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Welcome to the board! First of all, your build is very similar to mine. I've always been underwieght and am currently 105lbs (average wieght since the age of 12 and I'm 23 now). Of course, I would have loved to have reached 120 (which is actually the avg. wieght for 5'4), but my metabolism just wouldn't allow it. =/
OK, so you've heard how carbohydrates are capable of making people gain wieight, right? You've also heard that carbohydrates can cause of host of diseases and hormonal disorders, right? One of the [B]symptoms [/B] to these problems would of course be acne, as you've partially discovered. Based on what I've learned over the years, especially this past year, now that I think about it, it makes sense that I turned out to be at least on the thin side and with acne.

You see, carbohydrates can be good for us, but there are some that are also bad for us. Or MAYBE it's just because they aren't as "good and healthy" as they used to be, i.e. McDonalds, TV Dinners, Hydrogenated Oils, Refined Grains, etc. Either way you choose to debate this, if you get ENOUGH of an [B]Insulin Rush [/B] in your system, it's going to cause problems.

I'm sure some people must be sick of hearing that, infact, I know people that are beyond annoyed and angry when they hear this, but I can't help it if it's the truth. =) There are acne sufferers that are overwieght and there are those that are underweight and probably of normal wieght as well. In fact there are acne sufferers with a combination of problems or no other (outwardly visible at least) problems. That's because [B]Insulin Resistance [/B] can get your body any way [B][U]YOUR[/U] body sees fit![/B]

That's right, it does come down to genetics and [B]your genetics will decide the type of problems your body will have [/B] as a result of all of this Insulin (or [B]IGF-1).[/B] As such, it also usually comes down to having a healthy [B]liver[/B]. It's rather interesting to see how many enzymes, proteins, vitamins, and hormones that rely on a healthy liver. If your liver is burdened in some way...too much glucose to produce, too much toxins, or a genetic/enzyme defect, you will eventually have problems. The problem or [U]combination of problems[/U] that result from [B]Insulin Resistance [/B] include:

High Cholesterol,
High Blood Pressure,
Heart Disease,
Type II Diabetes (90% of cases, sometimes Type I can result),
HyperAndrogenism (another name for Acne, Hirsuitism, etc),
PCOS (Polycystic Ovarian Syndrome),
Hyperthyroidism (possibly Hypothyroidism)
Certain Cancers

Notice how some of these begin with Hyper? That's due to the [B]IGF-1 and its role in the body to increase cell growth [/B] (cell proliferation). Cell growth is a Good thing, but too much due to overstimulation (enlarged sebum glands or tumors) and it's a VERY bad or even Deadly thing. Therefore, the list can actually go on. I could add to the fact that it [U]increases skin cell proliferation, hyperkeritinzation, and increased sebum production[/U], which of course we know ADD to our acne delimas. In fact, if you can just get those in control, why you use [U]topical DHT inhibitors [/U] such as RetinA, Azelex, etc, or follow [B]The Regimen [/B] or [B]"The Acne Cure"[/B] (these work on the inflammation and proper skin cell shedding aspect), you will more than likely get clear skin, IF your problem, isn't that deeply rooted. However, for those of us that have one of the above problems (if you haven't visited an [B]Endocrinologist[/B] you should), topical solutions just aren't good enough of a solution.

That's why liver cleanses work for some, as do certain supplements such as [B]B5[/B] (hits the cholesterol aspect of hormone production) and [B]Saw Palmetto [/B] (natural anti-androgen). For others, they find that they need [B]Birth Control [/B] (estrodial acts as an anti-androgen by increasing our [B]SHBG[/B] which likes to bind to Male steriod Hormones) and/or another [U]anti-androgen [/U] such as [B]Spironolactone[/B] (accidently binds to androgen receptors). Of course, theres those of us that the above methods STILL didn't cut it and so we moved on to other drugs such as [U]Insulin Sensitizers [/U] ([B]Avandia[/B], Metaformin) or [U]Glucocorticoids[/U] ([B]Dexamethosone[/B]) to help our body's hormones stabilize. Glucocorticoids, help to reduce inflammation and rebalance your adrenal glands (another source for steriod hormone production). Whereas, Insulin Sensitizers, help your body's cells take in MORE Glucose...although it's been debated that FORCING your body take in more glucose when it's already full (form of Insulin resistance) can actually cause more problems down the road (Type II diabetes or Type I Diabetes due to pancreas burn out).

[B]Notice I said NOTHING about Antibiotics[/B]. The only reason these work is by [U]preventing inflammation[/U]. In fact some of these, such as Minocycline and Tetracycline, actually [B]Increase your DHT production![/B] I guess that would explain why some acne sufferers, including myself, brokeout worse the ever before after stopping them. =( Out of all the treatments and supposed cures out there, I think that Antiboitics is the worst of them. It gives us all false hope into thinking that we have attained clear skin, when in fact upon stopping we realize that we haven't.

Then again, the same can be said for [B]Accutane[/B] (temp. solution that works as an anti-androgen by decreasing IGF-1 levels) and practically any other solution, EXCEPT unlike certain antibiotics, they don't secretly increase our male hormones. If you are beyond puberty and find something that clears your skin, I can almost guarantee [U]you will have to stay on this treatment or regimen for the rest of your life[/U]. Therefore, [B]it's best to find the safest, healthiest, and most cost effective solutions [/B] out there, and that's where a change in diet comes in to play ;-)

Granted you can take supplements, or Birth controls, any prescription really, just as long as it works [B]and [/B] you won't experience any negative side effects. If these things will cause you problems or you've discovered they don't work very well, that's actually when dietary changes became so popular. This was actually the last thing I did for myself, although for 10 years I avoided Chocolate and Soda with no results. I wasn't desperate, but I was EDUCATED and aware of my own hormonal condition and along with the testimonies of former sufferers, I took the plunge.

Heck by changing your diet once can reduce inflammation, reduce sebum, reduce/balance steriod hormones (especially those androgens), reduce IGF-1, and Increases SHBG (anti-androgenic) and IGFBP-3 (binds to IGF-1) and Prostaglandins among others so why not???
to continue...

So like I mentioned before, I'm not surprised that I ended up being skinny and having acne. I tried to gain weight for years eating more carbohydrates (and protein) because I had heard how that would make you gain wieght. Except, right now it's not in my genetic makeup to gain weight (so I don't care as much). It turns out my mother had acne as bad as mine, body acne like me too and was skinny when she was younger and now she doesn't have acne, but she's a bit overwieght. She still eats the same foods, perhaps more so along the lines of unhealthy foods and she's definately a sugar addict. In fact, the majority of the women in her family are either overwieght or obese! Whereas, on my father's side of the family we've got a few (borderline) Diabetes Type II to deal with. So no wonder I turned out the way that I did ;-)

I've been dealing with acne for 16 years and I finally got a diagnosis over 2 years ago! After going through doctors, one nice dermatologist, and 2 other endocrinologists, I FINALLY hit the jackpot! I'm forever grateful to all of them, but this (3rd) Endocrinologist is the one that really helped me understand why the suggestion of low carbing, really should be much more emphasized. Granted he wanted me to stay on the Avandia (I didn't), but he freely admitted that my skin was doing really well after I had switched my diet =)

He dx me as being either PCOS or Insulin Resistant (same treatments) and since IR is the Precursor to PCOS and I don't really have those symptoms I just tell people I'm Insulin Resistant. There's actually [U]2 forms of Insulin Resistance[/U], but I usually only stress the aftermath of these forms and never really explained the difference between the two. Did you know that [U]within minutes of consuming too much glucose[/U], your cells become insulin resistant??? That's right, [u]you can become Insulin Resistant (IR) due to your diet being too HIGH in Glucose [/u] (why people low carbohydrate diet). [B]When your cells become FULL of Glucose, they stop responding to the Insulin that's required for the entrance of [U]More[/U] glucose. Furthermore, since your [B]liver[/B] (and muscles) will also become insulin resistant, it starts to [B]produce MORE Glucose [/B] as well. Thus further increasing your Blood Sugar levels, which, INCREASES your Insulin Levels. Therefore, [U]lower your (high) glucose levels[/U], and the cells will respond normally again, and Insulin resistance [U]disappears[/U][/B]. This is why it may not be wise for some people to take Insulin Sensitizing Drugs, because they may not be genetically prone to IR, but due to their [B]lifestyle[/B] they have become so. Taking drugs that FORCE your cells to uptake more Glucose, theoretically can eventually make you a diabetic.

So, just to give things a bit more perspective, [B]have you ever added up the amount of carbohydrates you eat in a day?[/B] Well if you were to follow the food pyramids suggestions and included a nice amount of junk food,[B] those on the "Western Diet" would be consuming 200g - 800g of Carbohydrates a day![/B] As a result of switching my diet, [B]I currently consume 200g - 300g of carbohydrates a day[/B], which is around the average (200g). So there's definately room for some form of low carbing for most people ;-) Unfortunately there are people that freak out over that because (the wrong) low carbohydrate dieting made them sick, but it's [B]NOT[/B] about eating 30g (a box of raisens) - 50g of Carbs a day! It's SIMPLY about [B]Lowering your EXCESSIVE amounts of carbohydrates [/B] and possibly the other foods that can also increase your Insulin Resistance or IGF-1 levels.

Now, the other way to become Insulin Resistant is due to your [U]genetics or some form of nutrient difficiency or alteration[/U]. I'm still looking this part up, but I apparently there are genes that code for Altered Insulin, thus the body's cells don't recognize it Infact, this can be due to the consumption of Hydrogenated/Partially Hydrogenated Oils and Trans Fats. [url][/url]


Also, Insulin Resistance is a natural part of puberty. Infact, [B]Puberty is actually defined as "a state of Insulin Resistance". [/B] Therefore, [B]anyone[/B] going through Puberty [B]MUST[/B] enter "a state of Insulin Resistance" in order for the body to grow (sounds odd I know).
[url][/url] (another accutane connection)
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So, [U]my theory [/U] on this (based on collected facts) is that since Insulin (glucose isn't really the problem) is a KEY player in [B]Steriod Hormone Synthesis [/B] (Estrogens, Androgens, and Progesterone) maybe the body signals the Insulin Receptor cells to deactivate in order to INCREASE these hormones so that we can have our Growth spurts and develop further as males and females (of course this can also screw up our development) during [U]Puberty[/U]. To further expand on this, since Cholesterol (we need the fats, but bad fats?) is what Steriod Hormones are made from (think Testosterone) that could be why some of us Get acne (more cholesterol to produce testosterone, etc from) while others end up having High Cholesterol Levels or Being Overweight....because Insulin Resistance Increases all of these factors and [U]your body decides which problem it would "prefer". [/U]

So let me say that again only a bit differenlty. Since Insulin Levels have also been connected to Leptin levels, Leptin is a proten that tells our brains to eat more so that we can have MORE fat cells, this would explain why 60% of the population in the U.S. are now considered Overwieght or Obese. OK, so that means that when we eat whatever we want, we are increasing the fats in our bodies, correct??? Except, some of us aren't overwieght, right? Perhaps that's because:

Our body says "hey, I don't want to be overwieght/obese, so I'm going to take these extra fats and turn them into cholesterol and just produce more steriod (male) hormones. Hence the BIRTH of a nice variety of [U]Hormonal Disorders that have acne as a symptom[/U]...

Where as, other teenagers and adults bodies are saying, "hey, I don't want to be overwieght either so I'm just going to not do anything and I'll let these fats compete with sugar in the blood stream (why B5 works) and clog our arteries."

With that knowledge and more, I'm sure you can come up with other scenarios that explain why "you have acne, and 'Jane' doesn't" or why "you are underwieght and 'joe' is overweight". Regardless, [B]finding the right [U]Insulin Controlling-Hormonal Balancing [/U] diet that's also healthy for your nutritionally can work wonders. [/B] As you've noted, your skin is now dryer and that's probably due to the fact that you don't get enough EFA's in your system (is the rest of your skin dry?). I would suggest fish oils, but since your a vegetarian I'm not certain you'd want that. You can try consuming Flax Seed, Evening promrose oil and others to give you a Vegan EFA supply. That should take care of the dryness (did you know hydrogenated oils, Insulin, & certain food enzymes can cause EFA imbalance?) and may just improve your acne even more ;-)

Indeed, EFAs are in charge of producing [B]prostaglandins[/B], body's hormone balancers, and are also involved in helping balance our insulin levels as well as increasing the [B]good[/B] prostaglandins involved in reducing inflammation (why I no longer suffer from menstrual cramps and all I did was stop eating most grains) . So taking 1 - 3 g max of this (especially Omega 3s) if you don't consume [B]seafood[/B], meats, is your best bet.

So tell me more about the diet you were on. I had no trouble following my diet (gluten free/low grain, and avoidance of peanuts, cashews, bananas, cherries, and soda), but of course, I'm not a vegetarian. So the ONLY foods you ate for two months were Vegetables, Nuts, Seeds??? No Diary? No Fruits? Fast Foods? Hmm, How clear did this get you? Were you consumng any of the other Intolerant Reaction/Inflammatory reducing foods (find a list in Perricone's acne prescription) such as Peanuts and Bananas??? You wouldn't believe what a difference eliminating additional (if they are a) PROBLEM foods will do for you. Some people don't have to and others like myself and several others around here had to do so in order to keep that cystic acne away.

Well anyway, that's all I've got for you. I hope I covered most of your questions and if you want food suggestions, medication suggestions and tests to ask your doctor about (if I can find that post) I can post those for you as well. Again, glad to see you here. There's so many knowledgeable people on here that I'm sure we'll help you figure things out. =)

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