Acne vulgaris. A disease of Western civilization

Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA.
Archives of Dermatology (Impact Factor: 4.31). 01/2003; 138(12):1584-90. DOI: 10.1001/archderm.138.12.1584
Source: PubMed

ABSTRACT In westernized societies, acne vulgaris is a nearly universal skin disease afflicting 79% to 95% of the adolescent population. In men and women older than 25 years, 40% to 54% have some degree of facial acne, and clinical facial acne persists into middle age in 12% of women and 3% of men. Epidemiological evidence suggests that acne incidence rates are considerably lower in nonwesternized societies. Herein we report the prevalence of acne in 2 nonwesternized populations: the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay. Additionally, we analyze how elements in nonwesternized environments may influence the development of acne.
Of 1200 Kitavan subjects examined (including 300 aged 15-25 years), no case of acne (grade 1 with multiple comedones or grades 2-4) was observed. Of 115 Aché subjects examined (including 15 aged 15-25 years) over 843 days, no case of active acne (grades 1-4) was observed.
The astonishing difference in acne incidence rates between nonwesternized and fully modernized societies cannot be solely attributed to genetic differences among populations but likely results from differing environmental factors. Identification of these factors may be useful in the treatment of acne in Western populations.

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Available from: Jennie C Brand-Miller, Aug 26, 2015
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    • "At present, no studies are available which followed the association between persistent milk consumption from early childhood to adulthood in dairy-consuming and non dairy consuming subpopulations. Intriguingly, T2D and other chronic Western diseases are rare in non-Westernized populations which do not consume dairy products and exhibit low basal serum insulin levels like Kitavan islanders [89] [90]. In contrast , acculturated hunter-gatherer populations who have adopted Western diets frequently are hyperinsulinaemic and insulin resistant and have high rates of T2D [91] [92]. "
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    ABSTRACT: The presented hypothesis identifies milk consumption as an environmental risk factor of Western diet promoting type 2 diabetes (T2D). Milk, commonly regarded as a valuable nutrient, exerts important endocrine functions as an insulinotropic, anabolic and mitogenic signalling system supporting neonatal growth and development. The presented hypothesis substantiates milk's physiological role as a signalling system for pancreatic β-cell proliferation by milk's ability to increase prolactin-, growth hormone and incretin-signalling. The proposed mechanism of milk-induced postnatal β-cell mass expansion mimics the adaptive prolactin-dependent proliferative changes observed in pregnancy. Milk signalling down-regulates the key transcription factor FoxO1 leading to up-regulation of insulin promoter factor-1 which stimulates β-cell proliferation, insulin secretion as well as coexpression of islet amyloid polypeptide (IAPP). The recent finding that adult rodent β-cells only proliferate by self-duplication is of crucial importance, because permanent milk consumption beyond the weaning period may continuously over-stimulate β-cell replication thereby accelerating the onset of replicative β-cell senescence. The long-term use of milk may thus increase endoplasmic reticulum (ER) stress and toxic IAPP oligomer formation by overloading the ER with cytotoxic IAPPs thereby promoting β-cell apoptosis. Both increased β-cell proliferation and β-cell apoptosis are hallmarks of T2D. This hypothesis gets support from clinical states of hyperprolactinaemia and progeria syndromes with early onset of cell senescence which are both associated with an increased incidence of T2D and share common features of milk signalling. Furthermore, the presented milk hypothesis of T2D is compatible with the concept of high ER stress in T2D and the toxic oligomer hypothesis of T2D and may explain the high association of T2D and Alzheimer disease.
    Medical Hypotheses 04/2011; 76(4):553-9. DOI:10.1016/j.mehy.2010.12.017 · 1.07 Impact Factor
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    • "Natural treatments for acne vulgaris, a common condition in industrialized societies and it is scientifically proved that in the industrialized area there is more acne like conditions than non-industrialized (Cordian et al. 2002). Herbs with antimicrobial, inflammation-modulating, anticomedogenic and in certain cases, hormone-balancing actions are also useful in the treatment of acne. "
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    ABSTRACT: Acne vulgaris is common dermatological disorder primarily acts on children and adolescents. This affects approximately 80% of the population between the ages of 12–25years. The clinically used anti-acne drugs suffer from the disadvantage of side effects and high cost of treatment. Alternative to these drugs are traditional medicines and natural products, which offer a great hope in the identification of bioactive lead compounds and their development into drugs for the treatment of skin disorder like acne vulgaris. The use of traditional medicines and phytopharmaceuticals for treating various skin ailments dates back several centuries. The aim of the present review is to compile relevant data on the mechanisms of action of various natural compounds from ethnomedicinal plants and their role in the resolution of acne vulgaris. An attempt is also being made to enumerate the possible leads from Indian traditional medicinal system for the treatment of acne. We tried to provide the readers with the array of outcome variables, which can be further worked upon in clinical studies. Finally, this paper puts forth issues that need to be addressed by researchers in the future. KeywordsAcne vulgaris–Herbal therapy–Ayurveda–Traditional medicinal systems
    Oriental Pharmacy and Experimental Medicine 03/2011; 11(1):1-9. DOI:10.1007/s13596-011-0006-6
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    • "Epidemiology of Acne in High School Pupils (Walton et al., 1988; Bataille et al., 2002; Cordain et al., 2002). In the Eskimo population, acne was absent when they were living and eating in their traditional manner, but upon acculturation, acne prevalence became similar to that in Western societies (Cordain et al., 2002). Moreover, among Zulus, acne became a problem only when this population moved from their rural African villages to cities. Acne severity can also be influenced by environmental factors (Walton et al., 1988). "
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    ABSTRACT: A cross-sectional, community-based study was performed to determine the prevalence and severity of acne vulgaris in adolescents and of factors influencing the acne severity risk. The presence of acne was clinically determined and the secondary outcome measures of family acne history and the relation of acne to nutrition habits, emotional stress, menstruation, and smoking were recorded in a questionnaire. A representative sample of 1,002 pupils aged 16+/-0.9 years was enrolled. The overall acne prevalence was 93.3, 94.4% for boys and 92.0% for girls. Moderate to severe acne was observed in 14%. The prevalence of moderate to severe acne was 19.9% in pupils with and 9.8% in those without a family history of acne (P<0.0005; OR: 2.3). Acne severity risk increased with the number of family members with acne history. A mother with acne history influenced the severity of acne the most. Increasing pubertal age, seborrhea, the premenstrual phase, mental stress, and sweet and oily foods were recognized as risk factors for moderate to severe acne. In contrast, gender, spicy foods, and smoking were not associated with acne severity. In conclusion, acne is a common disorder in Iranian adolescents, with a low rate of moderate to severe acne. A genetic background is suggested, with mother's acne history being the most important prognostic factor. Skin quality and certain nutrition habits may affect acne severity.
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