Could that age-old Sunday school lesson end up causing acne?

Could that age-old Sunday school lesson end up causing acne?

The Bible is, indeed, the Good Book–at least that’s what I gathered as a child from the bits and pieces directed at me from the pulpits of myriad churches. Don’t get me wrong; I’m no Bible scholar and don’t pretend to be an expert on all of the lessons its pages contain. But one thing I am sure of is that bread is the most overrated thing in the Bible. Many of my friends consider me irreverent to deny that bread is the staff of life. But it simply is not so. And now there is even more evidence to support my view.

This time, bread gets its comedown in the December 2002 issue of the Archives of Dermatology, which points the finger at bread as the culprit behind acne.

It’s a complicated pathway from bread to acne, but it goes something like this: (If you don’t like biochemistry and enzymology, skip to the next paragraph.) Bread turns into sugar when digested. In response to this, the body produces high levels of insulin and insulin-like growth factor (IGF-1). And here is where it gets interesting: Elevated insulin levels lead to an excess of testosterone. This causes the pores in the skin to secrete sebum, a greasy substance that attracts bacteria and thus creates the infection known as acne, also known in the trade (and in high school) as zits.

That is the theory, and it’s quite plausible. I’ve seen it demonstrated numerous times in clinical practice. If you give a young female testosterone, two things will happen. She will get amorous (to put it delicately), and she will develop a mild case of acne. Since eating significant amounts of bread increases testosterone levels, heavy bread intake could explain why some girls get acne.

In modern societies, up to 60 percent of 12-year-olds and 95 percent of 18-year-olds suffer from at least some degree of acne. In Aboriginal tribes around the world that stick to animal-protein diets–no sugar or grains–acne is almost unknown.

The importance of insulin in the etiology of acne is clearly shown in the use of the drug metformin. When women with polycystic ovary syndrome, a condition that causes an excess of insulin (and thus acne), were treated with metformin, their acne improved.

Action to take:

I’m not suggesting taking metformin as a first line of treatment for juvenile acne. I would try large doses of vitamin D and severe restriction of all starches in the diet (not just bread). Remember that sugar is the end result of eating starch. So you want to avoid all sugar products, such as killer colas, cakes, pies, Oreos, and anything that is made by Betty Crocker.

P.S. By “large doses of vitamin D,” I mean 5,000 IU per day. That’s not really even very large, but it’s enough to scare off most mainstream doctors. RH


“Diet and Acne Revisited,” Archives of Dermatology 2002; 138(12): 1,591-1,592

“Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne.” Journal of Dermatology 1995; 22(4): 249-252

“Acne and hirsutism in polycystic ovary syndrome: clinical, endocrine-metabolic and ultrasonographic differences,” Gynecological Endocrinology 2002; 16(4):275-84