Dermatologists have a nasty name for pimples. The term they use is “acne vulgaris.” Sounds vulgar, doesn’t it? But vulgaris actually means “common” in Latin, so the medical term means common facial eruptions.
There are lots of myths about the causes of acne. One of the most prevalent is that only teenagers suffer acne. A related view is that acne is an unavoidable consequence of the hormone surges of adolescence. The fact that 79% to 95% of adolescents in such places as North America, Europe, Australia and New Zealand are afflicted with acne helps keep that myth alive (Archives of Dermatology, December 2002).
In actuality, though, many adults are plagued with acne well beyond their teen years. Around half of men and women over 25 have some facial acne.
What’s more, adolescents in other places aren’t always troubled by zits. Anthropologists report that in Mali, for example, adolescent boys are far less likely to have acne than in the U.S. (Evolution, Medicine and Public Health, Sept. 20, 2016). If these boys do have breakouts, they are much less severe than is common elsewhere. Adolescents in non-Western societies in Papua New Guinea and Paraguay don’t experience acne as American and European teens do, either.
The scientists who reported on the Ache of Paraguay and the Kitavan youngsters of Papua New Guinea hypothesized that diet is an important driver. These populations consume almost no processed foods, dairy, alcohol, coffee, tea or oils. While their meals are high in carbohydrates, they are low in glycemic load. That is, they don’t raise blood sugar and insulin rapidly.
An editorial linked to this report points out that dermatologists have changed their attitudes toward diet over the years (Archives of Dermatology, December 2002). In the early 1950s, dermatologists were encouraged to warn patients “to avoid chocolate, fats, sweets and carbonated beverages.” But by the 1960s and later, dermatologists argued that diet had no role in acne vulgaris.
It now seems possible, however, that a diet high in processed foods that push blood sugar and insulin up quickly may also lead to a cascade of other hormonal changes that can affect the skin.
A review of studies concluded, on the other hand, that milk and other dairy products are strongly associated with the prevalence of acne (International Journal of Dermatology, March 19, 2009). A Norwegian study confirmed an association between high milk intake and acne in high-school students (Journal of the European Academy of Dermatology and Venereology, March 2017). Also, a meta-analysis concluded that “any dairy, such as milk, yogurt and cheese, was associated with an increased OR Odds Ratio — for acne in individuals aged 7-30 years” (Nutrients, Aug. 9, 2018).
We don’t know exactly how dairy products increase the risk of acne, but some researchers have suggested that the high levels of the amino acid leucine found in milk may drive the production of excess fatty acids in hair follicles (Dermatoendocrinology, Jan. 1, 2012). They proposed that controlling acne could best be achieved by lowering levels of the enzyme mTORC1: “An attenuation of mTORC1 signaling is only possible by increasing the consumption of vegetables and fruit, the major components of vegan or Paleolithic diets.”
Other scientists looking at the causes of acne vulgaris agree that mTORC1 (mammalian target of rapamycin complex 1) is among the most important factors (Archives of Dermatological Research, July 2019). A diet low in processed foods and dairy products and high in vegetables can dampen this enzyme’s activity and should prove helpful for clear skin.
King Features Syndicate