There is growing evidence that diet may influence the incidence and severity of acne vulgaris, one of the most common skin conditions in the US.1 Much of the previous literature on the role of diet in acne has focused on the association of milk consumption and high glycemic-load diet with acne. For instance, milk consumption is thought to increase insulin and insulinlike-growth factor 1 levels, which can induce lipogenesis and proliferation of both keratinocytes and sebocytes.2,3 In addition, insulinlike-growth factor 1 can stimulate androgen synthesis and decrease production of sex hormone–binding globulin. Bovine insulinlike-growth factor 1 and androgens present in milk may also promote the development of acne.2,3