I’m Mic, and today we are going to delve into the mystery that is acne. We are going to look deep inside the pore and see how acne progresses on the microbial level, and we’re also going to look at some of the well-studied dietary triggers of acne and hopefully get some answers. Acne is one of the largest health mysteries today. It is the most common skin condition on Earth. In western societies, it affects about 85% of teenagers, and now, nearly half of people into their thirties. And they had to go ahead and name it acne vulgaris, like, “Your face is vulgar. I’m a scientist.” Yet as much as these scientists know, we still do not have a cure for it. There are still a lot of questions, but one thing is for sure, and I vividly remember thinking this as a pimpled teenager, acne is not the natural state of the human body. That means it doesn’t have to happen to teenagers or adults alike, and that is backed up by looking at other cultures. In the past, when we’ve looked beyond the western world, we’ve been able to see societies that are entirely acne free, like the Kitavan Islanders and the Okinawans. These people had no acne vulgaris. But when these people started adopting a western diet and lifestyle, they started getting acne, so we know that this is not a genetic situation. But in recent history, the dietary connection to acne was largely dismissed by the medical establishment. It can all be traced back to a few studies that took people on a crappy Western diet, kept them on a crappy Western diet, and found no difference. As you can see by this study, one candy bar didn’t make a difference in a torrent of processed food, so we can cross diet off the list. Today, your local dermatologist might still tell you that there’s no connection between acne and diet, but as this 2016 review of the literature stated, “The association between diet and acne can no longer be dismissed.” Okay, before we get to the research on what foods trigger acne, let’s look at how pimples happen. We’re going to look at the microscopic level at your pores to see how most zits occur. This diagram is a cross section of your pore at the base of one of your hairs where your sebaceous glands release sebum. Sebum is a oily and waxy substance, mainly made up a variety of fats that vary depending on your diet. While sebum gets a bad reputation. It actually protects our skin from the sun, feeds our good microbes, suppresses bad microbes, and transports fat-soluble antioxidants to the surface of the skin, and more. And whether our pores are healthy or not, this sebum feeds a species of bacteria that dominates our inner pores, Propionibacterium acnes or P acnes. But don’t let the name acnes fool you. This is a good guy in normal quantities. But here is how things go south. P acnes can tolerate oxygen, but will thrive in an anaerobic or oxygen-free environment, so when we have excess sebum production that maybe dries and creates a cap on your pore, or if we have dead skin cells that are also cutting off the top of your pore, the oxygen level drops, and P acnes blooms like crazy and creates these byproducts that create inflammation within our cell, and creates an opportunity for other types of bacteria to get in and do damage, bacteria like Streptococci whose cousins will give you strep throat. And it’s worth noting that an elevated population of P acnes itself will cause an inflammatory immune response. So by the time all of your white blood cells make it to the party, you already have a pretty nasty zit. Now that you’re well versed in pimple mechanics, I think it’s worth taking a closer look at the nuances of P acnes. There are actually over 70 known strains of P acnes, and an interesting observation was gleaned from this study that took 100 people, 50 of which had acne, and 50 of which didn’t. They found that there were a couple strains that were more common in the acne-ridden group, but one strain in particular that was more common in the clear-skin group, and they believe that this clear-skin strain has genes that make it more effective at fighting off bacterial viruses and other bad microbes. Perhaps soon we’ll be able to spray these good guys’ strains on our face to help fight acne. We’ll see. Okay, now we’re finally getting to diet, starting with diet and sebum, as this review stated, (quote): “Increased sebum secretion is considered, among all features, the major one involved in the pathophysiology of acne.” This has been observed, since, (quote): “On average, acne subjects secrete more sebum than normal ones and secretion rates correlate well with the severity of clinical manifestations.” This is why Accutane is so effective. It actually shrinks pores and reduces sebum production. But it comes with a variety of potential harmful side effects. But this is where diet becomes undeniable because, as this paper states, (quote): “…dietary factors influence a variety of hormones and growth factors that influence sebaceous gland biology and the production of sebum.” One food that really fits the bill of hormones and growth factors is dairy. Yes, in fact dairy has been shown to manipulate estrogen and testosterone and other hormones. As this study showed, drinking milk manipulated testosterone and certain estrogens by a statistically significant 20 to 25 percent margin. Next, as this paper mentions, one of these growth factors that influences sebum production is insulin-like growth factor-1, or IGF-1. As we know, dairy not only contains IGF-1, but it also triggers the raising of IGF-1 through other mechanisms, as this study states, (quote): “The IGF-1 may be either absorbed by milk, or stimulated by its ingestion, or both.” And as this study shows, animal protein as a whole tends to raise IGF-1 blood levels, while plant protein in general does not, which might be why vegans have lower levels of circulating IGF-1. And yes, in case you were wondering, IGF-1 is that same hormone that, when elevated, fuels every stage of cancer growth. Moving on. And to tie it all together, there have been several epidemiological studies and multiple cohort studies showing that more milk means more acne So ditching dairy is a must if you’re trying to fight acne. But one thing that is not excluded in the vegan diet and is widely believed to be bad for acne is refined sugar. That is because blood sugar spikes increase sebum production. One potential pathway for this is how excess simple sugar is turning to triglicerides through novo lipogenesis and Triglycerides make up a large portion of sebum as you can see from this study those with Acne expelled a larger quantity of triglycerides out their face than those who had clear skin. While increasing fruit consumption is generally beneficial, taking the fructose out of the cell is very effective at raising triglycerides as this study showed So those breakouts on your fruit juice cleanse might not be Detox after all and here’s really important to note that that Triglyceride spike was not caused by complex carbs It was not caused by starch. You’ve got to get your carbs in a row. starch=angel carb. refined sugar=devil carb. It’s the devil. Another pathway is that refined sugar elevates insulin which elevates other hormones that increase overall sebum production, so it’s no wonder why this study that put 43 poor acne Ridden souls on a low glycemic diet found that their total number of zits decreased significantly [it’s] important to note that the severity of these blood sugar spice is not only determined by the amount of sugar one eats but also by the amount of fat, whether animal or vegetable This excess fat can make its way into our muscle cells which is called intramural cellular lipids and gum up our insulin key making us insulin resistant and preventing our body from responding appropriately to sugar. All of these things together might be why this study found that a high glycemic load diet, dairy foods and a high-fat diet all appear to play a role in exacerbating acne. So we looked at different foods and insulin and sugar and sebum But we haven’t looked at something that might be underlying all of this and that is MTORc1 hmm-torc1 Let’s just call it torc, that’s easier. The super gritty boring details of this might be for another video but it’s worth sharing as this paper said, quote: “epidemic acne has to be recognized as a MTORc1 disease of civilization”. Torc is over activated by… you guessed it: blood sugar spikes High insulin, high hormones Like IGF-1, but also by excess leucine which is highest in meat and dairy products. Because of this, scientists point to three main culprits: dairy, refined sugar and meat consumption. As this paper mentions the western diets over activation of torc not only increases sebum production But increases the size of your sebaceous glands making super-sized sebum factories in your face To show how effective over activating tor is, and giving you a tiny ounce of hope there is a compound in green tea that Inhibits torc and this study found that taking a 2% green tea lotion and applying it to the face of acne sufferers reduced the number of Acne lesions by 58%. And] I think it’s fair to say that it’s a safe home remedy to just kind of slap yourself in the face with a teabag, I don’t think anyone’s going to get hurt but finally fruits and vegetables to the rescue once again with quote: “an Attenuation of torc signaling is only possible by increasing the consumption of vegetables and fruit.” So there you have it It’s not all about eliminating foods but it does thankfully go past just fruits and vegetables also to nuts and seeds with ALA, that omega-3 fatty acid that is primarily found in plant foods. And since ALA is a component of Sebum, a more even ratio of Omega-3s to omega-6s might not only be beneficial for your heart But also for your skin. This study found that people [who] suffer from Acne were lower in ALA and as this study mentions low levels of ALA Impairs your skin’s barrier function and all of this actually brings us back to P acnes. Anything that keeps P acnes from over growing can be an effective treatment. And it just so happens that ALA is turned into a byproduct known as porphyrins by P acnes Which when exposed to UV light can kill them off and keep their population in check. As this study showed When illuminated with blue light the porphyrins damage the p-acne cells very efficiently: here is a picture of them leaking and dying. The researchers went as far as to say, quote: “a treatment protocol with a series of several illuminations or illumination after application of ALA may be suitable for curing acne.” Scientists don’t pull out the c-Word very often. With all this information one has to speculate that the higher ALA intake and increased sun increased sun exposure of Non-Western civilizations and our ancestors might have been a natural built-in mechanism that kept P-acnes from over growing and prevented acne all together. Alright, that’s it for sebum science, but really quickly I do want to mention that it’s important to get enough vitamins A, E and also the mineral zinc. As this study found, people with acne tend to have lower levels of all three of these which are all Important for skin health. Again, the importance of diet and acne is highlighted in the sort of self-congratulatory conclusion of these researchers with quote: “our study marks the importance of diet in patients with acne.” All right moving on and now just because I know there’s going to be somebody watching this who’s going to be like “Diet isn’t the only cause of acne, this is the worst video ever” and there are probably gonna be people who went vegan thinking they’re going to clear up their acne And they’re like: “I want a refund!” To you all: Yes, there are non dietary causes of Acne They include sun damage, chlorine exposure, which can compromise the skin’s barrier function, getting your face directly exposed to grease or perhaps fumes and also, of course, makeup. In the end, many people can and have cured their acne by simply going Vegan. They are the fortunate ones who when they take (off) those mammalian hormones from dairy and the excess leucine they get that stimulates torc from meat, it just does the job and they don’t have to worry about it anymore but for other people you might have to also ditch those processed foods, those refined sugars and even the fruit juice and maybe balance out your Omegas by eating more ALA and less omega-6 and perhaps then you can beat acne I personally saw an improvement in my acne when I went vegan and then another improvement when I stopped cooking with oil. Finally make sure you get enough of those vitamins A and E and also Zinc in fact feel free to let others know down below what some plant sources of those three nutrients are. Alright, that’s it for today, feel free to subscribe, so you don’t miss the next acne video. May your pores be clear and thank you for watching.