I think it's interesting that people believe Japanese suffer less from acne and have such a healthy diet. I've lived in Japan for 20+ years, a majority of my life, and would strongly disagree with this belief. I've mainly lived in populated areas, like Tokyo and Yokohama. I also lived on Okinawa for 3 years, and did notice a difference in skin there. However, I always attributed the heavy amount of coral and sea salt in the air for why Okinawans tend to age gracefully, have clearer skin, and live longer than mainland Japanese.

I've been raised on an Asian diet. I only seem to suffer from acne when I'm in Japan. My skin is pretty clear when I'm in America. I also have a terrible habit of examining other people's skin. I don't see many people with severe cystic acne here, but I do see people with acne, especially young adult men and teens. To me, it's no different than America.

Since reading this health board, I've actually been trying to figure out how to eat more healthy in Japan. Every meal in Japan seems to either have wheat noodles or white rice. Most sauces also include a good amount of salt, soy sauce (more salt) and sugar. I could be wrong but don't most people with acne avoid these foods? Japanese also love salty fishes. The saltier the salmon, the more it costs in this country. Japanese fish are also known to have a high level of mercury. That's not very healthy either. I will say that green tea is a good part of the Japanese diet. Although, many Japanese love to put salt in their green tea...

Yes, portions are smaller in Japan.but keep in mind, people are much smaller. I'm only 5'4". I feel like a giant in this country. I tower over most men. Even with smaller portions, I can't always finish a Japanese meal.

A couple weeks ago, I was walking through Yokohama Station, and smack in the middle of the station was this huge display for Proactive. There were several large vending machines and videos playing on how to get clear skin with Proactive. They've also been running campaigns in major cities. If there wasn't an issue with acne in Japan, I don't think Proactive would be investing so much in the Japanese market.

Have you ever noticed that Asians and Europeans tend to have bad teeth? I've always thought that was related to the lack of flouride in the water. Japan's water quality is also awful when compared to Western cultures. I've watched Japanese news programs on the quality of Tokyo water where they showed the bottom of the water tanks. It's simply scary to think I even shower in it.

Fluoride in the water is a bad thing, not a good thing. People here have horrible teeth as well. Most people I know have multiple fillings in their mouth.

But I totally agree about people in other countries not having perfectly clear skin. I've seen threads like this a number of times on this forum and I never understand where that idea comes from. I've traveled through south east asia and saw plenty of people with acne there.

If you're really interested in seeing the prevalence of acne in other cultures, studies broken by a variety of countries have been done:

http://www.ncbi.nlm....om_uid=17911988

Here's a summary of the one they did for adolescents in Japan:

In this community-based cross-sectional study, 1443 Japanese adolescents aged 13-19 years participated from two schools in Kagawa Prefecture. Students completed a self-administered questionnaire to assess the prevalence of acne, knowledge about acne, self-management of acne and emotional well-being. A five-item version of the Mental Health Inventory (MHI) subscale of the Short Form 36 was used to assess psychological health and depression status. Among respondents, 859 (59.5%) said they had acne (51.6% of the boys and 64.8% of the girls). A majority (56.8%) of those who said they had acne also reported a family history of acne. Of the 555 female respondents with acne, 39.1% reported experiencing acne flares in temporal proximity to menstruation. Less than half (38.8%) of respondents with acne had sought or were seeking treatment. The three most common factors believed to trigger or exacerbate acne were stress, lack of sleep and sweat. The mean MHI score of 847 students with acne was significantly lower than 475 students without acne. The mean MHI score of female students with acne was significantly lower than male students with acne. Students with acne were also significantly more depressed than those without acne and female students were significantly more depressed than male students. Acne is a common problem for Japanese teenagers and causes personal and social difficulties. Our results suggest the necessity of educational programs in school or public to ensure that adolescents are aware of acne and to encourage young people to improve their mental health through better acne treatment.