This article was originally published by Refinery29. Read the original post here.

As a consultant dermatologist based in London, I have been seeing patients with skin conditions for well over a decade. Acne is one of my main areas of interest. Over the past few years, there are some observations I have made which are causing me concern: with the rise of 'wellness' and its stubborn persistence, my increasing worry is how it is affecting our relationship with food in the context of managing skin problems.

Let me give you a bit of background. I am aware that I see a self-selecting group of patients in my private clinics. Many suffer with a longstanding history of acne, most are female and from an affluent background – that is the nature of working in exclusive areas of London. Like many of us, they are intelligent, clued-up women who care not only about their skin health, but also their general health.

By the time many of them are sitting opposite me in clinic for their acne, they have already exhausted numerous avenues of treatment. This includes changing their skincare, often having spent thousands trying to find the right product, as well as manipulating their diet.

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The nutrition aspect is a trend that I am finding hard to ignore. Patients are telling me how they are cutting out dairy, gluten and sugar in an attempt to clear their spots. Many are actively restricting food to the point where it is clear to me it has become an unhealthy obsession: finding excuses not to go to dinner with friends, refusing to eat a slice of birthday cake that has been lovingly made by a family member, skipping meals when out and about as there is no 'clean' café that can provide 'acceptable' or 'allowed' food. What I am dealing with is not just the acne itself, but also a very real fear of certain foods.