Most people living a modern lifestyle will have some experience of acne. Depending on the grading scale used, acne prevalence amongst adolescents ranges between 35% and 96%, with the most common range reported between 80 and 90%. Click here to learn more.

Is it likely that 80 to 90% of adolescent humans have always had unsightly pustules on their faces? Surely evolution isn’t that inefficient? There is growing consensus that we, as modern-living humans, have altered our living conditions too fast for our genetics to adapt. About 2 million years ago, our ancestors lost their body hair and started to walk upright. That’s approximately 140 000 generations. We started farming about 350 generations ago and the industrial revolution is only 6 generations in the past. Evolution takes a lot longer than 6 generations, so we haven’t been able to adapt to the daily stripping of our natural oils with soap. How long has it been since we started to spend the majority of every day sitting indoors in front of a computer screen? 25 years? We aren’t built for this.


We have the genetics of hunter-gatherers but we’re not living that lifestyle anymore and we’re paying the price. Researchers have evaluated the health of the few remaining hunter-gatherer tribes and they trump us on every health metric. They have better eyesight, higher VO2 max, superior bone health markers, lower insulin and BMI and much higher Vitamin D. Inflammatory disease is not an issue, and neither is depression or suicide. Many of the typical hallmarks of aging are not age-related in hunter-gatherers. Their blood pressure doesn’t change as they get older, and they don’t become more prone to bone fractures. Obesity is almost undocumented, and acne is either very rare or absent in these populations.


In one study (Arch Dermatol. 2002;138:1584-1590), 1200 hunter-gatherers from the island of Kitava in Papua New Guinea were examined by dermatologists, and not one case of acne was found. Not even a single Grade 1 case and there were more than 300 subjects between 15 and 25 years of age. The same was true for the Aché people in Paraguay. Many reports have documented the absence or near-absence of acne vulgaris in traditional-living populations like the Inuit, the Okinawans, and the Zulus. Traditional-living Tanzanians showed an acne rate of 0,1%.


What has changed?

  • Our genes haven’t had time to shift to the new normal but there have been a lot of changes in our lifestyles.
  • Diet is a big one. We used to eat much better food. We now take in less fiber, less omega-3, fewer carotenoids, and our food isn’t fresh.
  • We stay indoors, out of the sun for 93% of every day.
  • We are inactive for the vast majority of the day. The average hunter-gatherer walks more than 25km a day.
  • We’re in almost constant contact with man-made pollutants.
  • And, about 100 years ago, we started to use soap to wash our natural skin oils down the drain.