New acne issue -- 17yo girl

[LisaKinVA]

My oldest daughter has never really had an issue with acne -- barring the occasional hormone-related pimple here and there.  However, in the past 5 months, she has developed quite a bit of acne that doesn't seem to clear up.

The last time she had acne this badly, it was firmly rooted in her diet, she had gone vegetarian and her milk/whey/sugar consumption went way up.  A year ago, she went vegan.  She is a highly competitive athlete, so her nutrition is carefully monitored to make sure she's getting a full complement of bio-accessible micro-nutrients (and the macros).  She has strong food sensitivities to tree nuts.  She can (and does) consume pine nuts, seeds, almonds and peanuts.  She uses Almond/Flax milk and pea protein powder, and then eats quite a bit of Tofu, Tempeh and Seitan.  

My first thought was this could be dietary again.  The only change she had made in her diet was switching brands of pea protein powder.  She did notice that the new brand seemed to upset her stomach.  She switched back and those issues resolved, but the acne remains.

**full disclosure, I am extremely sensitive to peas and pea protein even today, although I can now tolerate peanuts -- which I really couldn't eat as a child** DD only responds to cashews the way I did to peas.    DD does not consume much bread or sugar**

We've already tested and ruled out anything that she's putting on her face, and she did recently grow an inch... could have another inch hiding in there somewhere I suppose.

The changes we made all had some minimal impact -- but she still has quite a bit of acne on her forehead.  The acne on her cheeks seemed to clear up when we switched her wash cloth (to a Norwex one, and just uses water).  

I'm guessing I need to take her to an allergist and have a full compliment of testing done again.  DD knows we need to do this, but a part of her is dreading it, because if dietary issues do come up, she will be very upset.  Maintaining her lifestyle has been fairly difficult already with the limitations she's had due to the known food sensitivities. -- in the meantime, is there anything else I should look into?  

Edited October 12, 2019 by LisaK in VA

[City Mouse]

If she is still growing, then I would assume that it is hormone related rather than allergies or dietary. 

[J-rap]

Apart from typical triggers, a couple of my kids swear that a change in water brings out acne in them.   They always knew that when they stayed at my parents' home for a few days, for example, their acne would break out after showering there.  It happened at other places too.  

[Guest2]

My daughter reacted to some gluten that was in her hair products.  I am not sure if it was shampoo, conditioner, or one of her many other products right now.  My DD started investigating and found gluten in  a surprising number of products.

[EKS]

When I was in my early 20s, that is to say 30 years ago, I went to a dermatologist about my acne, which had gotten worse as I aged.  It seemed counterintuitive to me, but she said that it was a common thing.  She gave me some potions to put on my face and after a few months it was all cleared up.  And it has stayed cleared up until this day.  

[Lawana]

Ds cleared up his face by taking Zinc, which I learned was a thing here on WTM. Zinc Picolinate 50mg (the Now brand I have is labeled vegan). Zinc is found predominantly in animal sources, and some say plant sources are not readily absorbed. So she might be deficient?