For a long time nobody knew why teenagers get acne. But many assumed that it would come from hormonal changes as teenagers grow up. But why then are there some ethnic regions in the world where teenagers do not get acne? In this blog I will present the background that shows that wheat, sugar and dairy products are the culprits. They are not eaten in those regions of our planet where acne does not exist.
Regions where acne does not exist
1. The Kitivan Islanders of Papua New Guinea have no cases of acne in teenagers. They adhere to the old hunter/gatherer diet of no sugar, no alcohol, no wheat and no grains. Instead they eat root vegetables such as sweet potato, yam, taro, tapioca; fruit like papaya, pineapple, banana, mango, watermelon, guava and pumpkin; and also vegetables, coconuts and fish.
2. African Bantus and Zulus: These original African warriors eat a low glycemic diet with no wheat, no milk and no refined sugar or starches. Their teenagers and young adult do not have acne, if they stick to the original tribal diet.
3. Aché hunter/gatherers of Paraguay: a study by researchers from the Colorado State University in 2002 showed that sugar, wheat and other high-glycemic foods were missing in the diet of these native tribes. As a result they have no acne when they consume this type of diet, which is very similar to the Kitivan Islanders of Papua New Guinea.
4. Japan’s Okinawans when sticking to their original diet before 1970 had clear complexion and no pimples (acne). But as this link shows the McDonald’s and other fast foods with too much salt, too much sugar, wheat, deep fried and convenience foods entered the scene after 1970 and the acne rate went up to the American level.
5. The natives of the Purus Valley in Brazil: A dermatological examination of 9955 school children age 6 to 16 showed an acne incidence of only 2.7%. In contrast in Westernized countries the rate of acne is 60 to 80%. The diet in this region is again similar to the other groups already mentioned above.
6. Canadian Inuit before 1950 did not consume dairy products and were acne free. Since then there has been a steady increase of dairy products, soda, beef, and processed foods.
How acne develops
The medical term for pimples or acne is “acne vulgaris”. For years it has been postulated that hormones and medication can cause acne. According to Ref.1 there are several steps that work together in causing acne. The hair follicle and sebaceous gland work as one unit. Male hormones, called androgens play an important role in the development of acne, both in males and females. Testosterone in males is not only produced in testicles, but also in the skin itself. It gets converted by an enzyme, 5-alpha-reductase, into the much more active metabolite dihydrotestosterone. In individuals with hypersensitive receptors in the sebaceous gland this will cause blockage in the sebaceous gland duct and at the same time stimulate the sebaceous gland oil production leading to the formation of a keratotic plug. White heads and black heads are formed this way. Contributing factors are inflammatory substances that are caused by insulin release stimulated by sugar, wheat and starch intake. This stimulates IGF-1 receptors in the skin, which causes growth of the subcutaneous skin layers, which is pushing up from the layer below the skin, kinking the sebaceous gland duct and causing acne pustules (pimples) to form. A skin bacterium, called Propionibacterium acnes (P. acnes), is getting trapped in the pimple causing a local skin infection, which in turn can cause acne cysts and furuncles, particularly in males where there is a family history of acne. High cortisol levels from stress can also be a contributing factor in causing acne. Today’s teenagers are exposed to a lot of stresses from exams, competitive sports and peer pressures.
Females with PCOS (polycystic ovary syndrome) have higher androgen production from ovarian cysts, which results in acne as well.
Both male and female teenagers experience an androgen surge when puberty sets in. If the teenager avoids the additional insulin response, which comes from eating sugar, starch, grain and particularly from consuming wheat and wheat products, the plugging up of skin pores will not occur, meaning these teenagers will be acne free. Some teenagers are also sensitive to milk protein from milk and milk products. In sensitive people whey protein allergy causes the same insulin/skin IGF-1 response described above, which leads to blocking of skin pores. If there is no blockage in the hair follicle, the P. acnes bacteria will stay on the surface of the skin (these bacteria are part of the normal skin flora) and the sebaceous gland secretions flow unimpededly to the surface of the skin keeping it naturally lubricated. These observations are further confirmed by a study from Malaysia in 2012 showing that a high glycemic load diet with milk and ice cream caused worsening of acne in teenagers of both sexes.
Treating acne correctly
A) Conventional acne treatment
This is a thorny issue, because Big Pharma has a firm hand in the treatment of acne and they are supporting symptomatic treatment of acne rather than treating the cause. There are surface treatment modalities that are supposed to open the skin pores: peeling agents such as benzoyl peroxide. General practitioners often treat the infection with antibiotic pills (tetracycline or erythromycin), but this is not treating the cause, only the super infection that comes from the plugged up skin pores (stasis of sebaceous gland secretions). Another approach is topical application of antibiotic and peeling agent in combination (1% clindamycin and 5% benzoyl peroxide gel), which is applied twice daily (Ref.2). Resistant cases, usually the ones who have a family history of severe acne, have been treated by a skin specialist who has a special license to treat with isotretinoin (Accutane), a vitamin A derivative, which works in many cases, but which can have serious side effects. These include skin dryness, eye dryness, muscle and bone pains, headaches, liver enzyme abnormalities, and instability of mood including depression and causing birth defects in the fetus of a pregnant woman (Ref. 3). In 2009 the manufacturer stopped distributing the drug in the US, because of too many lawsuits regarding damages from the drug.
I am not saying you should ever take this toxic medication. What I am saying is that treating symptoms, but not the cause has led to peculiar drug manufacturing. This drug is now used to treat brain cancer and pancreatic cancer.
B) Dietary approach to treat acne
There has been a renewed interest in the last 40 years to sort out the connection between dietary factors and acne.
The most straightforward treatment in my opinion is to modify what you eat.
A clinical trial from the University of Melbourne in 2007 showed that a low-glycemic diet reduced the acne lesions by 22% compared to a control group.
Two factors are clear: a low-glycemic diet produces fewer pimples, the stricter the low-glycemic diet is applied, the more effective the treatment will be. Up to 50% reduction in acne lesions were observed among patients with acne who adhered to a strict low-glycemic index diet in just 12 weeks. There is also evidence that milk and other dairy products can contribute to acne, which works through the same mechanism of IGF-1 stimulation mentioned above.
A US study from Boston showed a 22% increase in acne lesions with total milk consumption and increase of 44% after skim milk consumption.
Omega-3-fatty acid supplementation is useful for inflammatory acne in about 2/3 of the cases as this study showed. Here is a patient from this study who benefitted from omega-3 supplementation. The baseline image is seen with inflammatory acne lesions on his cheek. Only 12 weeks after taking 3 Grams of omega-3 supplementation daily his face looked much improved.
There is a lesson to be learnt from the analysis of the regions in the world where acne does not exist and from all these observational studies mentioned. Cutting out wheat, wheat products, grains, sugar, milk and milk products will lead to amazing results regarding acne prevention and improvement of patients who suffer from acne. We have been lulled into believing that medical science will give us a magic pill or magic potion that would solve our complexion problems. As mentioned above one of the “magic pills” (isotretinoin) is so toxic that it is now used for cancer treatments. All along we allowed the food industry to destroy our complexion by inducing an insulin and IGF-1 response that plugged up our skin pores. We can open them up by eliminating wheat and wheat products, sugar, high-glycemic foods as well as dairy products.
More information on acne: http://nethealthbook.com/dermatology-skin-disease/acne-vulgaris/
- Rakel: Integrative Medicine, 3rd ed., Saunders 2012. Chapter 73 : Acne Vulgaris and Acne Rosacea, by Sean H. Zager, MD
- Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed., © 2009 Churchill Livingstone.
- Cleveland Clinic: Current Clinical Medicine, 2nd ed., © 2010 Saunders.
Last edited Nov. 7, 2014
Incoming search terms:
- how do processed foods affect acne
- sugar intake acne
- food AND pimples
- food influence rosacea
- gluten and acne