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PickleShmickle

What Do You Think The Reason Is For The Fact That Diet Can Lessen Acne?

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Just curious what everone's stance is.

I know when I eat low carb I get less acne. I'm just not sure what's going on systemically. If acne is an internal, systemic problem, I'm curious why I only get bad acne on my face and nowhere else on my body.

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Doctors and scientists still don't know what is going on at a microbiological molecular level. The same way they do not fully understand cancer or heart disease.

If we fully understood any disease, I'm sure we could crush it.

I am of the opinion that modern civilized people are prone to acne while primitive, isolated peoples are not. Diet is one degree of separation from our primitive cousins. It could be the antinutrients, phytates etc in grains or maybe it's all the vegetable oil that we now consume. Perhaps a lack of Vitamins A, D, or E in today's diets?

It's a complicated subject to be sure. Why take risks? Why do we need to fully understand the process? Leave that to the scholars. Don't eat modern manmade garbage and at least reap the benefits.

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Leave that to the scholars.

I am actually a scientist earning my PhD in immunotherapy. I'm just curious what everyone thinks since most have tested themselves and have come to their own unique conclusions.

Edited by PickleShmickle
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Leave that to the scholars.

I am actually a scientist earning my PhD in immunotherapy. I'm just curious what everyone thinks since most have tested themselves and have come to their own unique conclusions.

I've experimented a lot over the past few years and come to a few conclusions. The primary conclusion is that acne, in many cases, is a symptom of immune dysregulation. That is, acne is the outcome of a hyperactive (probably Th1 or Th17) immune response against commensal bacteria - sort of like an autoimmune disorder, but targeted against the microbiome instead of your own cells (side note - I think dandruff is the same thing possibly involving a fungus instead of a bacteria, but that hypothesis is more shaky).

I've been on accutane twice, and both times I've made an interesting observation that has been reported once or twice in case studies. While on accutane, my persistent athlete's foot got about ten times worse; it went from practically negligible to covering 30% of the surface area of both feet. It also gave me smelly feet. I believe both of these effects to be outcomes of isotretinoin's proven immune-suppressing effects; my immune system while on the drug was unable to control certain pathogens, and was far more tolerant of other bacteria (which led to an increase in body odor). Even more interestingly, though, is the fact that my persistent low-grade athelete's foot, which I had had for a decade before taking the drug, was cured about a month after cessation of isotretinoin therapy. My immune system bounced back, and the balance between tolerance and intolerance to the dermatophytes was re-established in such a way that they were perfectly controlled. This effect, pertaining to foot fungi, has been reported sporadically, and hasn't really been investigated at all.

In the case of acne, I might wager that something similar is happening. You go on the drug for 6-12 months, suppressing your immune system, and then when you go off it, your immune system has a fresh encounter with P. acnes and establishes a more favorable tolerance equilibrium. Sure, accutane has sebo-suppressive effects (which are not long-term) and antimicrobial effects (also not long term), and it regulates skin turnover, but I don't think any of these other effects are responsible for long term remission.

With this in mind, I think the reason diet affects acne is because the immune system is closely intertwined with nutritional status and food antigens. If you tweak your diet, there's a good chance you're changing how your immune system reacts by a little bit. Adding cod liver oil, going into the sun, eating liver, avoiding antigenic foods, supplementing zinc, getting a lot of sleep, eating low glycemic - all of these holistic approaches to treating acne modulate the immune system, usually in a specific anti-inflammatory way, which would support the hypothesis that it's an overactive Th1 or Th17 response.

As a little side note, I've notice that for me, forehead acne was not a problem until I got severe food poisoning, after which my forehead became a battle zone, even upon resolution of the illness. It would be interesting to see if gut flora has anything to do with acne - I'm sure it does, but I'm not sure how. In my case, I wonder if the food poisoning threw my immune system off balance, so now I react to exotoxins/endotoxins from commensal bacteria that are structurally similar to those that gave me food poisoning. Perhaps some of them find their way into my blood where they interact with leukocytes which then travel and produce comedones. Or maybe there are memory cells embedded in my forehead's skin that react to the toxins in my blood when they are encountered. Unfortunately not a lot is known here, though I do find the fact that acne can affect distinct areas of skin (which histologically look very similar) to be extremely interesting.

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Leave that to the scholars.

I am actually a scientist earning my PhD in immunotherapy. I'm just curious what everyone thinks since most have tested themselves and have come to their own unique conclusions.

I've experimented a lot over the past few years and come to a few conclusions. The primary conclusion is that acne, in many cases, is a symptom of immune dysregulation. That is, acne is the outcome of a hyperactive (probably Th1 or Th17) immune response against commensal bacteria - sort of like an autoimmune disorder, but targeted against the microbiome instead of your own cells (side note - I think dandruff is the same thing possibly involving a fungus instead of a bacteria, but that hypothesis is more shaky).

I've been on accutane twice, and both times I've made an interesting observation that has been reported once or twice in case studies. While on accutane, my persistent athlete's foot got about ten times worse; it went from practically negligible to covering 30% of the surface area of both feet. It also gave me smelly feet. I believe both of these effects to be outcomes of isotretinoin's proven immune-suppressing effects; my immune system while on the drug was unable to control certain pathogens, and was far more tolerant of other bacteria (which led to an increase in body odor). Even more interestingly, though, is the fact that my persistent low-grade athelete's foot, which I had had for a decade before taking the drug, was cured about a month after cessation of isotretinoin therapy. My immune system bounced back, and the balance between tolerance and intolerance to the dermatophytes was re-established in such a way that they were perfectly controlled. This effect, pertaining to foot fungi, has been reported sporadically, and hasn't really been investigated at all.

In the case of acne, I might wager that something similar is happening. You go on the drug for 6-12 months, suppressing your immune system, and then when you go off it, your immune system has a fresh encounter with P. acnes and establishes a more favorable tolerance equilibrium. Sure, accutane has sebo-suppressive effects (which are not long-term) and antimicrobial effects (also not long term), and it regulates skin turnover, but I don't think any of these other effects are responsible for long term remission.

With this in mind, I think the reason diet affects acne is because the immune system is closely intertwined with nutritional status and food antigens. If you tweak your diet, there's a good chance you're changing how your immune system reacts by a little bit. Adding cod liver oil, going into the sun, eating liver, avoiding antigenic foods, supplementing zinc, getting a lot of sleep, eating low glycemic - all of these holistic approaches to treating acne modulate the immune system, usually in a specific anti-inflammatory way, which would support the hypothesis that it's an overactive Th1 or Th17 response.

As a little side note, I've notice that for me, forehead acne was not a problem until I got severe food poisoning, after which my forehead became a battle zone, even upon resolution of the illness. It would be interesting to see if gut flora has anything to do with acne - I'm sure it does, but I'm not sure how. In my case, I wonder if the food poisoning threw my immune system off balance, so now I react to exotoxins/endotoxins from commensal bacteria that are structurally similar to those that gave me food poisoning. Perhaps some of them find their way into my blood where they interact with leukocytes which then travel and produce comedones. Or maybe there are memory cells embedded in my forehead's skin that react to the toxins in my blood when they are encountered. Unfortunately not a lot is known here, though I do find the fact that acne can affect distinct areas of skin (which histologically look very similar) to be extremely interesting.

Thank you for this. You're dead on that this is an immunological disorder and that isotretinoin likely works at the immunologically level. The trouble with figuring these things out is that these small vitamins have such pleiotropic effects, making their consequences tough to study.

The thing that always perplexed me is why some of us only get acne on certain regions if the causative factor of acne is systemic immune dysregulation. In your scenario, these bacteria-reactive T cells would be everywhere, so why do they only manifest issues on the face? What is it about facial skin in particular that makes it susceptible? Vascularity? Amount of oil glands? Exposure to the elements?

Edited by PickleShmickle
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Leave that to the scholars.

I am actually a scientist earning my PhD in immunotherapy. I'm just curious what everyone thinks since most have tested themselves and have come to their own unique conclusions.

I've experimented a lot over the past few years and come to a few conclusions. The primary conclusion is that acne, in many cases, is a symptom of immune dysregulation. That is, acne is the outcome of a hyperactive (probably Th1 or Th17) immune response against commensal bacteria - sort of like an autoimmune disorder, but targeted against the microbiome instead of your own cells (side note - I think dandruff is the same thing possibly involving a fungus instead of a bacteria, but that hypothesis is more shaky).

I've been on accutane twice, and both times I've made an interesting observation that has been reported once or twice in case studies. While on accutane, my persistent athlete's foot got about ten times worse; it went from practically negligible to covering 30% of the surface area of both feet. It also gave me smelly feet. I believe both of these effects to be outcomes of isotretinoin's proven immune-suppressing effects; my immune system while on the drug was unable to control certain pathogens, and was far more tolerant of other bacteria (which led to an increase in body odor). Even more interestingly, though, is the fact that my persistent low-grade athelete's foot, which I had had for a decade before taking the drug, was cured about a month after cessation of isotretinoin therapy. My immune system bounced back, and the balance between tolerance and intolerance to the dermatophytes was re-established in such a way that they were perfectly controlled. This effect, pertaining to foot fungi, has been reported sporadically, and hasn't really been investigated at all.

In the case of acne, I might wager that something similar is happening. You go on the drug for 6-12 months, suppressing your immune system, and then when you go off it, your immune system has a fresh encounter with P. acnes and establishes a more favorable tolerance equilibrium. Sure, accutane has sebo-suppressive effects (which are not long-term) and antimicrobial effects (also not long term), and it regulates skin turnover, but I don't think any of these other effects are responsible for long term remission.

With this in mind, I think the reason diet affects acne is because the immune system is closely intertwined with nutritional status and food antigens. If you tweak your diet, there's a good chance you're changing how your immune system reacts by a little bit. Adding cod liver oil, going into the sun, eating liver, avoiding antigenic foods, supplementing zinc, getting a lot of sleep, eating low glycemic - all of these holistic approaches to treating acne modulate the immune system, usually in a specific anti-inflammatory way, which would support the hypothesis that it's an overactive Th1 or Th17 response.

As a little side note, I've notice that for me, forehead acne was not a problem until I got severe food poisoning, after which my forehead became a battle zone, even upon resolution of the illness. It would be interesting to see if gut flora has anything to do with acne - I'm sure it does, but I'm not sure how. In my case, I wonder if the food poisoning threw my immune system off balance, so now I react to exotoxins/endotoxins from commensal bacteria that are structurally similar to those that gave me food poisoning. Perhaps some of them find their way into my blood where they interact with leukocytes which then travel and produce comedones. Or maybe there are memory cells embedded in my forehead's skin that react to the toxins in my blood when they are encountered. Unfortunately not a lot is known here, though I do find the fact that acne can affect distinct areas of skin (which histologically look very similar) to be extremely interesting.

Thank you for this. You're dead on that this is an immunological disorder and that isotretinoin likely works at the immunologically level. The trouble with figuring these things out is that these small vitamins have such pleiotropic effects, making their consequences tough to study.

The thing that always perplexed me is why some of us only get acne on certain regions if the causative factor of acne is systemic immune dysregulation. In your scenario, these bacteria-reactive T cells would be everywhere, so why do they only manifest issues on the face? What is it about facial skin in particular that makes it susceptible? Vascularity? Amount of oil glands? Exposure to the elements?

My guess would be skin flora. I don't think it's necessarily general immune dysfunction, but rather a dysfunctional response against certain bacteria or antigens. I'm not sure how skin flora differs by area of skin, but I'm guessing that sebum has a rather large impact, which is why sebum is generally seen as a necessary condition for developing lesions.

Alternatively, it really could all be intestinal. We have a biome that is constantly secreting antigens into the lumen of the intestine, and some of them are absorbed. We're also constantly eating food. Differences in target tissues could determine reactions to these molecules, maybe by the presence of T cells that cross react with skin flora antigens, or maybe by the presence of growth factors that provide the right environment for an inflammatory response. It's really hard to know.

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Leave that to the scholars.

I am actually a scientist earning my PhD in immunotherapy. I'm just curious what everyone thinks since most have tested themselves and have come to their own unique conclusions.

I've experimented a lot over the past few years and come to a few conclusions. The primary conclusion is that acne, in many cases, is a symptom of immune dysregulation. That is, acne is the outcome of a hyperactive (probably Th1 or Th17) immune response against commensal bacteria - sort of like an autoimmune disorder, but targeted against the microbiome instead of your own cells (side note - I think dandruff is the same thing possibly involving a fungus instead of a bacteria, but that hypothesis is more shaky).

I've been on accutane twice, and both times I've made an interesting observation that has been reported once or twice in case studies. While on accutane, my persistent athlete's foot got about ten times worse; it went from practically negligible to covering 30% of the surface area of both feet. It also gave me smelly feet. I believe both of these effects to be outcomes of isotretinoin's proven immune-suppressing effects; my immune system while on the drug was unable to control certain pathogens, and was far more tolerant of other bacteria (which led to an increase in body odor). Even more interestingly, though, is the fact that my persistent low-grade athelete's foot, which I had had for a decade before taking the drug, was cured about a month after cessation of isotretinoin therapy. My immune system bounced back, and the balance between tolerance and intolerance to the dermatophytes was re-established in such a way that they were perfectly controlled. This effect, pertaining to foot fungi, has been reported sporadically, and hasn't really been investigated at all.

In the case of acne, I might wager that something similar is happening. You go on the drug for 6-12 months, suppressing your immune system, and then when you go off it, your immune system has a fresh encounter with P. acnes and establishes a more favorable tolerance equilibrium. Sure, accutane has sebo-suppressive effects (which are not long-term) and antimicrobial effects (also not long term), and it regulates skin turnover, but I don't think any of these other effects are responsible for long term remission.

With this in mind, I think the reason diet affects acne is because the immune system is closely intertwined with nutritional status and food antigens. If you tweak your diet, there's a good chance you're changing how your immune system reacts by a little bit. Adding cod liver oil, going into the sun, eating liver, avoiding antigenic foods, supplementing zinc, getting a lot of sleep, eating low glycemic - all of these holistic approaches to treating acne modulate the immune system, usually in a specific anti-inflammatory way, which would support the hypothesis that it's an overactive Th1 or Th17 response.

As a little side note, I've notice that for me, forehead acne was not a problem until I got severe food poisoning, after which my forehead became a battle zone, even upon resolution of the illness. It would be interesting to see if gut flora has anything to do with acne - I'm sure it does, but I'm not sure how. In my case, I wonder if the food poisoning threw my immune system off balance, so now I react to exotoxins/endotoxins from commensal bacteria that are structurally similar to those that gave me food poisoning. Perhaps some of them find their way into my blood where they interact with leukocytes which then travel and produce comedones. Or maybe there are memory cells embedded in my forehead's skin that react to the toxins in my blood when they are encountered. Unfortunately not a lot is known here, though I do find the fact that acne can affect distinct areas of skin (which histologically look very similar) to be extremely interesting.

Thank you for this. You're dead on that this is an immunological disorder and that isotretinoin likely works at the immunologically level. The trouble with figuring these things out is that these small vitamins have such pleiotropic effects, making their consequences tough to study.

The thing that always perplexed me is why some of us only get acne on certain regions if the causative factor of acne is systemic immune dysregulation. In your scenario, these bacteria-reactive T cells would be everywhere, so why do they only manifest issues on the face? What is it about facial skin in particular that makes it susceptible? Vascularity? Amount of oil glands? Exposure to the elements?

I don't think it's necessarily general immune dysfunction, but rather a dysfunctional response against certain bacteria or antigens.

If you activate a T cell against a particular bacteria antigen, those T cells spread throughout the body. There's nothing to tell the T cell to only go to the face. That's what I meant by systemic immunological dysfunction.

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Diet effects acne in so many ways: hormone balance, inflammation, Insulin levels, digestion, allergies and intolerances, liver function, adrenal function, SHBG levels, sebum quality, cell function and turnover, nutrient deficiencies, body fat, etc.
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