Medical Myths: Does Eating Greasy Food Cause Acne?

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Adolescence: that beautiful time in our lives in which we forge our personality and character, or at least we think we do, while we toil and suffer in that no-man's-land between childhood and adulthood, only to later realize that it was all in vain, and that we are still dangerously ill-prepared to cut the parasitic ties that bind us to our parents and face alone the difficult life of the responsible adult, with more doubts than certainties, and full of emotional instability and insecurities. Good times.


Many are the things that characterize this period in our lives, from what are usually our first romantic relationships (and generally also our first breakups, and subsequent hours crying in the shower; something that at least does prepare us well for the years to come), until high school and the moment when we have to pick a career (or study art history and end up working at McDonald's) and become a productive member of society. But something that happens at this stage that most of us are undoubtedly familiar with is acne: that horrible skin rash whose only apparent purpose is to destroy our self-esteem and generate income for pharmaceutical companies, caused by the explosion in the production of hormones and the consumption of fatty food that is so frequent at these ages. But, is it? It makes a lot of sense; After all, the content of acne papules is quite similar to fat, and it seems logical that consuming it in quantity will make it rise up to our face and ruin our chances of dating the girl we like.


But the truth, as my frequent readers will have already discovered (I apologize for all the time without posting, by the way: I was finishing my last months as a student, and I can finally use the name Dr. Mike without the first half being a lie) is usually more complex than it seems. Today we will discover the connection between diet and acne, in:

Medical Myths: Does greasy food cause acne?



License: Public Domain



Acne is one of the most common diseases in the world, ranking 8th in a 2015 ranking, and being present in around 80% of all adolescents, with the remaining 20% having sold their soul to the devil and bathing daily with the blood of Tibetan virgins. More than $ 2.5 billion is spent each year on its treatment in the United States alone, and if our own experience means anything, most of those expenses are wasted: the only permanent cure seems to be overcoming puberty, and even so, there are many who live the rest of their lives with both biological, in the form of scars, and psychological consequences, suffering from low self-esteem and distrust of pharmacological companies.


It is known that the hormones secreted in adolescence, when this pathology is more common, play an important role in its pathophysiology, but apart from this there are many factors that are believed to influence it. Stress, hydration, and diet supposedly have to do with the severity of the disease; being able to reduce the amount and size of the pustules if we limit our fat intake and drink a lot of water. But surely many of us will have tried these alleged cures, without obtaining the results we expected. What happened then? Were we lied to, and none of this has to do with the severity of acne? Or it is somehow possible to prevent the worst effects of this condition, but the universe simply hates us (or tries to teach a lesson about superficiality)? To answer all of these questions (beginning with the last one: the universe cares about you just as much as your ex who blocked you on Facebook), let's first look at exactly what acne is.


Acne vulgaris is a chronic inflammatory disease of the skin, specifically of the pilosebaceous units, due to a blockage in the hair follicles of the skin. Clarifying the above a bit, the pilosebaceous units are the conjunction of the hair follicle (the "root" of the hair) and the sebaceous glands around it, which produce a substance called sebum that lubricates the hair and helps to protect the skin. There are 4 basic mechanisms for the development of this blockage: exaggerated production of sebum, increased production of keratin that generates a comedo (medical name for pimples) that occludes the follicle canal, bacterial colonization, and local inflammation of the skin. Of these, the first is the most common during adolescence because sebum production is influenced by androgens: sex hormones whose production is greatly increased during puberty.


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When this kind of plug is formed, dead skin cells accumulate together with the sebum produced by the sebaceous glands and the pore of the hair follicle becomes clogged, forming a microcomedone. This microcomedone continues to grow while the production of sebum continues, until it becomes a comedone of varying color: if the obstruction is superficial, the sebum and melanin (the pigment that gives color to our skin, eyes and hair) within oxidize, turning black and creating blackheads. If, on the contrary, the microcomedone is deep within the skin, the sebum is not visible and a whitehead is formed, or a common and ordinary pimple. In both cases, the obstruction encourages bacterial growth, specifically Propionibacterium acnes and Staphylococcus epidermidis, causing the skin to become inflamed and leading to the formation of papules, infected pustules and deep nodules that tend to leave unsightly scars.


In summary, the content of pimples is not fat, even if it looks like it: it is sebum, which although is a lipid substance, its production has more to do with hormones than with diet. So does eating fat make pimples and acne worse? The short answer to today's question is no it does not. But things are a bit more complex than that. You see, although studies have not shown a direct connection between the appearance of acne and a high-fat diet, it is true that there are dietary factors involved: remember that the cause of this disease is overactive sebaceous glands, generally due to hormonal overstimulation, so it is suspected that a high consumption of dairy products can cause more pimples to appear (although even this depends on how genetically prone a person is to develop acne) because they contain small amount of hormones, however more studies are needed to verify this theory.


Foods high in sugar and simple carbohydrates, such as cookies, white bread, pasta, and soda can also worsen an existing rash, because their consumption raises blood glucose levels, causing the pancreas to secrete insulin in response, which has the secondary effect of increasing the production of sebum and increasing the probability that a hair follicle will become blocked. Likewise, it is important to drink a good amount of water daily to keep the skin properly hydrated and prevent pores from closing. And while greasy food won't cause acne as such, a greasy environment does: oil and grease particles, present in places where food is fried in large quantities (like a McDonald's; your mother was right, you should have chosen another career, but at least you know everything about the Impressionist period) can clog the skin pores, causing microcomedones that can progress to a skin rash.


License: Public Domain



On the contrary, foods rich in vitamin A, such as carrots, melon or sweet potatoes, contribute to a good skin complexion and reduce the chances of having rashes, as does washing your face regularly; about two or three times a day are generally sufficient. But those double beef burgers with cheddar cheese and bacon? Feel free to continue eating them: unless you rub them on your face first, their consumption will not cause acne and it may not make the one you already have worse, so you only have to worry about the other adverse effects of consuming fat in high quantities, such as obesity, diabetes, high blood pressure, atherosclerosis, dyslipidemia, sleep apnea, osteoarthritis, and difficulty finding clothes your size. But hey, your skin will look amazing in that XL casket.


For this reason, and at the risk of sounding like a nutrition blog, it is still necessary to have a balanced diet, especially during a stage as important for our development as adolescence, and to be well informed about the appropriate way of treating our problems and illnesses, in order to save time and money in unnecessary treatments and keep them from taking advantage of our easily influenced teenaged minds while time and experiences adequately prepare us for the consumer society in which we live in and which values the individual based only on what can be sold to him. Drink water, stay hydrated.

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Welcome back Dr. Mike. Its nice to have you back writing. On this pimple issue, I had a fair share of my own problem back in the days. It seems there's correlation between me eating groundnut and the appearance of pimples on my face. It was a nightmare. I never knew that there's no direct connection between fatty diet and pimples until now. Thanks for educating us.

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Thanks! It's good to be back.

It's probably a matter of causality vs casualty, though on that same matter, am I the only one who has noticed some new pimples on the areas covered by the face mask? I suppose that my pores are being clogged by sweat, but I do wonder how frequently this is happening to everybody else.

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