Acne is indeed a disease. However, it is not genetic. I strongly believe that.

People do all sorts of stuff to "cure" it but it won't work. Diet is effective, no doubt. But, it's not a cure-all. Nor is anything else you will find in any store or on these boards.

It is extremely probable that acne has its roots in the gut microbiota. There are countless reasons I could list as to why that's true, but anyone who's been around this for long enough eventually comes to terms with it. There's a lot of speculation about human genes, dairy and the IGF-1 thing, etc. More likely is that we have lost important microbes in the gut ecosystem that tone down inflammation. Dysbiosis is a hallmark of intestinal problems. And usually, there's a loss of microbial diversity (LOMD).

The more i've dealt with acne, and the more I see how nothing works, the more I see how indispensible these microbes are and the functions they might carry out. Nothing can replace them. We literally rely on them and need their genetic material. So... is acne genetic? Depends how you argue that point. Personally, I'd say it's not genetic in the sense of human genes. But it could be related to microbe genetics.

Some microbes do produce anti-inflammatory molecules that pull the strings of our own immune system. So you could say microbe genetics are in turn pulling the strings of our own genome. We are, in a scary sense, slaves to them. Their collective genome is over 150 times larger than our own. Ultimately, they have the final say in the direction of our health.

On 10/10/2019 at 2:02 AM, FvckAcne said:

Acne is indeed a disease. However, it is not genetic. I strongly believe that.

Then how would you explain the hereditary tendency to develop acne within some families? There may not be an acne gene per se, but there are obviously some genetic mutations that can increase a person's chances of developing acne, which could be passed on to their descendants. In my mind that would classify it as "genetic" acne, or perhaps more accurately as hereditary acne. Even hormonal acne could be described as "genetic", if the over/under production of said hormone is motivated by genetics rather than environmental exposure. I'm not suggesting that some peoples acne is caused solely by diet or other environmental factors, but to blanketly say "it is not genetic" would be disingenuous.

The microbiota that eventually develops within the gut is passed from mother to child. Diet later influences said microbes as does environment. Though I'd say diet is probably the strongest influence on gut microbes. With many of our microbes being obligate anaerobes, they are largely not exposed to external environmental factors, so our own dietary intake is what I'd say for the most part shapes them.

Bottom line: we take antibiotics for this condition. That points to a stronger microbial link rather than human genes. Perhaps I am ignorant here, but I have never known any other medical condition that is brought on by human genetics where antibiotics are necessary or is the standard treatment of choice. I think the medical community at large, or at least anyone who knows what they're talking about, would agree that acne in all likelihood is driven by microbes in the gut. Furthermore, I have never seen any concrete evidence that acne is driven by human genetics. However, the manifestation of acne by dietary influences again strongly points toward a microbiota in the gut responding to that.

As to your point regarding "hormonal" acne being genetic.. The gut microbiota is known to act as an endocrine organ itself. It doesn't just metabolize nutrients. Given that the collective genome of the microbiota is far bigger than our own, it's nonsense to assume they don't impact other aspects of our health in profound ways.

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but there are obviously some genetic mutations that can increase a person's chances of developing acne

Name one.

Definition of hereditary:

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determined by genetic factors and therefore able to be passed on from parents to their offspring or descendants.

Even if the composition of the microbiota were skewed somehow upon birth it still doesn't fit that description. Because it is not a genetic factor relating to your own DNA. All in all, acne appears to be far more of an environmental factor rather than a genetic one.

BUT that is to say, that just because you have acne now and change your dietary habits and environment doesn't mean you won't have acne. If it is true that we've lost diversity or needed microbes, nothing short of reintroducing them in the right place, right time and right amount will fix that. And this gives rise to that whole "but i'm eating healthy!", "but i've done x, y, z and i wash x times a day", etc. After the onset of acne, it doesn't matter.

It's a lot like the saying that it takes years to build a reputation and only 5 minutes to destroy it. Once it's done, it's done.

Some people argue that diet doesn't cause acne or that it does. Here's my take on it: You could argue both ways and still be right in some sense. Diet is interesting in that it can be a one-way street. In the sense that it can be a "cause" but not a cure. Let me explain.

Our microbes depend on our dietary habits. Some microbes ferment or favor some substrates over others. Consequently, those habits shape the type and number of those microbes. You could lose species entirely by not feeding them because other species will outcompete them. Once those species are lost or lose their dominant foothold, diet alone won't necessarily bring them back. It's possible to do irreversible damage to the microbiota through diet that dietary changes alone won't be able to fix.

In the event that acne were an infection instead, you could imagine how once the infection is established, diet only serves to further sustain it. Hence the "chronic" nature of acne.

In the end, dietary influences could further a loss of beneficial microbes. Is that the same as saying that foods inherently cause acne? No. Diet is only a mediator that helps drive the microbiota itself. To the question of whether diet "causes" acne... That could be both yes and no, depending on how you're looking at things. But probably via its role in managing the microbiota rather than some inherent aspect of the food itself. Does diet influence the microbiota? Yes. Does some specific food literally cause the condition known as acne? Unlikely. To an acne sufferer, it seems like everything causes acne. I call that bullshit. In reality, there is likely to be a single cause, or very small number of actual causes of the condition. It's called acne because it's well, acne. There is a characteristic pattern of the disease process.

As for the western world where acne is prevalent, dietary influences can skew the microbiota of a woman who later gives birth to a child, passing on that microbiota. So it would give the appearance that acne is a genetic component, even if it is really not. And diet could still be the main issue here.

Furthermore, how is it that some people who normally don't have the condition get it occasionally? How do you explain that with genetics? That their genes just tripped up accidentally? Not likely. More likely is that the shift in microbiota composition triggered it. Because it's a dynamic ecosystem that's always in flux. It responds to not only stress, but also diet and exercise, and any number of other things. Sure, human genes do too, but we'll just have to agree to disagree on this point for other reasons additionally.

Almost every week there's a new article out about how the human microbiome impacts some new aspect of our being. If they can do something as powerful as influence the functioning of our own brain, and with the hypothesis that human mitochondria evolved from bacterial symbionts (hence why mitochondria in cells have their own unique DNA), I wouldn't put it out of reach to somehow influence the hormonal system as well. They are tightly ingrained in everything about us, yet still separate.

I'd be willing to bet that the reason there is no solution to acne as it stands, after about 100 years of science on the topic, is because the riddle to the puzzle involves an area of research that is so new: the microbiota.