A Closer Look at the Connection between Western Diet and Acne

It is well-known anecdotally, although not deeply reinforced by clinical research, that diet plays a potentially big role in promoting acne. By some estimates, diet is responsible for up to 25% of the components of the growth and severity of acne. In particular, three main food classes are thought to promote acne: hyperglycemic carbohydrates; milk and other dairy products; and saturated fats. This is bad news for lovers of chocolate, French fries, and my personal favorite, Ben & Jerry’s Chubby Hubby ice cream.

Diet is almost certainly only a contributing factor to acne prevalence and severity. But a recent, exhaustive review in Clinical, Cosmetic and Investigational Dermatology strongly reinforces the idea that diet can play a particularly large role, alongside other factors such as hormones, stress, sleep levels, good skin care, and geography. The review is an essential read for dermatologists, because it looks at all the pertinent studies linking acne with dietary issues, explains the pathogenesis behind the impact of these foods, and provides some novel insights into the many factors that contribute to acne growth and severity.

Though the study is too large to adequately summarize here, there are a few interesting points worth mentioning. First, the authors discuss the fact that most dermatologists define acne as an androgen-dependent skin disease, and they acknowledge the involvement of AR-dependent signaling in the pathogenesis of acne. But the authors make the connection illustrated in earlier research that not serum androgens but serum levels of insulin-like growth factor 1 (IGF-1) plays the primary role in acne pathogenesis. “IGF-1 signaling is the central endocrine pathway of puberty and sexual maturation, and is the converging point of nutrient signaling in acne,” the authors note.

The study also cites the examples of Kitavan islanders of Papua New Guinea, the Ache hunters in Paraguay, and the Inuit—all acne-free populations—and point out that the Inuits and others showed an increase in acne prevalence after a transition from their traditional diets to Western nutrition.

According to the study authors, “Acne patients should control their total calorie uptake and restrict sugar and refined carbohydrates, milk, whey, and casein protein supplements, saturated fats, and trans-fats… The ideal ‘antiacne diet’ will be a paleolithic-like nutri­tion with accentuated intake of vegetables and fruits with low glycemic index and sea fish…”

So much for the Chubby Hubby.