Cause of adult acne: High glycaemic index dietsThe correlation between a Western lifestyle and rise in adult acne has shone light on the western diet. Is it to blame for the steep rise in this troublesome skin disease? Many dermatologists say yes. While there are marked variations in cuisine, there’s one over-arching dietary difference. If a person eats in the West, they are likely to have a high percentage of refined and high GI foods in their diet. If a person eats in the East, their diet has very few of these foods. The glycaemic index is a measure of the speed by which a food is broken down into blood sugar. Ultimately all foods are processed by the body to supply energy as blood sugar, the distinction is in how quickly each food allows this to occur. Foods with a high GI are broken down into blood glucose rapidly, supplying a quick energy spike. Foods with a low GI are broken down into blood glucose gradually, supplying a sustained energy release. Quick spikes in blood sugar provoke the release of a hormone called insulin. With insulin release come several accompanying hormones – one of which goes by the name of insulin-like growth factor (IGF-1). Studies show that levels of IGF-1 are significantly increased in patients with post-adolescent acne4. Insulin and IGF-1 stimulate skin’s rate of sebum production5 – a pivotal factor in the acne causation triangle. The pathology of adult acne relies on 3 factors – increased sebum production, dead skin and bacteria (p.acnes). Adult acne is provoked when plugs of sebum trap dead skin cells within hair follicles – these plugs then provide food to bacteria normally present on the surface of the skin, of which one kind, p.acnes secretes an inflammatory compound as a by-product of its metabolism.
Reduce your risk or incidence of adult acne by following a low GI dietControl of blood glucose levels has several health benefits for an individual, including the treatment and prevention of adult acne. Low GI diets prevent spikes in blood sugar, preventing insulin and IGF-1 release and therefore reducing sebum production. Following a low GI diet involves identifying and removing high GI food groups. The most common example of which are;
- White bread (baguettes, bagels)
- Cakes and patisseries (doughnuts, cupcakes, croissants)
- Energy drinks (Lucozade, Sports plus, Gatorade)
- Certain fruits (bananas, watermelon, raisins)
- Some cereals (Cheerio’s, Rice Krispies, Cornflakes)6
Cause of adult acne: DairyMany forms of dairy, especially low-fat alternatives rate highly on the GI scale, however, this food groups adult acne impact is three-fold;
- Dairy is a high GI food causing release of insulin + IGF-1
- Dairy contains hormones – providing young mammals with the nutrients needed to grow quickly
- Dairy contains a protein which is able to cause inflammation in many people – B-casein – type A1
Reduce your risk or incidence of adult acne by avoiding dairyOnly in recent history has dairy become a common staple in western diets. Before the evolution of industrial farming, dairy was consumed only by infants to help stimulate their growth. In the twentieth century dairy is now not only present in most adult diets, it’s also added to many pre-made foods. Dairy elimination should be trialled for 2-4 weeks and the effects monitored. Full elimination requires careful examination of food labels, pre-made foods such as guacamole, gnocchi, and ravioli commonly contain dairy-based ingredients.
Cause of adult acne: Comedogenic skincareAdult acne is caused as a consequence of blocked hair follicles, an event which can be provoked by the use of comedogenic skin care. Comedogenicity refers to the ability of individual skincare ingredients to block a person’s pores. If ingredients have a very small molecular size, they are easily washed in and out. If ingredients have a molecular size larger than a person’s pores, they will calmly sit on top of the skin. If skincare ingredients have a molecular size very similar to a person’s pore size, they are likely to become trapped within pores, being unable to wash out.
Comedogenic ingredients are ingredients that block pores. People who have acne need to avoid these ingredients in skincare, as they will make the acne condition worse. It is needless to say that at griffin+row we avoid including ingredients into our skincare products that are known to block pores.
Reduce your risk or incidence of adult acne by avoiding comedogenic skin careBy law, all skincare products must make available their full ingredients lists. These lists helpfully follow a set of rules defining that ingredients must be ordered in decreasing quantity until the 1% line after which skin care ingredients may be reported in any order. Comedogenicity studies show the following ingredients have high pore blocking potential11, 12;
- Acetylated lanolin alcohol (4-5)
- Cetearyl alcohol + ceteareth-20 (4)
- Cetyl acetate (4)
- Cocoa butter (4)
- Coconut butter (4)
- Ethylhexyl palmitate (4)
- Glyceryl-3-diisostearate (4)
- Isocetyl alcohol (4)
- Isopropyl isostearate (4-5)
- Isopropyl linoleate (4-5)
- Isopropyl myristate (5)
- Isostearyl isostearate (4)
- Lanolin acid (4)
- Laureth-4 (5)
- Lauric acid (4)
- Myristyl lactate (4)
- Myristyl myristate (5)
- Oleth-3 (5)
- Oleyl alcohol (4)
- PEG-16 lanolin (4)
- Polyglyceryl-3-diisostearate (4)
- PPG-5 ceteth-10 phosphate (4)
- Steareth-10 (4)
- Stearyl heptanoate (4)
- Xylene (4)
To reduce the risk and incidence of adult acne, a skincare regimen should be full of skincare products low in highly comedogenic ingredients. If ingredients rated as 4 or 5 on the comedogenicity scale are high on the ingredients list, the product in question should be avoided, if ingredients high in comedogenicity are low on the ingredients list, the product in question is likely appropriate for acne-prone skin.
griffin+row products do not contain any of the above ingredients.
Cause of adult acne: Lipid oxidationAll skin types produce sebum however oily and combination skin types produce a much greater rate than normal. Sebum is a complex mixture of fatty acids, ceramides, and cholesterol. Squalene is prevalent in sebum at a quantity of around 12%13. The molecular structure of squalene makes it vulnerable to oxidative attack. When squalene oxidises it forms squalene peroxide an oxidative compound that depletes skin of vitally defensive antioxidants such as vitamin E. Studies show that adult acne patients have a significantly lower level of vitamin E than non-sufferers14. The formation of oxidation by-products causes assault to the skin resulting in inflammation15 – a cause of adult acne.
Reduce your risk or incidence of adult acne by using antioxidant rich skincareLipid peroxidation can be both halted and compensated for through the use of appropriate skin care. To help halt the oxidation of sebum, sunscreen should be applied daily. UV light is a well-known oxidant and studies show it to be directly responsible for the depletion of squalene and creation of squalene peroxide16. Daily application of sunscreen helps to prevent lipid peroxidation caused by UV light.
To help defend against the antioxidant depletion lipid peroxides cause, antioxidant serums and moisturisers should be used regularly. Products such as our griffin+row Enrich – Antioxidant night cream help to replenish antioxidant skin reservoirs helping to resist future squalene peroxidation.
Cause of adult acne: Acid mantle impairmentHealthy skin types have a pH between 4.2-5.617 which rates as moderately acidic on the pH scale running from 0-14. An acidic pH is vital to a healthy skin type, technically called skin’s acid mantle when pH strays outside of normal, skin becomes dehydrated, desquamation (natural exfoliation) is impaired, resident microflora populations become perturbed and pathogenic growth of bacteria ensues. The bacteria seen to grow in pathogenic proportions in acne patients – p.acnes, has an impaired growth at pH values below 5.5, however, growth is easily facilitated at pH values between 6-6.518. When skin’s acid mantle is tweaked towards an alkaline pH, acne causing bacteria thrive.
Reduce your risk or incidence of adult acne by following a balanced diet and healthy cleansing routineSkin’s acid mantle is easily affected by skincare products. When skincare products with an alkaline pH are used, skin’s pH is temporarily perturbed. Changes to skin pH may last for hours, or with continued use of strong cleansing products, may become a persistent feature of a person’s skin condition. Traditionally used cleansing products such as bar soap, frequently have an alkaline pH. A recent review of marketed cleansing products showed some rate as highly as 1219 – an extremely alkaline pH.
To protect skin’s acid mantle and avoid the pathogenic growth of acne causing bacteria, strong cleansing products should be replaced with mild, sensitive skin friendly gels, creams, and oils. Products such as the griffin+row cleanse gel delicately cleanse skin while also helping to maintain a healthy pH balance.
Cause of adult acne: Polycystic ovary syndromePolycystic ovary syndrome (PCOS) is estimated to affect between 8 to 20% of people at reproductive age, worldwide22. The condition roots from hormonal abnormality, specifically an increased production of male sex hormones – androgens. As is the cause of adolescent acne, this heightened production of androgens often leads to the PCOS side effect of acne. Androgens cause an increase in skin’s production of sebum, leading to the accumulation of sebum and dead skin cells within hair follicles which in turn propagates the acne causing bacteria – p.acnes. Both a number of androgens produced and a person’s sensitivity to androgen hormones effects the corresponding increase in sebum production23.
Reduce your risk or incidence of adult acne with regular exfoliation and spearmint teaThe pathology of acne relies on 3 central factors – increased sebum production, dead skin collection and the pathogenic grown of p.acnes. All 3 factors are dependently interlinked – without an increased sebum excretion dead skin cells may not congregate, without dead skin cells congregating, p.acnes bacteria may not proliferate.
Regular physical or chemical exfoliation helps to deplete the residence of dead skin cells, leading to a reduction of p.acnes growth and therefore a reduction of acne. Regular manual exfoliation can be integrated with products such as the griffin+row muslin cloth and regular chemical exfoliation can be integrated through products containing salicylic acid.
- Goulden V, McGeown CH, Cunliffe WJ. The familial risk of adult acne: a comparison between first-degree relatives of affected and unaffected individuals. Br J Dermatol 1999; 141: 297-300
- Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles, A Bowe, Whitney P. A Logan, Alan C. J Lipids in Health and Disease Lipids in Health and Disease 2010 9: 141 DOI: 10.1186/1476-511X-9-141
- Uhlenhake E, Yentzer BA, Feldman SR: Acne vulgaris and depression: a retrospective examination. J Cosmet Dermatol. 2010, 9: 59-63. 10.1111/j.1473-2165.2010.00478.x
- Aizawa, H. and Niimura, M. (1995), Elevated Serum Insulin-like Growth Factor-1 (IGF-1) Levels in Women with Postadolescent Acne. The Journal of Dermatology, 22: 249–252. DOI:10.1111/j.1346-8138.1995.tb03381.x
- Smith TM, Gilliland K, Clawson GA, Thiboutot D. IGF-1 induces SREBP-1 expression and lipogenesis in SEB-1 sebocytes via activation of the Phosphoinositide 3-kinase (PI3-K)/Akt pathway. The Journal of investigative dermatology. 2008;128(5):1286-1293. DOI:10.1038/sj.jid.5701155.
- International table of glycemic index and glycemic load values: 2002. Kaye Foster-Powell, Susanna H. A. Holt, Janette C. Brand-Miller Am J Clin Nutr. 2002 Jul; 76(1): 5–56.
- Nutrition and acne Clinics in Dermatology, Volume 28, Issue 6, Pages 598-604 F. William DanbyJ Am Acad Dermatol. 2005 Feb; 52(2): 207–214. doi: 10.1016/j.jaad.2004.08.007
- Jianqin S, Leiming X, Lu X, Yelland GW, Ni J, Clarke AJ. Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutrition Journal. 2015;15:35. doi:10.1186/s12937-016-0147-z.
- Hoppe C, Molgaard C, Michaelsen KF. Cow’s milk and linear growth in industrialized and developing countries. Annu Rev Nutr 2006;26: 131-73.
- A re-evaluation of the comedogenicity concept. Zoe Diana Draelos, Joseph C. DiNardo J Am Acad Dermatol. 2006 Mar; 54(3): 507–512. doi: 10.1016/j.jaad.2005.11.1058
- JE Fulton, Comedogenicity and irritancy of commonly used ingredients in skin care products, J Soc Cosmet Chem 1989, 40, 321-333.
- WE Morris and SC Kwan, Use of the rabbit ear model in evaluating the comedogenic potential of cosmetic ingredients, J Soc Cosmet Chem 1983, 34, 215-225.
- Picardo M, Ottaviani M, Camera E, Mastrofrancesco A. Sebaceous gland lipids. Dermato-endocrinology. 2009;1(2):68-71.
- Picardo M. Sebaceous gland lipids. 2nd International Conference “Sebaceous gland, acne, rosacea and related disorders Basic and clinical research, clinical entities and treatment”; 2008; Rome.
- Briganti, S. and Picardo, M. (2003), Antioxidant activity, lipid peroxidation and skin diseases. What’s new. Journal of the European Academy of Dermatology and Venereology, 17: 663–669. doi:10.1046/j.1468-3083.2003.00751.x
- Ultraviolet a induces generation of squalene monohydroperoxide isomers in human sebum and skin surface lipids in vitro and in vivo. Swarna Ekanayake Mudiyanselage, Matthias Hamburger, Peter Elsner, Jens J. Thiele J Invest Dermatol. 2003 Jun; 120(6): 915–922. DOI: 10.1046/j.1523-1747.2003.12233.x
- Blank HI, Measurement of pH of the skin surface. J lnvrsl Dermatol 1939;2:67-79.
- The effect of detergents on skin pH and its consequences. Korting HC, Braun-Falco O. Clin Dermatol. 1996 Jan-Feb;14(1):23-7. Review. No abstract available.
- Correlation between pH and irritant effect of cleansers marketed for dry skin. Baranda L, González-Amaro R, Torres-Alvarez B, Alvarez C, Ramírez V. Int J Dermatol. 2002 Aug;41(8):494-9.
- Essential fatty acids and acne. Downing DT, Stewart ME, Wertz PW, Strauss JS. J Am Acad Dermatol. 1986 Feb;14(2 Pt 1):221-5.
- LETAWE, BOONE and PIÉRARD (1998), Digital image analysis of the effect of topically applied linoleic acid on acne microcomedones. Clinical and Experimental Dermatology, 23: 56–58. doi:10.1046/j.1365-2230.1998.00315.x
- Sirmans, S. M., & Pate, K. A. (2014). Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical Epidemiology, 6, 1–13.
- Hirsutism and acne in polycystic ovary syndrome. Archer JS, Chang RJ. Best Pract Res Clin Obstet Gynaecol. 2004 Oct;18(5):737-54. Review.
- Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Grant P. Phytother Res. 2010 Feb;24(2):186-8. doi: 10.1002/ptr.2900.