Acne and food intolerances - do you need a blood test?

Fiona Clark
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Could a food intolerance be causing your acne and should you shell out for a test to find out? 

There is a seemingly endless stream of ‘cures’ and ‘quick fixes’ for virtually every skin condition on the internet and social media and acne is no exception. A new one is doing the rounds offers tests for food intolerances claiming they could be the cause of your breakouts. Some practitioners, including some doctors, are offering blood tests – but are they worth paying for?

According to London-based Consultant Dermatologist, Dr Anjali Mahto, the premise for prescribing these tests is that acne stems from an intolerance to certain types of food. To diagnose this the practitioner will recommend a blood test looking for inflammatory markers such as immunoglobin G (IgG).

Certain food are eliminated from the diet and the tests are repeated to see if the markers improve or get worse so the culprit food can be identified.

These test are advertised online with claims that conditions like depression, anxiety, migraine and even the genetic disorder cystic fibrosis are ‘symptoms of food intolerance’ – and now acne has been added to the list.

When ordered by a doctor these tests can cost more than £100 a pop, so it’s not a cheap exercise. And even when you buy them online the starting price is upwards of £20, and since you need to repeat the tests it will add up quickly.

So, should you splash out? According to Dr Mahto, the answer is no and here’s why:

“Whilst IgG is part of the body’s immune response, there is no good quality evidence which demonstrates a positive IgG test is linked to skin disorders such as acne or food intolerance. The test may identify what you recently had to eat but little more than that,” she says. “The results are often positive in those who don’t have an allergy or a food intolerance.”

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This, she warns, may result in people unnecessarily eliminating foods from their diets and ending up with nutritional deficiencies, or developing anxiety or obsessive rules when it comes to food intake – and for no good reason.

Dr Mahto says if you enter the search term ‘acne and food intolerance’ into PubMed, a data base for clinical research articles, you get “a grand total of zero results”. She says bodies such as the American Academy of Allergy, Asthma an Immunology clearly state that “IgG and IgG subclass antibody tests for food allergy do not have clinical relevance, are not validated, lack sufficient quality control, and should not be performed.”

It’s a view that’s supported by the Canadian Society of Allergy and Clinical Immunology and the European Academy of Allergy and Clinical Immunology who have recommended against using IgG testing to diagnose food allergies, food intolerances or sensitivities the Academy states.

“There is no evidence to suggest that acne occurs due to diet alone, food allergy or intolerance. Acne [is a] complex interplay between hormones, genetics, altered skin shedding and inflammation caused by bacteria,” she says.

So it seems there is no little evidence to link food intolerance with acne, and the tests themselves fare no better.

Dr Mahto says that the Irish Health Products Regulatory Authority (HRRA) reviewed food intolerance tests last year and concluded that products “promoted as food intolerance tests test cannot diagnose food intolerance.”

A bigger price to pay

Mahto’s concern though is that there may be a bigger price to pay than just the cost of the tests. She is worried that people with acne may waste precious time in seeking the help they need with their condition which may put them at risk of scarring – not to mention prolonging their low self-esteem and possible poor body image issues.

There are a myriad of tried and tested therapies and prescription or over-the-counter products that can help, and seeking professional advice from a medical professional who specialises in skin health is vital.

This doesn’t mean that diet plays no role as eating well is vital for skin health. As Dr Mahto says some people who cutting out certain foods may see an improvement in their skin, but for others there may be no difference at all.

And she like many dermatologists and nutritionists agree there is growing evidence to suggest that simple sugars (or simple carbohydrates) may well be part of the problem for some people.

Although it’s not conclusive, some people with acne have reported improvement in their skin when they follow a low-glycemic index (GI) diet, which can be achieved by:

  • increasing the consumption of whole grains, fresh fruits and vegetables, fish, olive oil, garlic
  • decreasing the consumption of high-glycemic index foods such as white bread, biscuits, cakes, ice creams and bottled drinks.

Dr Mahto explains: “If someone eats refined sugar or a simple carbohydrate such as white bread or a piece of cake, their blood glucose level will go up. As a response their body will release the hormone insulin to try to combat this.

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“Once insulin is released, the body will also release other hormones called IGFs – Insulin-like Growth Factors- and these sometimes increase the activity of oil glands which in turn affect hormones such as testosterone which can drive acne.”

But she adds: “Guidelines in the US and UK do still clearly state that people should not try to control acne with diet alone as we just don’t have enough evidence, but there does seem to be an emerging link between acne and sugar.”

In his book Perfectly Clear, consultant dermatologist Dr Nick Lowe says there is less convincing evidence of the link between dairy products with acne.

However, it has been found that skimmed milk could be a trigger, as opposed to full fat milk which isn’t.

A study published in the Journal of the American Academy of Dermatology in 2015 found that teenagers with acne consumed more low fat or skimmed milk than those who didn’t.

This has less to do with milk being a dairy product and more to do with it having a higher GI index than full fat milk.

Their advice: if you have persistent acne that is a concern for you seek the advice of dermatologist or GP who specialises in skin conditions.

You can find GPs and Dermatologists here: https://www.harleystreetemporium.com/doctors/

 

 

 

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