Are these the same kinds of inflammation?
December 8, 2011 10:04 AM Subscribe
I went on Prednisone for allergies and asthma, and within a few days my acne completely, miraculously disappeared. What does this mean about my acne/skin and inflammation, and can I achieve a similar effect through diet?
My skin looks ah-mazing, and even the red marks have gone away. I can't stop looking at myself in mirrors. Today is my last day on the meds and I'm wondering about the anti-inflammation diets I've heard about (Andrew Weil, Paleo, etc.). Since Prednisone is a steroid that suppresses the body's inflammatory response, and this appears to have killed my acne, could I decrease the inflammation through diet? Is this "inflammation" the diets address even the same type of "inflammation" the Prednisone addresses? Input from doctors or biochemist types would be helpful!
My skin looks ah-mazing, and even the red marks have gone away. I can't stop looking at myself in mirrors. Today is my last day on the meds and I'm wondering about the anti-inflammation diets I've heard about (Andrew Weil, Paleo, etc.). Since Prednisone is a steroid that suppresses the body's inflammatory response, and this appears to have killed my acne, could I decrease the inflammation through diet? Is this "inflammation" the diets address even the same type of "inflammation" the Prednisone addresses? Input from doctors or biochemist types would be helpful!
Have you ever tried an elimination experiment to see what your skin might be allergic to, if anything? If allergy medication makes your acne go away it might be worth it to try that. My skin breaks out in an allergic reaction to, of all random things, dust. And it took me over 10 years to figure that out.
posted by cairdeas at 10:10 AM on December 8, 2011 [2 favorites]
posted by cairdeas at 10:10 AM on December 8, 2011 [2 favorites]
There are no foods associated with acne. None. Zero. Not chocolate. Not French fries. Not dairy. Not boiled rock hopper penguin. We have decades of research showing this.
Steroids will kick acne's ass. But steroids are serious which is why they don't hand it out like candy.
There are some topical steroid family drugs that you might want to look into. I don't think you'll find a doctor who would be okay with long-term prednisone for acne.
posted by Lesser Shrew at 10:14 AM on December 8, 2011
Steroids will kick acne's ass. But steroids are serious which is why they don't hand it out like candy.
There are some topical steroid family drugs that you might want to look into. I don't think you'll find a doctor who would be okay with long-term prednisone for acne.
posted by Lesser Shrew at 10:14 AM on December 8, 2011
It is not true that there is no correlation between consumption of certain foods and acne. While the old "chocolate/greasy foods cause acne" trope isn't accurate, there has been research showing that dairy consumption is connected to acne. (Here is one study; exploring links in the right sidebar in pubmed will show some other studies. Glycemic load may also play a part.)
posted by needs more cowbell at 10:23 AM on December 8, 2011 [3 favorites]
posted by needs more cowbell at 10:23 AM on December 8, 2011 [3 favorites]
Exactly. Every time I eat dairy (and I really avoid it, but sometimes it sneaks into a food where I don't expect it), every single time, I break out. Every time. I have a sensitivity to milk protein, and I break out with cyctic acne.
posted by Dolley at 10:25 AM on December 8, 2011 [1 favorite]
posted by Dolley at 10:25 AM on December 8, 2011 [1 favorite]
Dermatologists can prescribe prednisone for skin conditions. Talk to one of them and see what they say about your acne.
posted by zippy at 10:27 AM on December 8, 2011
posted by zippy at 10:27 AM on December 8, 2011
If you are having issues with inflammation, try a gluten-free diet. Gluten causes inflammation so that may help.
I have found that my not eating animal products help. Namely pork products. Try eliminating something for two to four weeks and see if it makes any changes, you will see results within four weeks. Everyone has different reaction to different things. I'd try that before I would try more steroids. That prednisone is serious stuff.
posted by Yellow at 10:28 AM on December 8, 2011
I have found that my not eating animal products help. Namely pork products. Try eliminating something for two to four weeks and see if it makes any changes, you will see results within four weeks. Everyone has different reaction to different things. I'd try that before I would try more steroids. That prednisone is serious stuff.
posted by Yellow at 10:28 AM on December 8, 2011
It's possible that it just won't come back. Drugs like Accutane aren't forever things-- my understanding is that you're on it for a set period of time, and then it's over and things don't regress.
Maybe talk to a dermatologist about a skincare plan to help keep things they way they are now?
posted by charmcityblues at 10:31 AM on December 8, 2011
Maybe talk to a dermatologist about a skincare plan to help keep things they way they are now?
posted by charmcityblues at 10:31 AM on December 8, 2011
Response by poster: Just to clarify: I know Prednisone is serious stuff. I have no intentions of trying to stay on it for acne. Thanks!
posted by Dilemma at 10:34 AM on December 8, 2011 [1 favorite]
posted by Dilemma at 10:34 AM on December 8, 2011 [1 favorite]
Anyone who tells you there is no link between food and acne does not understand the human body. I would start an elimination diet to see if dairy removal helps. I'd also drop refined sugars of you haven't already. Look up anti-inflammatory foods -- go veggie heavy.
posted by These Birds of a Feather at 10:35 AM on December 8, 2011 [2 favorites]
posted by These Birds of a Feather at 10:35 AM on December 8, 2011 [2 favorites]
Best answer: I'm wondering about the anti-inflammation diets I've heard about
They're bullshit. Andrew Weil, in particular, is a giant quack. I did my PhD looking at anti-inflammatory properties of food and there is no special diet you can go on that has overall anti-inflammatory effect (no matter what kind of claims you read on the internet). In particular, you will not find anything like the serious anti-inflammatory activity of corticosteriods. Which is probably a good thing because the side effects which go with that immune-suppression are pretty serious, having a diet with the same effect would be just as bad.
There are likely things you can do to reduce your acne, particularly since you've shown that it's really susceptible to anti-inflammatory activity. It's also likely that something topical is also effective and a lot safer than the systemic immune suppression you're currently getting. Work with a dermatologist and get on top of it, and avoid the quacks and fad diets.
posted by shelleycat at 10:35 AM on December 8, 2011 [11 favorites]
They're bullshit. Andrew Weil, in particular, is a giant quack. I did my PhD looking at anti-inflammatory properties of food and there is no special diet you can go on that has overall anti-inflammatory effect (no matter what kind of claims you read on the internet). In particular, you will not find anything like the serious anti-inflammatory activity of corticosteriods. Which is probably a good thing because the side effects which go with that immune-suppression are pretty serious, having a diet with the same effect would be just as bad.
There are likely things you can do to reduce your acne, particularly since you've shown that it's really susceptible to anti-inflammatory activity. It's also likely that something topical is also effective and a lot safer than the systemic immune suppression you're currently getting. Work with a dermatologist and get on top of it, and avoid the quacks and fad diets.
posted by shelleycat at 10:35 AM on December 8, 2011 [11 favorites]
The argument is not (at least in more scientifically-minded circles) that some foods are "bad" or "good" but that a lot of people have subclinical intolerances to some things, gluten being a common one and either casein or lactose or both being the other. If you are intolerant to those foods, eating them may cause inflammation in a bunch of tissues.
tl;dr: it's not that some foods are "anti-inflammatory," it's the some foods are, for some people, pro-inflammatory. (I'd have to look up some of the research on this, but there has been some that supports this contention.) "Paleo" is just shorthand for a collection of elimination tactics, and most of the reputable proponents strongly encourage people to try adding stuff back in after thirty days or so to try to narrow down what works and doesn't work for them.
posted by restless_nomad at 10:51 AM on December 8, 2011 [1 favorite]
tl;dr: it's not that some foods are "anti-inflammatory," it's the some foods are, for some people, pro-inflammatory. (I'd have to look up some of the research on this, but there has been some that supports this contention.) "Paleo" is just shorthand for a collection of elimination tactics, and most of the reputable proponents strongly encourage people to try adding stuff back in after thirty days or so to try to narrow down what works and doesn't work for them.
posted by restless_nomad at 10:51 AM on December 8, 2011 [1 favorite]
Steroids will kick acne's ass. But steroids are serious which is why they don't hand it out like candy.Huh, really? Prednisone gave me the worst case of cystic acne I've ever seen in my life.
I'm thinking that maybe what you had wasn't actually acne but something that looked like acne. I would ask your dermotologist what autoimmune thingies mimic acne.
posted by craichead at 11:03 AM on December 8, 2011 [1 favorite]
Best answer: Since Prednisone is a steroid that suppresses the body's inflammatory response, and this appears to have killed my acne, could I decrease the inflammation through diet? Is this "inflammation" the diets address even the same type of "inflammation" the Prednisone addresses? Input from doctors or biochemist types would be helpful!
I'm an academic physician who prescribes prednisone every day to patients following solid organ transplants and for life threatening lung diseases. My academic research involves the biology of inflammation as it pertains particularly to transplant recipients. The answer to your questions are:
a) No, dietary changes can't substitute for the effects of prednisone, though I can't rule out the possibility that diet might have some effect on your acne. The link between diet and acne is a controversial one in academic circles, with the available body of literature failing to yield particularly strong evidence in favor of dietary modification for controlling acne. Perhaps the best data relates to dairy intake and possibly high glycemic load, but again this is not definitive. Still, as you can read above, there is lots of anecdata about diet and acne out there to support whatever confirmation bias you choose to pursue.
b) "Inflammation" is a waste-basket term, for an incredibly complex cellular and biomolecular process that has many patterns. Diet (I believe the best data relates to omega fatty acids, shelleycat can correct me if I'm wrong) may have some effect on small facets of the inflammatory process, but nothing like what prednisone does. Food "intolerance" or allergies are a whole other subject, and in short order, skin findings can be a manifestation of reactions to food, but acne is not typically considered to be among these manifestations (things like atopic dermatitis, eczema, and with gluten intolerance, hepatitis dermatiformis).
While you're free to try any manner of dietary modification, don't let wishful thinking get in the way of common sense.
posted by drpynchon at 11:09 AM on December 8, 2011 [13 favorites]
I'm an academic physician who prescribes prednisone every day to patients following solid organ transplants and for life threatening lung diseases. My academic research involves the biology of inflammation as it pertains particularly to transplant recipients. The answer to your questions are:
a) No, dietary changes can't substitute for the effects of prednisone, though I can't rule out the possibility that diet might have some effect on your acne. The link between diet and acne is a controversial one in academic circles, with the available body of literature failing to yield particularly strong evidence in favor of dietary modification for controlling acne. Perhaps the best data relates to dairy intake and possibly high glycemic load, but again this is not definitive. Still, as you can read above, there is lots of anecdata about diet and acne out there to support whatever confirmation bias you choose to pursue.
b) "Inflammation" is a waste-basket term, for an incredibly complex cellular and biomolecular process that has many patterns. Diet (I believe the best data relates to omega fatty acids, shelleycat can correct me if I'm wrong) may have some effect on small facets of the inflammatory process, but nothing like what prednisone does. Food "intolerance" or allergies are a whole other subject, and in short order, skin findings can be a manifestation of reactions to food, but acne is not typically considered to be among these manifestations (things like atopic dermatitis, eczema, and with gluten intolerance, hepatitis dermatiformis).
While you're free to try any manner of dietary modification, don't let wishful thinking get in the way of common sense.
posted by drpynchon at 11:09 AM on December 8, 2011 [13 favorites]
Animal fats are proinflammatory. All the rheumatologists I've seen agree, and I've seen a crapload. None of them went so far as to suggest I not eat meat, and the overall idea is that while diet might help a tidge, it's not enough to get fussed over. I was tested twice for celiac disease, arguing all the while that wheat loves me and I love wheat. It took a biopsy to prove it to 'em. "Gluten intolerance" is not as widespread as people would like you to believe.
Sugar is very inflammory as well. In fact, anything that raises your glycemic load is inflammatory, as is stress and lack of sleep. So get rest, exercise, avoid white flour and sugar and animal fats (if you eat meat, choose lean meat, not fatty and not fried). Take a fish oil supplement. There are some studies that show less inflammation when a person gets a certain number of servings of vegetables per week/day. If you want proof, hit pubmed, or try to get access to your nearest university medical library. I did crap-tons of research when I was first diagnosed with an autoimmune condition, but I'm too lazy to drag out my binders with all that junk to post references. Pubmed is a pretty easy place to look. Beware the study methodology, and use your good judgment when reading studies. Many are preliminary and not conclusive. Whether or not ANY anti-inflammatory diet choices will help with acne I have my doubts.
Anyway, I was on immune suppressants for several years (which is basically what the steroids are doing to you) and anti-inflammatory prescription pills too, and after several years of that, my perfect, perfect skin turned to shit. I started getting whiteheads, blackheads, cystic bumps that looked infected, you name it. I never had so much as a pimple in high school and through my twenties. So I went to my dermatologist and she said "Hormones! Welcome to your mid-thirties." (My point is that I was on heavy anti-inflammatories and I got acne anyway). Now I use the right birth control pill, topic Clenia cream, and tretinoin cream (for the blackheads). My skin is good again. The problem with this is that many insurance companies won't pay for acne treatment and these creams are like $70 a tube. So I get around that by asking for a tube of Clenia every year for my birthday.
posted by thelastcamel at 11:18 AM on December 8, 2011
Sugar is very inflammory as well. In fact, anything that raises your glycemic load is inflammatory, as is stress and lack of sleep. So get rest, exercise, avoid white flour and sugar and animal fats (if you eat meat, choose lean meat, not fatty and not fried). Take a fish oil supplement. There are some studies that show less inflammation when a person gets a certain number of servings of vegetables per week/day. If you want proof, hit pubmed, or try to get access to your nearest university medical library. I did crap-tons of research when I was first diagnosed with an autoimmune condition, but I'm too lazy to drag out my binders with all that junk to post references. Pubmed is a pretty easy place to look. Beware the study methodology, and use your good judgment when reading studies. Many are preliminary and not conclusive. Whether or not ANY anti-inflammatory diet choices will help with acne I have my doubts.
Anyway, I was on immune suppressants for several years (which is basically what the steroids are doing to you) and anti-inflammatory prescription pills too, and after several years of that, my perfect, perfect skin turned to shit. I started getting whiteheads, blackheads, cystic bumps that looked infected, you name it. I never had so much as a pimple in high school and through my twenties. So I went to my dermatologist and she said "Hormones! Welcome to your mid-thirties." (My point is that I was on heavy anti-inflammatories and I got acne anyway). Now I use the right birth control pill, topic Clenia cream, and tretinoin cream (for the blackheads). My skin is good again. The problem with this is that many insurance companies won't pay for acne treatment and these creams are like $70 a tube. So I get around that by asking for a tube of Clenia every year for my birthday.
posted by thelastcamel at 11:18 AM on December 8, 2011
"Inflammation" is a waste-basket term, for an incredibly complex cellular and biomolecular process that has many patterns. Diet (I believe the best data relates to omega fatty acids, shelleycat can correct me if I'm wrong) may have some effect on small facets of the inflammatory process,
As drpynchon says. Be prepared to get into nitty gritty details if you do any real research. You'll be reading about things like cytokines more often than simply "inflammation" and modulatory responses and the proper names for certain types of fats, etc. Not for the faint of heart, but if you have the research bug it can make for some amusing reading. It helps to know a little bit about statistics.
posted by thelastcamel at 11:21 AM on December 8, 2011
As drpynchon says. Be prepared to get into nitty gritty details if you do any real research. You'll be reading about things like cytokines more often than simply "inflammation" and modulatory responses and the proper names for certain types of fats, etc. Not for the faint of heart, but if you have the research bug it can make for some amusing reading. It helps to know a little bit about statistics.
posted by thelastcamel at 11:21 AM on December 8, 2011
There's certainly nothing wrong with asking your dermatologist, "Hey, I had some prednisone and wow my skin, what does that mean?"
It could very well mean that the prednisone got you over the hump and you may continue on merrily, indefinitely, without as many problems.
posted by Lyn Never at 12:16 PM on December 8, 2011
It could very well mean that the prednisone got you over the hump and you may continue on merrily, indefinitely, without as many problems.
posted by Lyn Never at 12:16 PM on December 8, 2011
So, my instinct is to not try and add anything to what Drpynchon said, but I will mention topical and oral antibiotics like tetracycline are prescribed in Acne for their anti-inflammatory effects, to expand on what Shellycat said. Again, go to a Dermatologist.
posted by midmarch snowman at 12:31 PM on December 8, 2011
posted by midmarch snowman at 12:31 PM on December 8, 2011
Work with a dermatologist and get on top of it, and avoid the quacks and fad diets.
Eating a whole food diet devoid of processed foods is not a fad, it is the way humanity ate for thousands of years. The sugar/flour -based diet is the actual fad and has been a tragic blip in history.
posted by blargerz at 1:33 PM on December 8, 2011 [3 favorites]
Eating a whole food diet devoid of processed foods is not a fad, it is the way humanity ate for thousands of years. The sugar/flour -based diet is the actual fad and has been a tragic blip in history.
posted by blargerz at 1:33 PM on December 8, 2011 [3 favorites]
One of the doctors responsible for popularizing the paleo diet has often claimed that acne is a disease of civilization primarily caused by diet. There is a short review here (PDF) where he briefly discusses a few possible reasons why dairy and high-glycemic load diets have been found to contribute to acne. Both high-GL foods and dairy are highly insulinemic (that is, they induce a high insulin response), and dairy further contains a hormone that may be capable of passing the gut barrier and activating skin cell growth factor pathways.
In the comments on this blog post a few people claim that excess omega-6 fatty acids (primarily from vegetable oils) in the Western diet may also be a factor.
posted by hat at 2:36 PM on December 8, 2011 [1 favorite]
In the comments on this blog post a few people claim that excess omega-6 fatty acids (primarily from vegetable oils) in the Western diet may also be a factor.
posted by hat at 2:36 PM on December 8, 2011 [1 favorite]
RE: inflammation and diet. The major lupus organizations don't credit anecdotal evidence, but here's my anecdote anyway: I have systemic lupus. Meds didn't help; what has helped is dietary control. If I eat gluten or dairy, my hands visible constrict the next day, and I feel like I have the flu. I also eat very little refined sugar, and often take vitamin D (necessary since sunlight can trigger lupus flares, so I avoid it). And I went from having problematic skin to having at least one stranger per month stop, stare at me, and tell me that I have beautiful skin, which still surprises me every time. Even a staffer at my son's dermatologist admired my skin, and told me, "you must use great anti-aging products". Um... no.
My take on it: talk to your doctor, and try the elimination diets. Skipping gluten or dairy or animal protein or whatever for 4 weeks won't hurt you, and might show you something important about how your body reacts to food.
posted by theplotchickens at 4:58 PM on December 8, 2011 [2 favorites]
My take on it: talk to your doctor, and try the elimination diets. Skipping gluten or dairy or animal protein or whatever for 4 weeks won't hurt you, and might show you something important about how your body reacts to food.
posted by theplotchickens at 4:58 PM on December 8, 2011 [2 favorites]
Skin irritation--especially from dry skin that's not shedding skin cells with ease--can *look* like acne sometimes; so can rosacea.
Over the last few years I've suffered from skin irritation that I thought had an acne component, but it didn't, not really. Paul Begoun and Dr. Leslie Baumann talk about the kind of thing I had as inflammation. They also both agree that various skincare substances are anti-inflammatories or can function as anti-inflammatories. Key substances in this group are anti-oxidants, which Paula Begoun includes in many of her products, particularly in the Resist line.
And now, after a year of using Paula's Choice Resist Cleanser and toner, and various of her serums, my skin has completely cleared up. No more faux acne, barely any dryness; very little irritation to speak of.
YMMV and IANAD. But if I had a nickel for every dermatologist that was not helpful or every time I thought my problem must be a food allergy, I'd be a hell of a lot wealthier today.
posted by Violet Blue at 5:37 PM on December 8, 2011 [1 favorite]
Over the last few years I've suffered from skin irritation that I thought had an acne component, but it didn't, not really. Paul Begoun and Dr. Leslie Baumann talk about the kind of thing I had as inflammation. They also both agree that various skincare substances are anti-inflammatories or can function as anti-inflammatories. Key substances in this group are anti-oxidants, which Paula Begoun includes in many of her products, particularly in the Resist line.
And now, after a year of using Paula's Choice Resist Cleanser and toner, and various of her serums, my skin has completely cleared up. No more faux acne, barely any dryness; very little irritation to speak of.
YMMV and IANAD. But if I had a nickel for every dermatologist that was not helpful or every time I thought my problem must be a food allergy, I'd be a hell of a lot wealthier today.
posted by Violet Blue at 5:37 PM on December 8, 2011 [1 favorite]
Diet (I believe the best data relates to omega fatty acids, shelleycat can correct me if I'm wrong) may have some effect on small facets of the inflammatory process, but nothing like what prednisone does. Food "intolerance" or allergies are a whole other subject, and in short order, skin findings can be a manifestation of reactions to food, but acne is not typically considered to be among these manifestations (things like atopic dermatitis, eczema, and with gluten intolerance, hepatitis dermatiformis).
Yup, this is correct. I'm not saying food makes no difference, and there are definitely things that have specific effects in specific people, but any kind of promised wide-scale effects as pushed by people like Andrew Weil is quack territory.
Any diet which tells you that certain foods are always good for you or always bad for you are not scientific, it simply doesn't work that way. And anything pushing a certain way of eating as 'the only way' is a fad diet that should be avoided.
posted by shelleycat at 12:28 AM on December 9, 2011 [2 favorites]
Yup, this is correct. I'm not saying food makes no difference, and there are definitely things that have specific effects in specific people, but any kind of promised wide-scale effects as pushed by people like Andrew Weil is quack territory.
Any diet which tells you that certain foods are always good for you or always bad for you are not scientific, it simply doesn't work that way. And anything pushing a certain way of eating as 'the only way' is a fad diet that should be avoided.
posted by shelleycat at 12:28 AM on December 9, 2011 [2 favorites]
which tells you that certain foods are always good for you or always bad for you are not scientific,
(Oh, also not just any diet but any random internet commenter who makes sweeping comments such as "blah food is pro-inflammatory", people love to give black and white diet advice like this but the science just does not make sense. Ignore it, focus on what works for you instead.)
posted by shelleycat at 12:33 AM on December 9, 2011
(Oh, also not just any diet but any random internet commenter who makes sweeping comments such as "blah food is pro-inflammatory", people love to give black and white diet advice like this but the science just does not make sense. Ignore it, focus on what works for you instead.)
posted by shelleycat at 12:33 AM on December 9, 2011
Your "acne" may be something else. Sebaceous dermatitis is responsive to corticosteroids (i.e. prednisone). I am only aware of it because my husband had it. To me, it looked like acne but when he went to the doctor for a physical, she thought differently, and prescribed a topical corticosteroid (Desidone). Worked like a charm. He doesn't use it continuously after the first little while when it was clearing up, just when he needs it. I am not all up on the side effects, etc. but he hasn't had any problems, certainly nothing like the oral prednisone --of course you'd want to talk to your doctor (and I imagine, about other conditions that might be possible).
Here's the Mayo clinic website for more details:
http://www.mayoclinic.com/health/seborrheic-dermatitis/DS00984
posted by Tandem Affinity at 8:29 PM on December 9, 2011
Here's the Mayo clinic website for more details:
http://www.mayoclinic.com/health/seborrheic-dermatitis/DS00984
posted by Tandem Affinity at 8:29 PM on December 9, 2011
I want to tack on to my comment that the research shows correlation between diet and acne, but that, of course, correlation does not prove causation and that more study is needed.
posted by needs more cowbell at 2:37 PM on December 13, 2011
posted by needs more cowbell at 2:37 PM on December 13, 2011
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On the acne tip specifically, dairy seems to be a bigger part of it than grains - if I eat a bunch of cheese, my arthritis doesn't act up but I totally break out. (Of course, most of the time if I am eating a bunch of bread it's also when I'm eating a bunch of cheese, so it's better if I just do neither, but I do eat cheese more than grains and the acne is totally a reaction to it.)
posted by restless_nomad at 10:07 AM on December 8, 2011