Adult Acne as a Sign of Early Diabetes

Posted on by Jesse Santiano, M.D.

This article is to raise awareness about why acne may be a sign of early diabetes.

The Teenage Years

During the teenage years, the body needs to produce more cells to grow fast. Insulin is necessary to help build-up the body.  Insulin stores and uses the carbohydrates, fats, and proteins to make more cells.

Insulin resistance is adolescence is typical. The insulin resistance during that time is called physiologic because it is normal at that age, but insulin resistance can also be abnormal if the child is obese.

Insulin resistance makes the pancreas produce more insulin (hyperinsulinemia) to overcome insulin resistance.

Acne Formation

Insulin works on many organs and cells all over the body, including the skin. It makes the skin produce more cells than needed. Insulin can also raise the male hormones (androgens) that lead to more oil production in the sebaceous/oil glands.

The increased amount of oil in the skin leads to the proliferation of a bacteria called Propionibacterium acnes and yeast that feeds on oil called Malassezia furfur. These microorganisms cause inflammation in acne.

Acne is a Sign of Insulin Resistance in Adults

If insulin resistance persists beyond the growing teenage years, then it becomes abnormal and can lead to pre-diabetes, metabolic syndrome, and then to Type 2 diabetes, especially if the acne is resistant to standard treatment.

Blausen_0811_SkinPores

What can be Hiding behind Acne?

Since acne may be a sign of insulin resistance and high levels of male hormones (hyperandrogenism), it can be seen in other diseases like:

  • Polycystic ovarian syndrome (PCOS) a common cause of infertility in women
  • SAHA syndrome made of seborrheic dermatitis – red, scaly, oily skin, acne, hirsutism – excessive body hair,  and androgenetic alopecia – male hormone-induced hair loss
  • Hyperandrogenism in females – characterized as loss of hair on the scalp but increased facial and body hair, hypercholesterolemia, infrequent or absent menstruation, and acne.
  • The metabolic syndrome that eventually leads to other diseases if left untreated.

Take Away Message

The presence of acne that is difficult to treat and the appearance of excessive body hair,  abnormal menstruation, and infertility may need further tests like fasting blood sugar, hormone levels, and lipid profiles to evaluate other conditions. Talk to your physician about your concern. Early diagnosis of a medical condition avoids unnecessary expense and disease complications.

A healthy lifestyle of a low carbohydrate diet and exercise can prevent the most common and deadliest non-infectious diseases of modern society and is simple, affordable, and definitely doable.

From the American Academy of Dermatology –  10 Things to Try When Acne Won’t Clear 

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Thanks for reading.

 

References:

  1. Alison N. Jeffery et al., Age Before Stage: Insulin Resistance Rises Before the Onset of Puberty A 9-year longitudinal study (EarlyBird 26) Diabetes Care 2012 Mar; 35(3): 536-541.
  2. Tagi et al., Insulin Resistance in Children. Front Endocrinol (Lausanne). 2019 Jun 4;10:342. doi: 10.3389/fendo.2019.00342. eCollection 2019.
  3. Goran MI, Gower BA., 2001 Longitudinal study on pubertal insulin resistance. Diabetes 50:2444–2450
  4. Napolitano et al., Insulin Resistance, and Skin Diseases. The Scientific World Journal
    Volume 2015, Article ID 479354, 11 pages
  5. M. Del Prete, M. C. Mauriello, A. Faggiano et al., “Insulin resistance and acne: a new risk factor for men?” Endocrine, vol. 42, no. 3, pp. 555–560, 2012. 

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