Acne Results from High-Fat, High-Protein Diets

Woman with nose strip for removing blackheads

Many peo­ple think that acne is a nat­ur­al result of being a teenag­er. Yet the teenagers in many parts of the world are remark­ably free of acne. The low rate of acne in those pop­u­la­tions is not due to their genes. It is due to their low-fat, heav­i­ly plant-based diet. When peo­ple from those coun­tries grow up in the Unit­ed States, they gen­er­al­ly eat a typ­i­cal Amer­i­can diet which is rich in fat and ani­mal-source foods. As a result, they too tend to get acne in their teenage years.

The rich, fat­ty, Amer­i­can-style diet increas­es your risk of acne. It sup­plies a lot of fat, which can make your skin oily. It also con­tains lots of ani­mal-source foods, which can lead to an over­load of two types of hor­mones: male sex hor­mones (andro­gens) and a growth hor­mone called insulin-like growth fac­tor 1 (IGF-1). These two hor­mones work togeth­er to cause acne. That’s why acne tends to start when chil­dren go through puber­ty.

Types of acne pimples
The stan­dard Amer­i­can diet caus­es acne by caus­ing the skin to pro­duce too much oil and the skin cells to divide too fast. As a result, the pores can get blocked, which may lead to infec­tion.

What is acne?

Acne aris­es in the hair fol­li­cles (pores). Part of the prob­lem is that the oil glands in the pores pro­duce too much oil. Anoth­er part of the prob­lem is that the skin cells that line the pores divide too fast. (That prob­lem is called hyper­k­er­ato­sis.) As these extra skin cells die off, they are shed into the pore. There, they com­bine with excess oil to block the pores. One of these block­ages is called a come­do. (The plur­al form of the word is come­dones.)

A closed come­do, or white­head, is cov­ered by a lay­er of skin cells. In con­trast, a black­head is an open come­do. The tip of the open come­do turns dark because it is exposed to oxy­gen. The black­head might look like dirt embed­ded in the skin, but the black­head was actu­al­ly pro­duced in the pore.

The role of bacteria

A bac­teri­um called Pro­pi­oni­bac­teri­um acnes can feed on the oil and pro­tein in the come­do. If the skin is very oily and is shed­ding a lot of dead skin cells, the Pro­pi­oni­bac­teri­um acnes can mul­ti­ply rapid­ly. These bac­te­ria pro­duce enzymes to digest the oil and dead skin cells in the come­do. How­ev­er, these enzymes can also attack the live cells of the skin. This dam­age will cause inflam­ma­tion and will attract white blood cells. If a large enough num­ber of white blood cells gath­er in an area, they become vis­i­ble as pus. The result­ing pim­ple is a pus­tule.

In a par­tic­u­lar­ly bad pim­ple, the infec­tion goes deep into the skin, caus­ing a cyst: a red, ten­der bump that can be filled with pus. A bad case of acne can lead to severe, per­ma­nent scars. A case of acne may be only skin-deep, but it can cause severe suf­fer­ing at a time in life when peo­ple are emo­tion­al­ly frag­ile.

Treating the symptoms of acne

For many patients, the first step in man­ag­ing acne is to apply some sort of prod­uct to the skin. These treat­ments can work in sev­er­al dif­fer­ent ways:

  • Reduce the amount of oil pro­duced in the pores (sebo­sta­t­ic effect)
  • Sup­press the growth of the cells that line the pores (anti­hy­per­k­er­a­tot­ic effect)
  • Remove or break up the come­dones, so that they stop block­ing the pores (comedolyt­ic effect)
  • Kill bac­te­ria, such as Pro­pi­oni­bac­teri­um acnes (bac­te­ri­ci­dal effect)

Note that some prod­ucts can have more than one of these effects. For exam­ple, ben­zoyl per­ox­ide has sebo­sta­t­ic, comedolyt­ic, and bac­te­ri­ci­dal effects. In con­trast, the mech­a­nism of action of some acne med­ica­tions, such as tretinoin (Retin-A) is uncer­tain.

Some­times, peo­ple take pills to treat acne. Antibi­otics can kill the bac­te­ria that are caus­ing inflam­ma­tion. If a severe case of acne is not respond­ing to oth­er treat­ments, the doc­tor may pre­scribe a drug called isotretinoin (Accu­tane). Accu­tane is high­ly effec­tive against acne. How­ev­er, it can cause severe side effects, includ­ing sui­ci­dal depres­sion. Accu­tane can also cause severe birth defects among the babies of women who took even a small amount of it dur­ing preg­nan­cy. For this rea­son, Accu­tane is avail­able only through a pro­gram that is designed to ensure that preg­nant women nev­er take this prod­uct and that women do not become preg­nant while tak­ing the prod­uct.

Removing the cause of acne

Before you con­sid­er tak­ing pills to con­trol your acne, you may con­sid­er switch­ing to a health­i­er diet. A low-fat, plant-based diet works in two ways to fight acne.

  • It reduces the amount of oil pro­duced in the skin.
  • It reduces your skin’s expo­sure to ana­bol­ic (growth pro­mot­ing) hor­mones.

The rich, fat­ty Amer­i­can diet, with its heavy empha­sis on ani­mal foods, pro­motes acne for the fol­low­ing rea­sons:

  • It con­tains lots of fat. Most of the oil in your skin came direct­ly from the fat in your food.
  • Ani­mal prod­ucts, even if they are organ­ic, con­tain the animal’s nat­ur­al hor­mones. In par­tic­u­lar, dairy foods con­tain a lot of estro­gen because a lot of the milk comes from preg­nant cows.
  • The heavy load of ani­mal pro­tein pro­vides a big dose of an amino acid called leucine. This big dose of leucine caus­es your liv­er to pro­duce large amounts of a growth hor­mone called insulin-like growth fac­tor 1 (IGF-1).

Why vegans get less acne

A low-fat, plant-based diet tends to sup­press acne:

  • Plants do not have the same hor­mones that ani­mals have. As a result, you won’t get a big dose of steroid hor­mones from your food.
  • Plants do con­tain some sub­stances that have an estro­gen-like effect. How­ev­er, these phy­toe­stro­gens tend to be weak­er than your body’s own estro­gen. As a result, they can actu­al­ly end up decreas­ing the effect of your body’s own estro­gen.
  • Plants con­tain dietary fiber, which helps you excrete excess steroid hor­mones.

Because there is less oil and less over­growth of skin cells, the pores are less like­ly to become blocked. Also, there is less oil and pro­tein to feed the Pro­pi­oni­bac­teri­um acnes bac­te­ria. As a result, the skin clears up nat­u­ral­ly.

A low-fat, plant-based diet is also good for peo­ple who don’t have acne. Excess fat in the diet can also lead to clog­ging of the arter­ies, which can lead to heart attacks and strokes, which are major caus­es of death and dis­abil­i­ty in the Unit­ed States. Excess amounts of the ana­bol­ic hor­mones (includ­ing the sex hor­mones and IGF-1) can also increase the risk of many can­cers, espe­cial­ly can­cers of the breast and prostate. That is why breast and prostate can­cer are rare in the soci­eties that are also large­ly free of acne.

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