Date of Award

2018

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Russell Kauffman

Keywords

acne vulgaris; Western diet; sebum production; insulin sensitivity; IGF-1

Abstract

Acne vulgaris is one of the most common dermatologic conditions, especially among the adolescent population. The pathogenesis of acne is largely multifactorial, with heredity and hormones strongly contributing to one’s risk of developing the chronic inflammatory skin condition; it is related to excess sebum production by sebaceous glands, inflammation within comedones, and hyperproliferation of Propionibacterium acnes. High prevalence rates of acne in the adolescent population cannot be attributed to heredity alone, but by the influence of Western diet that overstimulates a key conductor of metabolism, the growth factor-sensitive kinase known as mTORC1. Many investigations show associations between acne and Western diet, which is a diet consisting heavily of processed carbohydrates, refined sugars, and dairy products. Both high glycemic load and dairy-rich foods increase the levels of insulin-like growth factors (IGF)-1 and can reduce insulin sensitivity. Increased IGF-1 levels and decreased insulin sensitivity can lead to androgen-mediated increases in sebum production, which in turn attributes to the manifestation of acne vulgaris, as excess sebum is one of the vital mechanisms in the pathophysiology of acne vulgaris.

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