Does Food Aggravate Acne?

Part 1: The Acne-Diet Controversy.

The topic does food aggravate acne is a controversial one. Many acne diet myths surround this hot issue.

Acne is one of the commonest diseases of the skin and about $4 billion is spent on treatment yearly in US alone. There are also significant social and emotional costs that is not included under this estimate.

Although acne affects all ages, prevalence starts to increase from the age of 8 years, and peaks at 16 to 18 years when 75% to 98% of the population is affected.An association between food and acne has long been postulated but remains unproven and hence controversial.

Most dermatology text books state that there is no role of food in the causation of acne. Majority of dermatologists, as expected,  toe the beaten path. My experience and observations with acne patients, however, tell a different story. Many of my patients who have been on remission (without clinical lesions of acne) after treatment and on a "no milk, no chocolate, no ice cream, no cola, no fried fast food' regimen have come back experiencing severe outbreaks after they restarted their junk food habits!

More than two decades of such consistent observations have convinced me that certain food items do stimulate the tell-tale facial eruptions. Does food aggravate acne is no more a doubt: it is a fact!

A scan of the medical literature showed that I am not alone in these convictions. There have been dozens of studies, mostly in favor, of a positive answer to the question "does food aggravate acne?"
Let us examine a few of these now:

1. Role of iodide in causation of acne

 It has long been known that iodine and its salt iodide stimulate the sebaceous glands and cause acne eruptions. Many natural and cooked foods contain iodide and iodine in varying amounts.

Such food when taken regularly and in excess could induce or aggravate acne lesions in predisposed individuals.

A list of iodide containing items on our 'gastronomical shelf' with the amount of iodide in each is given below. Only a selected few with high content and, for comparison, a few with low content are mentioned here. Now, with a list like that, we come nearer to the answer to the question "does food aggravate acne"

Food/Beverage Iodides (ppm*) Seafood   Clams 20 Crab 33 Kelp 1,020 Lobster 9 Oysters 8 Shrimp 17 Sole 24 Squid 39 Meat and Poultry   Beef liver 325 Chicken 67 Hamburger 44 Turkey 132 Vegetables   Asparagus 169 Broccoli 90 Brussels sprouts 23 Corn 45 Green beans 7 Onions (white) 82 Potato 9 Dairy Products   Butter 26 Cheddar cheese  27 Cottage cheese  5 Homogenized Milk 11 Sour cream 7 Yogurt 3 Drinking water 8 Miscellaneous   Coca-Cola 3 Iodized Salt 54 Potato chips 40 Seasoned 40 Sugar 2 Tortilla chips 80 Wheat germ 46 White bread 8 * ppm: parts per million

2. Acne inducing medications. In addition to iodides, the following drugs can either cause or exacerbate acne (list not complete): Corticosteroids (both systemic and local) Bromides Phenytoin (antiepileptic)  Lithium (antipsychotic) Isoniazid (antituberculous) Some oral contraceptive pills like Ovral, Loestrin, Norlestrin, and Norinyl etc increase acne formation, while some, like Diane 35 are used to treat certain types of hormone induced acne. So how do these support the "acne-food" theory or the question "does food aggravate acne"?

The fact that there are many medications which influence acne can be related to the acne-food relationship(does food aggravate acne)  thus:

1. Ingested food is absorbed and utilized by our body exactly in the same way it metabolizes oral medications. In other words, food is no different from any other drugs (treats hunger?) which can have both positive and negative effects on the body and its organs including skin!

Now, my question is this, if certain medications can affect acne by worsening or improving it, why can't food affect acne? Is there any rationale or proof to counter this deduction derived from pure common sense? Why should we doubt "does food aggravate acne"?

2. Many medications used to treat diseases in the cattle are found in varying amounts in their yields: the milk and the meat. If such medications can worsen acne, it follows that milk/meat consumption could affect acne adversely!

3. Anabolic steroids are used (as injectables and in feeds) to increase the mass and bulk of meat and poultry . Naturally varying levels of these hormones are found in the final diary and butchery/poultry products . Steroids, both anabolic and corticosteroids, are known to induce and exacerbate acneiform eruptions, not only on the face, but also on the back and front of the trunk.

So wouldn't such diary, meat and poultry trigger acne eruption? Unless of course, we can prove that all such medications are completely destroyed during the pasteurization (milk) and cooking processes, which is highly unlikely!

4. Acne, Vitamins and Minerals.

   A number of studies have proven the beneficial effects of some vitamins and minerals on acne. These are Vitamin A, Zinc, Magnesium, Selenium and Essential Fatty Acids (Omega 3). There are many food items which contain these vitamins and trace elements. Though the amount of these molecules to produce any clinical changes may be high, who can refute the possibility that even the minute amount(s) present do not affect acne? There are conflicting reports on B Complex Vitamins and Vitamin E , some studies finding a positive effect on acne while others noting that high amounts of these vitamins actually worsen the acne eruptions.

Now let us see what the medical journals have to say about"Does food aggravate acne"

Next: Part 2 of does food aggravate acne:Journal Studies

Part 3: Acne Diet Recommendations