Diet and Acne

Two years ago I guest-blogged at the Freakonomics blog about diet and acne. I wrote that the claim of dermatologists that there is no link between diet and acne was absurd, not only because I had seen for myself such a link but also because it was an impossibly broad generalization.

In an article in the Boston Globe, Cynthia Graber, a science journalist, describes quite a bit of evidence that yes, diet affects acne. The research on which the no-link claim was based tested only two foods (chocolate and sugar)! From which committees of dermatologists generalized to all foods.

SO WHY HAVE DOCTORS been taught for so long that there’s no link? The anti-diet hypothesis . . . arose solely from two studies from the late 1960s and early 1970s. . . . One compares real chocolate bars with fake ones and was conducted at the University of Pennsylvania School of Medicine with funding from the Chocolate Manufacturers Association. . . . The other study examines sugar in the diet of a small group.

It’s like that scene in the Wizard of Oz where the Great Oz is revealed to be an ordinary man behind a curtain. All those knowledgeable-sounding claims by dermatologists, based on nothing more than this.

Conventional research on the subject is difficult, both because of funding problems — drug companies won’t fund such research; and dairy farmers won’t fund experiments to find out if dairy causes acne — and because it’s clear that many different foods are involved. On the other hand, determining the effect of Food X or Y on your own acne is easy. I wonder why someone doesn’t build a website to gather information from such self-experiments. If I had superpowers, I would.

More about diet and acne.

9 Replies to “Diet and Acne”

  1. Maybe you do have superpowers and just don’t know it. I think the first thing you would need is a general collaborative framework for hosting self-experimentation studies. This would be a webapp with various features. Ability to create users, control access to various parts of the site based on roles that users have, forums for sure, and some wiki-like areas, but also some facility for allowing participants to submit their data. Maybe some generic spreadsheet like area where the study coordinator could create a spreadsheet template that participants use to submit their own data for a particular experiment. You’d probably need some kind of plugin architecture so custom modules could be added for specific studies.

    Anyway, thing out loud (i.e. blog) about what you’d want. What you’re actually doing is creating a spec (“specification” or document describing what a piece of software should do; typically when software is written, it is written to implement a spec. So when it’s tested, the tester checks to see if the software actually does what the spec says it should do). Perhaps someone out there will know of some combination of existing free software that already does what you want. Perhaps there’s a developer out there with acne and some free time who will start implementing it as an open source project for you.

  2. Thanks, David. Were I to try to create such a website, I think I’d start with a forum. Each food or food group or other possible cause (e.g., washing your face too much, too little sunlight) would be a branch of the forum. Perhaps each branch would have two subbranches: yes (this does cause acne) and no (this doesn’t cause acne). People with relevant experience would post their experience in the appropriate place. For example if you tried avoiding dairy for 3 weeks, you’d post about what you did and what you found under either the dairy-yes branch or the dairy-no branch.

  3. Someone, somewhere tested bread and came up with the idea that it, and probably other foods based on processed carbs increases the likelihood of acne. I suspect this particular blurb came from some weightlifting magazine, so I’m not sure of the source.

    I have, however, been on a bread making kick for the last few months, and I’ve also noticed more acne. Probably not nearly scientific enough, but it seems to match.

  4. You definitely could do the whole thing with just forums. I’m assuming though that in many cases the coordinator will need some empirical results to process (e.g. number of small, medium, and large pimples each day during the period; estimated amount of sunlight exposure that day, and so on). The coordinator would then have to do all the work of compiling results reported back through forum posts, which might involve a lot of manual data entry. But I assume test results would typically be numeric values, so a better solution is for the participants to enter their data directly into the site in a form that the coordinator could then analyze the aggregate data easily and without much time consuming, error prone manual reentry.

    Tangent: One thing I noticed about the SLD was that when I started eating less food, food allergies were less of a problem. In my case, I’ve always had problems with dairy. I can tolerate small amounts of dairy and when I started eating less overall, I was less likely to hit that limit.

  5. David, I think the forums might have a person who would be in charge of each possible cause who would keep track — who would write summaries of what the evidence so far meant.

  6. I have had rosacea (adult acne), a neurovascular disease for about 10 years. Eating certain foods is known to aggravate it and trigger outbreaks in those who have this condition, which has been most recently thought to be an auto-immune disorder. In my case, consuming cayenne and other hot peppers, alcohol, and also coconut oil are definite triggers. Hot weather/hot flashes/hot water…i.e., heat is also a trigger, at least producing ruddiness of skin (per Chinese medicine, I wonder if those consumed substances would be classified as heat-producing in the body). Using coconut oil steadily for the SLD on several occasions made me aware that it caused severe breakouts for me. I had begun to wonder if it was an auto-immune condition because of that.

    I had pimples as a teenager and well into my late twenties, although those substances did not trigger rosacea. I’m not certain what food and substances, if any, caused or affected it. I wonder, though, since health is often a matter of chemical balance and imbalance, if it might be possible that ordinary acne and adult acne could have similar causes related to certain proteins/peptides. Here is an excerpt from ThaiMed:

    “The team found that small proteins called anti-microbial peptides caused the same skin symptoms that are seen in rosacea. The peptides are part of the body’s immune system (and there are many other articles on the medical report to be found on the Internet).:

    ‘When we then looked at patients with the disease, every one of them had far more peptides than normal,’ Dr. Richard L. Gallo, chief of the division of dermatology at the University of California, San Diego School of Medicine, said in a statement.

    Gallo, who led the research team, also is part of the dermatology section of the Veterans Affairs’ San Diego Healthcare System.

    A precursor form of these peptides known as cathelicidin normally helps protect the skin from infection. Indeed, some skin problems occur when there is too little cathelicidin.But it turned out that people with rosacea had too much cathelicidin, and it was different from the form in people without the illness.

    Rosacea patients also had high levels of stratum corneum tryptic enzymes (SCTE), the precursor of the disease-causing peptide.

    ‘Too much SCTE and too much cathelicidin leads to the abnormal peptides that cause the symptoms of this disease,’ said Gallo.”

  7. I started working out 45min a day 5 times a week, and at first I would just starve myself, I would eat like an apple and some juice, for the day. I lost weight, but once the weekend hit I totally caved, and I was like oh well I can just diet again once the week starts, but I would really like to know what food and how much of it I should eat.

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