Acne vulgaris and spotty teenagers

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There might be a link between diet and acne – I explore this link over the next few articles

Acne – or Acne Vulgaris, to give it its proper name – is a chronic inflammatory disease of pilosebaceous units (Rathi, 2011). Let’s just call them sebaceous (se-bay-schuss) units, or sebocytes, for now. It is a common yet complex disease that affects individuals of all ages, typically adolescents, but can persist into adulthood (Smith, 2007). The scientific and medical community seem to have a good handle on treating acne vulgaris – despite not being totally clear on what causes acne – so if you/your child/a friend begins to suffer from acne, seek professional advice quickly! (I will detail more about treating acne via diet manipulation in Part 3).

The interesting thing is that acne vulgaris does not seem to occur in populations that have remained isolated from western lifestyles (i.e. the western lifestyles that we now live, typically characterised by a diet rich in refined/processed carbohydrates & sugar-containing beverages, ‘food-like’ products and fast/fried food).

refined carbohydratesAcne vulgaris

The current prevalence of acne could be irrespective of diet, and a result of a whole host of other factors such as: sunlight, stress, pollution, along with many more factors that co-exist with a much less processed diet typically found in non-westernised societies. So, from the outset, I should state that I don’t know for sure whether acne is *caused* by diet, and it’s quite possible that diet has very little to do with acne! However, diet is a major factor in environmental differences, and has also undergone a large change in recent years. Moreover, although observational research – like the one mentioned above – should not be used to demonstrate cause and effect, it can be a starting point for further investigation. Ultimately, if diet does in actuality have an affect on acne, I’ll try to explain the potential mechanisms by which this might occur.

Two such populations studied, with regard to acne, were the Kitavans and the Ache. The Kitavans live in Papua New Guinea and the Ache inhabit Paraguay. A study by Cordain et al (2002) revealed that not one single instance of acne was recorded when investigating the health of the individuals in these societies. This contrasted heavily with westernised lifestyles, in which acne is estimated to affect 80 – 90% of the adolescent population, and upwards of 40% of individuals over the age of 25.

Genetics

Is it simply a genetic problem, and nothing to do with diet? Twin studies suggest that sebum secretion (from sebocytes) is to some degree under genetic control, so the development of acne vulgaris has hereditary components, and therefore some people may get lucky and not have to worry about acne ever, whilst others get unlucky. Genetics does not solely account for development of acne, however, thus environmental factors do play a role. Moreover, when individuals from non-westernised societies (such as the Inuit, Kitavan, Ache etc.) transition to a westernised lifestyle, the incidence of acne increases significantly.

milkSo what causes acne, or what – from a dietary perspective – may makes acne more likely? It’s possible that there are two things: 1) high GI (glycaemic index) carbohydrates, and in turn a diet with a high glycaemic load; and 2) dairy foods. It is thought that foods with a high GI, eaten in a diet with a high Glycaemic Load, or dairy foods containing the milk proteins whey & casein, lead to a rapid release of insulin, and the repeated exposure to conditions of hyper-insulinaemia (high levels of insulin) may exacerbate/worsen or induce symptoms of acne.

In part 2 I’ll take a closer look at the mechanisms that actually stimulate acne development.