Evaluation of food consumption in patients with acne vulgaris and its relationship with acne severity

Investigating the relationship between anthropometric profiles, dietary oxygen radical absorption capacity and healthy eating index with acne in adolescents

OBJECTIVE

Acne is one of the most common skin diseases, especially among teenagers. Many factors were blamed for creating acne including nutrition. The purpose of this study was to evaluate the relationship between body mass index, oxygen radical absorption capacity (ORAC), and healthy eating index (HEI), and acne among adolescents. This case-control study was conducted on 57 students with acne and 57 students without acne. Demographic information, food frequency and anthropometric indices were collected. The amount of ORAC was determined by USDA data. The HEI was calculated using HEI-2015 for 9 components. The data were analyzed using SPSS software.

RESULTS

In this study cross-sectional study, the average weight in the group with and without acne was 62.27 ± 11.50 vs. 59.26 ± 14.33, and there was no significant difference between weight and acne (P = 0.219). Chromium intake in people without acne was significantly higher (P < 0.022). The macronutrient and micronutrient intakes were insignificantly higher in the healthy group. Food group intake was not significantly different between the healthy and sick groups. There was no significant difference in the ORAC (P = 0.814), and the HEI between the two groups with acne and healthy people (P = 0.616). No correlation was found between HEI, and ORAC with acne as well. The findings of this study showed that anthropometric indices, HEI and ORAC had no significant relationship with acne. To have tangible conclusion, further large-scale cohort study is highly recommended.

Elimination Diet Guided by Food-Specific IgG Antibodies Measurements in Chronic Adult Acne in Thailand: A Prospective RCT Study

Background: Adult female acne is increasingly prevalent and significantly affects quality of life. Current treatments, including antibiotics and hormonal therapies, often yield varied efficacy and risks. While adult acne shares similarities with adolescent acne, its pathogenesis involves genetic, hormonal, immune, and dietary factors. Emerging research implicates high glycemic load diets, milk proteins, and insulin/IGF1 signaling in exacerbating acne. Despite growing understanding, dietary influences remain poorly understood, overshadowed by persistent myths. Inflammation, preceding follicular plugging and hyperkeratinization, suggests a potential shift towards addressing gut inflammation and digestive issues. IgG-mediated food reactions, linked to conditions like IBS and migraines, are controversial in diagnosing acne but warrant investigation, especially in Thai patients. Objective: Evaluate the efficacy of elimination diets guided by food-specific IgG antibodies measurement in chronic adult acne. Patients and Methods: This randomized controlled trial and prospective cohort study enrolled 75 participants with chronic acne aged 19 to 45 years, meeting stringent inclusion criteria. Participants were randomized into three groups: one receiving elimination diets based on reversed IgG antibody measurements, another on common food-specific IgG antibodies, and a third on individual IgG antibody measurements. Elimination diets were informed by Genarrayt™ 200+ Food IgG kit results, with compliance monitored through dietary checklists. Primary outcomes were assessed using the Global Acne Grading System (GAGS) Score, with secondary outcomes including the Thai version of the Dermatology Life Quality Index Questionnaire and a Multiorgan-Symptoms Checklist. Follow-ups were conducted at 2, 4, 8, and 12 weeks. Results: The study cohort, predominantly female (74.7%), exhibited a mean age of 29.3 ± 5.3 years and an average GAGS Score indicating moderate acne severity. Significant differences in GAGS Scores were found among groups (P<0.001), indicating reduced acne severity in the elimination diet groups. Statistically significant reductions in weight and BMI were observed in one group (p-values = 0.048), but not in the other groups. Compliance with follow-up criteria was high. Conclusion: Elimination diets guided by food-specific IgG antibodies measurement show promise in reducing chronic adult acne severity, as indicated by GAGS Scores. This study sheds light on the relationship between diet and adult acne pathophysiology, emphasizing the potential of personalized treatment approaches. Further research is warranted to validate these findings and elucidate underlying mechanisms.

Impact of Diet and Nutrition in Patients with Acne Vulgaris

Acne vulgaris is a widespread a chronic inflammatory dermatosis that affects millions of people around the world, which has a significant influence on patients' standard of living. The progression of this dermatosis results in the appearance of inflammatory and non-inflammatory changes, and, in severe cases, disfiguring scars and hyperpigmentation. The aetiopathogenesis of acne is complex. It involves a complex interaction of many different factors, both endo- and exogenous in their effect on the hair and sebaceous unit. Genetic predisposition, hormones, the skin and gut microbiome, psychological stress, air pollutants, aggressive facial products, and certain medications are cited as factors influencing acne formation. The link between nutrition and acne is extensively debated for many years and is still relatively controversial. Diet is commonly recognised to have a direct relationship with certain biochemical markers and the transcription of genes related to sebaceous gland function, and the proliferation of bacteria and inflammation that encourage the progression of the disease. In this review, the authors take a closer look at the existing scientific reports on the involvement of nutrition in the development of acne vulgaris.

Metabolic and Dietary Factors in Acne Vulgaris and Evaluation of the Acne Vulgaris Treatment with Oral Contraceptive-Based Therapies in Young Adult Women

The etiopathogenesis of acne is complex, as several endo- and exogenous factors that affect the sebaceous-hair unit are involved in the development of acne lesions. The main aim of the study was to evaluate selected metabolic parameters before treatment. Another goal of the study was to determine the correlation between selected metabolic and dietary parameters and the severity of acne before treatment. The third objective was to assess the severity of acne before and after treatment, considering the type of treatment used. The final objective was to assess the relationship between the difference in acne severity before and after treatment, considering the type of treatment used and factors of dairy or sweets intake. 168 women participated in the study. The patients belonged to two groups: the study group (99 patients with acne vulgaris) and the control group (69 patients without skin lesions). The study group was divided into subgroups according to the treatment used: contraceptive preparation, contraceptive preparation and cyproterone acetate, and contraceptive preparation and isotretinoin preparation. We found that LDL levels and consumption of sweets correlated with acne severity. The mainstay of acne treatment is contraceptive treatment (ethinylestradiol and drospirenone). The effectiveness of the three contraceptive-based treatments was confirmed by observing the severity of acne. There were no significant correlations between the difference in acne severity before and after treatment with the three treatments and factors of dairy or sweet consumption.

A cell phone app for facial acne severity assessment

Acne vulgaris, the most common skin disease, can cause substantial economic and psychological impacts to the people it affects, and its accurate grading plays a crucial role in the treatment of patients. In this paper, we firstly proposed an acne grading criterion that considers lesion classifications and a metric for producing accurate severity ratings. Due to similar appearance of acne lesions with comparable severities and difficult-to-count lesions, severity assessment is a challenging task. We cropped facial skin images of several lesion patches and then addressed the acne lesion with a lightweight acne regular network (Acne-RegNet). Acne-RegNet was built by using a median filter and histogram equalization to improve image quality, a channel attention mechanism to boost the representational power of network, a region-based focal loss to handle classification imbalances and a model pruning and feature-based knowledge distillation to reduce model size. After the application of Acne-RegNet, the severity score is calculated, and the acne grading is further optimized by the metadata of the patients. The entire acne assessment procedure was deployed to a mobile device, and a phone app was designed. Compared with state-of-the-art lightweight models, the proposed Acne-RegNet significantly improves the accuracy of lesion classifications. The acne app demonstrated promising results in severity assessments (accuracy: 94.56%) and showed a dermatologist-level diagnosis on the internal clinical dataset.The proposed acne app could be a useful adjunct to assess acne severity in clinical practice and it enables anyone with a smartphone to immediately assess acne, anywhere and anytime.

Acne Vulgaris and Intake of Selected Dietary Nutrients-A Summary of Information

Acne vulgaris (AV) is a chronic disease that affects a significant percentage of the world’s population. Its development is influenced by both external and internal factors. The purpose of this review is to demonstrate the effect of basic nutrient intake on the exacerbation or alleviation of AV lesions. A retrospective review of publications in PubMed regarding diet therapy and the impact of individual nutrient intake on the skin condition of patients was conducted. Ingestion of products with a high glycaemic index may indirectly lead to sebum overproduction, which promotes infection with Cutibacterium acnes and causes inflammation. Consumption of certain dairy products may result in skin deterioration caused by the presence of hormones in these products, i.e., progesterone and testosterone precursors. The beneficial effect of fatty acids on the skin is manifested by the reduction in inflammation. Of significance in AV treatment are vitamins A, C, D, E and B, as well as mineral elements zinc and selenium. Proper nutrition may not only prevent or alleviate AV but also increase treatment efficacy.

Diet and acne: review of the evidence from 2009 to 2020

BACKGROUND

Dietary habits may play a non-negligible role in the development, duration, and severity of acne, as shown in past critical review articles on such association.

METHODS

The aim of this systematic review is to supplement data available on scientific literature spanning the last 10 years by inserting the keywords "acne" or "acne vulgaris" and "diet", "nutrition", "food", "chocolate", "dairy", "whey protein", "fatty acid", or "drink" in the timeframe "January 2009-April 2020" within the PubMed database.

RESULTS

Fifty-three reviewed articles met eligibility criteria. They included 11 interventional clinical trials (seven randomized controlled trials and four uncontrolled open label studies) and 42 observational studies (17 case-control and 22 cross-sectional studies, and three descriptive studies).

CONCLUSIONS

This review reinforces the notion of a rapidly growing exponential trend of interest in this subject by the scientific community. Acne-promoting factors include high GI/GL food, dairy products, fat food, and chocolate, whereas acne-protective factors include fatty acids, fruit, and vegetable intake. The role played by specific dietary components pertaining to different foods, as done for milk (full-fat/whole, reduced-fat, low-fat/skim milk), dairy products (milk cream, ice cream, yogurt, cheese, etc.), or chocolate (cocoa, dark/milk chocolate), remains an unsolved issue and objective of future research.