At 40 years old I developed moderate-severe cystic acne out of no where. I had never struggled with such bad acne. It was predominantly on my chin, jawline and sometimes my cheeks and forehead. I was prescribed countless topicals and oral antibiotics (including birth control and spiro). Nothing helped. My dermatologist, my gynecologist and my primary care physician all told me that Accutane was the only remaining option. And while I wasn't opposed to trying it, I wanted to exhaust less extreme options first. So, after two solid years of painful, cystic acne, I cut out gluten (and aimed to eat a low glycemic diet). Within two weeks of cutting out gluten, my acne seemed to calm down. Within three months it was entirely gone. At the 6 month mark I allowed myself a tiny bit of gluten (at one meal) and my acne came back within a week. It's now been 18 months of avoiding gluten and trying to eat a low-glycemic diet, and my acne is under control. I made the choice to have a tiny bit at one meal about a month ago and I'm still waiting for the pimples to clear up from that one gluten meal. It's worth noting that I'm a vegetarian and have been for 25 years (so, I was a vegetarian before the acne started and after). No idea what caused me to so suddenly have the acne reaction to gluten, but there's absolutely a connection. I eat gluten (or a high glycemic meal) and I get a horrible breakout. My pcp says it's hormonal/androgen related (we've done no blood work to confirm that...). Anyway, I wanted to share my story. I was a gluten-lover and it was tough to make the diet change, but if you're struggling with acne it might be worth trying. Good luck.