A Clear Connection?

Matthew, a 33-year-old from Jamaica Plain, has battled acne since adolescence. In high school and college, he became obsessed with how lighting could accentuate the marks on his skin. "Fluorescent lighting was the worst and could make me feel depressed all day," he says, "not to mention wildly self-conscious, to the point of hanging my head in an attempt to shade my acne from friends and family."

By high school, Matthew, who asked that his last name not be used, became convinced that certain foods could trigger breakouts. Anything with concentrated sugar or caffeine, from chocolate to orange juice to coffee, could intensify the occurrence of those scarlet bumps, he believed. But whenever he questioned a dermatologist, he got the same rather patronizing answer: There's nothing linking food and acne, but if something bothers you, don't eat it.

"I felt like I had such a clear experience. I felt like, how can this [response] just be so casual?" says Matthew. "I can't be the only one."

Matthew is not the only one. Dermatologists say that many patients ask about a connection between diet and pimples. These sufferers have, for the past 40 years, received the same information: Science shows no link between the two. Doctors learned this in medical school, where they were taught that the diet-acne connection is a myth. But what if the patients are right and the dermatologists wrong? Can a small band of defiant dermatologists - including one in Newton and another in New Hampshire - actually help prove that myth is fact?

DR. VALORI TRELOAR became a dermatologist in 1990, and since then, a large number of patients have come to her suffering from years of mild to severe acne. Treloar, whose practice is based in Newton, had a limited number of treatment options for these patients: cleansing techniques, topical retinoids such as Retin-A, topical or oral antibiotics, and the powerful drug Accutane. But the drugs, particularly Accutane, have a variety of side effects, and for some of her patients the standard acne treatments did not work or worked for only a few months.

After nearly a decade of practice, Treloar became frustrated and began to investigate alternatives. She stumbled across functional medicine, which holds that many diseases are affected by diet, nutrients, exercise, and trauma. She took courses and began to read everything she could about nutrition and physiology. Eventually she sat for the American College of Nutrition exam to become a certified nutrition specialist. "It gave me a whole new toolbox to use with people with chronic diseases for which conventional dermatology is not working," she says.

Treloar began poring over international scientific journals, even reaching outside dermatology journals for information that could help her patients. For instance, studies about heart health demonstrate that omega-3 fatty acids, like those in fish oil, reduce inflammation, and she explains that inflammation is a clear actor in the appearance of acne. Then Alan Logan - a Westchester, New York-based naturopathic physician, meaning a practitioner who encourages the body's ability to heal by considering lifestyle, diet, and stressors - invited Treloar to coauthor a book. In September, the two published The Clear Skin Diet. Filled with references to hundreds of scientific studies, the book explains, in biological detail, how everything from sugar, white flour, and dairy to stress and sleep affect hormones and chemicals in our body that could lead to acne.

http://www.boston.com/bostonglobe/magazine/articles/2007/12/16/a_clear_connection/