Help

Dear Doctor. I have had a spot problem for many years now which is completely related to the food I eat. If I have any food which contains lard like pork pies or has been fried like a burger or even full fat cheese; within an hour my whole face fills up with large ugly spots. I try to avoid these types of foods but of course every food contains some fat to some extent and so the problem NEVER goes away. I have tried taking supplements like cod liver oil and evening primrose oil capsules but these only make the condition worse making the skin oily and larger spots forming. I have tried taking lecithin capsules as a fat emulsifier and this did make a difference for the better but to have any impact I need to take much more than the recommended daily dose and it still never removes the problem. What do I do to completely remove the problem? Please help Doctor. I have just about given up.

[Alan Rockoff, MD]

The first thing you need is a specific diagnosis.  I have never seen, nor am I familiar with, a condition like the one you describe.  Even people who think their acne is food-related--and most don't--do not describe the kind of immediate breakout you say you have.

So step one is to see a skin doctor.  If you can provoke the rash, then eat a big fatty meal just before the visit.  Just to be sure, take some good-quality photos of the spots in full bloom to the appointment.

In the event that you do have some fat reaction (and again, I've never seen or heard of this) then perhpas a dietititan can advise you on the kind of restrictive diet you may need.

Best.

Dr. Rockoff