Αcne and Nutrition: Myths and truthy

Acne vulgaris is a dermatologic condition which not only affects the majority of adolescents, but also a great number of young adults. For as long as half a century, various perceptions of the role of diet in acne have prevailed. Nevertheless, in recent years, due to a better understanding of the link between dietary and endocrine factors implicated in the acne pathogenesis, this issue has taken new dimensions. At the level of nutrients, the possible beneficial effects of omega-3 fatty acids, vitamin A, zinc and other antioxidants, as well as the aggravating role of iodine have been investigated, primarily in view of their involvement in mechanisms of inflammation and/or their antimicrobial properties. Considering the endocrine background of acne (insulin, insulin-like growth factor-1, androgens), even though the implication of chocolate has pathophysiologically been proved to some extent, relevant clinical trials do not seem to confirm this. In contrast, there is data indicating that milk and especially skimmed milk, as well as the adoption of the Western diet and/or high glycemic load diets aggravate acne due to common mechanisms. There is also evidence that body weight and energy intake are positively associated with acne, which can be attributed to the causal relationship between increased Body Mass Index and insulin resistance, as well as early puberty. However, since puberty is physiologically followed by a reduction in insulin sensitivity and hormonal explosion, the effect of the aforementioned dietary factors may be less emerging in adolescents compared to young adults. Nonetheless, relevant dietary manipulations could provide some benefit, especially for people who do not adequately respond to medication.