I take a multi-mineral, Prescript Assist probiotics, Apple Cider Vinegar tablets (prebiotics), ZMA and MSM in conjunction with a cyclical ketogenic and paleo diet. I went from grade III acne to virtually none, except when I eat a little too much dairy or cheat and eat something "gluten free". All grains are a problem for me. But since I changed my diet, my migraines went away and I have kept off 10 pounds for 4 years. Low grade inflammation from leaky gut causes autoimmune diseases like acne. The book "Eat Dirt" by Dr. Axe is a pretty good read that compiles a lot of this type of information. Chew you food! The more you chew and digest your food with warmer drinks the better. Think about bacon fat. Do you really want to throw that down the cold sink pipes? That would clog everything up. On keto you shouldn't drink cold water and a bunch of fat. It's hard to digest. Also, there is nothing wrong with a water fast. It's an awesome detox. Eating a restricted calorie diet sucks. It feels horrible. I hate those type of detoxes. A straight fast doesn't cause that effect. You're barley hungry and your bodily happily sources energy from fat. And hopefully that fat isn't full of toxins, otherwise you can experience another type of breakout from that. In that case, take lots of supplements and then separately take activated charcoal. I suffered for over ten years and will never go back. My self esteem has changed dramatically for the better. I am now a successful esthetican and spa owner. This wouldn't be possible if I still had grade III acne. Don't just treat the surface. Some people cannot process some saturated fats and cannot change the enzymes in the body needed for keto with epigenetics. Some people will never thrive on a ketogenic diet. My sister in-law and her children cannot eat soy bean oil, coconut oil, and nut oils or they get severe cystic acne. It's all trial and error. Figuring out what works for your body takes a lot of patience and a lot of guess work and experimentation. For acne scarring there are many anti-inflammatory chemical peels. Microneedling is amazing and should be performed with a doctor. See a specialist and do not disregard the post care or you'll have bigger problems. Accutane causes leaky gut and a host of other problems. Find the diet that is right for you. Sometimes its your supplements that are temporarily causing acne. I've had many clients who took biotin and had cystic acne because the formulation needed more pantothenic acid for them. They took an extra pantothenic acid and the cystic went away. Or they stopped taking biotin and the acne went away. If you really can't figure it out yourself try taking an ALCAT test. Or see Naturopath or functional medicine doctor. It's expensive, but worth it. There may be more problems going on in the body when you have severe acne. A lot of my younger clients just won't change their diet until they get migraines, or something that really bothers them. A lot of my clients have infertility until they change their diet. Another thing to consider is Monsanto's RoundUp or glyphosate which is a real culprit for leaky gut and infertility. Consider other toxins, mold toxin and heavy metal exposure. Personal care products and perfumes can be some of the most carcinogenic and mutagenic things on and around us. I had the worst skin when I worked in an organic chemistry lab. If our bodies are processing all of this crap, how can it process natural stress hormone like cortisol and rebuild and repair skin at night? This requires so much vitamin C and Sulfur and glutathione. Also, about sugar, I see some people thrive on fruit diets and that's pretty high insulin spiking. Just saying. Insulin resistance is one thing, but is easily corrected by a water fast. Sometimes I eat fruit and I don't breakout at all. Some of my clients eat mango or pineapple and breakout like crazy. It's just so complicated in my experience to say what is right for any one person. Figure it out for yourself. If you need help discussing all of your products, your diet, and anything else please schedule an appointment with us. We love helping people figure things out and have many helpful referrals. Feel free to comment below.