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Acne Vulgaris: A Disease of Western Civilization (2002)
- katastic 9y agoOh man, this thread is gonna show in on n-gate for sure.
- JumpCrisscross 9y agoTL; DR A 2002 study believes we should explore “dietary interventions using low–glycemic load carbohydrates may have therapeutic potential in the treatment of acne because of the beneficial endocrine effects of these diets.”
- wasx 9y agoI haven't read the paper but do they define what they mean by "westernized"? China is very much the east, does acne vulgaris have the same prevelance in countries in Asia and the middle east?
- rflrob 9y ago"Herein we report the prevalence of acne in 2 nonwesternized populations: the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay." They also mention reports from an Inuit community as it transitioned from a traditional diet/lifestyle to a more industrialized one, and the concomitant rise of acne. The speculation is that low-glycemic load diets are related, possibly through insulin sensitivity/resistance. So probably an industrialized Chinese diet with a relatively high proportion of refined rice (or other grains) is also prone to acne.
- cageface 9y agoThe traditional Chinese diet is mostly rice and vegetables. Modernization brings a large increase of refined sugars and animal fats.
- billconan 9y agoI'm Chinese and my Acne problem is pretty bad.
- intro-b 9y agoyep - anecdotally, my family members living in both China and Japan experienced some bad bouts of acne during their adolescence and up through young adulthood. given that the paper's study population were hunter-gatherers and islanders, it would probably make more sense to frame it as "modern industrialized society" versus "hunter-gatherer" rather than "western" against "non-western
- oh_sigh 9y agoThe study is about enviromental factors, not genetic
- rosser 9y agoFrom a quick skimming of The Fine Article, it seems to mean people living in "modern" environments — like, e.g., plumbing. If I had to guess, diet is probably among the most salient characteristics, with lessened sun exposure from spending time indoors also being material.
- chiefalchemist 9y agoDiet, time inside/outside, exercise, environmental pollutants, stress, water supply (drinking and bathing), consumer products with (often untested) chemicals... I'd say there are plenty of western/Western attributes that could have a cumulative (?) impact.
- jayess 9y agoTotally anecdotal, but I started taking vitamin D supplements at the suggestion of my doctor because of my family history of colon cancer. I noticed that my acne declined significantly. I'm wondering if it has to do with the amount of time one spends outside in the sun.
- verbify 9y agoVitamin D deficiency is common in Saudi Arabia, especially among women - factors include traditional clothes, avoidance of sun, and inadequate dietary intake
- jonny_eh 9y agoDo they have more acne then?
- glibgil 9y agoNo one knows
- Cyph0n 9y agoActually, other women do... From what I saw in the UAE, Gulf women are naturally beautiful.
- oh_sigh 9y agoPlease take your fetishes elsewhere
- FuckOffNeemo 9y agoOh, I know this is sad but I found this comment hilariously blunt. So true.
- markhall 9y agoSame.
- jcroll 9y agoHow much time are those "non western" people spending outside shirtless soaking in the sun?
- perardi 9y ago"As in the Kitava sample, skin infections and intramuscular abscesses were common and responded well to treatment with antibiotics such as erythromycin and tetracycline." I'll take the occasional zit and cover it up with concealer, thank you very much.
- sevensor 9y agoIt doesn't have to be a package deal -- their low glycemic load diet isn't causing the abscesses.
- stochastic_monk 9y agoThis should be marked [2002].
- intro-b 9y agotaking a course of antidepressants and making some lifestyle changes during university for depression had the side effect of almost completely clearing up my acne that normal dermatological treatments were unable to deal with. given that there's some kind of biological link between chronic inflammation and depression, i wouldn't be surprised if some acne cases manifested the same way
- _delirium 9y agoThe HN title should probably say "nonwesternized" (the term used in the abstract) rather than "non-Western" (although the paper subtitle does use "Western"). Still an ambiguous term, but "non-Western population" would usually be understood to include countries like Japan and China, who this study definitely doesn't mean to include.
- ajhurliman 9y agoI was wondering about that; I was just in China and there were tons of people with acne there.
- dbcooper 9y agoThe title of the paper is "Acne Vulgaris - A Disease of Western Civilization."
- DeusExMachina 9y agoI noticed that on myself, high concentrations of sugar or high density carbs (pasta and bread) make it surge. A couple of friends of mine also cured a candida infection by avoiding carbs. So our diet might play a role.
- bacar222 9y agoI'm in the same boat.
- explorigin 9y agoTry cutting out dairy. That made a dramatic effect for the better in me. Milk chocolate is probably the worst for me.
- foxylad 9y agoTotally anecdotal, but too much chocolate is what makes me erupt. And I prefer dark chocolate, so it might be the chocolate rather than the dairy. Eating a large bar of dark chocolate should differentiate, purely in the interests of science of course.
- t3rmi 9y agoIts the dairy
- throwaway863601 9y agoI can't speak for other people's cases but in my case it's definitely not the dairy. The only time dairy ever had an effect on me was pre-elementary school when eating too many egg started giving me pimples, so I cut down on that and that fixed it. Never had a problem with it again.
- RobertRoberts 9y agoI would add possibly polluted or adulterated dairy. Raw milk (anecdote) may not cause the same issues as processed dairy. Also, I would add that most processed dairy (besides just plain old milk) is mixed with many other detrimental ingredients. So there may be a cause/effect relationship overlap with other foods.
- mtgx 9y agoHyperinsulinemia caused by a high-carb diet seems to result in many of our health issues: https://www.youtube.com/watch?v=wiVFtRlObZk https://www.youtube.com/watch?v=wiVFtRlObZk
- buckthundaz 9y agoYes. Great share on your link. Here's another good one: https://www.youtube.com/watch?v=SzcOz38FjaU https://www.youtube.com/watch?v=SzcOz38FjaU “There are a thousand hacking at the branches of evil to one who is striking at the root.” ― Henry David Thoreau,
- ars 9y agoThis title "Acne vulgaris is virtually nonexistent in non-Western populations" is not supported by the article. HN policy is not to change the title which is "Acne Vulgaris - A Disease of Western Civilization"
- huac 9y agoThe paper also only observes two groups: "the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay." That's not anywhere close to all non-Western populations!
- peterburkimsher 9y agoI guess that those two groups haven't had genetic contact with "Western" races. It's highly misleading, because my Taiwanese girlfriend has acne (worse than mine, and she's over age 30). She probably has some Dutch blood in her from 400 years ago (her mum is from Tainan, and the light brown hair, double eyelids, and larger cleavage are probably a result of that too). What the article is suggesting is that if that contact hadn't happened 400 years ago, she wouldn't have acne. Malicious propagandists could easily exaggerate that to blame Western civilisation for their ills, which I think is divisive. The real research has shown a statistical correlation within a small sample size. That doesn't imply causation, or give any guidance on how to manage or mitigate the effects. If future children getting acne is really your major worry about choosing a partner, the research might be of interest to you, but it fails to emphasise that even connections in the distant past can have an effect, and rejecting Westerners is not a suitable solution.
- teach 9y agoDoes your girlfriend eat a Western diet? My wife is a registered dietitian and has a PhD in nutrition and in her experience acne is incredibly influenced by diet.
- seanmcdirmid 9y agoMany Chinese that I knew in Beijing had bad bouts with acne with little western food in their diets. I bet it has more to do with pollution than diet in their cases.
- the_cat_kittles 9y agoi recently went on a little exploratory mission to see what the working explanation is for how the pores actually get blocked, and then swell. it sounds like the process, in super detail, is not well understood. from what i could gather, sebaceous glands get blocked, and the sebum they secrete starts to pool in the duct around the follicle, under the skin. the sebum creates an ideal environment for a bacteria called p acnes to flourish, which causes inflammation and redness. it seems that the rate of sebum production, and the composition of the sebum itself might have some effect on how likely the pore is to clog. and, of course, skin cleanliness is but one of many factors that seem to affect how often people get acne. as other people have noted, it sounds like "inflammation", a topic i know nothing about, seems to be at the root- basic idea seems to be that diet can cause inflammation which can then result in acne. im more curious about the actual point at which the pore becomes blocked, and why it happens, from a more mechanical way. i feel like a satisfactory answer to this question would address why some pores on someones face get clogged and others do not. im curious if anyone ever did a very detailed microscopic timelapse somehow. since i havent studied this field at all, its likely im not really asking the right questions, but if anyone reading this has anything interesting about this topic, id love to hear it.
- keyboardhitter 9y agoI do not know why you're being downvoted. I feel your comment added to the discussion of the article I also learned recently that sebum production -- and inflammation -- are both complex mechanisms. As with most regulatory systems I wouldn't be surprised if they were linked in some way. But obviously I don't want to claim this in some hand-wavy way. Can you share any reading material you found when exploring the topic? I have recently started Spironolactone for various PCOS symptoms, including acne vulgaris, so it's of interest to me
- platinumrad 9y agoProbably the formatting. I didn't downvote and found it interesting but had a bit of trouble reading the blob of text. I find that capitalization is really helpful when reading longer paragraphs, especially if many of the sentences themselves are compound.
- weeksie 9y agoWhy's everybody talking about vitamin D? (Same thing popped up in a Twitter thread I saw about this yesterday.) As far as I can tell the paper only talks about high insulin loads and refined sugars for etiology? Then again I might have missed something? Seriously, I'm in no way competent to read these papers but all I could see were mentions of insulin spikes and such. Could someone ELI5 what I'm missing?
- djsumdog 9y agoI immediately thought about sugar/carbs. A lot of people on Keto/Adkins report that reduced carb intake seems to help control acne.
- weeksie 9y agoSure, but I'm talking about the actual study linked. Or maybe I'm just being too generous with my assumption people are referring to the linked article.
- grondilu 9y agoOnly tangentially related, but recently I watched a documentary about the epidemic spread of myopia. Apparently the main culprit was the lack of time spent outside, which was interpreted as a lack of exposure to sunlight. I wonder if acne can't have the same cause.
- RobertRoberts 9y ago1. When I was a kid, just getting a tan cleared up my acne. 2. Changing my diet helped clean up my acne (not eating junk food) 3. When I was a teenager, I got hurt really bad, and my father found me and had to take me to the hospital. I saw massive acne breakout on his face in less than 15 minutes. 4. When I got older and was less stressed about life, my acne went away. When I got a family/career/house and life stress was severe, acne would come back. I think there a huge health and stress connection to acne.
- schuke 9y agoEverytime I take a plane somewhere I would have huge acnes in the two , three hour duration of the flight. I always suspected it’s the stress of having to be on time and everthing that flying involves.
- Rarebox 9y agoI've experienced the same, although I don't think I stress out about flights anymore. My theory is that it's caused by air being dryer in the plane, as my lips are usually chapped on/after flight.
- autokad 9y agoi think there is a connection in there, but not quite sure where. I myself pretty much only ate junk food, although my diet was very low cal. i avoided the sun because i burned very easy, but I was outside a lot. i was always under a high amount of stress, but i never got acne or anything like that edit: by junkfood, i mostly ate cereal and lots of cookies/candy bars
- RobertRoberts 9y agoI burn easy too, but it still helped. I know people that can eat what ever they want, and it won't affect their skin. And some people that avoid certain foods because it makes them break out.
- King-Aaron 9y ago
- rland12 9y agoGiven the link between diet and the microbiome, and the possible link between diet and acne, I wonder if the microbiome has something to do with it. Really, I'd be very surprised if the microbiome wasn't involved somehow.
- m3kw9 9y agoI mean you don’t need to be Sherlock to know sugar is bad for you, I’ve heard over and over again from all sorts of different publications and talks on the effects. You talk sugar out, you give yourself a better chance
- nashequilibrium 9y agoI grew up in a non-western country and at the age of 19 I sporadically got Acne and I ate meat once a week and hardly any sugar. It lasted a 1 1/2yrs, fast forward 5yrs I got Acne at age 26 again but worst, this time it wasn't going away, finally I decided to just use natural ingredients. I got tea tree oil and jojoba oil mixed them and would put it on my face and 3 months later it went away forever. I still don't get any pimples even after going back to normal lotion but around Halloween I always get a pimple or two because of all the candy.
- proee 9y agoCoffee is the source of my acne - but I'm not able/willing to give it up.
- elliotec 9y agoDo you put milk and/or sugar in it? I betcha anything it’s not the actual coffee.
- proee 9y agoI put a "tiny, tiny, tiny" amount of sugar, and maybe a few tablespoons of milk. Going off coffee for a week clears up my skins, while I continue to consume dairy and sugar products. So I do believe it's the coffee. Also for some reason, Kona Coffee make my acne even 2x worse than say columbia, etc.
- sundvor 9y agoBlack no sugar, as it comes?
- cal5k 9y agoI'm always amused/horrified by Hacker News comments on anything health-related. Herein lie a group of incredibly smart individuals sharing anecdotal evidence and folk remedies without a lick of irony.
- zaptheimpaler 9y agoIts not anecdotes, its a multi year study of 1200 people. Also people often forget that there are many things science doesn't know, many health problems we have no good answers for, and that anecdotes & intuition are the only way we can generate hypotheses to validate scientifically in the first place.
- JshWright 9y agoI suspect the parent comment is referring to the comment section (which is indeed full of anecdotes).
- brucephillips 9y agoThere have been many, many studies discrediting the folk remedies proferred in this thread.
- flatline 9y agoThis can be partly explained by different subsets of the overall user base. I have the same reaction to some of the posts on longevity research.
- wolco 9y agoI'm actually horrified at the opposite. The lack of knowledge around health issues scares me. When users comment they did not know tumeric is anti inflammatory it makes me wonder.
- nickpeterson 9y agoYou're frightened by people not knowing turmeric is anti inflammory?
- brucephillips 9y agoI grew up with cystic acne that persisted into my early 20s, until two courses of Accutane cleared it up. Anecdotally, I tried everything before going on accutane. I cut out sugar to the point of avoiding fruits with high glycemic indexes. I cut out dairy. I cut out meat. I tried every supplement you can imagine. If you're thinking about asking "but did you try X", don't bother, I did. Only accutane worked. Reading studies such as this, as well as the internet discussion regarding acne is a bit frustrating. Yes, there are anecdotes of this and that diet and lifestyle change reducing acne, but there's very little clinical evidence that non medical treatment improves cases of cystic acne, and yes, many diet studies have been performed. Even this study grossly overstates their conclusions. Studying two primitive societies is not nearly enough data to support the conclusion in the title of this article.
- SOLAR_FIELDS 9y agoEvery acne thread has the inevitable comment about Accutane. And every comment is essentially the same. It’s the only thing that worked for me. I still love to read them. I’m still amazed by it. It’s literally the only drug I’ve ever encountered that could truly be called a “magic pill” in that it will permanently cure you of what you are taking it for. The side effects are pretty crazy though. I had to wear sunglasses even when it was cloudy due to photosensitivy for the months I was taking it. Carried Aquaphor in my pocket for the perpetually dry lips and my whole face pretty much flaked off during the first few weeks. 100% worth it. I get a minor pimple every 6 months or so if I don’t wash my face. It used to be completely covered with acne.
- brandonmenc 9y agoCan confirm, Accutane is magical. A single round of it when I was 16 totally cleared me up. That was over 20 years ago. Luckily for me, my mom remembered how my dad's acne in high school left his face scarred, so she got me into a dermatologist at the first signs of cystic acne. The doctor tried everything on me, and Accutane was the last resort. I implore: If you have kids with acne, please, take them to a real skin doctor. Don't rely on unproven treatments like cutting carbs or dairy or meat. You have one chance to get it right, and if you don't, they'll have to live with facial scarring forever. I see adults with acne or scarring and I am so thankful I was put on Accutane.
- ccc111 9y ago*anecdotal started shaving with a safety razor, helped quite a bit. vs 5 blade massacre
- markhall 9y agoI always love when obscure (but interesting) topics surface to the top of HN. Great community.
- reillyse 9y agoThe double negatives here make this heading really hard to parse (I actually read the abstract thinking something totally different and had to come back to check), maybe something along the lines of "Acne vulgaris exists predominately in Western populations" or "Acne vulgaris mostly exists in Western Populations" would make it clearer.
- buckthundaz 9y agoSugar and carbs. Read Weston A. Price's, 'Nutrition and Physical Degeneration'
- bjourne 9y agoHere is a challenge for everyone who claims to have found a connection between reduced acne and $X, where $X is whatever: sugar, carbs, exercise, sun light, nose picking, masturbation, sex, chocolate, stress, soda, tv, dairy, razor blades, vitamin d, coffee, pasta... Take a picture of your face in good light conditions as it looks today and send it to me. Then you spend one month doing the EXACT OPPOSITE of your wonder method. That is, if your claim is that dairy causes your face to break, you indulge in massive amounts of dairy products. If it's shaving, you start shaving every day. You keep this regimen for one month's time. Then you send me a new picture of your face in equally good lighting. If in that picture, your acne has gotten significantly worse I will pay you $2000, no questions asked. I'm sorry that I'm poor so $2000 is all I can afford to wager, but perhaps we can make it into some kind of crowdfunding, where everyone chips in a little to produce some new research? I'm totally serious about this "challenge."
- throwaway863601 9y agoAcne vulgaris is the same as the one adolscents get, right? How is the claim possibly true? Do they mean something other than what "non-Westerners" means literally? It happens e.g. in the middle-east too and I don't imagine that's an exception. I thought it was a pretty common human phenomenon.
- ggm 9y agoGiven that all humans share a remarkably high % of genome, and race is a social construct, I'm struggling with the 'this is not genetic' part. Either its a truism, or its backed by strong evidence of no genetic linkage. Because this 'its not your race' thing, applies to almost anything. For instance the supposed Asian intolerance to unmodified milk proteins which has been changing as diet shifts. Is that also now not actually genetically determined?
- katastic 9y ago>and race is a social construct So is sickle-cell anemia then.
- CryoLogic 9y agoHuman and pig genomics are also very similar. It's not the 98% that make or break these things. Lactose intolerance is inherited and as a result of LCT gene not expressing due to downregulation by another gene MCM6.
- colordrops 9y agoI know this is anecdotal, but I lived in Beijing for 8 years, and it was VERY existent amongst the population there. Perhaps it's a function of the "western" cosmopolitan lifestyle of urbanites.
- wst_ 9y agoThey decided to choose a closed, often tribal cultures for comparison. We can assume they behave as most of us do, mate within the group mostly. So the genes pool/variation differences must be huge between them and Western population (whatever Western means in this context - let's say United States.) On what premises they excluded genetic factor, then?
- cmrdporcupine 9y agoFor my wife, it's lots of sugar that causes outbreaks. Or worse, cheap American chocolate (British chocolate doesn't trigger it as bad). But all the dermatologists she saw as a teen and young adult... always ridiculed this and insisted it had nothing to do with diet.
- cageface 9y agoThere's a strong link between acne and consumption of dairy products. https://nutritionfacts.org/video/the-acne-promoting-effects-of-milk/ https://nutritionfacts.org/video/the-acne-promoting-effects-... https://nutritionfacts.org/video/saving-lives-by-treating-acne-with-diet/ https://nutritionfacts.org/video/saving-lives-by-treating-ac...
- janwh 9y agoAs per my personal anecdotal evidence: diet is always key to Acne. I have been suffering from Acne vulgaris, Acne conglobata, and—worst of all—Acne inversa for all my life (26yo), and whenever I fell into bad eating habits with lots of (saturated) fats and carbohydrates, my skin issues are worsening. Western food is just poor quality in general, being heavily processed and “enhanced” and all.
- snarfy 9y agoI'v read a few studies about demodex mites causing chalazion[1]. Demodex mites are something humans picked up from having dogs and cats as pets. Do non-western countries have these animals as pets? [1] ]https://www.ncbi.nlm.nih.gov/pubmed/26408604 https://www.ncbi.nlm.nih.gov/pubmed/26408604
- dgregd 9y agoI have always wondered why evolution has allowed such a defect. Maybe this is the effect of crossing with Neanderthals.