Eighty-five percent of all teen-agers have acne at some time, and for many people the skin trouble continues into adult life. Nevertheless, acne is a preventable disease, not a normal condition. Certainly, the hormone surges that accompany puberty are related to increased sebum production and therefore to acne. Some scientists have considered acne to be an inherited disease, while others believe that environmental factors, such as diet are more important. In a society like ours, where most people eat foods rich in fats, genetic factors do play an important role in determining individual susceptibilities. To learn if diet is a primary factor in acne cases, we would have to demonstrate absence of the disease in populations of people whose diet differs considerably from that of Americans.
Unfortunately, population studies on relationships between diet and acne are limited. But recent surveys in Kenya and Zambia report far less acne in their native populations than among black people in the United States. Some evidence exists, too, that acne becomes a problem for black Africans who move from the villages to the cities and there adopt a diet with higher fat content that is more similar to the richer American diet.
Follow a very low-fat diet; keep your skin free of dirt, oils, and oil-based cosmetics; wash several times a day with a mild soap and a “buff pad.” A person with acne must be very strict for at least a month before evaluating the effects of the diet. Don’t cheat!
If you have taken full advantage of the new diet for at least 2 months and your problem persists, then consider lotions, gels, and creams (Benzoyl Peroxide, Retin-A, tetracyclines and other antibiotics). Next, try antibiotic pills. As a last resort, a few of the very worst cases, after careful counseling (especially concerning the risk of birth defects), may find value in Accutane.
Rosenberg, E. Acne diet reconsidered. Arch Dermatol 117:193, 1981 Pochi, P. Sebum production, casual sebum levels, titratable acidity of sebum and urinary fractional 17-ketosteroid excretion in males with acne. J Invest Dermatol 43:383, 1964
Wilkinson, D. Psoriasis and dietary fat: The fatty acid composition of surface and scale (ether-soluble) lipids. J Invest Dermatol 47:185, 1966
Rasmussen, J. Diet and acne (review). Int J Dermatol 16:488, 1977
Fulton, J. Effect of chocolate on acne vulgaris. JAMA 210:2071 1969