Previous posts have implicated Western Civilization and face-washing with soap in the etiology of acne. What else might be involved? A reader writes:
My girlfriend suffered from acne for years. She went to a dermatologist, tried every fancy soap and skin cleansing system, but nothing worked. She was also a Diet Coke fanatic. Every morning while she was getting ready for work, like a coffee drinker, she’d have one. It was her daily jolt of caffeine.
When I read about your diet modification, part of which included giving up soda, and your subsequent acne disappearance [I found that Diet Pepsi caused acne], I of course told her about it. “No, it has nothing to do with my diet, it’s hormones and bacteria.” She was not about to give up her beloved Diet Coke! How else could she function in the morning? In the meantime, she would periodically get upset at what she called the “open sores” on her face.
About 9 months ago, she decided to go on a detox diet — not with the aim of treating her acne, but just to lose a couple pounds. It required her to eliminate as many artificial chemicals and preservatives from her diet as possible. Out went the Diet Coke. Within days, her skin cleared up. She hasn’t had a major breakout since.
Yet more evidence that acne is due to lifestyle factors and can be completely cured by lifestyle changes, often dietary. There should be a list somewhere, ordered from most to least likely, of lifestyle causes of acne. If you have acne you just go down the list eliminating each one in turn until you find the culprit.
I tried just washing with water for about a month, and my face broke out even worse. Bummer.
If you read the boards on acne.org, people are trying EVERYTHING…and I think it all comes down to whatever-works-for-you-particularly. There’s definitely no one size fits all cure for it.
Between acne and migraines, I get the feeling sometime that my body pretty much doesn’t want me eating anything but brown rice and a few vegetables and water. And that’s darned no way to live.
Brody, thanks for telling us your experience. When I was a teenager I asked my dermatologist when my acne would go away. “Everyone’s different,” she said. Not helpful. Even if “there’s no one size fits all cure” for acne, it would help to learn what the most common causes are.
Milk.
I had the same experience as your reader’s girlfriend, but with milk instead of Diet Coke. Inspired by your site I have been experimenting. And I am just coming off a round of drinking milk again, which caused a bad break out. After my face clears again, I’m going to try organic milk, as I believe it might be antibiotics or growth hormones.
To show causality in a situation like that you really need to see a change in both directions, not just one. That is: verify that if she resumes drinking diet coke the acne *comes back*. Otherwise you could be fooling yourself.
Analogous example: Somebody is depressed. Tries drug A; still depressed. Tries a higher or longer dose of drug A; still depressed. Switches to drug B; still depressed. Adjusts the dose higher or lower, then switches to drug C…Eventually the depression goes away right after switching to drug D. Doctors conclude that this person’s depression is cured by drug D, but for all we know it’s just the passage of time since whatever caused the depression.
Acne problems eventually diminish in most adults. People who are paying close attention are likely to remember some change prior to the improvement, but that doesn’t mean the change caused it.
Glen, when I take other things into account — the lack of change for several years, the sudden change when the diet changed, outside evidence that Diet Pepsi causes acne, outside evidence that diet causes acne — I find this particular case convincing evidence of causality. Without that other evidence I would agree with you.
Not only is there the question of “What causes acne?” but also the question of “how much of it is necessary?”
I recently went off the pill, which I originally went on to solve my skin problems. It works. But it’s a bit creepy too. Two months ago, I decided to go off the pill once and for all, to solve the skin issues. I’ve been seeing a naturopath during this process, who seems to be a bit more dedicated to finding root causes.
In a word, the approach has to be “radical.” For 1 month, I eliminated every possible trigger:
1. Soy
2. Gluten
3. Refined grains
4. Sugars (agave and stevia were permitted)
5. Corn (a sensitivity or allergy to corn often shows up on the face specifically)
6. Caffeine (yes, even in green tea)
7. Nightshade vegetables
8. Soap
9. Bananas (I suspected an allergy)
10. Portion control. I find eating too much causes an inflammatory reaction
I began the trial as a vegan so meat and dairy were already ruled out.
I stuck to the “radical” elimination diet for a month, and included vigorous workouts (promotes good sleep and sweating). Surprise, surprise, my skin cleared up.
Slowly, I began to add things back. Soap was fine. Gluten was fine. Bananas were fine. Until finally I realized:
The SMALLEST amount of sugar and refined flour did the trick. Overblown portions didn’t help. I never suspected these items because I don’t eat a lot of sugar to begin with. I’m 5’8 and 125 lbs so how much could I possibly be overeating? I didn’t realize that micro amounts would have an effect.
In my case, the point was that the accumulation of too much refined food and the accumulation of big portions, caused my skin to first get red (next morning). Then, small bumps (2 days after). If I didn’t correct it, I was in for a week of larger blemishes and scaring.
The word is “radical.” I had to be radical to find out what was causing my acne and I have to be radical to avoid it. It’s an easy way to feel sorry for yourself but, calling the glass half-full, it’s a great reminder and incentive to stay away from foods we should never have invented in the first place.
If you believe the low-carbers like Taubes, etc. (little to no refined carbohydrates like sugar and white flour and moderate to low amounts of complex carbohydrates like fruit) sugar consumption in the modern/Western diet is linked to the other diseases not found in traditional, non-westernized cultures like obesity and heart disease. It wouldn’t surprise me if highly refined carbohydrates were to blame for acne as well.
@Annie,
Thanks for the summary of your experiment. By ‘sugars’, do you mean just refined sugars (white sugar, brown sugar, fructose-glucose)?
I don’t doubt that a person could have skin-evident sensitivity to something in the soda — all those company-proprietary flavors and colors can cause reactions in some people. My heart goes out to people who have to go through this process of elimination.
For a contrasting data point: I consume several cans of diet soda a day (along with a low-glycemic, low-processed vegetarian diet) and I can count on one hand (!) the number of pimples I’ve had in my life.
It’s probably not a personal-care practice thing: Back in high school I never used cosmetics and only washed my face with water, plus avoided sun/tanning (being a shut-in nerd kept me from those teen-girl rituals, happily). But I’ve begun to wear cosmetics and wash my face with soap now, no problem.
It’s probably not a diet thing: Back in high school I was also acne-free, but my diet was more similar to my peers — pizza, cake, etc.
It’s probably not a genetic thing: The rest of my family is not at all low-acne. I’m very odd for the genetic pool.
Which leaves me with….
I had cancer and high-dose chemotherapy right before puberty. This may have done a funny hormone hack on me in this narrow aspect, giving me oh-so-amazingly-clear skin. Chemotherapy can give you very odd little outcomes (for me, my ability to ingest near-unlimited quantities of capsaicin was another one). But needless to say, it’s not an acne-prevention program I’d recommend.
My daughter went through the whole acne regimen. Every lotion and potion, birth control pills etc. until we finally found a dermatologist who would prescribe accutane. 7 months later the acne was gone and has stayed gone for 2 years now. My daughter blossomed into a beautiful young woman and has so much more self-confidence than a few years ago. The drug worked miracles on her. I know there are possible side effects so no negative comments about that, just anted to let people know that it does work.