22 Jun 2021
Acne is a condition which causes spots or pimples on the skin. The most common type is formally called acne vulgaris.
It occurs most frequently during your teenage years. Up to 85% of teenagers will experience it to some degree. However, it can continue beyond adolescence and some people do experience it later in life.(1)
For many years, acne didn’t get the attention it deserved from the medical community because people often thought of it as not being particularly serious. While it’s true that acne doesn’t cause serious physical illness and is largely a cosmetic issue, it can seriously affect your quality of life.
Embarrassment or feelings of shame caused by acne can contribute to damaged confidence, low self-esteem and can even lead to anxiety and depression.(1)
Astonishingly, for a disease that so rarely gets taken seriously, some scientists believe that the effect on one’s quality of life is comparable to diseases such as epilepsy, asthma and diabetes.(1) In the United States, scientists estimate that acne cost the country around $3 billion in 2016 thanks to healthcare costs and lost productivity.(2)
Fortunately, attitudes to acne are changing. Now, there are a range of treatments that can help manage the symptoms. If you suffer from acne, it’s important to speak to your doctor as soon as possible, as early treatment can help you avoid issues like scarring.
Alongside treatments recommended by your doctor, you may also want to make changes to your diet. Before we get into the best foods for acne, let’s take a look at what causes it in the first place.
The exact causes of acne aren’t known, but we do understand the mechanisms behind how it produces spots.
It all starts in your sebaceous glands. These little glands are found in the dermis (the second layer of your skin) and produce sebum, or natural oil. Its job is to help moisturise and protect your skin.
Sebaceous glands are closely linked to your hair follicles; in fact, if you look at a diagram of a follicle, you will see that the sebaceous gland is almost a little offshoot to one side.
Sebum also helps to lubricate the hair shaft so that it can grow up and out of the skin.
Sometimes, a mixture of sebum and dead skin cells can clump together, creating a blockage.(1)
The term ‘acne’ refers to a skin disorder, one of the symptoms of which is spots. However, even if you only experience the odd spot now and again, rather than the clusters commonly seen in people with acne, they’re still formed in exactly the same way.
The blockage of cells and sebum causes a ‘plug’ to form in the hair follicle. Sebum builds up behind it, pushing it up to the surface of the skin. You will see this as either a whitehead or a blackhead.
The difference between the two is that in a blackhead, the blockage is exposed to the surface. In a whitehead, it is still enclosed under a layer of skin.(1)
Things can get trickier if a certain type of bacteria shows up.
Propionobacterium acnes is a particularly annoying species which gets into the blockage in our pores and starts to reproduce. It breaks down the sebum, turning it into triglycerides which irritate the skin.(1)
Next, your immune cells get word that there’s an invader in their midst, and head off to fight the infection. However, the sudden arrival of lots of bacteria, plus your own immune cells (such as lymphocytes and neutrophils) cause the follicular epithelium to burst, releasing the whole lot into your dermis.(1) (Sorry, you weren’t reading this on your lunch break, were you?)
As the tussle between the bacteria and your immune cells continues, the area becomes inflamed and pus forms.
This is all good stuff, in terms of your ability to fight infection. Inflammation, for instance, is the result of your blood vessels dilating. The purpose of it is to make sure more blood can reach the injured tissue, delivering vital nutrients, immune cells and oxygen.
Meanwhile, pus contains dead white blood cells and the bacteria they have successfully killed off.
Unfortunately, both can cause spots to swell, become red and inflamed, or fill with unsightly pus.
Now that we’ve covered the mechanics behind acne, let’s look at the available treatments.
Speak to a pharmacist or doctor about the options which are most appropriate for you.
If you have mild acne, your pharmacist will likely recommend that you try a topical treatment containing benzoyl peroxide. This works as an antiseptic, helping to remove some of the bacteria on your skin which may otherwise go on to cause spots. It takes a few weeks to show results.(3)
If that doesn’t work, or if you have more severe acne, your doctor may recommend prescription medication such as antibiotics or retinoids.(4) Antibiotics are a stronger method of killing off bacteria.
Meanwhile, retinoids help to stop ‘plugs’ of sebum and dead cells forming, and also act to reduce inflammation.(2)
Some doctors may also recommend the contraceptive pill for women. This is particularly common if flare-ups of acne seem to be related to your menstrual cycle or hormone-related health conditions.(4)
While many of the treatments available are very effective at managing the symptoms of acne, they do take some time to work. You may also want to support your treatment by taking some positive steps in terms of lifestyle alongside it. If so, making some changes to your diet can be really helpful.
Here are the best foods for acne, along with some recommendations of what to avoid.
There is some evidence that eating a diet made up of low GI (glycemic index) foods can be beneficial for people with acne.
The glycemic index is a scoring system from 1 to 100 which measures how much a particular food elevates your blood sugar levels.
The reason it may be useful for acne sufferers is that scientists believe that high levels of insulin in the blood encourage your skin to make more sebum. Insulin is released into the blood when your blood sugar levels are raised, and helps to bring them back down to a normal level.(5)
There are a number of studies which seem to support this hypothesis.
A 2002 study looked at the prevalence of acne in two non-Western communities: the Kitavan islanders of Papua New Guinea and a group of Paraguayan hunter-gatherers called the Aché. There were no instances of acne in around 1300 participants, a fact that the researchers attributed to their diet of local whole foods.
This led scientists to wonder whether the difference was definitely down to diet, as opposed to some other unidentified reason.
An older study from 1971 shed some light on the matter. As it turns out, a community of Inuits living in Canada had no cases whatsoever of acne until Western foods were introduced. It was only once the community began to eat foods like beef, dairy, soda and processed foods that instances of acne began to occur.(5)
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