Insight into Acne. Why Dairy, Sugar, and Insulin Are Bad for Skin

acne from insulin and sugarIf you suffer acne or treat acne, then 2012 was an important year. That’s when this ground-breaking paper came out of Germany: Diet in Acne: Further Evidence for the Role of Nutrient Signalling in Acne Pathogenesis.

One sentence from the abstract says it all:

“Acne should be regarded as an mTOR-driven disease of civilization, like obesity, type 2 diabetes and cancer induced by Western diet.”

What is mTOR?

Don’t be intimidated by the biochemist-speak. In layman’s terms, mTOR is a sensor of food energy. Here’s how it works.

High energy foods like sugar and dairy cause increased levels of insulin, IGF-1 hormone, and mTOR, which is an enzyme. mTOR, in turn, stimulates keratin, inflammation, and sebum production—all of which contribute to acne.

mTOR is not all bad.  You need some mTOR to be able to build muscle. But too much mTOR causes acne, and eventually other conditions such as diabetes, PCOS, cardiovascular disease, and cancer.  You can think of mTOR and acne as an ‘early warning signal’ of metabolic dysfunction.  (Acne was nonexistent in traditional hunter-gatherer societies.)

Does inflammatory casein play a role in acne?

The research shows that dairy causes acne.  Insulin, IGF-1, and mTOR are the proposed reasons, but there’s more to the story. Many acne sufferers do improve off dairy, but some do not.  That’s where intestinal permeability, zinc status, and inflammation come into play.

Dairy can be highly inflammatory for some people and it’s all because of the A1 casein from Holstein cow milk. A1 casein causes inflammation and that inflammation coupled with mTOR activation is the perfect storm for acne. The A2 casein in goat, sheep, and Jersey does not cause inflammation. That kind of dairy is fine for skin and is a healthy food because of lactoferrin (discussed below) and fat-soluble nutrients.

When you stop eating sugar and milk, your skin should clear within 3-4 months. That is my overwhelming experience with patients. But you may need a little more help:

Effective natural treatments for acne:

1) Zinc. Hands down, zinc is the most helpful supplement. It reduces keratin production, so it keeps pores open. Zinc kills bacteria and reduces inflammation. Zinc is also essential for healthy ovulation, which increases estrogen, and reduces testosterone in women.

2) Berberine. During my 18 year career, I have consistently prescribed berberine-containing herbs (Goldenseal, Barberry, Phellodendron) for skin, and have usually had good results. Berberine improves intestinal permeability (and thereby reduces inflammation), has a local anti-microbial at the skin, and also improves sensitivity to insulin (thereby lowering insulin and IGF-1). Berberine also directly inhibits mTOR.

A recent clinical study found that just 4 weeks on berberine improved acne by 45 percent. I recommend berberine not be used for more than eight weeks continuously, because its antimicrobial effect may damage intestinal bacteria.

3) Lactoferrin is a dairy protein that is anti-inflammatory and anti-microbial. It has shown promise for skin. Lactoferrin is included in some probiotic formulas and follows nicely after berberine.

4) Reduce stress. Stress worsens skin because it disrupts insulin and female hormones and because it causes inflammation.

5) Estrogen reduces sebum production. That’s what the birth control pill’s synthetic estrogens do. Your own estradiol can work just as well but remember: The only way to make estradiol is to ovulate.

6) DIM (diindolylmethane)2016 update. After writing this post, I received many comments and questions about the broccoli-derived nutritional supplement DIM. It does work well for acne, and I have started to prescribe it more and more. It works because it is an androgen-blocker. DIM also assists in the natural detoxification of estrogen, but that’s a separate effect and is not why it helps acne.

Acne is not trivial, and as a doctor, I take it very seriously. Skin problems can damage self-esteem and happiness, but not only that. They often lead to harmful medications such as the pill, spironolactone, and the most frightening of all: Accutane (isotretinoin).

Avoid Accutane

The drug’s mechanism of action is to alter DNA expression, which means it targets the deepest level of your biology. Accutane also damages the hippocampus, which may be why it causes depression and is linked to inflammatory bowel disease and osteoporosis.

One of my patients intuitively said this about Accutane: “I felt its side-effects at my deepest soul-level.”

I beg you not to take it.

242 thoughts on “Insight into Acne. Why Dairy, Sugar, and Insulin Are Bad for Skin”

  1. I am at my wits end having tried all the tips, I take 30mg zinc with dinner, also magnesium, am on NAC, Berberine, licorice, peony, and more recently sporadic antihistamine. I have regular periods and confirmed ovulation at last period, period pain is much better after a lot of work with acupuncture, supplements and diet (sugar, gluten and dairy free), and the digestive issues I have had in the last couple of months (bloating, gas, diarrhoea, and constipation aggravated by painkillers for period) have improved a lot following Berberine and NAC, but my acne (mainly on my chin) keeps getting worse and angrier.

    2 dermatologists have recommended low dose accutane (one said 20mg, the other 5mg daily). I’m 45 and worried of permanent damage to my skin if I don’t follow their advice. Is accutane really so bad if taken at 5mg daily? Why would vitamin a (eg at 30,000iu) be any safer?

    Also, why does histamine issues flare at perimenopause if estrogen is actually reducing at that point? Perhaps I should be more consistent with the antihistamine- is there a time of your cycle you should take it? Just conscious I’m taking quite a lot of supplements. (Did try DIM but noticed a trunk rash after so have suspended)

  2. Hi Lara,
    So much of this article resonates with me. I have struggled with acne through the years and this has worsened recently, I suspect due to hormone changes associated with being in my mid-forties. I would dearly love to have some years without large swollen pustules, scarring, and redness on my face.
    Can you suggest a dosage for zinc, berberine and DIM that I could start with?
    The dermatologist has prescribed accutane (5mg Oratane) to deal with it but I’m very hesitant given your comments on avoiding this. Meantime I am on your waitlist just in case any spots open up.
    Thanks so much,
    Kind regards,

    (historical elevated testosterone but polycystic not diagnosed due to scan.. put on spirolactone but eventually stopped working at the maximum dosage. Prior to that a couple of nasty courses of Roaccuatne which worked wonders at the time only to have spots reoccur 6 months later. A history of severe period pain, which I have more recently managed to address with a lot of accupuncture (last couple of years) and chinese pills. Now the latter sort it out largely which is amazing! I’d love to see the same kind of shift with my acne while I’m still young enough to enjoy it. The dermatologist has prescribed accutane (5mg Oratane) to deal with it but I’m very hesitant given your comments on avoiding accutane. Meanwhile, the GP has suggested oral erythromycin and topical AzClear (having tried other topicals.. rosex, retrieve, differin, mino tablets etc)

    • Hi Rebecca, it could be worth looking at Olena Beleys website regarding caring for the skin. This is a huge component of healthy skin and is often overlooked. Hope you can avoid roaccutane, good luck, you got this!

  3. Hey Lara, just found your webside. I try to find out, if DIM could caused my mild thyroid swelling and problems swallowing. I took it a month in a higher dose (First DIM then Indol 3 carbinol) and ist helped me so much with my skin and hair problems after quitting the pill (was my second try). Can Iodine deficency be the problem? Of course I have an appointment with a specialist. Just hope to find a way to feel healthy, as I now stopped taking DIM all the skin problems and fatigue came back. I would be so happy if you could answer. Greetings from Germany, Eva

  4. I’ve successfully reversed insulin resistance (went low-carb & my cycles became regular) and I haven’t been eating cow’s dairy for 2 years. Also taking magnesium, zinc, vitamin D & K.
    I don’t have any major outbreaks on my skin anymore, but my forehead is still oily and “bumpy”, as if there are lots of small pimples. This started when I was about 10/11 and now I have the feeling it will never go back to normal 🙁 Any advice?

  5. Hi Lara, I really hope you could help me with this. I have suffered with acne all my life. Since I started following your blog I ditched the birth control pill 2 years ago. I have stopped consuming A1 milk and reduced my diary and sugar intake. I also exercise frequently and my eating window is from 12pm – 8pm. I currently take 2 capsules of Thorne berberine (over one month), zinc picolinate 50mg (1year) and magnesium biscyglinate 200mg (1 year). I know I ovulate because I check my temperature and Luteinising hormone every month and I have regular periods. However, I havent noticed any difference in my acne since taking these supplements. I am thinking about perhaps taking an anti-androgen such as reishi mushroom, given that I won’t be able to have doctor monitoring my progress with peony and licorice (financial reasons). Where I live blood tests without a referral are very expensive and I am poor student and my doctor is adamant to put me in a birth control pill, which I definitely don’t want. Could you please advise me whether reishi mushrooms would be an appropriate combination with the aforementioned supplements? Many thanks for the priceless work that you do.

  6. Years ago I went to a dermatologist and she recommended spironolactone. I only took it for a few days and thought I was going to pass out! I hated how it made me feel. I know it makes your potassium low. It was not worth taking!

  7. Hello! Can I ask, you say to take estrogen but below that you advice DIM also and there you say it detoxes estrogen… so is or is estrogen not good to take when you have acne?

  8. I have the same question. I cannot take berberine due to drug interactions, I’m wondering if Evening Primrose Oil is recommended.

  9. Hi lara,
    I find that when I start eating fruit my skin breaks out a lot. Is there any reason for this? Its making me so confused because fruit is supposed to be good for you right and you recommend a couple of servings because it can help with insulin sensitivity. Except whenever I have fruit (except low fructose ones like lemon, lime, avocado, tomato etc) I get bumps all over my face 🙁

  10. Dear Lara,

    first of all big thank you (from SLovakia:) for your book “Period Repair Manual”, which gave me first time in my life the hope for period health improvement and after 20 years on birth control (interrupted only by pregnancy and unsuccessful attempts to quit) finally also the courage to stop the pill.

    I am 45 mother of two and with many so called civilization diagnoses… Hashimoto thyrodithis (successfully treated with Levotyroxin), histamine intolerance and lactose intolerance (confirmed with tests by the allergologist), depression linked to long-term use of the BCP, SIBO linked to years of antibiotic use (tonsilitis, later bronchitis), PMS, …but the worst problem throughout the years was and is hormonal acne…That was also the main reason why my gynecologist repeatedly prescribed me the pill…
    A few months ago I quit cow’s milk and sugar, skin has improved slightly…I will stop the pill now, three weeks ago I started using DIM.

    In your book you are recommending for post pill acne DIM and berberine – is it safe to add also milk tistle? How to take all this supplement during the day?
    I already supplement zinc, selenium, vitamin C, E, some of B vitamins and probiotics, avoiding inflammatory food etc….
    I definitely want to add magnesium (possibly with P5P) for PMS and perimenopausal problems and my second question is:
    Do you think the amount of 10-25mg of B6 in P5P form per day during the luteal phase is sufficient to improve PMS-related problems?

    Anyway, thank you once again:)
    With your advice I have the courage to go into it and get off the pill.
    The final message from your book gives me the hope for improvement 🙂

    Best regards
    Hana Pingitzer

  11. Hi Lara! Thanks so much for your informative post, I’ve really enjoyed reading through your entire blog as a whole! I was wondering if you have any thoughts on or experience with evening primrose oil as a supplement? Is it known to increase acne or affect it at all?

    I have been suffering from some pretty bad breakouts, I believe it to be attributed to me stopped the pill back in October, and like many others here have been trying to fix things naturally! I started evening primrose over a month ago, but I’m not sure if it’s making things worse or not. Thanks so much!

  12. Hi Lara, thanks so much for this fantastic information.
    I have mouth & chin acne since turning 30. I presume it is hormonal. I have never been on the pill.
    Recently I have started evening primrose with vit B6, this has made it flare up more. I have just read that B6 can cause more androgens so I am stopping taking both. I have had acid stomach problems recently too. My diet is good, I am mostly vegetarian so I understand from your article that I probably need zinc. I dont eat too much dairy, I do have black tea with milk afew times each day. I could probably up my fibre intake.
    I wonder is ZInc and Berberine safe to start taking together?
    Will this disrupt my gut? do I need a Probiotic also?

    Thanks so so much,
    this is the best information I have come across in my years of research,

    • Zinc and berberine can be taken together. The main precaution is that berberine is not safe in pregnancy and can interfere with some prescription medications.

      • Thank you so much Lara. I am not taking anything else. So I may try to take both for a month or two to see if I notice any improvements in my skin. Happy new year to you! Thanks so much.

  13. I’ve been struggling with acne since I left the pill a few years ago. Now it is back again. I left sugar, gluten, dairy. I eat healthy, and also started taking zinc and magnesium, but it seems that it got worse since I started doing all this. The only thing that seems to cure my acne is saw palmetto, but I don’t want to take it because it decreases estrogen. Why did it got worse? I’m tired of this.

  14. What about help after taking accutane…. I took it as a teen bc of cystic acne and of course it didn’t work and a few years later another doctor said that was my only option and I was too scared to do it again. Any ways to undo the damage?

  15. Thank you! I have PCOS: since switching from Metformin to Berberine, my testosterone levels have DOUBLED. Horrible side effects. I’ve read that Metform ‘lowers’ testosterone, but Berberine does not. What a shame – I was really hoping Berberine would work for me… Any thoughts Lara?

  16. Hi Lara,
    Do you ever prescribe over-the-counter vitamin A supplements for treating acne, (assuming the patient is not trying to conceive)?
    I am unsure as to what constitutes a ‘safe’ intake of vitamin A and for how long it can be supplemented in the treatment of acne.

    • That’s a very good question. I sometimes prescribe 20,000 to 30,000 iu for a few months. But advise patients that they should stop if they become pregnant. Thorne makes a 25,000 iu capsule.

  17. Hi Lara,

    I am 31-years-old and I haven’t had a period in 3.5 years since coming off the pill.

    I’m struggling with severe/persistent acne (approx. 20-30 large whiteheads, pustules and painful cysts) around my mouth/jawline.

    I have Hashimotos thyroiditis (this is under control since I started medication in January 2018). Ultrasounds reveal ‘mild’ PCOS (13-17 cysts per ovary), but I know you said there are better testing methods.

    My blood test results over the past few years reveal ‘normal’ hormonal levels and reasonably normal thyroid levels. My thyroid antibodies were up for a while, and my IgE is always high. My zinc goes up and down.

    I’ve tried gluten-free, low-histamine, and dairy-free diets for a long time.

    I’ve been taking a Candida supplement for 2 months and not seeing any results (my husband has seen incredible results in terms of weight, brain fog, anxiety).

    Can you please let me know if the following mix of supplements are ok to take, or if I should substitute for something else?

    – DIM (200mg) for 6 months
    – ‘Candida complex’ by SupplementsYou (antimocrobials) for another 6 months (8 months total)
    – Zinc citrate 1 cap 15mg
    – Magnesium citrate powder (2 spoonfuls)
    – Calcium citrate powder (1 spoonful)
    – Magnesium + B6 supplement (150mg + 1.4mg respectively)
    – Digestive enzymes and chlorella powder for digestion
    – Probiotic (can you recommend a good one)?
    – Should I add a ‘liver detox’ supplement like Isabella Wentz recommends – ‘Liver Reset’ by Rootcology (contains Vit A, B, C, D & E, NAC, Quercetin, Biotin, Folate, Calcium, Iron, Magnesium, Zinc, Selenium, Iron, Milk Thistle, Inositol)

    I wish I’d read your book years ago! I’ve been recommending it to everyone.


  18. Hello Dr. Lara,

    Thank you for the informative post. You seem to be one of very few doctors who acknowledge and understand post-pill acne very well. I have been struggling with hormonal acne since more than 1.5 years. Before that, I had clear skin all my life (I just turned 29). I took BC pills for 15 days in Jan 2017 and since then I started getting acne, however, it started to worsen after 6 months when I started getting cystic acne. I am still battling with angry, inflamed acne. I had ultrasound and my left ovary is bigger than the right one but the Gyno has ruled out PCOS. BC has triggered this massive chain of acne.

    Nuts and flaxseeds break me out right away. I have tried various supplements; berberine quickened my heartbeat and Omega 3 fish oil gave me under the skin bumps on my forehead. Probiotic wasn’t a massive help either.I am now taking zinc and vitamin D, it is helping somewhat but I still get acne. I avoid dairy and sugar for the most part. I have become very depressed because of persistent acne and losing the will to carry out daily acitivities. Is there any way out? Can you suggest anything? I am running out of options to clear this pill-induced acne.

  19. Hey Lara! I was wondering what you would recommend more (berberine or DIM) to help with PCOS (high androgens) related acne? Also could I take both at the same time or would you recommend one over the other? thank you!

  20. Hi! I’m glad to have found your blog. I’ve struggled with hormonal acne since I was teenager. I was on spirolactone from 2014 to 2015, which completely cleared my skin. Wanting to be more natural, I stopped taking it in May of 2015 and by that November the chin acne was coming back. I’m off all birth control to try to be off any hormones, and even a year later still getting acne on my chin. I’ve been taking saw palmetto as recommended by a Chinese medicine doctor for about 6 months, which has improved the painfulness of the cysts but has not healed it. If I know spirolactone 100% clears my acne, do you recommend any natural supplements? I did a blood test about 6 months ago with everything coming back normal. I was slightly deficient in vitamin d, b12 and omega 3, so have been taking those vitamins, but all hormone levels were in normal range. I work out about 5x a week and am in shape. No signs of insulin resistance and I eat healthy. Please any advice is very appreciated!

  21. Hi Lara, do you know any products that remove copper from the system? I have been taking metagenics zinc for the past two years, to still have low zinc levels on my blood test. My zinc was 12 umol in February and just got it retested and it is still 12umol. My copper is 18umol. What is the ideal zinc to copper ratio for blood tests?

  22. Hi Lara,

    I have been struggling with excessive sebum on my scalp for almost two years – this started exactly 2 months after quitting ortho-tri in December 2015, which I had been on for only a year and a half. In April I did a 30 day elimination cleanse of sugar/gluten/dairy/alcohol that greatly helped with my skin (I was also battling acne for the first time ever, which also started after quitting the pill)…I have more or less continued with this elimination cleanse, but not quite as strict. I’m focusing mainly on nutrient rich foods and

    however, I have yet to see any benefits for my hair. I still lose hair relentlessly, the color and texture has completely changed, no luster or shine, and my hair feels like it’s coated in wax, in as little as 12 hours after showering. It hangs limp and lank and flat on my head, has thinned dramatically, is wispy at the temples, and I can pull out the tiny baby hairs on my hairline without even a bit of discomfort – they just come right out with the slightest tug.

    I originally blamed birth control and the sebum up regulation period that you describe in your book, and did my best to wait things out……however, my periods have been pretty stable for the past 16 months, it has been way more than a year of this, and while my acne has improved slightly (combination of intense skincare line + healthier diet), my hair is still a disgusting mess. I have seen five different doctors who have all done the same tests, and all said that my thyroid is fine. However, as you will see below, there have been some fluctuations….like my thyroid is sputtering. I briefly took a natural thyroid grain November-January that was supposed to help….but instead my TSH went UP (note the March bloodwork.) Why is it sputtering back and forth like this? Is there anything else I can do to help with the scalp sebum? It seems clear to me that this is a direct manifestation of an internal hormonal imbalance, or some type of triggered reactivity that I didn’t have before…..I just can’t figure out what! Any advice would be so appreciated.


    July 2016 2.85
    October 2016 2.51
    March 2017 4.72
    May 2017 1.670
    August 3.45

    Free T4

    July 2016 1.19
    October 2016 1.42
    March 2017 1.16
    May 2017 1.16
    August 1.28

    July 2016 55
    October 2016 55
    March 2017 56 (after 3 months daily supplementation)

    Other current levels, as of May 2017
    B12 907, Vitamin D 40, platelets 141k, negative for celiac

  23. I read that you recommend Thorne brand for zinc. Is there a reason for this recommendation? Are they better quality supplements with higher efficacy?

  24. My acne was so severe that my only way out was isotretinoin… absolutely nothing else worked. My skin was getting damadged and it was hurting me. My organism is responding greatly (im almost in the end), and after the treatment i’ll try the zinc for manteinance. Thanks for the tips!

  25. Hi Lara,

    I have PCOS and have struggled with acne for about a year now. I get it along my jaw and across my forehead. I went to see a naturopath in December who put me on various herbal formulas and supplements and sightly helped me for a while only this year she put me on Vitex which made everything a lot worse. I stopped seeing her and am taking all the supplements you suggested and have been for at least 3 months now. I am also doing all the dietary advice too you mention in your book for optimum period health. Only I can’t see any noticeable changes. I’m at a bit of a loss and have decided to go to the doctors for help as I don’t want my acne to get worse. They have put me on an oral antibiotic. Should I be taking a probiotic with this? Thanks for your help.

      • Yes I quit all forms of sugar and diary products except for butter which I still eat. I am wondering if my PCOS might be caused by something to do with my thyroid as I’ve tried everything else possible. How would I find out about this? If you have any other suggestions do let me know.

        • I’ve just checked actually and my doctors did do a thyroid function test and everything was normal when I had my hormones tested in November. So I’m still at a loss of what could me causing my PCOS. I have been taking the supplements you suggested in your book for insulin resistance and have been noticing some good changes. I am eating less during meals and feeling fuller for longer now. If you have any more suggestions on what I could be doing to heal my acne do let me know. Thanks, Eleanor.

  26. The article you site is not at all about DNA damage, it’s about the changing in expression of genes. Very spurious journalism….

    • Thanks for your comment. Yes, isotretinoin induces epigenetic changes, or what I would refer to as epigenetic damage. I’ve revised the post to read “The drug’s mechanism of action is to alter DNA expression”, which hopefully is more clear.

  27. Hi Lara.
    What could/can be the reason to repeatedly getting blackheads? I’m on a dairy, wheat and sugarfree diet, but my blackheads still keeps coming every day. They are so deep and stubborn it’s driving me mad!. I’ve read it could be because of elevated androgenes, but could it also be because of the liver?

  28. Thanks SO much for your book, Lara!! I have IR PCOS. I just finished my third week gluten- and sugar-free (was already dairy free). I began the zinc picolinate, berberine, vitamin D, and magnesium glycinate regimen, and am already a long-time DCI user. Unfortunately I have started feeling very dizzy, even on my off day for the pills. Any thoughts on what I could be doing wrong?

    Thank you much!!

    • If you think it could be a reaction to the supplements, then best to stop them all for a few days. If the symptoms subside, then try reintroducing them one at a time.
      And of course, make sure you’re eating enough food including meat and vegetables and starch.

      • Thank you much! I’m vegan, but since starting the GF, sugar free diet I’ve upped my intake of protein and healthy fats. I’ll try removing and reintroducing the supplements as you suggested. Thanks again.

          • I’m using beans and lentils (main sources), soy products (moderately), plus nuts (peanut, tree nuts), seeds (chia, hemp, sesame), grains (like quinoa), and the protein found in veggies. In addition to my regular meals I also have a daily veggie and fruit smoothie. Before the GF diet I also used a lot of gluten in my meal planning.

          • Soy can suppress thyroid function, so you may want to check in with your thyroid with a blood test. And while you’re at it, maybe test for vitamin B12, which is always deficient on a vegan diet.

  29. Hey there!
    Thanks so much for this information, I have found your website very helpful!
    As a teen my period was very irregular, I skipped months all the time. It never was a major problem, and then I started getting acne just after my senior year. I started birth control and it “worked” but now I am trying to come off it. What I am wondering is, should I be trying zinc etc. for the acne or would the irregular period be contributing to the acne (and should I therefore try an different approach)?

  30. In regards to acne pre-Pill, how many milligrams of zinc and berberine would you recommend daily? I am seriously considering not going back on the Pill (I am off for my week currently) because my acne seems to be growing immune to the hormonal benefits of it. I don’t want to rely on the Pill for acne treatment forever, as I don’t need it for anything else. I’ve ordered both zinc and berberine. Should I begin taking them immediately and continue the Pill for another month so my acne doesn’t explode?

    • Also, I don’t want to continue on the Pill because it causes my scalp to be VERY dry, itchy, and horribly flaky. I never had to deal with that before taking it :-/

  31. Lara why don’t you recommend vitamine-c in your period reapire manual? Is vitamine-c a good chooce to use as a daily supplement whan having acne?

  32. Hello Lara.
    Does dim downregulate estrogen? Or Do it upgrade to high estrogen? All the info out there on dim is so different. Dim makes my acne better, but I get bad symptoms when taking them: sleep bad at night, dry skin, feel bloated, feeling dryer in my vagina during sex, have burning pain in my bladder.

    • DIM blocks androgen receptors. As a separate effect, it promotes the healthy detoxification of estrogen.
      Generally, I would say that it should not push estrogen below normal, but occasionally I encounter women who’ve had estrogen-deficiency side effects like you describe. In that case, I usually recommend to stay at a low dose. 100 mg per day, or less. Maybe 100 mg every second day. Also, some popular DIM supplements also contain I-3-C (indole-3-carbinol), which I do not recommend.

      • Do you have a go-to formula that you prescribe your patience? I always get back fluid retention and breast tenderness combined with my acne.

  33. Hello Dr.

    I’ve been treating my acne with zinc, magnesium , probiotics and DIIM with great resault. My acne is gone. But I always get breast pain and fluid retention (in my face) 1-2 weeks before my period. I’ve read your book and read that iodin is a supplement u subscribe often. Could this be a solution or is there a better supplement for my problem? I would highly appreciate an answear 🙂

    • Wow!!! this is exactly what is happening to me!!! I am also taking all of the above and got fluid retention in my face. What can be done to prevent this? my right cheek is so puffy that it really make me feel unattractive!
      Doctor please help me!

        • I’ve been treating my acne with zinc, magnesium , probiotics and DIIM. my Acne is gone!!! but I have fluid retention in my face. would that be a side effect from the DIM supplement that I am taking?

          • Oh holy! I also get fluid retention in my right cheek 1-2 weeks before period! How is this possible that our symptoms match like this!! I’ve also thought of the din causing this, but what supplement can be applied to prevent this?

          • I am shocked!!! Eva, is there a way that we can connect? I already made an appointment to see my family doctor next week for the swelling in my right cheek! I am really starting to get the feeling that this is a side effect of the DIM!!! I was so excited to finally be acne free, but this side effect is really hurting the way I look!!! it gives me moon face!!!

  34. Hi,
    I was hoping you could help me. Ive been suffering acne all over my t zone for three almost four years straight since I was 17. I’ve tried so many things. Nac, Zinc, dim, inositol, vitamin d and A, standard fish oil, oral antibiotics (just once recently cuz I was desperate) plus topical treatments like duac, zyneret lotion, retinoids, linoic oil cleansing exposed skin kit etc… My hormones have been checked. I had really high prolactin at one point tested at (850) but now it’s apparently almost normal level again(410). otherwise everything is fine…but it’s not fine. I don’t eat wheat or dairy. I even tried a sibo diet with herbal anti micro balls cuz my stomach is constantly inflamed…I’m just really unsure what to do. My period does come but it takes a really long time, I go from 16 days to 56 day cycles with no rhyme or reason.
    Right now I’m trying borage seed oil with vitamin d and a. I have to take vitamin d cuz I keep dropping to insufficient levels really quickly.
    I’m just really depressed by the whole thing. Every part of me seems broken in some way. The doctors want to put me on birth control but I really want to fully fix myself I just can’t figure out how. Nothing seems to work.
    Thank you for your time

  35. Dear Lara,

    It is simply not true that accutane’s “mechanism of action is DNA damage.” If that were the case it would cause cancer; in point of fact, accutane is a treatment for certain kinds of cancer.

    The scientific paper you cited discusses changes in gene expression while taking accutane. This is neither surprising nor concerning; it simply means that different genes are being used by cells. Modifying diet and lifestyle also causes changes in gene expression. Altered gene expression is in no way equivalent to DNA damage.

    All the best,
    Beth Birch

  36. everytime i take b6 combined with magnesium and vitamine c to boost my low progesterone, but everytime I take 50mg b6 I get acne. Why is this? Is there anything else i can take?

  37. Hi!
    I am blown away by your website!!! I have a severe acne flare up on my chin. I am interested to try the Berberine supplement. can you recommend a good brand for this supplement? and also how much of it to take per day?
    Thank you so much!!!

  38. Hi, My acne is directly correlated to what I eat. I’ve found that i can eat some carbs just not as freely as before, but still can’t have fruit high in fructose at all, or I get acne immediately. Based on my symptoms and reaction to sugar/carbs, I figured it must be insulin resistence–and it quite possibly is. My question is, since I’m a 5’4, 31 yr old who’s hovered around 110 pounds since I was 13 and do not have pcos, and I have a small waist… is it still possible for me to be insulin resistant? My period is like clockwork (although since the pill considerably lighter) . A friend of mine brought up the notion that maybe I have some kind of fungal/bacteria going on? I do not have candida, in fact I cleared up a problem with it 5 years ago with a strict diet and have been generally a clean eater since. I know I should get bloodwork done to see if I’m insulin resistant, but I’ve had bloodwork done before and doctors never said anything was abnormal, and unfortunately I am uninsured at the moment so it’s just not feasible. Trying to play health detective on myself 🙂 Would it be harmful to proceed with supplements as if I did have a fungal/parasite issue just to have my bases covered in case that’s the issue? Thanks! Just trying to get on track so I can eat watermelon and cherries again!!!

  39. Hi Lara, I have suffered with acne for over 20 years. I went on the pill in my late teens for this reason. Over a year ago, I quit the pill and my acne has returned with a vengeance as well as extremely oily skin. I have had my hormones tested and I have normal androgens levels but low progesterone. I have worked with a naturopath over the past year but the results are minimal to short term at best. I was taking vitex for 6 months as well as zinc, magnesium and a methlated B vitamin complex as well as diet changes such as no dairy, low sugar etc. Did a 2 week course of Bactrex which cleared my skin temporarily.
    The dermatologist advises that I have over active sebaceous glands and can only recommend Roaccutane.

    My skin is super oily. I have acne on my face, chest, breasts, neck and back as well as permanent scarring. My periods are regular and pain free. My naturopath doesn’t think DIM will help me based on my blood results and keeps advising I take zinc even though i have seen no results after taking them for a year. I am currently on another course of Bactrex and may return to vitex after that. Is there anything you can recommend which will work long term? I don’t want to take Roaccutane but the state of skin is doing my head in and I feel like I have no other options left.

    • You’d probably know if DIM helped within a few weeks of taking in, so it wouldn’t be a commitment to buy a bottle and see how it works. If after a month it’s not helping then I wouldn’t continue using it, BUT I’d def stay on the zinc during this. I used pure encapsulations DIM detox and it worked pretty great for almost a year. Like miracle great. But then for me it stopped. It could have been that I started eating poorly or that I was under a crazy amount of stress, but for whatever reason I’ve had to find other solutions. Through my ups and downs with supplements I’ve found that the only sure fire way to clear my skin is with an incredibly strict diet. It may not work for everyone but it did for me and one of my close friends.. basically a ketogenic diet… and if it works you’d know by a couple weeks depending on what your current diet is like. Berberine was helpful for me but I think I was eating too high carbs and too much fruit for it to be effective long term. I did acutane ten years ago it’s not the answer at all. The fastest things that worked for me were diet and Berberine, but like I said, you can’t take berberine and eat a pint of ice cream of pastries etc. It probably won’t be much help long term with a highly processed/high sugar diet.

  40. Hi Lara. I know this may be a silly question but I want to be safe. I just started taking berberine along with a paleo diet and I dont usually drink at all but is it ok to occasionally have a glass of wine while on berberine?

  41. Dr Briden, Is it safe to take DIM while on Clomid? I can’t seem to find much information about this online. My doctor doesn’t seem to know much about DIM supplements.

    Thank you!


  42. Hi Dr. Lara, I’m 9 days into this keto diet and my skin is transformed. Within two days I noticed I wasn’t getting any new breakouts. My concern is, today I noticed my hair was shedding considerably more than normal.. I looked online and apparently it’s a normal side effect from a low carb diet, which is incredibly distressing as I already went through this on the pill, it’s in fact the reason I got off it a few years back. I’ve been able to find ways of eating a normal amount of calories but I guess there’s more going on than just that. Any suggestion? I really thought I had cracked the code for my skin.

    • A low carb diet wouldn’t cause hair loss that quickly. There’s always a delay, so it would take a minimum of 6 weeks.
      What was happening with your health about two months ago? (medication, dental surgery, heavy periods, virus etc). That would be a more likely explanation.

    • That said, a low carb diet does often eventually cause hair loss in many women. There’s usually a happy medium somewhere. Cut fructose and wheat, but eat Gentle Carbs, and skin should be happy.

      • Thanks dr. Lara. I think what’s most surprising is that I hadn’t consumed dairy, with exception of butter, in years and now that I’m not having any sugar I’ve allowed some cheese every now and then with no ill effects! Just surprising! I’m slowly allowing healthy carbs like oats back into my diet.

  43. Hello Lara, thank you for your articles. Could I ask you what kind of zinc (opti zinc, zinc piccolinate, chelated zinc… or etc) would you recommend for helping acne? Which is the best form? There are many forms now, and there is very difficult to choose. What are the differences between it? I am struggled with acne all my life. I used to take DIM. It worked very well on me. I also experienced little less breast tenderness before periods, when taking DIM. Although it didn’t gone completely. But it was milder than without DIM. Now I make a break from it, and try to take Vitex for pms, depresive mood (and acne). But it is too early to say it works or not. I am 34 now and have 2 children. I guess my problems are somehow caused by hormones and by lack of minerals. I also struggle with pms. And all my life, since childhood I have hang nails. I also drink magnesium citrate, vitamin D and vitamin B complex now, as I read in you vise blog. (I hope I am drinking and are going to drink not too much supplements (?) ). Magnesium helps very much for legs cramps at night. I also will order iodine supplement. Thank you, if you could answer me. Best regards, Aurelija.

  44. Hi dr. Lara, I’ve had a tug a war with acne forever. Some things gave me relief, like DIM and berberine but never long term. I know diet is critical in staying clear and while I never have dairy and try to stay low sugar, sometimes I’m not as strict on my fruit consumption as I’d like. I recently decided to try a ketogenic diet because it cleared my friends skin, and after 3 days, I’m almost clear. My question is, how many carbs is a safe amount for someone who is apparently super sensitive skin-wise? I’m consuming about 18 a day, maybe 4 grams of sugar. Before I ate rice and beans almost every day, but based on how I’m reacting to cutting those carbs I feel like I have to be cautious of them as well as sugar in the future when I try to have a more sustainable diet. What do you think?

    • I forgot to mention that I’ve been gluten free for years and off the pill for 3 years. I also supplement with magnesium and zinc.

    • Thanks for sharing your experience about your skin clearing on a very low carb diet. It’s possible that you will be able to reintroduce some starch after your skin has been clear for some months (and once your insulin sensitivity has improved). Do you know if you were insulin resistant prior to starting the ketogenic diet?

      • I don’t think so. I’ve been thin my whole life and never had diabetes or the symptoms I found associated with insulin resistance. The trickiest part of this diet is getting enough calories while having so few carbs.

  45. You mentioned Berberine should not be taken more than 8 weeks at a time due to it being an anti microbial. Does the same then apply for Lactoferrin? I’ve been taking both!

    Thank you for all that you do, you’ve been a huge help for me in many ways!

  46. Hi Lara! Your blog is very interesting! I ceased taking birth control in October 2015. Since then, I’ve been experiencing with more natural approaches to my acne, but I’ve since been dealing with very oily skin, worsened acne, air loss, and wrinkles, all things brought on by stopping BC! How much zinc would be beneficial? Should I take all suggested supplements? I feel as though I’m grasping at solutions and spending lots of money on things that don’t work. Thank you!

  47. Hi Lara this is Katy we have talked before and I ended up started taking Yaz but I just want to let you and the other followers that I had to quit in a week . I felt horrible , chest pain and felt like I could breath I have never suffered of anxiety and now I know when my patients told me that they felt had like a rock on top of their chest. Please do not take Yaz it can kill you. Anyways I broke up more after two weeks but I started taking Zinc Picolate and Estro block regular one pill for the first week then bump it to two. My skin is much better, almost clear I also drink a tea for liver support. My question is if you recommend to bump to Estro block pro just one pill a day since it is triple dose. Please advice

  48. Hi Dr. Lara,
    Your blog has been a huge help. I’d like to ask whether it’s common for skin to, in addition to acne, become very DRY and flaky after coming of birth control? I’m also wondering if it’s common to become really sensitive to topical skin products ie: moisturizers ( that used to work just fine )?

    • Yes, the skin can change in different ways when stopping the synthetic estrogen of hormonal birth control. It should improve once you start ovulating and making your own estrogen.

  49. Hi Lara!
    First, your blog is extremely helpful!
    I would love to hear what dose you recommend for lactoferrin? I am taking 500 mg a day.
    And is it okay to take both berberine and lactoferrin?
    I am also taking 400 mg berberine a day.
    Kind regards 🙂 🙂

  50. hi lara, i found a supplement similar to Estroblock called DIM Plus by Nature’s Way. i am very reluctant to start taking it as i am not sure if i am estrogen-dominant or deficient. how would i know if this is the right supplement to take for my acne? will it make my acne worse? if it does get worse, can i stop taking them immediately? will my hormones get even more out of whack if DIM Plus is not the right thing for my body? what other risks are there of taking DIM Plus? thanks in advance 🙂

    • To be honest, DIM is almost always helpful for acne. As long as you have enough estrogen to ovulate, then you probably have enough estrogen to take DIM. But please speak to your clinician about it.

      • thanks for the reply. i started DIM Plus 3 days ago and also incorporated a Burdock Root supplement for liver support. i plan on adding Alive Women’s Multivitamin to gain more vitamin support for my body and hopefully my skin. i want to incorporate Zinc as well. do you think a daily multivitamin is “enough” or should i take Zinc in its individual form to aid my acne? the Alive Multivitamin contains 15mg of Zinc Gluconate per serving. also, is DIM, Burdock Root, and Zinc “too much” to ingest daily?

  51. Hi Dr Lara,
    You and your blog are blessing for me. Thank you from the bottom of my heart!
    I’ve got one question – what do you think about taking Vitex, Zink, DIM and Berberine at the same time? Do you think it’s a good combo?
    I will be grateful for your answer.

    • Vitex can sometimes be a problem for acne, so I would rarely prescribe it at the beginning of treatment.
      But yes, generally berberine and zinc can be taken together. But please check with your clinician to see if they’re right for you.

      • Thank you so much for your answer.
        You wrote that Vitex raise LH and lower PRL. My LH is quite low: 5,8 and prolactin is quite high: 43. Is it steel a risk?
        Unfortunatelly my clinician’s advice is going back to the pill…

          • Lara is it possible that DIM messed up my period?
            After almost 15 years I went off the pill. Thanks to flaxseeds and maca for 5 months my period was almost perfect – every 28-30 days (I tried to go off earlier with no help of maca and I had acne and no period for a long time). Then because of severe acne and hair loss I decided to take other supplements. I started from Vitex and Berberine. My period was ok. After 1 month I added DIM and Zinc and now there has been no period for almost 40 days. What happed? Could DIM or Zinc be dangerous for period? Please help, I did everything you recommended (supplementing, going dairy, sugar, even gluten free).

          • It’s more likely to have been a problem with Vitex, especially if you have any PCOS tendency. Have you seen my Vitex post?
            Generally, DIM and zinc do not affect the timing of the period.

          • Yes, I’ve seen it. But I thought that if I have quite low LH it would work for me. Would you recommend to go off Vitex completly?

          • I can’t give you specific advice over the internet. I can just say that Vitex is a tricky herb to use, and if one of my patients experienced menstrual irregularity on it, then I would probably advise to stop. Probably best to check with your local herbalist or naturopathic doctor.

          • Hi Lara, unfortunately it wasn’t Vitex. I stopped taking it and my cycle was 33 days but the next one was 47! I have no idea why. I did everything you recomend to promote ovulation (for my skin and hair) but it didn’t help my skin and now my period is messed up. I feel helpless…

          • Where are you located? I might be able to offer you a Skype consult. Please email me from the email link on this blog.

  52. Hi Lara thanks for your posting so helpful first I feel somebody got all the problem of PCOS and androgens well define
    I am a RN who is fighting for more than 25 years with acne, hard to be pregnant and miscarriages. I was diagnosted with PCOS I am now 43 and after OCP for mane years, hormones treatments, 5 artificial insemination and one failed IVF and my doctor blamed me for the quality of my egos but thanks God pregnant naturally at 36 and have a beautiful daughter now, one child ?.
    After that 2 miscarriages with no explanation, all good with my labs
    Now a couple years ago I feel things are changing, started feeling bloating, breast tenderness and acne flared up like teenagers, oil skin again, and more acne flares around periods that heal and then here we go again for next period. So I decided to give a shot to OCP again but got the low dose so no good, took it only one month then I convinced my Pcp do all my testing testosterone, free and total, tsh, even dhea all normal. I am trying now Vitex and Maca that I have been taking for years and it seems to help but I want to try Vitex. For how long do you recommend to take it and should I try this Vitex first and then DIM
    My diet is super clean, green juice three times a week and very minimal dairy.
    Please help ????????

    • Hi Katy, as I explain in my PCOS post, Vitex is not my first choice for Type 1 classic PCOS (if that’s what you have). Do you have insulin resistance?

      • Thanks Lara I am not sure but I am thin and don’t have the typical POCS type one I never really fell under any type especially now that my labs are normal even the DHEA which I always thought I was adrenal since I had a dermatitis once and I took steroids for one week and my skin was all clear and dry. My glucose is normal and I am borderline lower BMI for my height, 5 feet.
        But I have to say that I bough Vitex Gaia brand at sprouts and I took the dose recommend 1000mg I felt horrible, thought I was going to pass out, heartburn and then chest pain I was so scared
        I try the next day so stubborn thinking I got too much dose and I did only one pill and less heartburn but still this weird cheat pressure. I am sorry that I can go natural
        Oh and I forgot my prolactin is 35 I was dx also with micro adenoma about 15 years ago, was taking cabergoline and stop about 5 years after due to clear MRI but now I guess it is a little elevated
        My hormones are disbalance but I think it is because my age 43 and maybe I am going perimenopause so o decided to go western and take the Yaz for a couple years to see if this will help with acne and PMS that is driving me crazy and my family as well ?Thanks Lara

          • Yes i just started yesterday to give it a try I did try Vitex as I mentioned but I still have some tummy ache I am not if for the Vitex or the Yaz now but thanks God chest pain is gone I was really scared and I am a nurse but I guess at this point I try natural and did not work I don’t like OCP but I have to give it a try for the sake of my face, I just want to have normal skin before I get too old ? I am not sure if I am too vain or what but I have been fighting acne my whole life and only OCP and pregnancy had me right for a couple years, also my irritability is pretty bad before my period so I hate myself pretty much those days I can’t imagine how my husband deal with that and I have a 6 years old ?
            What do you think ? again all labs are good I can send you a picture of the result but my LH is lower than my FSH
            Like 1:2 ratio LH 3.44 FSH 6.99 prolactin 35 normal DHEA and normal testosterone but acne and mild hair on face my back is all clear only my face

          • I took low dose of ortho cyclen back in March for one month because I could not stand the breast tenderness and the sad feeling, then I went to my Pcp got the labs 2 days after last pill, the FSH and LH was on day 3 of my cycle but after about 6 days of the last pill of ortho cyclen lo. I got a call from my doc today about my prolactin of 35
            He wants to check it out again and send me for MRI for my hx of adenoma.
            I started Yaz last Sunday 5/ 15 to see how it goes because I start breaking out again a lot on my forehead and some cyst around my chin.
            I don’t know what to do I really hate to be on the Yaz. But what else I could do
            Do you think the high prolactin is that high that is giving me all this breakouts. I ask my doc to test testosterone again but I am not sure if it will be affected by drosperidone.
            Do you know why drosperidone is 3mg everyday, it seems high dose to me for a progestine.
            Thanks for you time Lara. I just want to know what is not in balance for me

          • Hormone tests don’t mean anything until you’ve been off the Pill for at least 3 months because the Pill suppresses all hormones, except for prolactin, which it elevates. (so your elevated prolactin could be because of the Pill. Your doctor may want to look at this study: Effect of oral contraceptives on serum prolactin: a longitudinal study in 126 normal premenopausal women

            I know that makes it very difficult to know what’s going on. Did you see the acne-Pill conversation my Facebook page yesterday. A few women shared their Pill-withdrawal acne stories. Because Pill steroids suppress skin oils so strongly, the skin up-regulates sebum production, which makes it very hard to stop. Essentially, the skin becomes addicted to the pill steroids.

            The only treatment that I’ve found to work is to do the treatment that I explain in the post: 1) dairy-free, sugar-free diet, 2) zinc, 3) maybe DIM and/or berberine, and do it for a couple of months before stopping the pill, and then continue for at least 6 months. It works best if ovulation (and hormone production) can be reestablished as soon as possible.

            Please understand, this what works generally for my patients. You are not my patient, so I cannot give specific advice. Please consult your local clinician.

          • Well I only took the pill for a month so maybe the prolactin was so much affected,in the study stated 3 month and 12 months and the increase was very minimal about 3 points my prl was 35 comparative with last year around same time 24; and the fact that I have the hx of adenoma confirmed with MRI made think perhaps the adenoma is coming back and that is preventing ovulation even though I have my periods every month. In your experience do you think moderate elevation of prolactin affect testosterone so maybe that is the bottom line of my acne coming back. I really need your opinion, you seem very well informed about this issues. I hate to be in Yaz so I will start with the alternative regimen you suggested zinc ( but how much ) diet and bernerine or DIM or should I do both. I mean bernerine and dim or just one and zinc
            I also take probiotics everyday I never get sick with that
            Thanks so much for helping me I really appreciate a lot your time even though I not your patient. I am moving to Okinawa next month so I make sure I will keep you in mind, maybe you can see me as a long distance . One more thing any brands yo I would recommend for dim and bernerine and do you supplement zinc with cooper since it depletes that mineral

          • Hi Katy, as much as I’d like to help you more, it would not be responsible of me to provide you with individualised advice or doses. Obviously your step is to follow up with your doctor and investigate the microadenoma. And then take it from there.

          • Thanks Lara for your help I do understand your position. I will try to get in contact with you when I am in Okinawa maybe I can travel to Australia my husband will be there in July
            Thanks for all you do

  53. Hello 🙂
    What is your thoughts on estroblock and chaste tree supplements for acne? Do these help? And how much zink should be taken per day when you have cystic acne?

    • Hi Hilde, I’ve had many question about DIM (diindolymethane) — which is the main ingredient in Estroblock. Yes, it works well for acne. I’ve just added it as supplement #6 in the post.

      • Hi Dr Briden,

        You mention DIM is a good way to fight acne bc it’s antiandrogenic. Does this make it a good supplement to use while weaning off of spironolactone? Thanks in advance.

          • Thanks for answering:) I have been using estroblock pro (1-2 tablets a day) since Christmas along with zink, c-vitamin, probiotics and Thorne S.A.T as I read on thelovevitamine, then for a month ago I added chaste tree, and my acne has improved but not nearly gone. I still get a lot of cystic acne around my jawline and neck every week. And some blackheads in my forehead, chin and also jawline. Often the blackheads turn into acne. I’m so frustrated and unhappy! Been suffering for 6 years, and here in Norway all the doctors only want to subscribe accutane… I’ve been using thousands of dollars to try cure my acne. I’m on a strict diet too: no dairy, milk, sugar (been doing this for about a month now). What am I doing wrong? I have noticed that mye acne gets worst before period. I have taken a hormonal test, and that came back normal my doctor said….

          • One month is not very long to have been off dairy and sugar. You probably need more time.

  54. Lara thank you for your blog. I am finding it very fascinating. In regards to taking Berberine, is I ok to take at the same time as Lactoferrin and If so what sort of dosage would you recommend?

  55. Hi, I just finished your book and I am under the impression that I may have pill induced PCOS. I am not insulin resistant but I do have acne. Would you recommend taking berberine in addition to peony and licorice? Is this combination OK to begin treatment? Thank you so much.

  56. Hi Lara,

    I’m curious about whether there is anything that can be done once someone has taken accutane. I took it as a teenager – regretfully – and now at 30 have acne again. However I wonder if there are any long-term underlying effects I should be looking for/treating as a result of having taken the accutane back then?

      • ‘Accutane can have a negative effect on intestinal bacteria, that could–in theory–last that long’.
        Lara – read that as last forever. My daughter was prescribed Accutane as a teenager. She was nineteen so her dermatologist didn’t need my consent. I only found out after the event, and when her hair (once beautiful) had thinned beyond recognition. She now has a severe thyroid problem. Trouble is she did NOT have full-blown acne. To this day I am saddened beyond belief.
        Like you, I beg anyone, male or female, NOT to consider this dangerous drug. To be honest I can’t believe it’s still on the market.

      • I too regret taking accutane at 24. I’m 33 now and still suffer the consequences. I have permanent side effects. My lips still peel to this day. My hair is as dry as straw and about 20-25% of it is strangely kinked and curly/wiry whilst the rest remains straight. Altered gene expression perhaps? I don’t know but it’s very odd looking indeed. I had severe period issues and got diagnosed with endometriosis as soon as I finished the drug. My depression/anxiety is off the chart, I can not even work now (after studying for years at university.) My thyroid and hormone blood tests look ‘normal’ yet I feel far from it. I sometimes feel completely psychotic and suicidal right before my period now. I was not like this before accutane. I have no idea if there’s any way to make any of this better, I’ve tried many things. Progesterone helped some things but it caused my hair to recede rapidly and I couldn’t dominate estrogen, even with high amounts of it. I just bought Lara’s book as I just recently discovered her. I feel truly helpless. I can only hope to pass on Lara’s wisdom to my 3 year old daughter so that she won’t have to live the life I do.

        • Hi Nicole, I’m so sorry to hear about your experience! Thank you very much for sharing it and helping others.
          As for how to recover from Accutane, I don’t have an easy solution… But very happy to have any other readers chime in here and help us out!

  57. Hello Dr Lara

    I am curious if these supplements you recommend have any impact to synthroid which I am currently taking for thryoid.

    • And mineral (including zinc) must be taken well away from thyroxine medicaton — because they can interfere with its absorption.

  58. Dear Lara,

    I just found you website – which is very helpful. Thank you for sharing all these information.

    I stopped taking birth control almost 2 years ago and still suffer from mild acne (clogged pores mainly on the cheeks which get inflammed quite often). Even ifi it is not super worse it realy bothers me.

    My doctor told me that my estradiol level (21pg/ml) is a bit low and I should start taking the pill again.
    Testosteron and Progesteron are all right.
    I also have Hypothyroidism since 1 year.

    So therefore I am wondering what you think about it? Do you think there is a connection between my estradiol level and acne. And what can I do to improve this condition?

    Looking forward to your response.
    Thank you and best wishes from Germany

  59. Hi Dr. Briden,
    Thank you so much for your blog and all your information. It’s been a huge help for me since coming off the pill. I just started lactoferrin for acne and have noticed a huge improvement already. I’m a little confused though as the bottle says it contains milk and I thought acne prone people are to avoid dairy? Do you have a recommended dosage and can I continue taking it without breaks?

    Thank you!

  60. Thank u so much for the great article.
    I would really like to know what you think could be the next step, when i am already on the sugar, dairy and gluten free diet, and taking the supplements. But still have pcos and acne?

      • For half a year completely off dairy and sugar exept for friut juice. Sometimes I have a little fruit juice. No yoghurt or honey or dates.. Guess it is okay to have fruit, but not fruit juice at all? I am very underweight but i guess sugar is poison for me.
        I have borderline, ptsd and eating disorder, dont know if the stress mess up the hormones. 🙂 🙁

  61. What can you take to improve acne when you are trying to get pregnant. I love what berberine did for my skin but was told to stop taking it because berberine is known to cause birth defects. It seems like all medicines and herbs that help with acne cant be taken when pregnant.

    • Just to clarify, there’s no evidence that berberine causes birth defects. Most clinicians (including myself) recommend avoiding it during pregnancy because it may cause uterine contractions.

      Safer acne treatments include: 1) sugar-free dairy-free diet, 2) zinc, and 3) DIM (diindolylmethane)

  62. Hi Dr.Briden,

    I have had low ferritin readings (11 ng/ml) for 2 years now. I struggle with cystic acne (among many other hormonal issues) and I have read that iron supplements can aggravate acne. I was wondering why iron supplements would tend to aggravate acne (perhaps it is the intestinal issues?) and what you would suggest to counteract this side effect? Have you observed this side effect with your own patients? Thank you!

    • I’m not aware that iron can worsen acne. Are you thinking of iodine? (Iodine supplements can be a problem for skin.)

  63. Hi Dr. Lara!

    I know this is an older post but am hoping you may still respond to comments. I took Accutane for a few months when I was 15 for acne. I am now 25 and just went off the birth control pill; my husband and I have decided to try to get pregnant. I have been off the pill for three months and have yet to get my period. Have you seen any infertility or reproductive issues you believe to be related to Accutane? Do you have patients who took Accutane and go on to have successful pregnancies?

  64. Hi Lara,

    I would like to start taking berberine to help with my acne. However, I am also taking St. John’s Wort to help with mild depression. Do you know if it is okay to take those two supplements together?

    Thanks so much.

  65. Is it possible for Berberine to be the cause of my absent periods? I started taking about 6 months ago (taking one month off after 12 weeks as you recommend in your book) to address issues of hormonal acne and over the months I have watched my periods become lighter and lighter to the point of disappearing. Before I started Berberine I had 40day cycles (I know a bit long but always regular and normal flow). My skin has cleared, but with it my periods have stopped (when I don’t have periods my skin clears up, which is great for my skin but bad for my body of course!) I cannot think of anything else that has changed since this change in my period. I have always eated a paleo diet with whole foods so I avoid grains and rice, no sugar or dairy–I do eat fruits and sweet potatoes conscious of needing carbs. I am a normal weight. I was wondering if berberine can make your blood sugar too low to the point that it can make your body think it is not getting enough carbs and therefore stop periods? I have increased my carbs since taking berberline hoping that if this is the case, it will compensate for the lowering of my blood sugar. What do you think Dr. Laura?

    • Thanks for sharing your experience. I don’t think berberine would push blood sugar too low. It may affect periods and estrogen in other ways that we don’t yet understand, but I have not seen that with my patients.
      My guess would be that you’re lower carb than you think because the surest way of shutting down periods is a low carb diet. You might want to try reintroducing potatoes and rice.

  66. I think I’m experiencing a backlash to Berberine because I took it for too long. It worked quite well for two months and I took it for about two and a half.. I’ve been off it now for two weeks, and still my acne is somehow even worse than when I started–instead of just hormonal acne which I’ve always dealt with, it’s all over my face in areas I haven’t had breakouts since I was like 13 years old. Do you think I could take it again after some time off? It was SO effective until it wasn’t.. I’m eating extra clean lately, even limiting my fruit intake to grapefruits and berries because I’m trying to get a handle on it, I even added a few hormonal supplements like Maca and Saw Palmetto but nothing seems to be helping matters. My fault! You say 2 months and that’s when I should have stopped. Just looking for a way to get back on track.

    • Hi Krista, thanks for sharing your story. I’ve never had a patient experience rebound acne like you describe. Was there anything else that changed around that time? Maybe just before you started berberine? Had you used any other medication or stopped hormonal birth control?

      • I’ve been asking myself that question and trying to come up with something. I did stop taking my magnesium supplements because I ran out and didn’t get more, and at the time I did start consuming a lot of farm raised eggs cause I was house sitting-I probably ate like four a day. Otherwise I haven’t made any changes. I’ve been off the pill for nearly two years now. I was taking 1200 mg of Berberine, so maybe the combination of that slightly higher dose for that slightly prolonged period made a difference? I’m not sure. Before I took berberine it was solely hormonal acne though, but it was pretty stubborn and cystic.

        • Eggs are a common food sensitivity so it could have been that.
          I assume your periods are regular and hormones are normal?
          I agree with Lou that zinc might be the way to go right now, and if you were my patient, I might suggest to give berberine a break and try again at some point in the future. (I do recommend you seek advice from a herbalist or naturopathic doctor near you)

          • Thanks Lara, yeah when I made the egg correlation I stopped, I was eating so so many eggs, thinking how healthy I must be with all my home raised eggs 🙂 at least four a day for about two weeks straight, I’m hoping that was the cause. Just eager for it to be out of my system!

    • Hi Krista, I’ve read quite a few places that Maca can actually aggravate acne. I’ve definitely noticed this for me personally. I know everyone is different so it may not effect you negatively but I thought I’d just add my opinion. Oh, and also add zinc like Laura had suggested. This has helped my skin tremendously! I take 2x 50mg Zinc Picolinate pills per day. I hope this helps!

      • Lou, I forgot to mention in my reply that I take Zinc already, in addition to a slew of other supplements like DIM, primrose oil and I recently added Thorne SAT as a liver support to keep my bases covered.The maca I recently introduced is Femenseesence Maca that was recommended from theholykale, a nutritional therapist that has given a lot of helpful advice. But I’m trying everything. It’s just incredible because the Berberine had my skin looking perfect, and then suddenly after 2.5 months it’s like my skin just broke out all over the place, though at least it’s not the cystic kind, and it’s been two weeks with no indication it’s clearing… I hope I can re-introduce berberine again soon because it had done wonders for me, and I noticed a difference after just a few days which was amazing.

  67. Hi Lara,

    I’ve been doing a little bit of reading about berberine, and I’ve seen some articles that talk about berberine interfering with muscle protein and development. Some of the more detailed articles are too technical for me to understand fully. Can you speak to whether berberine does indeed decrease muscle tone?
    I have been a life-long athlete and am hesitant to take any supplement that will affect my physical performance and muscle tone. At the same time, I have been struggling with adult-onset acne for over a year now and am at my wits’ end. I thought that berberine might be a great supplement for me to try, but, again, I do not want to take anything that is going to impair muscle development.



      • I also found similar info on this website (scroll all of the way down the page to the editor’s thoughts section):

        I even think I saw one site suggesting that berberine can have a negative effect on the liver, though I can’t find the exact site at this time (I don’t think I saw that suggestion on either of the links above).

        Again, much of this information is too technical for me to understand without the help of a medical professional. But given that multiple sources contained the same suggestion–that berberine can impede muscle growth–I started to wonder whether there might be something to it.

        Thank you so much for your help!

        • Thanks. In that rat study, they gave berberine by injection. If you scroll down to the comments, you’ll someone quote another study ( which showed that oral administration improved muscle mass. It makes sense that its benefits come with oral administration, because most of it is not absorbed anyway. It acts in the gut to repair intestinal permeability and reduce inflammation. The second examine link is very detailed. Very helpful. Thanks.

  68. Hi Dr. Lara Briden can I take berberine if I am hypoglycemic already? Will it cause my sugar to drop more? please respond as soon as you can.
    thank you!

  69. Hi Lara, The berberine recommendation was spot on for me. I went to amazing, found some and after ordering realized it wasn’t in a herb form like the specific recommendations you’ve made have been, it’s just straight Berberine. it was also a 400 mg dose, and recommended taking it 3x a day (on bottle). I went ahead with it since I already ordered it and it was super effective, i took one day off a week from it. When I ran out, I went ahead and got the 500 mg and took it 2x a week, and, my acne came back. Here’s the specific brand I was using, both for the 400 and for the 500. Is it too much to take 1200 a day? It seemed to work great when I was on that dose. Is this type less effective than that herb linked one you mentioned?

    • Okay, I realize I didn’t investigate what I was taking adequately! I see that it’s Berberine as well as Banana Leaf Extract… I’m not sure if that matters?

  70. Hi Dr.Briden, I’ve just stumbled upon your blog while researching ways to go off the pill. I’ve been on the pill and spironolactone for the last 5-6 years. I was originally out on it at age 15 for acne. Thank you so much for your posts. I can’t wait to start the acne regimen when I finish this month of birth control. I am attending NCNM in Fall 2016 to pursue naturopathic medicine where I want to specialize in women’s health I hope in time I will be as knowledgable as you!

  71. Love this article. I came here from reading your article, Pill bleeds are not period bleeds. I have a big interest in how hormones affect people’s bodies and minds. I turned 22 last month and still get acne. I have noticed how diet and stress affects my skin. I have been on the contraceptive pill in the past to deal with my acne but I have a medical condition to do with my blood (blood clots). My doctor has wanted me to try Accutane but I also deal with moodswings and depression. I know I’ve had an imbalance with my hormones but could never afford a naturopath #Studentlife. Just wanting to say because of people like you, I can get a really good insight into how I can look after my health. Hormones or skin. You most probably get comments like this all the time but thank you heaps. It helps alot and really makes a really positive difference 🙂 <3

  72. Hi Lara,

    Your website is a blessing! Thank you so much. I stumbled upon the dietary needs, giving up dairy for acne about a year ago accidentally, when I realized I developed cystic acne whenever I ate anything dairy related. However, I was still on birth control, antibiotics AND spironolactone as well as every other thing a dermatologist gives you to slather on your face. I am apprehensive to stop taking the pill, as I have already had hair-loss from topamax (which I am tapering off now), and had acne prior to BCP. I started taking zinc and magnesium supplements prior to the knowledge that it aided these symptoms of cessation from the BCP. MY question is, will this have harmed my body’s recovery by taking it prior to stopping? Do I need to increase my dosage of both?

    Thank you so much for your blog.

  73. As a person who took a round of accutane in high school, is there anything I can do now to repair any damage?

  74. Hi Lara! I have really been enjoying your blog and your great advice. I have been taking burdock root which has mostly cleared up my acne and after reading this I am curious if burdock root contains berberine? I’m also wondering if it’s safe to take these herbs for long periods of time, or is it better to take a break?

    I have also been taking magnesium and ever since I started faithfully taking it (200mg/day), along with the burdock root, my skin is now about 99% clear (if I happen to get a blemish, it’s very tiny). I’ve also found eliminating dairy (I still consume some butter, however) has helped as well. Another thing I will note is that I used to take a multi-vitamin and found it caused me to have terrible neck/jawline acne. I read that b-vitamins can sometimes cause people to breakout, so I quit taking them and the neck/jawline acne cleared up. Something to note for those who are trying to figure out what is causing your breakouts. It has taken me over a year to figure out my acne situation after coming off of the birth control pill (and I was only on it for a bit over 2 years)!

  75. Any advice/insight into myo-inostiol? been struggling with post-pill pcos/acne. vitex made everything much worse so i assume i have elevated lh. i know my testosterone is too high too.
    i’ve been taking inositol and would love to know what you think about it.

  76. Thanks so much for this info, Dr. Briden. I’m wondering whether you’ve given berberine to anyone taking celexa? I’m weaning off and am currently at only about 15mg. Between this med and a thyroid condition that prevents me from taking anything goitrogenic like DIM, maca, etc, treating my cystic acne naturally is starting to feel hopless. I’ve been taking zinc for years. I’d love to try berberine.

  77. I’m already get Zinc through my multivitamin (15 mg daily, which says 100% DV) but still have some hormonal acne problems. Is it safe to take a Zinc supplement in addition to this amount?

  78. Hi Doc, Could you comment on the dose of Berberin that you recommend and how often it should be taken? I am just now reading a lot about how it can be used to treat acne, and after trying everything else, I’m willing to give it a go. My naturopath is also curious about it. As I’m also suffering from hair loss/thinning, would Berberin be of any concern in that regard? Thanks for your time!

    • The exact quantity of the herb depends on the concentration of the formula, so best to use as directed. Your naturopath should be very familiar with berberine. It is the active ingredient in the popular herbal medicines: goldenseal, barberry, many chinese formulas with phellodendron. It might help with hair loss, depending on the cause of your hair loss. (For example, berberine improves insulin resistance, which is a common cause of PCOS, which is a common cause of hair loss).

  79. Dr. Lara, Can Lactoferrin be taken at the same time as berberine? Of should it be after the 8 weeks of Berberine? Thank you!

  80. hi Lara
    In your article you say that oestrogen helps acne, but I find that if I use progesterone supporting herbs in the second half of my cycle and supplements like DIM and calcium D glucurate to reduce oestrogen, then my skin gets heaps better. And so do PMS symptoms such as sore breasts. And I have noticed this a lot with other people that I’ve spoke to. Therefore, it makes sense that high estrogen/low progesterone makes acne worse, espcailyl when just before a period. What do you think?

  81. Hi Chantell, though I’m not a doctor I can offer some insight. I’ve been taking Berberine off and on since September with my naturopath’s guidance. I just started a new regimen and I’m currently on 500 mg twice daily for the first two weeks of my cycle, then taking a two week break. I hope that helps! I love Berberine and have noticed great improvement in my hormonal acne and sugar cravings when on it.

  82. Hi,

    I was wondering how much Berberine I should take a day and how often? As of now, I take 1 400mg pill each day. Will this do? Thanks and I loved the article.


  83. Hi Lara, I suffer from hormonal acne and hair thinning. I do not have PCOS. My periods are consistant. I think my hormonal inbalance come about for a couple of reasons, one I gained a lot of weight and two I ran my pill together so I didn’t have a period for over two years (my doc told me this was okay, hmmm not so sure now). I was also taking Ava20 which has levonorgestrel I believe this mucked up my hormones. I have been researching a lot myself lately as my doc is of no use what so ever.

    I am currently taking spiro and have been for the past 8 months I have had no improvement in either my hair or my acne. I am scared to stop taking it incase it starts to work soon, I have heard it can take a long time to start working. I have read your article about spiro and it is seriously making me want to stop taking it. I have been prescribed Metformin but haven’t started taking it yet as I’m afraid of the side effects. I need to do something I’m desperate to get rid of this acne and hair thinning it has been a couple of years now and I’m sick of it.

    I have in the last week started taking, magnesium, zinc, fish oil, evening primrose oil. I am yet to start Vit D I have read that it shouldn’t be taken with diuretics so really need to come off the spiro first. I am also thinking about taking Saw Palmetto and or berberine. Plus I have heard of a chinese hair tonic that is suppose to be quite good.

    Any advice you can give me would be much appreicated. What are your thoughts on Saw Palmetto for acne and hair loss?

    thanks 🙂

    • Hi Tarn, your post is a mirror of my problems! do you have any answers to your questions? I’m desperate to know what I can do to fix the very same problems. Any advice is truly appreciated. Jo x

      • Hi Jo, no I don’t have any answers. and now my periods have stopped completely. I haven’t had a period for 2 months now, I’m only 35. my gp has been of no help whatsoever. She sent me for blood tests which have all come back ‘normal’, whatever, ‘normal’ is. but I don’t think it’s normal to not have a period.

        I read in Dr Libby Weavers book that the most womanly thing you can do is have a period, it’s what separates us from being men. that was my light bulb moment when i knew that stopping my periods had been a big mistake. That’s when I went off the pill that was 12 months ago. Although I haven’t noticed an improvement in either my skin or my hair yet, I was getting a period consistently. but then it disappeared…

        I’m booked in at a oriental medicine practice next week, I’m seeing a lady who specialises in hormone health, hopefully she will have some answers for me. I’m desperate to get back on track. Feel free to email me directly if you like we can share notes, I might have some more answers once I see the hormone lady next week. 🙂 my email is [email protected]

        by the way I stopped the spiro and I never took the metformin. I am completely drug free at the moment. still taking vitamins though.

  84. Love your posts. How much would u charge for private telephone consultation?and I tried all supplements for insuline like Nac or lipolic acid but they just make me very hungry . Maybe my blood sugar its droping to low? X

  85. I just started taking Berberine (Berberis aristata root) a week ago and my skin has never looked better. ( I also added some zinc, 50mg a day and a good quality probiotic (Ultimate Flora-Critical Care). I did pass on the Lactoferrin though because I don’t consume dairy for ethical reasons).
    But, I am in complete and utter shock at how great my skin looks. And I feel an immense amount of gratitude for finding your site and learning about Berberine. So, what I am worried about is what will happen in 8 weeks, when I am to stop taking it. Do I stop taking it indefinitely? Or do I just give my body a break, then resume taking it? I’m trying not to stress about what will happen to the state of my skin in less than 8 weeks….

    • I recommend that patients take a month or so break from berberine, and then repeat the 8 week course. Many times they don’t need to do that more than two or three times.

    • Just starting taking Berberine and Zinc to treat hormonal acne and am wondering how it worked for you in the long run?

  86. Hi! Your post was very interesting to me. I came off the pill a year ago, and it was hard.. My acne was out of control but DIM and primrose oil have completely remedied that problem, although I’m sure cutting dairy and hardly ever having sugar didn’t hurt either. I quit the pill because at 25 my once incredibly thick hair had become quite thin, and it scared me to death. Even a year off the pill and it’s not what it once was, but I’m hoping it will eventually get back to it’s original fullness. Any suggestions for supplements that might help with my hair? Also, what are your thoughts on primrose oil? It’s been wonderful for my skin and cramps, but I noticed that I started to experience some slight breast tenderness after taking it, but it’s a small price to pay for the benefits.

    • thanks for sharing your experience Elizabeth. I don’t prescribe evening primrose oil, so I cannot really comment. I can’t see why it would be a problem for your breasts. You might find that now that your skin is clear (and you’re past the Pill-withdrawal acne), that you don’t need the supplements anymore.

      As for hair, yes the Pill causes hair loss. If you haven’t already, please see my hair loss post (and the comments).

      • You were right, the primrose oil didn’t cause my breast pain! I recently started to supplement with iodione, hoping that helps

  87. Hello
    I have had irregular menstrual cycles in my teens. I was normal weight even though I ate really bad (mostly only sugar).
    I started developing acne in high school.
    When i went to college i took the pill. All my symptoms faded. I had many compliments on my skin.

    I stopped it once. My acne came back so i took it back.

    Then i had to stop it again because of all the stuff i read about it (dianette).
    My period came regularly right after quitting it but irt stopped 6 months after. It came back now quite regularly.

    Now, 2 years after leaving the pill, i am strugling with bad acne.

    My fasting glucose was 0.98, high LH, very high testosterone.

    I am about to start dim and vitamin d and progesterone cream.

    Can you please advice ?

    Thank you so much for sharing all the information.

    • Just wondering how you got your hormones tested? Thinking of doing the saliva test but unsure if I should or if there is a better/cheaper option?

  88. Hi Lara,
    I came off the pill over two years ago, and since then have been struggling with acne, hair loss, really oily skin and infertility. I have been to a reproductive endocrinologist and have not been diagnosed with pcos but feel that my symptoms are in line with pcos symptoms. My periods are also very light. Could this all be related to pcos?
    Thank You

    • The diagnosis of PCOS really comes down to whether you are ovulating regularly, or not. And also, if you have normal insulin and testosterone. Did the doctor say anything about that?

      • Hi Lara,
        My testosterone came back in the “normal” range and I’m waiting for my insulin blood work results. I just fit so many of the symptoms, what else could it be?
        Thank You

  89. When you say that sugar elimination is needed to improve acne, are you referring to processed sugar or all sugar? Would I need to eliminate honey, grade b maple syrup, and all fruits? Thank you! I have been processed sugar free and dairy free for a year now, and my acne is still here. I’ve been gluten-free for 8 years.

    • Yes, I’m referring to concentrated sugar/fructose – in desserts. This includes honey, maple syrup and dried fruit. Whole fruit is ok. It’s really about quantity, rather than type of sugar.

      • What do you think is a reasonable amount of sugar in grams? I stick to 85% dark chocolate and maple syrup sweetened chocolate tarts, with the occasional conventional sweet treat, if course all have sugar but for a daily recommendation would 12 grams of sugar be too much?

        • Hi Elizabeth, what really matters is the grams of fructose. I recommend a maximum of 15 grams (or less) fructose per meal (maximum 30 grams per day), and preferably from whole fruit so we also get the beneficial nutrients and fibre. For example, one apple has about 10-12 grams fructose.

          85% cocoa chocolate has almost no fructose: 0.7 grams fructose (1.3 gram sucrose) in two squares.

          As for other desserts, I guess ok if you stay below 12 grams, but I don’t know how you’d do that with something made from maple syrup or dates.

          • Oops, that gram count is for 90% cocoa chocolate. 85% will have a bit more fructose.

          • Thanks for helping me on the sugar amount. I get these raw chocolate tarts from whole foods, Haill Merry, half a tart is about 12 grams 🙂

  90. I believe that you are right…I was put on the pill as a method of treatment for Endometriosis at a very young age of 15, unfortunately I haven’t had a libido since then and it really does affect me. I’m currently back on the pill as a means of helping with endometriosis again. I wish I didn’t have to take it, in fact I would love to not take it. But doctors give you no other choice!! To this date I still struggle with symptoms of Endo. I’m nearly 21 🙁

  91. Hm. I have hesitated to get off the Pill because when I do, I get these horrible skin infections (not quite boils, but pretty close) on my breasts and in my groin area. Do you think these could be diet related, like regular acne?

  92. Hi I have pcos and I lost lots of my hair and they got also vert thin what do u recommend ? I’m on good diet . Thank u


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