbins (gotmag.org) is the guy to read about on all the iron issues.

  15. Christina says

    I’m confused. I was just about to purchase some FCLO for my teen daughter to help her with her acne and now I stumbled across your reply where you state you no longer recommend FCLO! Why the change?

    • Devin Mooers says

      Hey Christina! Sorry about the confusion here – I wish we could keep the same recommendations forever, but our knowledge (and the science, and reader experience, etc.) forces us to change our recommendations now and then, and it’s hard to change everywhere all at once! We changed this recommendation because FCLO is basically pure PUFA (polyunsaturated fat), which is more susceptible to lipid peroxidation than other fats, and this is a major contributor to acne, we now believe (lipid peroxidation). The vitamin A in FCLO tends to be very beneficial, but you can get that vitamin A from eating liver, taking desiccated liver capsules, or taking a vitamin A supplement such as this one by Pure Encapsulations. We now think it’s best to reduce the total body load of PUFA as much as possible, rather than trying to boost omega-3s, for instance. Does this make sense?

    • Devin Mooers says

      Hey Sam! That’s actually a really good idea. We currently do not recommend taking FCLO or cod liver oil – we’ve updated our book but haven’t found the time yet to update our cod liver oil blog post – we’ll do that soon! We recommend taking desiccated liver capsules or eating grass-fed liver regularly, or taking a vitamin A supplement like this one:

      Pure Encapsulations Vitamin A 10,000 IU

      Taking vitamin E is a great PUFA defense strategy when you’re eating out at restaurants or for some reason consume a large amount of PUFA. We’re working on a “PUFA Shield” supplement that incorporates full-spectrum E along with some other lipid peroxidation blockers to make it easier for travelers, folks who eat out a lot, etc. to avoid the worst PUFA effects on acne.

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