What causes acne?

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This article looks at the possible causes of acne

Quote: Recent evidence has demonstrated that the hormonal cascade triggered by diet-induced hyperinsulinaemia elicits an endocrine response that simultaneously promotes unregulated tissue growth and enhanced androgen synthesis (Cordain et al. 2002)

What this means: certain foods we eat may trigger an insulin response that leads to an environment promoting acne development.

What causes acne?

Consuming carbohydrate and protein leads to the release of insulin, a hormone responsible for storing the products of digestion. It promotes amino acid uptake (amino acids are what we get when we breakdown protein), fostering muscle growth, and glucose uptake, which fosters glycogen (energy store) replacement. The amount of insulin released is affected by a variety of factors e.g. time of day, type of food eaten, amount of food eaten etc. However, it appears possible that chronically high levels of insulin – and the numerous consequences that this has – might increase the likelihood of acne development.man-945481_1280

High levels of insulin (hyperinsulinaemia) increases IGF-1 (insulin-like growth factor 1), which in turn promotes tissue growth. This would be a really beneficial thing in childhood or adolescence, when growth is of primary importance. This isn’t as paramount, however, much further beyond adolescence. One tissue affected by IGF-1 is follicular tissue i.e. sebaceous follicles. So here’s one potential link…

Hyperinsulinaemia also reduces something called IGFBP-1 and -3 (insulin-like growth factor binding protein 1 &/or 3), which acts to inhibit tissue growth by preventing IGF-1 from binding to its receptor. Low levels of IGFBP-3, induced by hypersinsulinaemia, may reduce the effectiveness of the body’s natural retinoids to activate genes that would normally limit follicular cell growth/proliferation. Consequently, the mechanisms that might help to limit/prevent acne run low, and the processes that lead to acne development are very much switched on. So here’s another potential link between acne and diet … a method that may slow-down or prevent excessive tissue growth goes ‘missing’…

In addition, sebum production – essential to the development of acne – is stimulated by androgens (a group of male sex hormones, hence the rapid onset of acne in adolescence). IGF-1 & insulin stimulate the synthesis of androgens (in female ovaries and male testes). Here’s another link then…. AND…..Additionally, sebum production is stimulated by IGF-1 and insulin directly, as well as by the androgen these hormones stimulate.

footprint-285191_640So, Sebum is stimulated by androgens, insulin & IGF-1 (hyperinsulinaemia means high levels of IGF-1 & insulin). And, IGF-1 & insulin stimulate androgens DIRECTLY too. Hyperinsulinaemia inhibits SHBG also, thereby increasing the bioavailability of circulating androgens

*SHBG = sex hormone binding globulin

The role of insulin in acne development is also supported by the prevalence of acne in women with PCOS (Poly cystsic ovarian syndrome), a condition associated with insulin resistance, hyperinsulinaemia and hyperandrogenism. *However, one may experience a much greater improvement in symptoms through weight loss, and not necessarily what one eats/avoids eating*

Hyper = high / greater than / above (opposite to ‘hypo’)
Hyper insulinaemia = high levels of insulin
Hyper androgenism = high levels of male sex hormones (which are found in both men and women, its perfectly normal)

Take home – what causes acne: it is possible that in an individual prone to suffering from acne may experience a worsening of symptoms with a diet high in dairy products, or repeatedly consuming foods consisting of a high glycaemic index. It is also very possible that there are many individual differences. It is also quite possible that diet doesn’t affect acne, either way. However, if there is in fact a link – i.e. if it’s demonstrated in research trials, or you personally find a solution that works for you – then what I’ve described above may be the process by which it occurs.

That’s it for Part 2! Read part 3 for treating acne with diet manipulation