Journal of the American Academy of Dermatology
Volume 63, Issue 1 , Pages 124-141 , July 2010

Diet and acne

  • Whitney P. Bowe, MD

      Affiliations

    • Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
    • Corresponding Author InformationReprint requests: Whitney P. Bowe, MD, 450 Clarkson Ave, Brooklyn, NY 11203.
    • ,
  • Smita S. Joshi, MD

      Affiliations

    • Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • ,
  • Alan R. Shalita, MD

      Affiliations

    • Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York

References 

  1. Fulton JE, Plewig G, Kligman AM. Effect of chocolate on acne vulgaris. JAMA. 1969;210:2071–2074
  2. Anderson PC. Foods as the cause of acne. Am Fam Physician. 1971;3:102–103
  3. Campbell GG. The relation of sugar intolerance to certain diseases of the skin. Br J Dermatol. 1931;43:297–304
  4. Belisario JC. Acne vulgaris; its etiology and treatment. Aust J Dermatol. 1951;1:85–111
  5. Ormsby O, Montgomery H. Diseases of the skin. Philadelphia: Lea and Febiger; 1954;p. 1365
  6. Sutton RJ. Diseases of the skin. St Louis: Mosby Co; 1956;p. 683-90
  7. Becker S, Obermeyer M. Modern dermatology and syphilology. Philadelphia: JB Lippincott Co; 1947;p. 590-5
  8. Thiboutot DM, Shalita AR, Yamauchi PS, Dawson C, Arsonnaud S, Kang S. Combination therapy with adapalene gel 0.1% and doxycycline for severe acne vulgaris: a multicenter, investigator-blind, randomized, controlled study. Skinmed. 2005;4:138–146
  9. Berger R, Barba A, Fleischer A, Leyden JJ, Lucky A, Pariser D, et al. A double-blinded, randomized, vehicle-controlled, multicenter, parallel-group study to assess the safety and efficacy of tretinoin gel microsphere 0.04% in the treatment of acne vulgaris in adults. Cutis. 2007;80:152–157
  10. Leyden JJ, Krochmal L, Yaroshinsky A. Two randomized, double-blind, controlled trials of 2219 subjects to compare the combination clindamycin/tretinoin hydrogel with each agent alone and vehicle for the treatment of acne vulgaris. J Am Acad Dermatol. 2006;54:73–81
  11. Mackie BS, Mackie LE. Chocolate and acne. Australas J Dermatol. 1974;15:103–109
  12. Treloar V. Diet and acne redux. Arch Dermatol. 2003;139:941–943
  13. Treloar V. Comment on the commentary: diet and acne. J Am Acad Dermatol. 2008;59:534–535
  14. Rasmussen JE. Diet and acne. Int J Dermatol. 1977;16:488–492
  15. Cordain L. Implications for the role of diet in acne. Semin Cutan Med Surg. 2005;24:84–91
  16. Robinson HM. The acne problem. South Med J. 1949;42:1050–1060
  17. Adebamowo CA, Spiegelman D, Danby FW, Frazier AL, Willett WC, Holmes MD. High school dietary dairy intake and teenage acne. J Am Acad Dermatol. 2005;52:207–214
  18. Darling JA, Laing AH, Harkness RA. A survey of the steroids in cows' milk. J Endocrinol. 1974;62:291–297
  19. Danby FW. Diet and acne. Clin Dermatol. 2008;26:93–96
  20. Hartmann S, Lacorn M, Steinhart H. Natural occurrence of steroid hormones in food. Food Chem. 1998;62:7–20
  21. Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58:787–793
  22. Giovannucci E, Pollak M, Liu Y, Platz EA, Majeed N, Rimm EB, et al. Nutritional predictors of insulin-like growth factor I and their relationships to cancer in men. Cancer Epidemiol Biomarkers Prev. 2003;12:84–89
  23. Holmes MD, Pollak MN, Willett WC, Hankinson SE. Dietary correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations. Cancer Epidemiol Biomarkers Prev. 2002;11:852–861
  24. Heaney RP, McCarron DA, Dawson-Hughes B, Oparil S, Berga SL, Stern JS, et al. Dietary changes favorably affect bone remodeling in older adults. J Am Diet Assoc. 1999;99:1228–1233
  25. Cara JF. Insulin-like growth factors, insulin-like growth factor binding proteins and ovarian androgen production. Horm Res. 1994;42:49–54
  26. De Mellow JS, Handelsman DJ, Baxter RC. Short-term exposure to insulin-like growth factors stimulates testosterone production by testicular interstitial cells. Acta Endocrinol. 1987;115:483–489
  27. Crave JC, Lejeune H, Brebant C, Baret C, Pugeat M. Differential effects of insulin and insulin-like growth factor I on the production of plasma steroid-binding globulins by human hepatoblastoma-derived (Hep G2) cells. J Clin Endocrinol Metab. 1995;80:1283–1289
  28. Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentiation. Endocrinology. 1999;140:4089–4094
  29. Webster GF. Acne vulgaris. BMJ. 2002;325:475–479
  30. Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360–366
  31. Webster GF. Commentary: diet and acne. J Am Acad Dermatol. 2008;58:794–795
  32. Bershad SV. Diet and acne–slim evidence, again. J Am Acad Dermatol. 2005;53:1102–1103
  33. Arbesman H. Dairy and acne–the iodine connection. J Am Acad Dermatol. 2005;53:1102
  34. Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, et al. Milk consumption and acne in adolescent girls. Dermatol Online J. 2006;12:1
  35. Menon C, Gipson K, Bowe WP, Hoffstad OJ, Margolis DJ. Validity of subject self-report for acne. Dermatology. 2008;217:164–168
  36. Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values. Am J Clin Nutr. 2002;2002(76):5–56
  37. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002;138:1584–1590
  38. Attia N, Tamborlane WV, Heptulla R, Maggs D, Grozman A, Sherwin RS, et al. The metabolic syndrome and insulin-like growth factor I regulation in adolescent obesity. J Clin Endocrinol Metab. 1998;83:1467–1471
  39. Liu S, Willett WC. Dietary glycemic load and atherothrombotic risk. Curr Atheroscler Rep. 2002;4:454–461
  40. Brand-Miller JC, Thomas M, Swan V, Ahmad ZI, Petocz P, Colagiuri S. Physiological validation of the concept of glycemic load in lean young adults. J Nutr. 2003;133:2728–2732
  41. Cordain L, Eades MR, Eades MD. Hyperinsulinemic diseases of civilization: more than just syndrome X. Comp Biochem Physiol. 2003;136:95–112
  42. Thiboutot DM, Strauss JS. Diet and acne revisited. Arch Dermatol. 2002;138:1591–1592
  43. Bershad S. The unwelcome return of the acne diet. Arch Dermatol. 2003;139:940–941
  44. Aizawa H, Niimura M. Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne. J Dermatol. 1995;22:249–252
  45. Aizawa H, Niimura M. Mild insulin resistance during oral glucose tolerance test (OGTT) in women with acne. J Dermatol. 1996;23:526–529
  46. Kaymak Y, Adisen E, Ilter N, Bideci A, Gurler D, Celik B. Dietary glycemic index and glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels in patients with acne. J Am Acad Dermatol. 2007;57:819–823
  47. Treloar V, Logan AC, Danby FW, Cordain L, Mann NJ. Comment on acne and glycemic index. J Am Acad Dermatol. 2008;58:175–177
  48. Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007;86:107–115
  49. Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol. 2007;57:247–256
  50. Smith R, Mann N, Makelainen H, Roper J, Braue A, Varigos G. A pilot study to determine the short-term effects of a low glycemic load diet on hormonal markers of acne: a nonrandomized, parallel, controlled feeding trial. Mol Nutr Food Res. 2008;52:718–726
  51. Smith RN, Braue A, Varigos GA, Mann NJ. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci. 2008;50:41–52
  52. Marsh K, Brand-Miller J. The optimal diet for women with polycystic ovary syndrome?. Br J Nutr. 2005;94:154–165
  53. De Leo V, Musacchio MC, Morgante G, Piomboni P, Petraglia F. Metformin treatment is effective in obese teenage girls with PCOS. Hum Reprod. 2006;21:2252–2256
  54. Ciotta L, Calogero AE, Farina M, De Leo V, La Marca A, Cianci A. Clinical, endocrine and metabolic effects of acarbose, an alpha-glucosidase inhibitor, in PCOS patients with increased insulin response and normal glucose tolerance. Hum Reprod. 2001;16:2066–2072
  55. Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab. 2005;2:35
  56. Rouhani P, Berman B, Rouhani G. Acne improves with a popular, low glycemic diet from South Beach. 67th Annual Meeting of the American Academy of Dermatology. Poster 706. San Francisco, 2009.
  57. Brouns F, Bjorck I, Frayn KN, Gibbs AL, Lang V, Slama G, et al. Glycemic index methodology. Nutr Res Rev. 2005;18:145–171
  58. Flint A, Moller BK, Raben A, Tetens I, Holst JJ, Astrup A. The use of glycemic index tables to predict glycemic index of breakfast meals. Br J Nutr. 2005;94:135–136
  59. Alfenas RC, Mattes RD. Influence of glycemic index/load on glycemic response, appetite, and food intake in healthy humans. Diabetes Care. 2005;28:2123–2129
  60. Wolever TM, Yang M, Zeng XY, Atkinson F, Brand-Miller JC. Food glycemic index, as given in glycemic index tables, is a significant determinant of glycemic responses elicited by composite breakfast meals. Am J Clin Nutr. 2006;83:1306–1312
  61. Gannon MC, Nuttall FQ, Westphal SA, Seaquist ER. The effect of fat and carbohydrate on plasma glucose, insulin, C-peptide, and triglycerides in normal male subjects. J Am Coll Nutr. 1993;12:36–41
  62. Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21:495–505
  63. Logan AC. Omega-3 fatty acids and acne. Arch Dermatol. 2003;139:941–943
  64. Zouboulis CC, Nestoris S, Adler YD, Orth M, Orfanos CE, Picardo M, et al. A new concept for acne therapy: a pilot study with zileuton, an oral 5-lipoxygenase inhibitor. Arch Dermatol. 2003;139:668–670
  65. Bhathena SJ, Berlin E, Judd JT, Kim YC, Law JS, Bhagavan HN, et al. Effects of omega 3 fatty acids and vitamin E on hormones involved in carbohydrate and lipid metabolism in men. Am J Clin Nutr. 1991;54:684–688
  66. Hitch JM, Greenburg BG. Adolescent acne and dietary iodine. Arch Dermatol. 1961;84:898–911
  67. Rubin MG, Kim K, Logan AC. Acne vulgaris, mental health and omega-3 fatty acids: a report of cases. Lipids Health Dis. 2008;7:36
  68. Briganti S, Picardo M. Antioxidant activity, lipid peroxidation and skin diseases: what's new. J Eur Acad Dermatol Venereol. 2003;17:663–669
  69. Arican O, Kurutas EB, Sasmaz S. Oxidative stress in patients with acne vulgaris. Mediators Inflamm. 2005;2005:380–384
  70. Abdel Fattah NS, Shaheen MA, Ebrahim AA, El Okda ES. Tissue and blood superoxide dismutase activities and malondialdehyde levels in different clinical severities of acne vulgaris. Br J Dermatol. 2008;159:1086–1091
  71. El-Akawi Z, Abdel-Latif N, Abdul-Razzak K. Does the plasma level of vitamins A and E affect acne condition?. Clin Exp Dermatol. 2006;31:430–434
  72. Michaelsson G. Decreased concentration of selenium in whole blood and plasma in acne vulgaris. Acta Derm Venereol. 1990;70:92
  73. Michaelsson G, Edqvist LE. Erythrocyte glutathione peroxidase activity in acne vulgaris and the effect of selenium and vitamin E treatment. Acta Derm Venereol. 1984;64:9–14
  74. Liao S. The medicinal action of androgens and green tea epigallocatechin gallate. Hong Kong Med J. 2001;7:369–374
  75. Sato T, Takahashi A, Kojima M, Akimoto N, Yano M, Ito A. A citrus polymethoxy flavonoid, nobiletin inhibits sebum production and sebocyte proliferation, and augments sebum excretion in hamsters. J Invest Dermatol. 2007;127:2740–2748
  76. Lim YH, Kim IH, Seo JJ. In vitro activity of kaempferol isolated from the Impatiens balsamina alone and in combination with erythromycin or clindamycin against Propionibacterium acnes. J Microbiol. 2007;45:473–477
  77. Docherty JJ, McEwen HA, Sweet TJ, Bailey E, Booth TD. Resveratrol inhibition of Propionibacterium acnes. J Antimicrob Chemother. 2007;59:1182–1184
  78. Prasad AS. Zinc deficiency. BMJ. 2003;326:409–410
  79. King JC, Shames DM, Woodhouse LR. Zinc homeostasis in humans. J Nutr. 2000;130:1360S–1366S
  80. Michaelsson G, Juhlin L, Ljunghall K. A double-blind study of the effect of zinc and oxytetracycline in acne vulgaris. Br J Dermatol. 1977;97:561–566
  81. Fitzherbert JC. Zinc deficiency in acne vulgaris. Med J Aust. 1977;2:685–686
  82. Amer M, Bahgat MR, Tosson Z, Abdel Mowla MY, Amer K. Serum zinc in acne vulgaris. Int J Dermatol. 1982;21:481–484
  83. Michaelsson G, Vahlquist A, Juhlin L. Serum zinc and retinol-binding protein in acne. Br J Dermatol. 1977;96:283–286
  84. Dreno B, Amblard P, Agache P, Sirot S, Litoux P. Low doses of zinc gluconate for inflammatory acne. Acta Derm Venereol. 1989;69:541–543
  85. Goransson K, Liden S, Odsell L. Oral zinc in acne vulgaris: a clinical and methodological study. Acta Derm Venereol. 1978;58:443–448
  86. Hillstrom L, Pettersson L, Hellbe L, Kjellin A, Leczinsky CG, Nordwall C. Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Br J Dermatol. 1977;97:681–684
  87. Liden S, Goransson K, Odsell L. Clinical evaluation in acne. Acta Derm Venereol Suppl (Stockh). 1980;89(Suppl):47–52
  88. Michaelsson G, Juhlin L, Vahlquist A. Effects of oral zinc and vitamin A in acne. Arch Dermatol. 1977;113:31–36
  89. Verma KC, Saini AS, Dhamija SK. Oral zinc sulphate therapy in acne vulgaris: a double-blind trial. Acta Derm Venereol. 1980;60:337–340
  90. Dreno B, Moyse D, Alirezai M, Amblard P, Auffret N, Beylot C, et al. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate versus minocycline hydrochloride in the treatment of inflammatory acne vulgaris. Dermatology. 2001;203:135–140
  91. Orris L, Shalita AR, Sibulkin D, London SJ, Gans EH. Oral zinc therapy of acne: absorption and clinical effect. Arch Dermatol. 1978;114:1018–1020
  92. Weimar VM, Puhl SC, Smith WH, tenBroeke JE. Zinc sulfate in acne vulgaris. Arch Dermatol. 1978;114:1776–1778
  93. Bowe WP, Shalita AR. Effective over-the-counter acne treatments. Semin Cutan Med Surg. 2008;27:170–176
  94. Cunliffe WJ, Dodman B, Ead R. Benzoyl peroxide in acne. Practitioner. 1978;220:479–482
  95. Cunliffe WJ. Unacceptable side-effects of oral zinc sulphate in the treatment of acne vulgaris. Br J Dermatol. 1979;101:363
  96. Penniston KL, Tanumihardjo SA. The acute and chronic toxic effects of vitamin A. Am J Clin Nutr. 2006;83:191–201
  97. Wall M. Idiopathic intracranial hypertension (pseudotumor cerebri). Curr Neurol Neurosci Rep. 2008;8:87–93
  98. Kligman AM, Mills OH, Leyden JJ, Gross PR, Allen HB, Rudolph RI. Oral vitamin A in acne vulgaris: preliminary report. Int J Dermatol. 1981;20:278–285
  99. Kaufman WH. The diet and acne. Arch Dermatol. 1983;119:276
  100. Logan AC. Dietary fat, fiber, and acne vulgaris. J Am Acad Dermatol. 2007;57:1092–1093
  101. Danby FW. Acne and iodine: reply. J Am Acad Dermatol. 2007;56:164–165
  102. Harrell BL, Rudolph AH. Kelp diet: a cause of acneiform eruption [letter]. Arch Dermatol. 1976;112:560
  103. Jackson R. Nonbacterial pus-forming diseases of the skin. Can Med Assoc J. 1974;111(801):4–6
  104. Pennington JAT. Iodine concentrations in US milk: variation due to time, season, and region. J Dairy Sci. 1990;73:3421–3427
  105. Wagner CL, Greer FR. Prevention of rickets and vitamin d deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142–1152
  106. Grant JD, Anderson PC. Chocolate as a cause of acne: a dissenting view. Mo Med. 1965;62:459–460
  107. Bett DG, Morland J, Yudkin J. Sugar consumption in acne vulgaris and seborrheic dermatitis. Br Med J. 1967;3:153–155
  108. Chiu A, Chon SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol. 2003;139:897–900
  109. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes . Food and Nutrition Board Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington (DC): National Academy Press; 1997;

 Supported in part by the Skin Cancer Foundation and Orlando Dermatology and Aesthetic Conference's Leonard L. Mazur Resident Research Award (Young Investigator Research Grant; Dr Bowe) and the American Acne and Rosacea Society Clinical Research Grant (Dr Bowe).

 Conflicts of interest: None declared.

PII: S0190-9622(09)00967-0

doi: 10.1016/j.jaad.2009.07.043

Journal of the American Academy of Dermatology
Volume 63, Issue 1 , Pages 124-141 , July 2010

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