hello,
I'm a 24 year old female who has been dealing with mild/moderate acne for the past few months (which seems to be getting worse and worse). I was one of those lucky teenagers who managed to get away with only a few spots and mostly managed to have perfect skin. This continued throughout my twenties up until very recently. I've always had bangs, so I would get the occasional pimple on my forehead but they usually healed quickly. About a year ago exactly I started noticed lots of little tiny pimples/clogged pores on my right cheek. I freaked out a little but got them to go away by using more moisturizer (at this point, I used all comercial products and never had a problem). I also had started a job that was stressful, and was not sleeping many hours at night so I figured it was all related to that. It was not until September that I noticed that I had about 15-30 clogged pores all over the side of my right cheek and chin (right side ONLY). In late September, these clogged pores started turning into pimples and for some reason remained on my right side. I tried using more natural products (like Desert Essence which my skin wasn't in love with, but it did the job) and started taking about 3000 mg of Evening Primrose Oil. At this point I also didn't have an extremely healthy diet, but I did not eat the typical American diet either. Vegetables have always been a part of my diet, as well as carbs and minimal meat (usually chicken and fish). I also never consumed that much dairy, mainly in cheeses and milk for my coffee and never had a problem.
The EPO really helped and I noticed that my skin was breaking out a lot less on the right side (the left side was still completely clear at this point) and that my cramps were not as painful. However, my job became increasingly stressful and I was in a constant state of anger/depression/anxiety. I cut my hair in December, partly because I was convinced it might help my skin clear by getting it out of my face completely... it was cut very short which was a little tramatic but I eventually loved it and became happier. I was still taking EPO and a Centrum women's multi vitamin, however I noticed that from that point forward, my skin was ALWAYS breaking out worse around my cycle. This was hardly ever really a problem for me... but I noticed that I started getting more pimples that were inflamed and painful (never cysts thankful, just bigger painful pimples). From that point forward, it was the same every month, even as I continued with the EPO. It wasn't until about February that I started really getting serious with my diet, hoping that would help. I also lost my job and was spending more time at home, without make up, and was feeling very happy and positive. I cut out dairy, coffee, meat, all white flour, eggs, and rarely ate bread, even whole grain, or soy. I started eating mostly fruits and veggies, nuts, brown rice, rolled whole grain oats, honey, and flax. I began making green smoothies which I felt gave me a lot of energy and tasted great. This was all working so well that when I ran out of EPO, I didn't rush out to buy more and I just kept a healthy diet, including 30-40 min walks every afternoon. I still broke out but it was nothing like it is today....
Something changed.... I kept this diet and rarely ate out at restaurants or ate any frozen foods. A typical day would be:
breakfast: rolled oats which I prepared myself, with organic honey, organic cinnamon, and ginger with 1 banana, a few nuts and fresh organic blueberries
lunch: tuna wrap w/ avocado instead of mayo, with carrots, onion, spices, tomato, etc (all organic)
snack: whole wheat crackers/carrots with organic hummus (I have recently completely cut out all prepackaged snacks) or homemade guacamole
dinner: brown rice/whole wheat pasta (I've cut out whole wheat pasta recently too) with veggies like spinach, broccoli, asparagus, garlic, etc (also all organic) OR green smoothie of fresh organic kale, fresh ginger, carrots, blueberries, cinnamon, and almond milk
I also stopped washing my face twice, and only started washing it once a day which helped a lot but gave me a lot of flakes. I've always had dry skin, but I felt that it had gotten even drier (possibly because of winter). I rarely wore make up this time, maybe once a week.
I thought I was on the right track, and my skin was finally calming down but then around my next cycle, ALL HELL BROKE LOOSE. I noticed I was breaking out on both the left cheek and the right cheek, several pimples at a time that were painful. I started breaking out in the front part of my cheeks, about a 1/2 inch from my nose which I had NEVER (and i mean NEVER) experienced before. I freaked out and started taking EPO again, as well as 1000mg Vitamin C (both made with no soy, gluten, dairy, nuts, etc) and a multivitamin. I also started a new regimin of using oatmeal as my face wash (I tend have a lot of flakes and dead skin... always have) and Desert Essence pure jojoba oil as my moisturizer. My skin seemed calmed down a bit throughout March and I really thought I was getting clear. THEN... SOMETHING HAPPENED! I attempted to go on a raw food diet in April, hoping it would be the final missing piece that would help clear out the toxins... I also started drinking Dandelion tea (liver cleansing) and continued drinking lots of green tea. This caused a lot of stress because I felt like I couldn't keep up the diet, and I had lost a ton of weight (I'm already skinny to begin with) so I went back on a cooked food diet, limiting grains and still no meat, dairy, or any other acne causing foods.
I have to say... that the month of April has been the worst my skin has ever looked. Not only have I gotten more acne than I ever gotten in my entire life, but my right cheek is literally covered in tiny red pimples that have been there for weeks. It's like a combination of a rash and acne... something I have never seen before EVER. I noticed that while changing my diet to a healthier organic diet, the type of acne and the location of it changed. For the first time EVER, I was constantly breaking out on the front part of my cheeks. My forehead became a lot clearer with the healthy diet, but the rest of my face looks horrible and even the left side became worse, but still not as bad as the right. The redness on my right cheek is so strange because there is nothing like it on the rest of my face, and I don't understand why. I don't have long hair, I change my pillow cases often and try to sleep on my back or left side, I speak with my cell phone away from my face, and I am eating the healthiest I've ever eaten. I've also started taking Enzymes which help with the digestion problems (most started during my raw diet) and very recently added probiotics. I also very recently added meat (free range organic chicken w/o hormones and antibiotics) back in which I feel helped my digestion but my skin looks worse than ever, mostly because of the redness and right cheek situation.
I've been to the dermatologist and I'm hesitant to take antibiotics and put a bunch of products on my face (I have sensitive skin)... If anything I'd like to find out the cause of this so I can fix it. I currently have no health insurance (but will soon) and was considering acupuncture/holistic medicine approach because I read great things about it. I just don't understand how my skin has gotten progressively worse and worse over these past few months very quickly. Worse than it's ever been, with a redness on my right cheek that often itches and tingles at night. I very recently stopped using the Jojoba oil because I thought that might be a possible factor, but have yet to see improvement. I have been eating SO HEALTHY to the point where I often cannot go anywhere because I worry about what I'll eat when I get hungry. I'm wondering if this is hormonal and if so, why has the EPO stopped working??? I also wonder if it is more connected with the slight digestion issues I had, stress, or all of it?? I'm so confused and sick of looking like this. I don't want to have to worry about this anymore, it's causing my life to come to a complete stop. I need to get a job soon and I honestly don't feel that anyone will hire me looking like this... (my last job was a receptionist). I used to notice that my skin would get better and then worse around my cycle, but now it's just bad all around, especially with this redness. Obviously I need to go to the doctor, which I'm working on... but in the meantime, has anyone gone through something similar??? Why did my acne get worse with a healthy diet and EPO no longer working?? Please help if you've gone through this or can offer advice. Very long entry but as most of you know, this is the life of an acne sufferer 
Well the stress could have messed up your adrenals and/or thyroid starting you on a path towards estrogen dominance. And it could take time to recover.
It could have also damaged the digestive tract making your more sensitive to things, like all that wheat you are eating.
I would focus on things that improve estrogen dominance, adrenal/thyroid function and digestion.
Look here: http://www.acne.org/...n-t230714.html
And of course, relax, sleep well, be active, etc.
The rash-like acne you described is probably related to digestion. I would guess that drastically changing your diet disrupted the balance of flora in your intestines and allowed an opportunistic pathogen to grow. A lot of the other stuff seems like it's hormone related, but if your immune system is functioning properly and not fending off a bacerial overgrowth then that too should fade.
Edit: Yeah I wouldn't do topicals unless you have no other choice or want a quick temporary fix. You're right to be leery about antibiotics, but they might prove to be your best option. Course, you'll want to figure out the problem first, so maybe some tests are in order...
Your acne seems to be exactly like mine, It seems like the diet has really stressed you out. This article is really helpful http://www.thelovevitamin.com/3906/10-ways-intuitive-eating-could-make-you-happier-and-healthier/ . My acne is under control now but at one point it was so red and inflamed, I got it under control by no diet but just avoiding the food that triggers my acne, my EMOTIONS and lifestyle. Exercising everyday and getting sunshine.
The key is everything in moderation.. Theres no way you can follow a diet 100% because then you just can't enjoy your life hence more stress.
PM me if you need any support 
I could have wrote your entire post, except I went through exactly what you did at age 21. Every diet change that you made, including going vegan for a year, raw vegan for around 6 monthes, eating completely organic, juicing daily and drinking green smoothies 1-2x a day...It's kind of crazy to hear someone with such a mirror story to mine. I haven't been on here in a long time, and this was one of the first posts that I opened up, very weird. I will pm you when I'm on my laptop as I'm just surfing from iPad right now. Just want to tell you that there is hope - after years of these diet/lifestyle changes my skin reflects my inner health. I don't know what was more tough; not seeing my skin reflect my healthy lifestyle changes for so long ( it takes time girl, more time than I ever imagined) or my family and friends doubting my choices since it "doesn't make sense that you eat so 'healthily' and your skin looks terrible". Im really interested in sharing my story with you, because what you are currently going through reminds me so much of myself.
Pm you tomorrow at some point.
Take care, things will get better, and things do happen in life to teach us lessons, even if they don't seem fair. For me, I'd rather change my lifestyle because of acne when I was 21-24, instead of having to change my lifestyle 10-20 years down th road when more serious illnesses come up. Acne is a blessing in disguise that I didn't realize until I looked back on all the positive changes I made, and realized I likely wouldn't have made those changes if it hadn't been for acne coming into my life.
Take care and talk to you again soon,
Jayne from Canada
You sound very similar to me, except it was over a year that I struggled with terrible acne and desperately tried to control it with diet, supplements, etc.
Long story short, it didn't work, I gave myself an eating disorder and my acne was worse than ever. Like you, it is triggered by hormone shifts (ovulation, my period etc) but after a while it just stayed all the time and never went down, not even after my period.
I eventually had to go on the regimen. I know you don't want to put chemicals on your face, but it's only been a few weeks and I'm seeing major improvements so far. I don't want to be dependent on a medication, but life is short. It isn't worth it to suffer miserably with acne and limit your diet down to nothing--just to still have acne and grow more and more miserable, afraid to have a job, afraid to go out in public, etc.
Benzoyl peroxide does help, when used correctly. Eating good is important for health too, of course. But it isn't enough for many acne sufferers, especially those of us with raging female hormonal acne.
First of all, I am sorry to hear of the loss of your job. Several people in my family are receptionists, and almost all of them are part time. Two got laid off two years ago and now currently work in restaurants. I've seen my female relatives at work before... the state of their skin was definitely important, but it was a kind of silent agreement between them and their bosses. Being a math/tutor/computer major myself, my acne made me look as though I don't take care of myself. People without acne assume these things even with good intentions on their behalf... they simply do not know. And with all the scam advertisements on TV all the time for "dirt in the skin", they assumptions are unfortunately understood.
I'm with everyone else pretty much. Stress combined with that diet of yours will most certainly change your skin. It is INCREDIBLY likely for your skin to get worse before it gets better, no matter what you are doing. My regime includes juicing raw vegetables almost every day too, but when I started doing this I had a HUGE break out for almost a month before everything began to slowly diet down. (Also, make sure that rash isn't eczema or psoriasis... signs of possible food allergies).
My tip for you right now is to ditch the stress and pick up a few exercising/yoga techniques. I know I know, easier said than done but only because we all have different things that stress us out. There are many, many free resources across the internet to get you started on relaxation techniques, you can even type in "acne free yoga" or "skin clearing exercises" in whatever search engine you use, as well as thousands of videos on youtube.
The only thing I would like to point out from your diet is all that gluten (wheat) in your rice, snacks, and other munchies you're swallowing. You're doing great with some of the fruit, but a salad every day is incredibly beneficial. Even that banana your having may be too much for you since they're high in GI. If you're eating this kind of high GI diet and not getting enough raw leaf/green vegetables and omega-3's from fish/fish oil, then I would expect you to have incredibly slow progress with your skin at this rate. Vegetarian diets can be extremely high in GI and even hidden sugar, so watch out for the fructose/glucose confusion!
You're doing the right thing by coming here, so please don't give up. There are many wonderful discussions on the diet forums, but quite a few of them to require an updated mental medical terminology dictionary, lol. Keep track of that food journal you were telling us and if possible, take pictures for your own private collection.
Wow sounds like what is happening to me now!! I've been eating much healthier for the past 3 months, lost 4kg from my already quite slim figure. I feel healthier! But my right aide of my face keeps breaking out! It also kindof concentrates on the bottom jawline area more. I'm just starting on doing honey masks daily and using honey to wash my face. I'll probably try to stop aexfoliating it too. But I'm really puzzled by the healthy eating and acne relation. I'm stopping epo too because I feel they haven't helped my skin condition at all... How have u all been??.
Stress can do a number on your thyroid, and unfortunately sometimes just "de-stressing" doesn't set everything right
However finding a great doctor who will prescribe desiccated thyroid, getting all the right tests, etc. is a bitch and crazy crazy expensive. I would try supporting your thyroid naturally first. Recommended supplements:
1. Vitamin D3. 5,000 to 10,000 IU daily (go to Vitamin D council website for more information on everything vitamin D3 affects in your body as well as why they are recommending higher doses)
2. Selenium (google selenium deficiency)
3. Magnesium (google magnesium deficiency)
4. Betaine HCL (google "achlorhydria and acne")
Cut out the multivitamin. One size fits all multis often cause more problems than they help. I get bad acne reactions to B vitamins (except for B5) and high levels of zinc, most multis contain both.