Advertisement

The role of nutrition in acne vulgaris and hidradenitis suppurativa

      Abstract

      Acne vulgaris and hidradenitis suppurativa (HS) are chronic inflammatory, multifactorial skin disorders that often develop in adolescence and young adulthood. Both acne vulgaris and HS can cause significant morbidity and psychologic distress, with a negative effect on the quality of life. The relationship among diet, acne, and HS remains somewhat controversial; however, there is increasing evidence that high-glycemic diets and consumption of milk and dairy products promote acne. Studies suggest that weight loss through dietary interventions or bariatric surgery and brewer's yeast exclusion diets have the potential to ameliorate the signs of HS. We review the role of diet in the pathogenesis, prevention, and treatment of HS and acne vulgaris.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinics in Dermatology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bhate K
        • Williams HC.
        Epidemiology of acne vulgaris.
        Br J Dermatol. 2013; 168: 474-485
        • O'Neill AM
        • Gallo RL.
        Host-microbiome interactions and recent progress into understanding the biology of acne vulgaris.
        Microbiome. 2018; 6: 177
        • Napolitano M
        • Megna M
        • Timoshchuk EA
        • et al.
        Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment.
        Clin Cosmet Investig Dermatol. 2017; 10: 105-115
        • Jemec GBE
        • Kimball AB.
        Hidradenitis suppurativa: epidemiology and scope of the problem.
        J Am Acad Dermatol. 2015; 73: S4-S7
        • Prens E
        • Deckers I.
        Pathophysiology of hidradenitis suppurativa: an update.
        J Am Acad Dermatol. 2015; 73: S8-S11
        • Silfvast-Kaiser A
        • Youssef R
        • Paek SY.
        Diet in hidradenitis suppurativa: a review of published and lay literature.
        Int J Dermatol. 2019; 58: 1225-1230
        • Szyszkowska B
        • Łepecka-Klusek C
        • Kozłowicz K
        • Jazienicka I
        • Krasowska D.
        The influence of selected ingredients of dietary supplements on skin condition.
        Postepy Dermatol Alergol. 2014; 31: 174-181
        • 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
        • Logan AC.
        Omega-3 fatty acids and acne.
        Arch Dermatol. 2003; 139: 941-942
        • Kris-Etherton PM
        • Taylor DS
        • Yu-Poth S
        • et al.
        Polyunsaturated fatty acids in the food chain in the United States.
        Am J Clin Nutr. 2000; 71: 179S-188S
        • Pochi PE
        • Strauss JS.
        Sebaceous gland response in man to the administration of testosterone, delta-4-androstenedione, and dehydroisoandrosterone.
        J Invest Dermatol. 1969; 52: 32-36
        • Arora MK
        • Yadav A
        • Saini V.
        Role of hormones in acne vulgaris.
        Clin Biochem. 2011; 44: 1035-1040
        • Cohen EB
        • Rossen NN.
        Acne vulgaris bij gebruik van progestagenen in een hormoonspiraal of een subcutaan implantaat.
        Ned Tijdschr Geneeskd. 2003; 147 ([Acne vulgaris in connection with the use of progestagens in a hormonal IUD or a subcutaneous implant]) ([in Dutch]): 2137-2139
        • Chen W
        • Obermayer-Pietsch B
        • Hong JB
        • et al.
        Acne-associated syndromes: models for better understanding of acne pathogenesis.
        J Eur Acad Dermatol Venereol. 2011; 25: 637-646
        • Skampardonis N
        • Kouskoukis A
        • Karpouzis A
        • Maroulis G.
        Marked hyperandrogenemia and acne associated with polycystic ovaries in Greek women with polycystic ovary syndrome.
        Clin Exp Obstet Gynecol. 2011; 38: 168-171
        • Timpatanapong P
        • Rojanasakul A.
        Hormonalprofiles and prevalence of polycystic ovary syndrome in women with acne.
        J Dermatol. 1997; 24: 223-229
        • Borgia F
        • Cannavò S
        • Guarneri F
        • Cannavò SP
        • Vaccaro M
        • Guarneri B.
        Correlation between endocrinological parameters and acne severity in adult women.
        Acta Derm Venereol. 2004; 84: 201-204
        • Marynick SP
        • Chakmakjian ZH
        • McCaffree DL
        • Herndon JH.
        Androgen excess in cystic acne.
        N Engl J Med. 1983; 308: 981-986
        • Stewart ME
        • Downing DT
        • Cook JS
        • Hansen JR
        • Strauss JS.
        Sebaceous gland activity and serum dehydroepiandrosterone sulfate levels in boys and girls.
        Arch Dermatol. 1992; 128: 1345-1348
        • Ebede TL
        • Arch EL
        • Berson D.
        Hormonal treatment of acne in women.
        J Clin Aesthet Dermatol. 2009; 2: 16-22
        • George R
        • Clarke S
        • Thiboutot D.
        Hormonal therapy for acne.
        Semin Cutan Med Surg. 2008; 27: 188-196
        • Deplewski D
        • Rosenfield RL.
        Role of hormones in pilosebaceous unit development.
        Endocr Rev. 2000; 21: 363-392
        • Vora S
        • Ovhal A
        • Jerajani H
        • Nair N
        • Chakrabortty A.
        Correlation of facial sebum to serum insulin-like growth factor-1 in patients with acne.
        Br J Dermatol. 2008; 159: 990-991
        • Mesiano S
        • Katz SL
        • Lee JY
        • Jaffe RB.
        Insulin-like growth factors augment steroid production and expression of steroidogenic enzymes in human fetal adrenal cortical cells: implications for adrenal androgen regulation 1.
        J Clin Endocrinol Metab. 1997; 82: 1390-1396
        • Belgorosky A
        • Baquedano MS
        • Guercio G
        • Rivarola MA.
        Adrenarche: postnatal adrenal zonation and hormonal and metabolic regulation.
        Horm Res. 2008; 70257267
        • Guercio G
        • Rivarola MA
        • Chaler E
        • Maceiras M
        • Belgorosky A.
        Relationship between the growth hormone/insulin-like growth factor-I axis, insulin sensitivity, and adrenal androgens in normal prepubertal and pubertal girls.
        J Clin Endocrinol Metab. 2003; 88: 1389-1393
        • Colón E
        • Svechnikov KV
        • Carlsson-Skwirut C
        • Bang P
        • Soder O.
        Stimulation of steroidogenesis in immature rat leydig cells evoked by interleukin-1α is potentiated by growth hormone and insulin-like growth factors.
        Endocrinol. 2005; 146: 221-230
        • Cara JF.
        Insulin-like growth factors, insulin growth-factor binding proteins and ovarian androgen production.
        Horm Res. 1994; 42: 49-54
        • Nagpal M
        • De D
        • Handa S
        • Pal A
        • Sachdeva N.
        Insulin resistance and metabolic syndrome in young men with acne.
        JAMA Dermatol. 2016; 152: 399-404
        • Cappel M
        • Mauger D
        • Thiboutot D.
        Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women.
        Arch Dermatol. 2005; 141: 333-338
        • 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
        • Rich-Edwards JW
        • Ganmaa D
        • Pollak MN
        • et al.
        Milk consumption and the prepubertal somatotropic axis.
        Nutr J. 2007; 6: 28
        • Hoppe C
        • Mølgaard C
        • Vaag A
        • Barkholt V
        • Michaelsen KF.
        High intakes of milk, but not meat, increase s-insulin and insulin resistance in 8-year-old boys.
        Eur J Clin Nutr. 2005; 59: 393-398
        • Östman EM
        • Liljeberg Elmståhl HGM
        • Björck IME
        Inconsistency between glycemic and insulinemic responses to regular and fermented milk products.
        Am J Clin Nutr. 2001; 74: 96-100
        • Hoyt G
        • Hickey MS
        • Cordain L.
        Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk.
        Br J Nutr. 2005; 93: 175-177
        • Liljeberg Elmståhl H
        • Björck I
        Milk as a supplement to mixed meals may elevate postprandial insulinaemia.
        Eur J Clin Nutr. 2001; 55: 994-999
        • 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
        • Adebamowo CA
        • Spiegelman D
        • Berkey CS
        • et al.
        Milk consumption and acne in adolescent girls.
        Dermatol Online J. 2006; 12: 1
        • Adebamowo CA
        • Spiegelman D
        • Berkey CS
        • et al.
        Milk consumption and acne in teenaged boys.
        J Am Acad Dermatol. 2008; 58: 787-793
        • Di Landro A
        • Cazzaniga S
        • Parazzini F
        • et al.
        Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults.
        J Am Acad Dermatol. 2012; : 671129-671135
        • Ulvestad M
        • Bjertness E
        • Dalgard F
        • Halvorsen JA.
        Acne and dairy products in adolescence: results from a Norwegian longitudinal study.
        J Eur Acad Dermatol Venereol. 2017; 31: 530-535
        • Ismail NH
        • Manaf ZA
        • Azizan NZ.
        High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study.
        BMC Dermatol. 2012; 12: 13
        • Smith RN
        • Mann NJ
        • Braue A
        • Mäkeläinen 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
        • 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
        • Smith RN
        • Mann NJ
        • Braue A
        • Mäkeläinen 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
        • Burris J
        • Shikany JM
        • Rietkerk W
        • Woolf K.
        A low glycemic index and glycemic load diet decreases insulin-like growth factor-1 among adults with moderate and severe acne: a short-duration, 2-week randomized controlled trial.
        J Acad Nutr Diet. 2018; 118: 1874-1885
        • Suppiah TSS
        • Sundram TKM
        • Tan ESS
        • Lee CK
        • Bustami NA
        • Tan CK.
        Acne vulgaris and its association with dietary intake: a Malaysian perspective.
        Asia Pac J Clin Nutr. 2018; 27: 1141-1145
        • Huang X
        • Zhang J
        • Li J
        • et al.
        Daily intake of soft drinks and moderate-to-severe acne vulgaris in Chinese adolescents.
        J Pediatr. 2019; 204 (e3): 256-262
        • Jung JY
        • Yoon MY
        • Min SU
        • Hong JS
        • Choi YS
        • Suh DH
        The influence of dietary patterns on acne vulgaris in Koreans.
        Eur J Dermatology. 2010; 20: 768-772
        • James MJ
        • Gibson RA
        • Cleland LG.
        Dietary polyunsaturated fatty acids and inflammatory mediator production.
        Am J Clin Nutr. 2000; 71: 343S-348S
        • Woods RK
        • Thien FC
        • Abramson MJ.
        Dietary marine fatty acids (fish oil) for asthma in adults and children.
        Cochrane Database Syst Rev. 2002; CD001283
        • Pappas A.
        The relationship of diet and acne: a review.
        Dermatoendocrinol. 2009; 1: 262-267
        • MacDonald I.
        Changes in the fatty acid composition of sebum associated with high carbohydrate diets.
        Nature. 1964; 203: 1067-1068
        • Llewellyn A.
        Variations in the composition of skin surface lipid associated with dietary carbohydrates.
        Proc Nutr Soc. 1967; 26: 11
        • Spencer EH
        • Ferdowsian HR
        • Barnard ND.
        Diet and acne: a review of the evidence.
        Int J Dermatol. 2009; 48: 339-347
        • Kucharska A
        • Szmurło A
        • Sinska B.
        Significance of diet in treated and untreated acne vulgaris.
        Postepy Dermatol Alergol. 2016; 33: 81-86
        • Zaenglein AL
        • Pathy AL
        • Schlosser BJ
        • et al.
        Guidelines of care for the management of acne vulgaris.
        J Am Acad Dermatol. 2016; 74 (e33): 945-973
        • Eichenfield LF
        • Krakowski AC
        • Piggott C
        • et al.
        Evidence-based recommendations for the diagnosis and treatment of pediatric acne.
        Pediatrics. 2013; 131: S163-S186
        • Wolf R
        • Matz H
        • Orion E
        Acne and diet.
        Clin Dermatol. 2004; 22: 387-393
        • Cordain L.
        Implications for the role of diet in acne.
        Semin Cutan Med Surg. 2005; 24: 84-91
        • Revuz JE
        • Canoui-Poitrine F
        • Wolkenstein P
        • et al.
        Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies.
        J Am Acad Dermatol. 2008; 59: 596-601
        • Vazquez BG
        • Alikhan A
        • Weaver AL
        • Wetter DA
        • Davis MD.
        Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota.
        J Invest Dermatol. 2013; 133: 97-103
        • Edlich RF
        • Silloway KA
        • Rodeheaver GT
        • Cooper PH.
        Epidemiology, pathology, and treatment of axillary hidradenitis suppurativa.
        J Emerg Med. 1986; 4: 369-378
        • Bettoli V
        • Naldi L
        • Cazzaniga S
        • et al.
        Overweight, diabetes and disease duration influence clinical severity in hidradenitis suppurativa-acne inversa: evidence from the national Italian registry.
        Br J Dermatol. 2016; 174: 195-197
        • Canoui-Poitrine F
        • Revuz JE
        • Wolkenstein P
        • et al.
        Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity.
        J Am Acad Dermatol. 2009; 61 (Jul): 51-57
        • Sartorius K
        • Emtestam L
        • Jemec GBE
        • Lapins J.
        Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity.
        Br J Dermatol. 2009; 161: 831-839
        • Sabat R
        • Chanwangpong A
        • Schneider-Burrus S
        • et al.
        Increased prevalence of metabolic syndrome in patients with Acne inversa.
        PLoS One. 2012; 7: e31810
        • Alikhan A
        • Lynch PJ
        • Eisen DB.
        Hidradenitis suppurativa: a comprehensive review.
        J Am Acad Dermatol. 2009; 60: 539-561
        • Nazary M
        • Van Der Zee HH
        • Prens EP
        • Folkerts G
        • Boer J.
        Pathogenesis and pharmacotherapy of Hidradenitis suppurativa.
        Eur J Pharmacol. 2011; 672: 1-8
        • Popko K
        • Gorska E
        • Stelmaszczyk-Emmel A
        • et al.
        Proinflammatory cytokines IL-6 and TNF-α and the development of inflammation in obese subjects.
        Eur J Med Res. 2010; 15: 120-122
        • Straczkowski M
        • Dzienis-Straczkowska S
        • Stêpieñ A
        • Kowalska I
        • Szelachowska M
        • Kinalska I.
        Plasma interleukin-8 concentrations are increased in obese subjects and related to fat mass and tumor necrosis factor-α system.
        J Clin Endocrinol Metab. 2002; 87: 4602-4606
        • Kromann CB
        • Ibler KS
        • Kristiansen VB
        • Jemec GBE.
        The influence of body weight on the prevalence and severity of hidradenitis suppurativa.
        Acta Derm Venereol. 2014; 94: 553-557
        • Golbari NM
        • Porter ML
        • Kimball AB.
        Antiandrogen therapy with spironolactone for the treatment of hidradenitis suppurativa.
        J Am Acad Dermatol. 2019; 80: 114-119
        • Randhawa HK
        • Hamilton J
        • Pope E.
        Finasteride for the treatment of hidradenitis suppurativa in children and adolescents.
        JAMA Dermatol. 2013; 149: 732-735
        • Joseph MA
        • Jayaseelan E
        • Ganapathi B
        • Stephen J.
        Hidradenitis suppurativa treated with finasteride.
        J Dermatol Treat. 2005; 16: 75-78
        • Gallagher C
        • Kirthi S
        • Burke T
        • O'Shea D
        • Tobin AM
        Remission of hidradenitis suppurativa after bariatric surgery.
        JAAD Case Rep. 2017; 3: 436-437
        • Boer J.
        Resolution of hidradenitis suppurativa after weight loss by dietary measures, especially on frictional locations.
        J Eur Acad Dermatol Venereol. 2016; 30: 895-896
        • Thomas CL
        • Gordon KD
        • Mortimer PS.
        Rapid resolution of hidradenitis suppurativa after bariatric surgical intervention.
        Clin Exp Dermatol. 2014; 39: 315-318
        • William Danby F
        Diet in the prevention of hidradenitis suppurativa (acne inversa).
        J Am Acad Dermatol. 2015; 73: S52-S54
        • Barrea L
        • Fabbrocini G
        • Annunziata G
        • et al.
        Role of nutrition and adherence to the mediterranean diet in the multidisciplinary approach of hidradenitis suppurativa: evaluation of nutritional status and its association with severity of disease.
        Nutrients. 2019; 11: 57
        • Kurzen H
        • Kurzen M.
        Secondary prevention of hidradenitis suppurativa.
        Dermatol Rep. 2019; 11: 32-36
        • Cannistrà C
        • Finocchi V
        • Trivisonno A
        • Tambasco D.
        New perspectives in the treatment of hidradenitis suppurativa: surgery and brewer's yeast-exclusion diet.
        Surgery. 2013; 154: 1126-1130
        • Aboud C
        • Zamaria N
        • Cannistrà C.
        Treatment of hidradenitis suppurativa: surgery and yeast (Saccharomyces cerevisiae)–exclusion diet. Results after 6 years.
        Surgery. 2020; 167: 1012-1015
        • Colboc H
        • Fite C
        • Cannistrà C
        • et al.
        Interest of brewer’s yeast-exclusion diet in the management of hidradenitis suppurativa.
        J Clin Exp Dermatol Res. 2016; 7: 1-7
        • Alikhan A
        • Sayed C
        • Alavi A
        • et al.
        North American clinical management guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations: part I: diagnosis, evaluation, and the use of complementary and procedural management.
        J Am Acad Dermatol. 2019; 81: 76-90
        • Poveda I
        • Vilarrasa E
        • Martorell A
        • et al.
        Serum zinc levels in hidradenitis suppurativa: a case–control study.
        Am J Clin Dermatol. 2018; 19: 771-777
        • Hessam S
        • Sand M
        • Meier NM
        • Gambichler T
        • Scholl L
        • Bechara FG.
        Combination of oral zinc gluconate and topical triclosan: an anti-inflammatory treatment modality for initial hidradenitis suppurativa.
        J Dermatol Sci. 2016; 84: 197-202
        • Brocard A
        • Knol AC
        • Khammari A
        • Dréno B.
        Hidradenitis suppurativa and zinc: a new therapeutic approach - A pilot study.
        Dermatol. 2007; 214: 325-327
        • Guillet A
        • Brocard A
        • Bach Ngohou K
        • et al.
        Verneuil's disease, innate immunity and vitamin D: a pilot study.
        J Eur Acad Dermatology Venereol. 2015; 29: 1347-1353
        • Ingram JR
        • Collier F
        • Brown D
        • et al.
        British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018.
        Br J Dermatol. 2019; 180: 1009-1017
        • Layton A.
        The use of isotretinoin in acne.
        Dermatoendocrinol. 2009; 1: 162-169
        • Colburn WA
        • Gibson DM
        • Wiens RE
        • Hanigan JJ.
        Food increases the bioavailability of isotretinoin.
        J Clin Pharmacol. 1983; 23: 534-539
        • Aktürk AŞ
        • Güzel S
        • Bulca S
        • et al.
        Effects of isotretinoin on serum vitamin E levels in patients with acne.
        Int J Dermatol. 2013; 52: 363-366
        • Besa EC
        • Abrahm JL
        • Bartholomew MJ
        • Hyzinski M
        • Nowell PC.
        Treatment with 13-cis-retinoic acid in transfusion-dependent patients with myelodysplastic syndrome and decreased toxicity with addition of alpha-tocopherol.
        Am J Med. 1990; 89: 739-747
        • Dimery IW
        • Hong WK
        • Lee JJ
        • et al.
        Phase I trial of alpha-tocopherol effects on 13-cis-retinoic acid toxicity.
        Ann Oncol. 1997; 8: 85-89
        • Strauss JS
        • Gottlieb AB
        • Jones T
        • et al.
        Concolmitant admmistration of vitamin E does not change the side effects of isotretinoin as used in acne vulgaris: a randomized trial.
        J Am Acad Dermatol. 2000; 43: 777-784
        • Kus S
        • Gun D
        • Demircay Z
        • Sur H.
        Vitamin E does not reduce the side-effects of isotretinoin in the treatment of acne vulgaris.
        Int J Dermatol. 2005; 44: 248-251