A Blemished Record of Acne Advice

Slate had an article last week about the evolutionary reasons behind acne and our reaction to it (here). I’ll save you the trouble of having to read it by summing it up for you here:

  1. Allegedly, as a species, we lost our hair faster than our skin could adapt. All that waxy sebum is a remnant of our hairier days and it clogs pores.
  2. We evolved to have a shared disgust of anything considered contagious, so blood, pus, and flaking skin trigger these deeply rooted feelings.

Okay, great. But that doesn’t explain acne’s prevalence, now does it?

If a build-up of facial oil were truly the culprit, then washing would fix the problem, right? And since that’s what everyone thinks, it’s okay to think someone’s dirty and just not washing often enough?

This reminds me of something…hmm…what is it?…Oh yeah. It’s also popular to blame fat people for being lazy and eating crap. And I hope we all know by now that’s not what’s going on.

I’ve mentioned previously that one of the benefits of this diet is the clear skin (see here). I’m not sure I can properly explain this liberation. It means I can look someone in the eye, unafraid of what they might be seeing. It means that people who’ve known me for years might see me for the first time ever without make-up on (even camping!). It means that a huge anxiety has been lifted. All these years—almost 20 of them—of constant worry, scrutiny, covering up, and disappointment, just *Poof!*.

I went from miracle treatment to miracle product. I heard that I needed to use this cleanser or that. I tried benzoyl peroxide, salicylic acid, sulfur, Differin gel (concentrated Vitamin A), alcohol. A doctor suggested a round of tetracycline antibiotics. And still I woke up every morning with at least three new eruptions, sometimes so big and painful that my lymph nodes would swell too. In high school, people weren’t shy about pointing them out. I have no doubt that my poor complexion contributed to my overall teenage depression. And, yeah, I often heard, “Don’t you use soap?” Gee, I never thought of that one. If soap cured acne, I would’ve had the clearest skin of anyone in school.

Slate’s “reasons” also don’t answer the hormonal connection. Why do women break out around their cycle? Why is it that the very first symptom of my pregnancy was a sudden back full of acne? Why was my skin clear all through breastfeeding, but the pimples returned with a vengeance afterward? Nothing in their supposedly evolutionary explanations come close to touching that.

So I’m weary of hearing another faux explanation that blames the victim. What’s Slate’s solution?

Whether your acne disappears by your teens or not until your 40s, your sebaceous glands will one day, I promise you, run dry as an ancient riverbed…all of you with reddened hides in hiding, those in sore, oozing discontent, acne is but a passing cosmetic calamity. There’s no shame in shame, so ask for help if you need it. You aren’t alone in your distress, but save some worrying for those slowly gestating, well-earned wrinkles to come.

To outlast it?! Wow, thanks. I’m 34 years old and I can tell you it was not “a passing cosmetic calamity.” And ask for help? What help have they offered here?

Loren Cordain markets a version of his Paleo Diet as The Dietary Cure for Acne. He places acne firmly on the list of diseases of civilization, next to obesity, diabetes, and heart disease. I’m not sure of the particulars—he seems to be keeping those for his book—but from what he does mention on his site (here), it sounds like all the crud of the SAD prevents our bodies from functioning well everywhere, including our skin.

Cordain gives some frightening statistics:

In the U.S., between 79-95% of all teenagers between 16 and 18 years of age have acne. Acne is present in children as young as 4 and about half of young men and women over age 25 experience some form of acne.

Contrast that with:

…there is intriguing evidence from frontier physicians, explorers and anthropologists that the prevalence of acne is incredibly lower in native people when living and eating in their traditional ways…Out of the 300 young people examined on the Kitavan Islands, there was not a single pimple to be found.

Even Slate agrees with this (bold mine):

Intriguingly, and for reasons that are still unclear, certain human populations such as the Kitavan Islanders of Papua New Guinea and the Aché of Paraguay are spared the blackheaded plague. Although their diet and lifestyle are very different from our own, so are their genes.

I disagree about the genes being different though. This is a completely empty statement without knowing whether or not the genes responsible for acne are the same between populations. And, as we now know, all humans are genetically similar, with relatively little variation within our species. But I love how they acknowledge the diet and lifestyle differences begrudgingly and dismissively, as though those are just minor details. They’re everything!

I’ve seen some messages from folks who are still struggling with acne even after going Paleo/Primal. I wish them luck on their journey, and hope they find the peace I now have about it. I take a lot of pride in knowing that when my now 20-month-old daughter reaches adolescence, she’ll find much to angst about, but hopefully not her complexion.


3 Responses to “A Blemished Record of Acne Advice”

  1. Great article! How long were you on the Paleo diet before your skin cleared up?

  2. So many great statements here! I think we’re cut from the same cloth. I truly think acne is one part hormones, one part massive, long-term nutritional deficiency (probably contributing to how difficult it is to perfectly balance said hormones.) Slate is starting to irk me – did you see their CrossFit/Tomato Can article?

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