# Talk:Acne

I feel that this article downplays the role of diet on acne. There is strong (and more recent) evidence on dairy in particular: [1][2][3][4] (one of these discusses milk vs dark chocolate as well, further contradicting the information in the Wikipedia article). Alcohol deserves a mention as well: [5]. Cigarettes also do seem to be a factor given my cursory search on PubMed but I don't have the time to read right now. 142.118.85.96 (talk) 01:59, 4 July 2024 (UTC)

I'm not sure what you think ought to be changed.  The last source says "results should be interpreted with caution due to heterogeneity and bias across studies", which makes me think that the research showing a connection between dairy and acne is possibly weaker than it looks like.
But Acne#Diet already says that dairy causes more and worse acne (though perhaps it doesn't do so in plain enough English for most readers, especially younger ones, to know what it's saying).  What makes you think it's "downplaying" it, compared to a source that says the research on this is probably overplaying it? WhatamIdoing (talk) 06:41, 4 July 2024 (UTC)
"High-glycemic-load diets have been found to have different degrees of effect on acne severity...weak observational evidence suggesting that dairy milk consumption is positively associated...Available evidence does not support a link between eating chocolate or salt and acne severity."
This is beyond a comprehension problem. Surely there is a way to word it more accurately while still expressing that research on the topic continues to develop? And alcohol for sure deserves a mention. Although I'm sure the astroturfers from the dairy association and alcohol lobbies would love to disagree. 142.118.85.96 (talk) 17:51, 5 July 2024 (UTC)
The article currently says this about milk:
"There is weak observational evidence suggesting that dairy milk consumption is positively associated with a higher frequency and severity of acne. Milk contains whey protein and hormones such as bovine IGF-1 and precursors of dihydrotestosterone. Studies suggest these components promote the effects of insulin and IGF-1 and thereby increase the production of androgen hormones, sebum, and promote the formation of comedones."

You would like this to say something stronger.  Here is what I find about milk in PMID 34423427, the first one that you linked:
"A correlation between acne onset and exacerbation and a high-glycemic diet, milk, and chocolate consumption has been postulated."
A long paragraph about possible mechanisms that ends with the statement that "Further randomized controlled studies are warranted before any milk restrictions are implemented as beneficial in acne patients."
"Populations exposed to a paleolithic diet with a low glycemic index, no milk or dairy consumption, are generally acne-free...In a cohort consisting on New York young adults, acne severity was associated with the following: a hyperglycemic diet, the number of daily milk servings, and the amount of saturated fat and trans-fatty acid (TFA) intake."
"Additionally, milk is implicated in sebaceous lipogenesis by promoting anabolic signaling of mTORC1, thus exacerbating acne lesions. Moreover, a paleolithic dietary approach consisting of a low glycemic load diet and no milk consumption is linked to acne-free populations."
Words like "correlation", "has been postulated" "studies are warranted", "implicated", and "linked to" all sound to me like "not actually scientifically proven".  In fact, this all sounds like there is weak observational evidence suggesting that a diet that differs from the Western pattern diet in multiple ways, including being dairy-free, is associated with less acne, and that there are some plausible, but still unproven, mechanisms by which this might happen (assuming it actually does happen).  This does not strike me as being very different from what the article presently says. WhatamIdoing (talk) 19:14, 5 July 2024 (UTC)
I agree that "weak observational evidence" does not summarise the state of the science. Every year there's a new observational study from another country that shows a correlation. I could produce 20 of those. Milk is discussed in textbook chapters, not just individual studies anymore. That's not "weak".
Additionally, there are plenty of studies discussing the pathways , e.g. (https://doi.org/10.1007/978-3-031-83677-0_2). There is not just observational evidence.
Also there are meta-analyses available now(https://www.clinicalnutritionjournal.com/article/S0261-5614(18)30166-3/abstract) -- can you accurately summarise a meta-analysis that says there is a "significant linear relationship" as 'weak observational evidence?'
The AAD mentions the milk-acne-connection on their website (https://www.aad.org/public/diseases/acne/causes/diet).
How about "A correlation between milk and acne severity has been observed in several instances." Hypochonda (talk) 21:20, 16 May 2025 (UTC)