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The Nuance
How Acne Became ‘a Disease of Western Civilization’
Acne was once rare. Today, up to 95% of American teens have it.
In 1990, a Swedish doctor named Staffan Lindeberg traveled to the Island of Kitava in Papua New Guinea.
Kitava was home to a few thousand indigenous inhabitants — people whose lives were little touched by modernity. They had no cars or electricity, and their diets were “virtually uninfluenced by Western foods,” Lindeberg observed.
During his seven weeks on the island, he performed 1,200 health checkups, which included a skin examination. He found “[n]ot a single papule, pustule, or open comedone.” Pimples, in other words, didn’t exist on Kitava.
In the U.S., by contrast, up to 95% of adolescents experience at least mild acne — a condition that often persists well into middle age. Rates of acne are similar in many other Western nations, and the rest of the world is catching up quickly. According to a 2021 study in the British Journal of Dermatology, the global incidence of acne has risen by more than 50% in the last three decades.
Lindeberg and his colleagues described his Kitava findings in a 2002 JAMA Dermatology paper. While the total absence of acne among the island’s inhabitants was striking, other remote populations around the world likewise experience far, far lower rates of acne than people living in wealthy industrialized countries.
Acne, they concluded, is “a disease of Western civilization.”
Newer work has strengthened this conclusion. “Only when indigenous people moved to Westernized cities did acne reportedly become a problem, proving the impact of environment and lifestyle on the skin disease,” wrote the authors of a 2020 study in the American Journal of Clinical Dermatology.
And it’s not just acne. Atopic dermatitis (eczema) and other inflammatory skin conditions are also much more common in the West than in other parts of the world.
“Foods that are readily available in modern societies tend to be pro-inflammatory, and acne is a disease of inflammation.”
