“If you're dealing with persistent or severe adult acne, it might be worthwhile to consider tests for pre-diabetes, other hormonal imbalances, and gut microbiome imbalances.”
Acne not only stands out as one of the most common skin diseases globally, but its incidence is also on the rise. It’s estimated to affect 80-90% of teenagers in Singapore. Furthermore, there’s a growing prevalence among adults (especially women), with 41 percent experiencing breakouts.
Besides pointing fingers at our hot, humid climate or the recent ‘maskne’ phenomenon due to Covid, our westernised diet and sedentary (and often stressful) lifestyle are likely culprits for this acne outbreak.
The increasing prevalence of insulin resistance (pre-diabetes) has been a worrying trend in Singapore, mirroring many westernised, developed societies. In the recent years, researchers have found a connection between insulin resistance and acne. A study showed a correlation between the severity of acne and higher levels of blood markers associated with insulin resistance. In fact, acne has been coined “diabetes of skin”.
Epidemiological studies have also shown that acne is virtually absent in populations with natural, whole food diets with low glycaemic load and no dairy products. There are tribes that do not even have a word for “acne”, as they have never seen it before.
Sweet Addiction. Bitter News
Our diet greatly impacts our metabolic health, and skin is a direct reflection of our inner wellbeing.
In the case of acne, the interplay between insulin and insulin-like growth factor (IGF-1) plays an important role in the formation of acne. IGF-1 promotes cell growth, and is naturally higher during puberty. It’s during this adolescent phase when mild acne tends to manifest, due to highest levels of IGF-1. Furthermore, foods with a high glycaemic load not only induce a significant spike in blood insulin levels but also elevate IGF-1 levels in both adolescents and adults.
Elevated insulin and IGF-1 levels increase sebum production and over-production of the cells which surround sebaceous follicles, leading to pore clogging (comedones).
Bacteria such as P. acnes, can become trapped and overgrow in clogged pores, causing inflammation, redness, and swelling—which we see as pimples.
Next time you reach for a sugary bubble tea to relieve stress, consider this: increased IGF signaling may decrease the expression of stress resistance genes, reduce stress resistance proteins, and exacerbate inflammation, thereby fanning the flames of acne.
Quality matters, too. My teenage daughter once argued that our home-cooked meal—comprising rice, vegetables, and salmon—has carbs similar to the hamburger-fries-coke zero (highly emphasized) fast food she wanted. Regrettably, the typical fast food fare not only boasts a high glycaemic load but also often lacks the essential nutrients required to sustain a healthy metabolism.
One study found that a nutrient-rich meal reduces post-prandial blood glucose and insulin by 44%, compared to a less nutritious fast-food meal with a similar glycemic load.
In fact, the rapid insulin spike after fast food or a dessert buffet is likely to leave you feeling peckish soon after the meal as blood sugar levels crash again—not good news for your health, waistline, or your skin.
Dairy, Dairy, Quite Contrary
Perhaps, milk is a superfood meant only for baby mammals. Nature designed this power nectar to boost rapid growth in newborns, intending for them to swiftly transition to regular solids once they’ve developed sufficiently. Interestingly, humans stand out as the only mammals who not continue dairy consumption past infancy but also consume milk from other species.
Consumption of cow’s milk results in a significant increase in blood levels of insulin and IGF-1. It also contains many other hormones, including male hormones or androgens, which are known to increase skin oiliness and worsen breakouts, especially in acne-prone individuals.
Here’s a short list of the 60 over hormones in your average glass of milk, even organic, raw milk:
- insulin-like growth factors 1 and 2 (IGF-1 and IGF-2)
- 5α-pregnan-3β-ol-20-one, 20α- and 20β-dihydroprogesterone (from progesterone)
- dehydroepiandrosterone sulphate acyl ester
Dairy isn’t limited to milk. It includes other milk-derived products like cheese, yogurt ,and health foods like whey protein supplements. Whey protein extracted from cow’s milk contains multiple growth factors, making it popular among gym-goers for boosting muscle mass—the same reason it may aggravate acne.
Certainly, both acne and insulin resistance are intricate issues extending beyond merely consuming simple sugars and dairy. However, taking a proactive approach by monitoring our intake of refined carbs (such as sugary drinks, fruit juice, desserts, white bread, or rice), eliminating dairy, and focusing on enhancing our nutrient intake—rather than just calories— is a significant step towards a healthier body and skin.
If you’re dealing with persistent or severe adult acne, it might be worthwhile to consider tests for pre-diabetes, other hormonal imbalances, and gut microbiome imbalances.
Sugar and dairy – you might love them, but they will not love you back.
DR. TAN WANG THENG