The two things underneath it, and what I did about them on the plate

The first is hormonal. That is why acne arrives with puberty and not before — androgens ramp up, sebum production climbs with them, and the follicle starts behaving differently to how it behaved a year earlier.

The second is inflammatory, and it runs from one end of the process to the other. Inflammation is there when the pore first clogs. It is there while the lesion is active. And it is still there during the repair afterwards, which is the part that decides what mark gets left behind and how long it sits there.

Which reframed the entire thing for me. If the two drivers are hormonal and inflammatory, then everything I had been putting on my face for four years was arriving at the very end of a process that began somewhere else entirely. Two levers stood out in what I was eating: refined carbohydrate, and — more arguably, and I will be straight that this one is still genuinely contested — dairy.

I want to be careful here, because this is exactly the point where pages like this normally start lying to you. I am one person. This is what I changed and what happened to me. It is not a protocol and it is not a promise.

More of: meat, poultry, fish and seafood, eggs, vegetables, nuts.

Much less of: sweetened drinks and energy drinks, fruit juice, bread and wraps, pasta, breakfast cereal and granola, white rice and instant oats, crisps and crackers and the rest of the snack aisle, and sugar in all of its polite disguises — honey, syrup, agave.

And then the middle ground, where I stopped being dogmatic. Dairy sits in an honest grey area: milk and sweetened yoghurt carry a lot of sugar and were the easiest for me to drop, while butter, ghee, hard cheese and plain yoghurt carry far less. Beyond the sugar there is a live argument among researchers about whether dairy of any kind nudges hormones or inflammation, and it has not been settled — so I am not going to settle it for you. Most fruit is worth moderating for the same reason as everything else above, with berries the cheap exception. Beans, potatoes, sweet potatoes and unprocessed grains like quinoa or brown rice are whole foods carrying real fibre, and I eat them without ceremony. Oils are low in carbohydrate but heavily processed, and virgin olive oil is what I default to.

If you are vegetarian this is harder and the honest advice is narrower: choose whole vegetarian food over processed vegetarian food, and do not tie yourself in knots about the rest of it.

And if you want to go further — strict keto, carnivore, the extreme end — people do, and some of them report exactly what I did. Read properly before you start, and get bloodwork done every few months once you have. I say that as somebody who has already gambled with his body once and would rather you did not.

Supplementation is where this subject gets loudest and least honest. Everybody selling one has a study, the studies mostly disagree, and the doses in the studies rarely match the doses in the bottle.

[[PLACEHOLDER — the list of what you actually took, in your own words. Name them, say why you started each one and roughly how long you have been on it. Do not put doses on a public page, and do not claim any of them did anything to your acne — 'this is what was in my cupboard' is both more honest and more persuasive than a claim you would have to defend.]]

Eventually I got tired of buying five things to get three ingredients I wanted, at doses somebody else had chosen, wrapped in marketing aimed at somebody who is not me. So I made the one I had been trying to assemble out of other people's products.