The Clear Skin Diet

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FROM A LIFE DEVASTATED BY ACNE TO CLEAR SKIN

It was August 2014. Acclaimed entertainer Robin Williams had committed suicide a few days earlier. I remember walking into my parents’ home office and saying to my mom, “I feel like Robin Williams.”

My mom responded, “Get your swimsuit, we’re going to the pool.”

But I didn’t want to go. I didn’t want to leave the house. I didn’t want to be seen in public.

Up to that point, I had been a smiley, outgoing twenty-year-old girl with a burgeoning career in the entertainment industry. Why was I so depressed that I was having suicidal thoughts and wanted to avoid contact with others?

The answer was written all over my face.

Only a few months earlier my twin sister, Randa, and I were experiencing a dream trip in Europe. We toured England and France, stayed with family friends, and saw the sights. Much to our surprise, we were recognized by other kids. They would approach us and say, “Are you Nina and Randa? Oh, my gosh! Can I get a picture with you?”

That was unexpected, even absurd. Yes, we had a small but growing YouTube following. And yes, we had worked with Justin Bieber and were featured in one of his most popular music videos. But we didn’t think of ourselves as celebrities! And yet these friendly strangers thought we were Hollywood starlets who they had to meet and get a picture with.

Being a performer seemed like a relatively ordinary occupation to us. We grew up and attended a school in the Los Angeles area—Sierra Canyon—which happens to be filled with the offspring of movie and TV stars, musicians, writers, producers, and directors. So everyone and their brother, literally, had ties to the entertainment industry.

Because we grew up as performers and had several friends whose parents are in the entertainment industry, it wasn’t much of a stretch to think that a career in show business was possible. Every day after school and during summers too, Randa and I had several hours of dance and musical theater training. Our childhood normal was school and dance, school and dance, school and dance.

When we were just sixteen, a friendly conversation with a nice couple while waiting in line for a private movie screening led to our being signed by a major Hollywood talent agency. Turned out the gentleman we were chatting with was the head of the agency. After he handed us his card and told us to call him on Monday, he added, “You are going to remember this as the night you were discovered.”

We signed with his agency that week and began working frequently. Overnight, we were cast in commercials, television shows, music videos, and movies and even began modeling.

We were just a couple of high school juniors who were lucky enough to be in the right place at the right time. We were booking regular gigs, having the time of our lives, and increasing our bank balances. We later applied and were accepted together at the university of our choice and made plans to attend college while pursuing our burgeoning showbiz career. The summer after graduation, however, Randa and I began to consider deferring college for a year so that we could take advantage of the professional opportunities we were being offered. We met with the head of admissions at the college, who encouraged us to “go for it.” So we did.

Our career was on a roll. We starred in commercials for companies like Nintendo, ESPN Sports as the Doublemint twins, Petco, Samsung, JC Penney, Target, Taco Bell, Google, and more.

We sweated in 17 Fit Club workout videos as fitness trainers. We were featured in music videos with Ariana Grande; Tyler, The Creator; Miranda Cosgrove; Victoria Justice; Zendaya—even Pat Boone (“the Justin Bieber of the fifties,” my grandmother said; she was thrilled). We made appearances on shows like Modern Family, Good Luck Charlie, and The Neighbors. We posed in print and catalog ads, appeared in half a dozen films, and had a fast-growing YouTube channel. We also wrote songs, gave live musical performances at various venues around Los Angeles, and produced our own music videos.

I wouldn’t say that at twenty years old Randa and I were at the pinnacle of success—but we were working regularly with impressive people and having loads of fun, and our careers seemed off to a solid start.

Then the nightmare began. And our dreams started to unravel.

Acne.

Randa and I had pretty much sailed through puberty and our teen years without suffering any real pimple problems. We were athletic and healthy, and we ate a good diet. While some of our friends were having issues with acne, we had virtually none.

But something completely unexpected happened when we turned twenty. Horrendous breakouts. The acne started gradually, and then suddenly was raging. An explosion of angry red spots materialized on our faces. Then it spread. Big, red painful zits and blackheads engulfed our cheeks, chins, and foreheads. The inflammation was so virulent, we looked like we’d contracted some contagious disease.

The acne horror began in early 2014, while our parents were away in Hawaii on a business trip. We both caught the flu and had to fend for ourselves. We were living on peanut butter and toast because we felt too sick to cook anything else. The acne got a toehold when our resistance was down. Suddenly, we were weak, helpless, and feeling increasingly hopeless. We texted photos of our faces to our mom, who told us to get to a dermatologist immediately. The abrupt acne onset looked too scary to be a normal breakout.

We rushed to Urgent Care, and the doctor prescribed antibiotics. He was disturbed by the virulence of the sudden breakout. The acne, and the flu, started to recede. Thank goodness! Maybe the acne was a temporary a side effect of the nasty flu. Unfortunately, after the initial relief, the flu went away—but the acne returned with a vengeance. Subsequent antibiotic courses were less and less effective.

Managing acne became a job. We embarked on a succession of ridiculously expensive, dermatologist-recommended oral and topical prescriptions. We tried doxycycline, clyndamycin, Epiduo, Retin-A, and Aczone, to name a few. Bear in mind that before this acne bout, we had taken antibiotics maybe once in our lives. We hadn’t needed them. We slathered our faces with numerous over-the-counter creams and started getting regular facials. One facial was so aggressive I ended up with second-degree burns, which required medical treatment.

Meanwhile, our professional life was crashing. We were being sent out on the same number of auditions, but we weren’t getting callbacks. If you don’t get the callback, you’re not getting booked.

Although we plastered on a ton of makeup to try and cover the lumps and bumps, the skin deception wasn’t working. We had gotten accustomed to auditions where you had banter with the casting director, schmoozing in the audition room. Now we were being hustled in and out quickly with hardly any friendly talk. The encounters started to dent and bruise our self-esteem.

“OK, you are…?” said the impatient voice behind the audition camera.

“Nina Nelson, Daniel Hoff Agency,” I said, smiling. The casting director zoomed in on my face, said nothing for a few seconds, then:

“OK, great. Thanks very much… Who’s next?”

Sometimes there was dialogue for the role, and we wouldn’t even get a chance to read the lines at the audition. And it wasn’t just the acne preventing us from getting jobs, it was our complete lack of self-confidence. Acne had taken over our lives and was mentally exhausting. Around this time some friends at Native Foods Café asked us to do a short promo for their restaurant. I had such bad anxiety about the acne that I refused to appear on camera during the shoot. Randa did the stand-up, and I did the voiceover.

There came a point when Randa and I didn’t even want to bother with auditions. Casting directors could probably sense our depression and negativity; we began to turn into young hermits, our outgoing personalities collapsing inward. We were afraid our agency was going to drop us because we couldn’t get work.

We discontinued live singing and performances and only made new YouTube videos sporadically. We assumed (wrongly) that other people would be as focused on our acne as we were. We didn’t even want to hang out with our friends and would turn down invites to parties. We were too self-conscious to be out in the world with our raging acne.

The worst part of all of this was that we felt totally helpless. When your skin is so completely and utterly out of control, you start to believe you’ve lost control of everything. We obsessed on washing our faces, trying different lotions and pills, and taking multiple trips to dermatologists and specialists who couldn’t seem to do anything but offer more drugs. Truly a vicious cycle. We tried scrubs, light therapy, and high-frequency electrical currents. We changed our special satin towels, pillowcases, and sheets daily. We were frantic to discover anything that would get the acne under some semblance of control. Nothing worked. Our skin just seemed to get worse and worse, until even patches of normal skin were gone. We were at war with our skin, and we were losing. The severe acne had captured all of the territory.

Our longtime dermatologist, seemingly as confused as we were about the source of this virulent acne, finally decided to refer us to a leading acne expert at UCLA. This was basically our last hope. We waited months to get an appointment with this in-demand doctor. Our dermatologist was optimistic, reassuring us that “they have more tools in the bag at UCLA than I have here.” When the appointment with the UCLA doctor finally came, however, he took one look at us and repeated what the other doctors had all agreed on: Accutane. Our hopes were dashed. He sent in his nurse to give us the “Accutane talk.” We were told that the potential side effects were so severe for a baby that we’d have to go on birth control in case we got pregnant. The Pill on top of pills. As a parting gift, we were handed an Accutane information pamphlet the size of a phone book. Nothing completely terrifying about that, right?

Wrong. Accutane was not an option. We had friends and relatives who had taken it and believed it had saved their skin. We also knew others who had taken it for a short time and weren’t able to tolerate it. Their skin got super dry, or their hair fell out, or they felt weird and became suicidal. One got strange rashes and very dry eyes. Another reported getting colitis and had to drop out of college to recover. Then there are the side effects they don’t even know about that might show up eight or ten years after you’ve stopped taking the drug.

Hair loss, dry skin, depression, inflamed colon—the idea that you had to take a pill for acne that might provoke destructive side effects seemed preposterous. We became even more confused and fell deeper into despair.

One of our lowest points was in August 2014, when American Idol flew us to New Orleans to audition for its show. This was a major opportunity, a chance to perform in front of celebrity judges Jennifer Lopez, Keith Urban, and Harry Connick Jr. Our acne was on a rampage. We attempted to disguise our faces with heavy makeup and big floppy hats, hoping they wouldn’t notice how ravaged our skin had become. The judges were all incredibly nice and supportive. Jennifer Lopez was especially kind, mentioning that she had her own twins and what a joy they were. But because our insecurity threw us so far off our game that day, the experience felt like a disaster. We wondered later why we even bothered going.

When we returned from New Orleans, we convinced ourselves that our goal to be professional entertainers had evaporated. Our careers were over before they began. We couldn’t be public personalities when we didn’t even want to go out in public. Randa tearfully announced she wanted to get a job at our local Whole Foods Market because she liked the people there and what the store represented. I thought maybe I could work there, too. We hoped that we wouldn’t be judged too harshly because of our tortured skin.

A few days after my troubling thoughts about Robin Williams, my parents, brother, sister, and I decided to visit our grandparents. The five of us began the trek up the Interstate 5, passing through the farmland of central California to arrive eight hours later in the San Francisco Bay Area. During the daylong road trip, the conversation constantly returned to the bane of our existence, our painful acne. We cried, we whined, we expressed our despair and frustration.

At one point my dad, probably sick of our hours of carping and complaining, asked us: “What about the amount of fat in your diet? Have you thought about that? Yeah, we all eat a healthy diet,” he said, “but maybe Dr. McDougall has information on acne that might be helpful? Why don’t you do a search?”

Dr. John McDougall is a physician and nutrition expert in Northern California who had saved my mom’s life. Literally. My mother had been diagnosed with a rare autoimmune disease in 1995 and had suffered and taken strong medications to cope with it for about a year. Then she discovered a book by Dr. McDougall and, based on Dr. McDougall’s recommendations, radically changed her diet. The diet put her disease into remission, and this miracle was the reason our family had been vegan since 1996, virtually my whole life. Dr. McDougall prescribes a low-fat plant-based or vegan diet.

Back on the Interstate 5, Randa pulled up a couple of Dr. McDougall’s articles on my phone. As she read aloud his observations about acne and diet and how people in parts of the world who don’t eat the standard American diet don’t get acne, we started to feel a glimmer of hope. Dr. McDougall described how acne was cured with a very low fat vegan diet. Nuts, nut butters, soy products, avocados, coconut—these were healthy plant foods, he said, but they could wreak havoc when hormones are running wild.

This struck a chord. I remembered when the acne had first flared, when our parents were away in Hawaii. What were Randa and I living on during that time? Peanut butter on toast—fat on bread. Bingo.

All of this sounded very logical. We decided we were going to start following Dr. McDougall’s acne guidelines immediately, even while visiting our grandparents.

A new chapter in our life began with our very next meal.

When you are afflicted with severe acne, you develop the habit of constantly examining your face. You stare in the mirror, cocking your head at different angles, searching for new red areas, new blackheads, new problems. You’re instantly aware of improvement or deterioration. The obsession makes you constantly anxious. I had stared at my face so much, I knew every single spot.

So I was shocked when, after only three days of our new diet regimen, there weren’t any new pimples! I recognized that I still had a lot of active zits, and my skin still looked red and inflamed, but there were no new breakouts.