The effect of diet and nutrition on acne vulgaris

A new study published in the journal nutrients, researchers are reviewing existing publications to determine the role of nutrition in the development of acne vulgaris. To this end, the complex interplay of various factors was investigated to elucidate how diet affects biochemical markers, gene transcription related to sebaceous gland function, bacterial proliferation, and acne-related inflammation.

To work: The Effect of Diet and Nutrition in Patients with Acne Vulgaris. Image Source: maxbelchenko / Shutterstock.com

What causes acne?

Acne vulgaris is a chronic inflammatory skin condition that primarily affects adolescents and young adults. It is 80-100% common in individuals between the ages of 11 and 30, thus affecting approximately 9% of the world’s population. The complex etiology of acne vulgaris includes genetic, hormonal, and environmental factors.

Acne presents with inflammatory and non-inflammatory lesions such as papules, pustules, and comedones, with a variety of clinical forms categorized by lesion severity. Microcalcifications play a role in lesion formation due to hormonal disorders, sebum secretion and sebum secretion. Cutibacterium acne proliferation and keratinization abnormalities.

Severe acne can cause scarring and hyperpigmentation, thus significantly affecting the well-being and quality of life of affected individuals. The effects of diet on acne development are currently being investigated alongside new therapeutic approaches to alleviate symptoms and improve patient outcomes.

The role of food in the pathogenesis of acne vulgaris

Due to nutritional differences, a higher prevalence of acne is observed in Western societies than in non-Western societies. Western diets, characterized primarily by low levels of long-chain omega-3 fatty acids and increased consumption of refined carbohydrates, dairy products, chocolate, and saturated fat, may exacerbate acne by promoting inflammation and altering metabolic cues.

More specifically, saturated fatty acids found in the Western diet induce inflammation through the expression of toll-like receptor 2 (TLR2)/interleukin 1B (IL-1B) receptors, thereby leading to increased IL-17A secretion and hyperproliferation of keratinocytes.

Diets with a high glycemic index (GI) and high dairy consumption are also associated with high levels of hormones involved in acne pathogenesis, such as insulin-like growth factor-1 (IGF-1) and insulin. Hyperinsulinemia resulting from high GI diets stimulates IGF-1 synthesis in the liver and subsequently promotes fat cell proliferation and lipogenesis. Insulin and IGF-1 promote sebaceous gland growth, lipid synthesis, and keratinocyte proliferation, leading to activation of the mammalian target of rapamycin complex 1 (mTORC1), which contributes to acne development.

Abnormalities in the gut microbiome caused by an abnormal diet further exacerbate acne pathogenesis through dysregulation of the mTOR pathway and increased intestinal barrier permeability. In general, diet plays an important role in acne pathogenesis by affecting hormonal levels, inflammation, and gut microbiota composition.

Foods that may have negative effects on acne

Milk and dairy products, especially those high in whey protein and casein, have been associated with increased levels of IGF-1, which can lead to hyperinsulinemia and exacerbation of acne lesions. Cow’s milk also contains hormone precursors that can be converted to dihydrotestosterone (DHT), a potent acne trigger. Although there is conflicting data regarding the fat content of milk and its role in acne, it is suggested that the hormones and bioactive molecules in milk make a more important contribution.

Consumption of chocolate, especially dark chocolate, has been linked to worsening acne symptoms. The presence of saccharides in chocolate can trigger insulin secretion and trigger signaling pathways that promote acne lesions. Cocoa components may also increase the secretion of inflammatory cytokines, which can make acne worse.

Saturated and trans fatty acids obtained from animal fats and hydrogenated vegetable oils also play a role in acne pathogenesis. These oils can stimulate pro-inflammatory cytokine production and activate signaling pathways such as mTORC1, leading to increased sebum production and dermal inflammation.

Other dietary factors, such as alcohol intake, excessive salt consumption, and high-GI foods such as salty snacks, eggs, soft drinks, corn, candy, and high-gluten diets, have also been linked to acne flare-ups.

Results

Acne vulgaris significantly impacts patients’ quality of life and well-being, thus highlighting the importance of understanding contributing factors and implementing effective treatments. It was not previously widely accepted that dietary factors were significant contributors to acne; however, increasing scientific evidence supports their role in pathogenesis.

Dairy products, chocolate, and saturated fats have been identified as key dietary components that contribute to the development of acne. Other factors such as alcohol, salty products, gluten, eggs, biscuits, corn, fruit, sweets or soft drinks can also aggravate acne; however, more research is needed to confirm its effects.

Future studies should be designed meticulously to avoid limitations and provide accurate information regarding the effect of diet on acne. Knowing the dietary factors that negatively influence the development of acne will allow clinicians to provide appropriate recommendations and guidance, including elimination diets, to reduce acne lesions and improve the quality of life of individuals with acne vulgaris.