If you’ve ever been to a Western medicine provider for the treatment of your acne, you may have asked about your diet and the role it plays in breakouts. You may have also heard the answer, no, there is no evidence to show diet plays a role in acne. Eat what you like.
I never used this line in my practice, however, prior to the holistic education I gained myself, I used to tell patients something along the lines of: we don’t have any specific evidence of diet and acne, mostly because this is such a difficult study to perform. In Western Medicine, we rely heavily on evidence-based studies to make our recommendations.
If you’ve read any of my other articles, you’ll understand now that many things play a cohesive role in the development of acne, such as skin care, hair care, oral care, stress, sleep, additional hygiene habits, living environments, and food. How do we control all of these things on a large number of people, to check, for instance, if eggs cause acne? It would be really hard, maybe impossible.
I recently read the book The Clear Skin Diet, by authors Alan C. Logan, ND, FRSH, and Valori Trelar, MD, CNS, FAAD. This was written in 2007, but still contains 276 pages of fascinating research articles and clinic drawn information regarding diet and acne. They noted an opinion piece by dermatologist E. William Rosenburg in the Archives of Dermatology (1981), sharing a quote from his article: “We could make a good case for diet as the primary [cause] for acne if we could demonstrate enough absence of the disease in populations whose diets are unlike those of people in the West.”
The authors went on to discuss the journal article Acne Vulgaris, A Disease of Western Civilization, published in the Archives of Dermatology in 2002. The authors of this article (Loren Cordain, PhD; Staffan Lindeberg, MD, PhD; and Magdalena Hurtado, PhD) were comprised of primary care physicians who observed the prevalence of acne in two different communities, the Kitavan Islanders of Papua New Guinea and the Ache community of Paraguay (1). Both of these communities were relatively untouched by Western society dietary influencers at the time of writing, and an amazing observation was made:
“Of 1200 Kitavan subjects examined (including 300 aged 15-25 years), no case of acne (papule, pustule, or open comedone) was observed. Of 115 Aché subjects examined (including 15 aged 15-25 years) over 843 days, no case of active acne (mild, moderate, or severe) was observed (2).”
It was noted that the Kitavans mostly consumed fish, roots, fruits, and coconuts. The Ache consumed diets rich in wild-caught game, local farmed goods, nuts, and foraged roots. Western food prevalence was near nil in the Kitavans, and around 8% in the Ache community. Consumption of dairy was near nil in both communities. Omego-3 fatty acid intake was high. Both diets were also high in antioxidants and low in glycemic load (2).
The authors also discussed the consideration of genetics here. We know genetics play a role in the development of acne, so maybe genetically the Kitavans and Ache couldn’t create acne? But previous studies had shown members of the same ethnic backgrounds living in more Westernized settings, including a daily Western diet, did experience acne (1).
Authors of The Clear Skin Diet further went on to quote additional articles regarding the same changes, including one that had been published in Nutrition Today (1971) by Dr. Otto Schafer, a physician that had spent 30 years treating the remote Inuit in Alberta, Canada. Their diets initially included mostly fish, wild game, berries, roots, some greens, and seaweed, but as the Western dietary influences reached them, and the intake per person of sugar increased by 75% over the course of 8 years, the rates of acne soared (1).
Similar changes were noted in Eskimos (Hospital Practice, 1974), as well as the Japanese (Japanese Journal of Dermatology, 2001): as the Western diet reached their communities, the acne became more prevalent (1).
So, while it may be difficult to impossible to isolate diet in a Western community as a cause of acne, when we look at those communities who have been without the Western diet, we see clear skin. Diet is not the only factor playing a role in acne, but it is a major factor. It is oftentimes one of the hardest to change as well. It’s hard to give up the cookies, and ice cream, and fried foods, etc. But when you’ve gone through all the other countless routes to clear up your acne, and you haven’t yet found your cure, this may be the next and best place to start.
Links to articles about:
Dairy
Eggs
Processed foods
Peanut butter
Etc. all food artciles I write
The Clear Skin Diet
https://jamanetwork.com/journals/jamadermatology/fullarticle/479093
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