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In recent years, I have noted with concern that, with the increase in messages about “well-being” and the persistent emphasis on this topic, our relationship with food in the context of skin problems has been changing.
Many people with acne have suffered a long history of acne, most are women of high social class.
Like many of us, these are smart people who care not only for the health of their skin, but also for their health in general.
By the time many of them visit a doctor it is because they have already exhausted numbers or treatments for their acne .
This includes changing the methods of caring for your skin and often comes from spending a lot of money trying to find the right product.
What they ingest
Many of them have also modified their diets and it is precisely this aspect, that of nutrition, the tendency that I find hard to ignore.
People say that they eliminate dairy products, gluten and sugar in an attempt to get rid of their spots.
Many are actively restricting food to the point that, for me, it has become an unhealthy obsession : finding excuses not to go out to dinner with friends or refusing to eat a piece of birthday cake that has been lovingly done by a family.
Some avoid eating out, as there is no “clean” restaurant or cafeteria that can provide “acceptable” or “allowed” food.
So, as a dermatologist, I’m dealing not s or so with acne, but also a very real fear of certain foods.
A controversial link
But let’s look at the evidence. What is the relationship between acne and diet?
The link has been discussed for decades and remains controversial.
Doing good quality dietary studies is a difficult task and many of them depend on the good memory of people about what they ate in the past.
Can you remember exactly what you ate last week? Imagine if I ask you: what did you eat 10 years ago ?
What we do know is that there is a growing relationship between the development of acne and foods that have a high glycemic index (GI), so, potentially, sugar could have something to do.
However, the way I would interpret this is not cutting the sugar completely , but being aware of its consumption.
This is not only good for your skin, but also for your general well-being.
And the dairy products?
The link with dairy products is actually much weaker.
Even so, I could have a role in acne that develops a small and select group of people, but not all!
For reasons that are not completely understood, low-fat dairy products seem to be worse than full fat.
There is no guide to acne in the United Kingdom or the United States, which recommends the elimination of dairy products for the treatment of acne.
There are many people that I see following a vegan diet and still have spots on their skin.
In the same way, I have many patients who have eliminated whole food groups , but their spots persist.
Labeling food as the problem is too simplistic and does not take into account the multifactorial nature of acne , which includes variations in hormones and genetics.
The shame of eating
If the dietary restrictions were not bad enough, the second aspect that I can not ignore is causing and feeling embarrassed about the food that is eaten.
There are people who think it is socially acceptable to give advice or make judgments (even if nobody asks them) about someone’s eating habits and, in addition, to blame them for the state of their skin.
This has also happened to me and I quote some examples:
- The stranger on the street who tells you that you have acne because you eat ice cream on a hot summer day.
- The worried relative who tells you to leave the chocolate because it obviously causes the stains.
- The troll in social networks that tells you that it is not surprising that you have ugly skin because you published a photo of a piece of pizza .
We are living in a world of information overload. Everyone has a voice and a platform and social networks allow us to reach a wider audience that would not have been possible 20 years ago.
But how are scientifically reliable voices distinguished from charlatans?
If you feel desperate for your spots and your self-esteem is on the floor, it is totally understandable that you go to the internet to ask for advice.
The difficulty is that not all the advice can be accepted in the same way, because there is a lot of conflicting information that sometimes even comes from the same health professionals.
And just because something will function to someone does not mean you serve yourself .
We are all individuals, with our unique DNA, environment and intestinal and cutaneous microbiome.
Beyond the skin
Acne has already been linked to a series of mental health problems such as anxiety, depression, social isolation and poor body image.
Telling people that they are vulnerable to develop mental health problems that have to restrict their diet is in itself worrisome.
But that is happening in social networks, where people ( bloggers , through naturopaths and functional medicine) promise to get to the “root of the problem”.
No one denies that good nutrition is important to your skin .
Food has multiple roles in health and skin problems. But that does not mean that you have to make people feel bad about their dietary choices by giving advice that is not requested and that has no scientific basis.
This creates a culture of unjust guilt , because people who are already fighting a battle are being criticized.
Patients tell me that such comments are affecting their mental health or are causing disordered eating patterns .
Many worry much more about what they eat than they should. Others think twice before daring to eat a sugary food in public.
The friends who work in nutrition and psychology tell me that I am not alone in this observation, they are also seeing that in their offices.
So what is the solution? If you are suffering from acne and some of what I have said here sounds familiar to you, it is important that you seek medical help .
In the same way, if you notice that a loved one is cautious with food because of his spots, encourage him to talk to someone.
Be open with your primary care physician or your dermatologist about your concerns regarding food .
It can be really useful to work with a team of people, such as a dietitian and a psychologist, as well as a skin specialist.
Food does not have to be “good” or “bad”, because the labels are too binary.
Eating well for your skin implies eating patterns sustained over time, not just the package of sweets you ate today.