Almost every teenager has wondered why their fat friend or classmate is completely free from acne. After all, obesity is the definition of bad health; people can’t comprehend why somebody so far away from the peak of fitness would have such clear skin. In all likelihood, medieval teenagers, Roman teenagers and even Ancient Greek teenagers were wondering the same thing.
Perhaps you used to be overweight or obese and are delighted with your new-found fitness, but disappointed that your skin has started breaking out again. Other attributes people notice in the obese are smooth skin, younger looking skin, and even a healthier skin tone in general.
Is there actually a correlation? Yes, and the fact is that the connection between obesity and clear skin isn’t complicated at all.
Despite the centuries of confusion, it’s all down to overweight people having less testosterone than everyone else.
Higher body fat equals less clogged pores
It’s been proven in science again and again that excess body fat can mess with your hormones. An extra ten pounds of fat on your stomach can increase the production of stress hormones, subsequently creating symptoms like anxiety, a racing heartbeat, and a frantically worrying mind.
Fat tissue is extremely active biologically, in many different ways compared to muscle tissue or indeed any other tissue. Importantly for us, countless studies have shown that excess body fat can lower testosterone levels:
STUDY ONE – in this study scientists analysed the effect of obesity on various hormones including testosterone and free testosterone. Details of over 3000 men who had been treated for testosterone deficiency were obtained from medical records. On average, obese men showed significantly lower blood testosterone concentrations compared with healthy men.
STUDY TWO – this study spelled it out clearly. Levels of both total and free testosterone were “negatively correlated with waist/hip circumference ratio and visceral fat area”.
The fatter the 23 men aged 25-50 who were tested were, the less testosterone they had in their bloodstream. Interestingly, this effect wasn’t observed in women, but obviously, men and women differ massively in their level and functions of testosterone and other hormones.
STUDY THREE – this study on 110 Japanese-Americans analysed their levels of body fat, insulin, and total testosterone. Both subcutaneous fat and visceral fat were measured. Subcutaneous fat is your normal skin surface fat. Visceral fat is the fat found underneath muscles such as the abdominals; one example is a massively round beer belly which still seems hard somehow, or the pregnant look that pro bodybuilders get.
The results showed a big correlation between obesity and low testosterone levels, and in particular, intra-abdominal fat and low testosterone.
STUDY FOUR – finally, this big review stated that low testosterone levels are commonly encountered in obese men who have no separate issues with hormone production.
Moderate obesity decreased total testosterone, whereas severe obesity decreased free testosterone (the biologically active form) as well. Furthermore, the scientists claimed that low testosterone in obese men was non-permanent and reversible, but only through substantial weight loss.
How do testosterone levels affect acne? It’s extremely simple.
Testosterone and DHT, the secondary androgen which is manufactured from testosterone, bind to androgen receptors in your sebaceous glands. This stimulates them to pump out more oil, and your pores get clogged. The stage is set for an outbreak of pimples.
So we have our answer. The more weight you gain, the less stimulated your skin’s oil production will be.
If you have an overweight friend who laughs about how great his skin is, saying that he’s glad to be fat, then testosterone is almost certainly why he has the advantage.
It isn’t guaranteed of course; he or she could have great skin genetics, with an example being naturally tighter skin pores which are less prone to clogging. Alternatively, they could live in a village, where the pristine rural air is nourishing to the skin and free from pollution.
You also never know exactly why a person is fat. For example, if your friend is obsessed with eating omelettes, steaks, and cheese then they’ll be ingesting a ton of acne-clearing nutrients. An obese person who loves burgers and fries, meanwhile, will be pumping their body with pure inflammation.
However, in the vast majority of cases that have you questioning the very nature of reality, the testosterone factor will be responsible.
Another reason – obese people have less DHT
Then there’s another twist in the testosterone phenomenon. Excess fat tissue can inhibit the conversion of testosterone to the second most abundant androgen in males, DHT.
Dihydrotestosterone (DHT) increases sebum production even more strongly than testosterone does. Both bind to androgen receptors but DHT specialises in those in the skin.
This study found that enzymes produced in adipose tissue (body fat) can completely destroy DHT molecules. It began as a general study into testosterone and obesity like the ones above. Canadian scientists gathered 21 morbidly obese men and 11 lean to obese men and took an extract of their fat tissue.
They found that an enzyme called 3α/β-HSD, churned out by fat cells, deactivated DHT and turned it into a harmless by-product called 5alpha-androstane 3alpha,17beta-diol which had little androgenic effect.
The more obese the patients, the more of this enzyme they churned out and hence the lower their bodily DHT levels were.
Another study analysed DHT from a separate angle; the conversion of testosterone into DHT. All DHT is manufactured from testosterone molecules, specifically by the 5-alpha reductase enzyme. For example, hair loss patients fear DHT as it’s said to prematurely deactivate hair follicles, and hence they’re obsessed with deactivating 5-alpha-reductase. Scientists found that excess body fat significantly inhibited the activity of the 5-alpha reductase enzyme.
What this means is that being fat, overweight, obese, or even slightly chubbier than average can prevent acne in two ways. Firstly, by lowering overall testosterone levels. Secondly, by shifting the overall ratio of androgens away from DHT and towards testosterone. Both work by significantly reducing your sebum production and clogged pores.
The interesting thing is that with reduced conversion of testosterone to DHT, you would expect overall testosterone levels in the obese people to increase. Essentially, less testosterone would be being depleted. However, levels still declined; that shows just how strongly being overweight reduces androgen levels overall, and hence, just how strong an effect your body fat has on acne.
Fat cells increase estrogen levels
In addition to clear skin you might have noticed some other characteristics of fat people’s skin. Firstly, they sometimes have a beautiful, healthy looking skin tone. Secondly, their skin often looks quite young for their age.
There’s a simple explanation for this, and another explanation for the reduction in testosterone – fat cells are where estrogen is born.
Adipose tissue produces a major player in human hormones called the aromatase enzyme. This enzyme is responsible for the conversion of male androgenic hormones into female hormones, including estrogen.
Woman produce most of their estrogen through their ovaries, and a small portion in fat cells. Men, meanwhile, produce a big portion through their fat cells.
The more fat tissue you have, the more aromatase enzyme you produce and the higher your estrogen will be. This study found that two common types of estrogen were elevated two fold in a group of morbidly obese men. In fact, the estrogen was elevated in direct proportion to their levels of obesity. This study concluded that “adipose tissue can contribute significantly to the circulating pool of estrogen”.
This study meanwhile, concluded that obesity had little effect on estrogen levels in women, which is unsurprising, since it would just vanish into the huge pool of estrogen women naturally produce. Overweight men, on the other hand, had significantly higher estrogen levels.
The implications for your skin? For tone, estrogen is linked to faster wound healing, delayed ageing and improved collagen content (study).
I recommend against any man trying to increase his estrogen levels, but it’s undeniable that estrogen can improve your skin in certain circumstances. Estrogen almost certainly accounts for a portion of the great skin commonly found in overweight people.
More importantly, estrogen is yet another reason why overweight people have less testosterone, since the hormone and its relatives are direct antagonists to androgens.
Estrogen can target enzymes down in your balls before they even make testosterone. Estrogen can inhibit a bunch of different enzymes like P450c17 and HSD17B – meaningless to most people, but without them you make very little of the big T. This study found that these vital enzymes were reduced “severely” in the presence of estrogen.
Studies have confirmed that high estrogen levels lead to suppressed testosterone, but it’s common knowledge really. Estrogen could reduce testosterone production by 20-30% in both rats and humans, in this study, by manipulating certain genes. Estrogen targets testosterone at its root.
What’s more, estrogen and testosterone compete for similar receptors in the human body. If a DHT molecule shows up to find estrogen stimulating the skin then its ability to increase sebum production will be impaired.
Is estrogen the main reason why being fat reduces testosterone, and hence acne? I’d say that it accounts for at least half of the reduction.
The increase in estrogen caused by being fat can 1) improve skin tone by itself, and 2) contribute to the big reduction in testosterone and oily skin.
The cortisol connection
Cortisol is the main stress hormone in humans. Ordinarily it’s a huge villain behind acne; it slows wound healing and it disrupts your digestion. However, in the case of overweight people, cortisol might help acne, because it’s another hormone that can inhibit testosterone.
Cortisol is like estrogen; fat tissue seems to generate it. This study claimed that obese mice and humans have been observed to have higher cortisol. In humans, the scientists said that fat tissue damages the ability of the adrenal glands to regulate cortisol and stress levels.
This study speculated that fat tissue might enhance the conversion of cortisone to cortisol; cortisone has similar effects to cortisol, but is a far more biologically inert form. This study, however, said that body fat was associated with a slight hypocortisolemia, AKA low levels.
The evidence is a lot less clear than with either estrogen or DHT, but there’s a good chance that being obese or overweight can cause constant elevation of stress hormones.
The connection to acne? Cortisol is an even stronger antagonist of testosterone than estrogen is. High cortisol levels in your bloodstream can destroy molecules of testosterone the very moment they enter the bloodstream. The synthesis of cortisol also depletes cholesterol, an important building block of testosterone.
While cortisol is usually one of the worst hormones for acne in existence, the fact that overweight people have more may actually help acne. It would push the levels of androgens even further into the abyss, and further reduce oily skin.
Overall I’d judge the importance of cortisol to be lower than DHT or estrogen, since the evidence is less conclusive that adipose tissue can increase it.
Obese people do have less acne, it isn’t a myth. If you’ve noticed the phenomenon in the past without your friends or family telling you about it, then well done. It’s all down to lowered androgenic hormones.
There could be other factors at play; maybe fat cells deplete certain immune system chemicals or proteins which cause acne in excess. Eating lots of foods equals eating lots of nutrients. Obese people could be pumping their bodies with so many compounds that they don’t need to think about the specific vitamins and minerals.
Nevertheless, diminished stimulation of the sebaceous glands is the main factor. Also, if you’ve found this article promising or exciting for your own acne, then don’t get it confused. I recommend against lowering your testosterone levels if you’re a man, and I definitely recommend against getting fat.
The goal of this article is simply to expose the truth about this classic acne mystery. If you’re a newcomer to Supernatural Acne Treatment, then here’s what you should do – check out this article on the root causes of acne, and read its follow up, part 2 of the root causes of acne (chronic inflammation).
Thanks for reading!