Causes and Treatments for Acne

Traditionally, there are thought to be three contributing factors to acne. These usually define the treatments. Diet was thought to be a minimal contributor to the problem. However, I believe that diet is more significant than previously believed (for two main reasons). While I don’t think that this is revolutionary or categorically changes how we deal with acne, I do believe that it is worth a discussion.

One article in the Journal of Drugs in Dermatology provides a framework for how diet and sugar affect acne. In this 2014 article, Drs. Whitney Bowe and Shereen Mahmoud discuss the mechanisms by which carbohydrates affect acne. Traditionally, dermatologists have told their patients that diet really does not change their skin. Despite the patients who come in telling us that when they eat chocolate they break out, dermatologists have responded by largely ignoring them.

However, these doctors studied the effects of diet on acne and discuss a mechanism that makes a great deal of sense.

The prevalence of acne as well as its psychological and physical consequences are significant. As Drs. Bowes and Mahmoud point out, more than 85 percent of adolescents will suffer from acne. The factors that seem to precipitate acne include diets rich in carbohydrates. These types of diets, in contrast to diets rich in anti-oxidants, fish, lean meats, fruits, and vegetables, will cause the body to produce higher levels of insulin. This, in turn, alters the levels of androgens which can produce acne.

Based on this, it is reasonable to recommend a low carbohydrate diet in conjunction with treatments for acne.

Other potential dietary contributors to acne include hormones and antibiotics in the food chain. In many instances, cattle are treated with estrogens and testosterone to increase the rates of growth. Recombinant growth hormones are also used to increase yield. It is clear that hormones such as testosterone can increase acne because it stimulates the sebaceous (oil) glands. The effects of other hormones are less clear. There are many ways to avoid these chemicals. The most obvious is to avoid them consuming meat, milk, and fish that is free of hormones.

Treating acne has evolved over the past few years but the mainstays are still drugs that decrease bacteria (either topically or orally), drugs that decrease oil production or drugs that decrease the stickiness of the skin cells. Vitamin A derivatives including isotretinoin (Accutane), tretinoin (Retin A), adapalene (Differin and now over the counter versions) and tazarotene (Tazorac) all act to decrease the adhesion of the skin cells. This helps to decrease blackheads and white heads. Isotretinoin also helps to decrease the amount of sebum that is produced.

Antibiotics either topically or orally have been used for decades to decrease the bacteria that cause acne. In general they are well tolerated although each drug has its own set of adverse events. Hormones can be altered in females by administering oral contraceptives that lower male hormones or by giving aldactone which can accomplish this as well.

Acne is a common reason why people come to my office and there are so many causes and treatments. In my office, we conduct clinical research for new treatments, use lasers and light sources when appropriate and employ a range of strategies to help decrease acne. If you or a relative are suffering from acne I would recommend seeing a dermatologist to help get clear.

Kenneth Beer, MD is a board certified dermatologist and dermatopathologist in West Palm Beach and Jupiter, Florida (www.beerdermatology.com). He was an AB Duke Scholar at Duke University and then attended medical school at The University Of Pennsylvania. After completing a year of internal medicine in Philadelphia, he trained in dermatology at The University of Chicago. Dr. Beer has volunteered at the University of Miami for more than 20 years and believes strongly in their mission of providing healthcare. He is actively involved in clinical research for cosmetic medicine, general dermatology and skin cancer. He blogs at Newsmax to discuss issues that pertain to the skin as well as to healthcare in general. To read more of his reports — Click Here Now.