Topical and oral mainstream medications are overwhelmingly favored for acne treatment, but they don’t address the root of the problem. Not to mention the boatload of negative side effects they come with, as well.

If you had a rash or hives, you would look to environmental causes or allergic reactions to food, right? Well, the same goes for acne. If we are getting pestering bumps on our face, why don’t we consider the substances that we are exposing our skin to, both externally and internally?

Acne is a common disease in Westernized nations, according to recent studies linking acne and diet. This should immediately ring alarm bells — we’ve heard it before. Except usually, we’re talking about diseases like obesity, diabetes, coronary heart disease, and a host of other diseases associated with the Standard American Diet (SAD), which refers to increasingly calorie-dense, nutrient-poor, and sugar-filled foods and beverages.

For some, acne can be an occasional annoyance. For others, it can be a chronic, life-shattering condition. “I’m baffled,” says Dr. F. William Danby, dermatologist and pioneer in major studies linking diet and acne, “on the lack of attention that diet gets when it comes to acne.”

Lost In Time

In the late 1800s and early 1900s, diet was accepted as a form of treatment for acne issues. Dermatology textbooks of the time are cited as recommending dietary restrictions alongside medical treatment for acne. But how have the two become so disconnected? The answer lies in a series of causes and events: past studies, culture, and corporate and financial influences of the health industry.

A series of studies in the 1960s attempted to examine the effect of various aspects of diet on acne. One study noted that restriction of carbohydrate intake didn’t reduce the severity of acne. Another noted “no changes in acne among participants consuming chocolate, in addition to usual dietary intake, after one week.”

The two major factors that make the “Westernized diet” perfect for acne presence are high glycemic load foods and high intake of dairy products. The glycemic index (GI) is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating. Foods with a high GI are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels. A food’s ranking on the glycemic index (GI) is not the same as that food’s glycemic load (GL). GI measures carbohydrate quality of equal quantities of foods, while GL is calculated by multiplying the GI by the food’s carbohydrate content, and therefore measures the impact of a serving of this food.

Examples of foods with a high glycemic load (GL) include white bread (GL 34.7), table sugar (GL 64.9), Rice Krispies (GL 77.3), and jelly beans (GL 74.5). Low GL foods include mostly fruits and vegetables and whole foods, such as bananas (GL 12.1), boiled lentils (GL 5.8), and peanuts (GL 2.6).

The studies note that the Westernized diet “Also has a very high intake of dairy products. This is not just milk but in the U.S. the intake per capita of cheese over the past  years has quintupled.”

Milk, Hormones, And Skin Havoc

What is it about milk that makes so many people’s skin break out? Look to hormones. Danby describes milk not as a singular factor in causing acne, but rather a contributor of ‘reproductive’ hormones which add to the many other hormones present in each individual’s body, and polypeptides — small proteins that act as hormones and actually make the normal hormones in our bodies work harder doing what they do.

Humans are the only species that consume another species’ milk after babies are weaned off their mother’s’ milk. The hormones in cow’s milk contribute to their calves’ growth, just as human milk contributes to human infants’ rapid growth. “But that is supposed to stop when you’re weaned, and all dairy products after you’ve been weaned are basically foreign materials [to your body],” points out Dr. Danby. 

Milk contains small amounts of powerful hormones like testosterone, progesterone, and a host of other growth-enhancing hormones and growth factors. These hormones are all naturally-occurring within our bodies — to varying extents — based on age, weight, and other factors. Each individual has different threshold levels as to how much of these hormones they can handle without having an acne breakout. Teenagers have naturally high levels of growth hormones within their system, already — that is what causes the growth spurt at puberty — so they are even more susceptible to dairy’s added hormonal influence.

Teenagers have extremely high levels of growth hormones within their system already, so they are even more susceptible to dairy’s influence. 

Like most medical conditions — you may be at risk for a certain condition based on your genes and family history, but it is your environment, your habits, and our lifestyle — that ultimately “turn it on.”

“As I tell my patients, Paris Hilton will never get a zit. Genes rule,” says Danby. This could be why one person might have to eliminate hormone-containing, inflammatory foods to control acne, but the next person could go their whole lives eating ice cream, pizza, and milk and have flawless skin.

In a study of two non-westernized populationsthe Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay, an astonishing zero cases of acne were observed of the 1,315 subjects studied over 843 days. In another example cited by the study, “In South Africa, dermatologists found lower rates of acne [16 percent] among the Bantu than among whites residing in Pretoria [45 percent]. It was suggested that acne became a problem only when these [native] people moved from rural African villages to cities.”

When studying Inuit natives in Northern Canada, Dr. Otto Schaefer “reported that in those Eskimos who ate their traditional foods, acne was absent. Only when they adopted Western foods laced with refined sugars and starches and dairy products did acne appear.”

Another study that examined a variety of factors, including patient’s’ body mass index, family history, and selected dietary factors as related to their risk for acne found a strong association between acne and milk consumption.

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Clear The Way

OK, so once we decide that diet is a factor, what do we do about it?

“The single most important thing to do is discontinue milk. That includes dairy products,” says Danby. Any foods that contain milk, cream, butter, or milk proteins (like whey protein, for example), should be eliminated.”

Popular diets at the moment, including The South Beach Diet, Paleo, and Whole30, report results of improved skin conditions, which is no coincidence: all involve elimination of dairy products and a focus on reducing one’s Glycemic Load.

Don’t Be Afraid To Change Doctors

If the links are becoming clearer, why do the vast majority of dermatologists focus on treatment instead of prevention via dietary changes? Dr. Danby says that unfortunately, treatment is the focus for money-making reasons. He explains, “Talking prevention does not make money. If I booked a patient for preventative counseling, he or she would be denied payment.”

So how can you incorporate dietary changes into your dermatological treatment? Dr. Danby advises to first ask your dermatologist if they are aware of “the broad scientific literature linking hormones and acne to the hormones in dairy products.” If not, he recommends to ask “How many patients have you managed who were on a zero dairy low glycemic load diet?” If the answer is still negative, consider whether your dermatologist is open-minded and flexible enough to continue working with you while considering dietary factors.

The connection between diet and acne cannot be ignored. Research is gradually amassing to add weight to the idea that dairy and high GL foods can make certain individuals’ hormones go out of whack. Clearly, the adage “you are what you eat” applies as much to your skin as it does to the rest of your body.

Annie Bacher is a is a journalist based in Buenos Aires, Argentina with a focus on food and health. She spends her spare time cooking, training for marathons, and blogging about both.

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