THE ROLE OF DIET IN THE PATHOGENESIS AND TREATMENT OF ACNE VULGARIS

Paulina Sadkowska; Weronika Popow; Katarzyna Jania; Tomasz Antczak; Monika Gajda-Bathelt; Monika Dąbek; Zuzanna Perlicka; Karolina Smolińska; Julia Kulczycka; Michał Ciołkosz

doi:10.31435/ijitss.3(47).2025.3522

Paulina Sadkowska Samodzielny Publiczny Zespół Zakładów Opieki Zdrowotnej w Kozienicach, Aleja Generała Władysława Sikorskiego 10, 26-900 Kozienice, Poland https://orcid.org/0009-0000-7409-2460
Weronika Popow ORLIK Medical Clinic Sp. z.o.o., Motorowa 6, 04-041 Warszawa, Poland https://orcid.org/0009-0005-6680-0750
Katarzyna Jania Powiatowe Centrum Zdrowia w Otwocku Sp. z.o.o., Batorego 44, 05-400 Otwock, Poland https://orcid.org/0009-0004-4399-1016
Tomasz Antczak Warsaw Medical University, Poland https://orcid.org/0009-0006-3407-0981
Monika Gajda-Bathelt Beskid Oncology Center - Municipal Hospital of John Paul II in Bielsko-Biała, Wyzwolenia 18, 43-300 Bielsko-Biała, Poland https://orcid.org/0009-0006-6231-607X
Monika Dąbek Mazovia Rehabilitation Center STOCER Włodzimierz Roefler Hospital, Warsztatowa 1, 05-800 Pruszków, Poland https://orcid.org/0009-0008-4403-556X
Zuzanna Perlicka Beskid Oncology Center - Municipal Hospital of John Paul II in Bielsko-Biała, Wyzwolenia 18, 43-300 Bielsko-Biała, Poland https://orcid.org/0009-0000-6153-7299
Karolina Smolińska University Clinical Centre of the Medical University of Warsaw, The Infant Jesus Clinical Hospital Lindleya 4, 02-005 Warszawa, Poland https://orcid.org/0009-0001-4115-0297
Julia Kulczycka Mazovia Rehabilitation Center STOCER Włodzimierz Roefler Hospital, Warsztatowa 1, 05-800 Pruszków, Poland https://orcid.org/0009-0009-9624-8273
Michał Ciołkosz Czerniakowski Hospital, Stępińska 19/25, 00-739 Warszawa, Poland https://orcid.org/0009-0008-7330-7069

DOI: https://doi.org/10.31435/ijitss.3(47).2025.3522

Keywords: Acne Vulgaris, Inflammatory Skin Diseases, Glycemic Index, Comedogenesis, Sebum Production, Nutritional Dermatology

Abstract

Background: Acne vulgaris is a common chronic inflammatory skin condition affecting the pilosebaceous unit. Although hormonal factors are well-recognized in its pathophysiology, emerging evidence suggests that dietary factors may influence the onset, severity, and progression of acne.

Objective: This review aims to evaluate the current literature on the role of diet in acne vulgaris, focusing on specific dietary components that may exacerbate or alleviate the condition.

Methods: A literature review was conducted to examine the relationship between dietary patterns—including glycemic index, dairy intake, dietary fats, and micronutrients—and acne pathogenesis. The biological mechanisms through which these factors may influence sebaceous activity, inflammation, and hormonal regulation were also explored. Databases such as PubMed and Google Scholar were searched using the following terms: “acne vulgaris,” “IGF-1 and acne,” “mTORC1 acne pathway,” and “inflammatory skin diseases.” Studies were selected based on their relevance to dietary modulation of acne pathophysiology, mechanistic insights, and clinical outcomes.

Results: High-glycemic index diets, dairy consumption, and saturated and trans fats have been associated with increased acne severity, potentially through the stimulation of insulin and IGF-1 (nsulin-like growth factor-1) pathways, activation of mTORC1, and upregulation of sebum production. Conversely, diets low in glycemic load and rich in omega-3 fatty acids may have protective effects by reducing inflammation and normalizing sebaceous gland activity.

Conclusion: Diet appears to play a significant role in acne pathophysiology through various hormonal and inflammatory mechanisms. While further large-scale and controlled studies are needed, dietary modification may serve as a useful adjunct in acne management.

References

Adebamowo, C.A. et al.. (2004) 'High school dietary dairy intake and teenage acne,' Journal of the American Academy of Dermatology, 52(2), pp. 207–214. https://doi.org/10.1016/j.jaad.2004.08.007.

Baldwin, H. and Tan, J. (2020) 'Effects of diet on acne and its response to treatment,' American Journal of Clinical Dermatology, 22(1), pp. 55–65. https://doi.org/10.1007/s40257-020-00542-y.

Barclay, A.W. et al.. (2021) 'Dietary Glycaemic Index Labelling: A Global Perspective,' Nutrients, 13(9), p. 3244. https://doi.org/10.3390/nu13093244.

Bhate, K. and Williams, H.C. (2012) 'Epidemiology of acne vulgaris,' British Journal of Dermatology, 168(3), pp. 474–485. https://doi.org/10.1111/bjd.12149.

Burris, J. et al.. (2018) '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,' Journal of the Academy of Nutrition and Dietetics, 118(10), pp. 1874–1885. https://doi.org/10.1016/j.jand.2018.02.009.

Burris, J., Rietkerk, W. and Woolf, K. (2014) 'Relationships of Self-Reported Dietary Factors and Perceived acne severity in a cohort of New York young adults,' Journal of the Academy of Nutrition and Dietetics, 114(3), pp. 384–392. https://doi.org/10.1016/j.jand.2013.11.010.

Cava, E. et al.. (2024) 'Investigating the health implications of whey protein consumption: A narrative review of risks, adverse effects, and associated health issues,' Healthcare, 12(2), p. 246. https://doi.org/10.3390/healthcare12020246.

Claudel, J.P. et al.. (2018) 'Acne and nutrition: hypotheses, myths and facts,' Journal of the European Academy of Dermatology and Venereology, 32(10), pp. 1631–1637. https://doi.org/10.1111/jdv.14998.

Dall’Oglio, F. et al.. (2021) 'Diet and acne: review of the evidence from 2009 to 2020,' International Journal of Dermatology, 60(6), pp. 672–685. https://doi.org/10.1111/ijd.15390.

Deplewski, D. and Rosenfield, R.L. (1999) 'Growth hormone and Insulin-Like growth factors have different effects on sebaceous cell growth and differentiation1,' Endocrinology, 140(9), pp. 4089–4094. https://doi.org/10.1210/endo.140.9.6957.

Guertler, A. et al.. (2024) 'Deficit of omega-3 fatty acids in acne Patients—A Cross-Sectional pilot study in a German cohort,' Life, 14(4), p. 519. https://doi.org/10.3390/life14040519.

Heng, A.H.S. and Chew, F.T. (2020) 'Systematic review of the epidemiology of acne vulgaris,' Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-62715-3.

Juhl, C.R. et al.. (2018) 'Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 children, adolescents, and Young adults,' Nutrients, 10(8), p. 1049. https://doi.org/10.3390/nu10081049.

Jung, J. et al.. (2014) 'Effect of Dietary Supplementation with Omega-3 Fatty Acid and Gamma-linolenic Acid on Acne Vulgaris: A Randomised, Double-blind, Controlled Trial,' Acta Dermato Venereologica, 94(5), pp. 521–525. https://doi.org/10.2340/00015555-1802.

Kim, H. et al.. (2017) 'Insulin-Like growth factor-1 increases the expression of inflammatory biomarkers and sebum production in cultured sebocytes,' Annals of Dermatology, 29(1), p. 20. https://doi.org/10.5021/ad.2017.29.1.20.

Kwon, H. et al.. (2012) 'Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial,' Acta Dermato Venereologica, 92(3), pp. 241–246. https://doi.org/10.2340/00015555-1346.

LaRosa, C.L. et al.. (2016) 'Consumption of dairy in teenagers with and without acne,' Journal of the American Academy of Dermatology, 75(2), pp. 318–322. https://doi.org/10.1016/j.jaad.2016.04.030.

Liu, M. et al.. (2025) 'The role of lipid metabolism in acne risk: integrating blood metabolite and genetic insights,' Skin Health and Disease [Preprint]. https://doi.org/10.1093/skinhd/vzae009.

Makrantonaki, E. et al.. (2008) 'Interplay of IGF-I and 17β-estradiol at age-specific levels in human sebocytes and fibroblasts in vitro,' Experimental Gerontology, 43(10), pp. 939–946. https://doi.org/10.1016/j.exger.2008.07.005.

Makrantonaki, E., Ganceviciene, R. and Zouboulis, C.C. (2011) 'An update on the role of the sebaceous gland in the pathogenesis of acne,' Dermato-Endocrinology, 3(1), pp. 41–49. https://doi.org/10.4161/derm.3.1.13900.

Meixiong, J. et al.. (2022) 'Diet and acne: A systematic review,' JAAD International, 7, pp. 95–112. https://doi.org/10.1016/j.jdin.2022.02.012.

Melnik, B. (2015) 'Linking diet to acne metabolomics, inflammation, and comedogenesis: an update,' Clinical Cosmetic and Investigational Dermatology, p. 371. https://doi.org/10.2147/ccid.s69135.

Melnik, B.C. and Schmitz, G. (2009) 'Role of insulin, insulin‐like growth factor‐1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris,' Experimental Dermatology, 18(10), pp. 833–841. https://doi.org/10.1111/j.1600-0625.2009.00924.x.

Mirnezami, M. and Rahimi, H. (2018) 'Is Oral Omega-3 Effective in Reducing Mucocutaneous Side Effects of Isotretinoin in Patients with Acne Vulgaris?,' Dermatology Research and Practice, 2018, pp. 1–4. https://doi.org/10.1155/2018/6974045.

Penso, L. et al.. (2020) 'Association between adult acne and dietary behaviors,' JAMA Dermatology, 156(8), p. 854. https://doi.org/10.1001/jamadermatol.2020.1602.

Podgórska, A. et al.. (2021) 'Acne vulgaris and intake of Selected Dietary Nutrients—A summary of information,' Healthcare, 9(6), p. 668. https://doi.org/10.3390/healthcare9060668.

Ryguła, I., Pikiewicz, W. and Kaminiów, K. (2024) 'Impact of Diet and Nutrition in Patients with Acne Vulgaris,' Nutrients, 16(10), p. 1476. https://doi.org/10.3390/nu16101476.

Smith, R.N. et al.. (2007) '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,' Journal of the American Academy of Dermatology, 57(2), pp. 247–256. https://doi.org/10.1016/j.jaad.2007.01.046.

Smith, R.N. et al.. (2008) 'The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides,' Journal of Dermatological Science, 50(1), pp. 41–52. https://doi.org/10.1016/j.jdermsci.2007.11.005.

Tan, A.U., Schlosser, B.J. and Paller, A.S. (2017) 'A review of diagnosis and treatment of acne in adult female patients,' International Journal of Women’s Dermatology, 4(2), pp. 56–71. https://doi.org/10.1016/j.ijwd.2017.10.006.

Vasam, M., Korutla, S. and Bohara, R.A. (2023) 'Acne vulgaris: A review of the pathophysiology, treatment, and recent nanotechnology based advances,' Biochemistry and Biophysics Reports, 36, p. 101578. https://doi.org/10.1016/j.bbrep.2023.101578.

Williams, H.C., Dellavalle, R.P. and Garner, S. (2011) 'Acne vulgaris,' The Lancet, 379(9813), pp. 361–372. https://doi.org/10.1016/s0140-6736(11)60321-8.

Wu, W. et al.. (2020) 'Targeting gut Microbiota Dysbiosis: Potential intervention Strategies for Neurological Disorders,' Engineering, 6(4), pp. 415–423. https://doi.org/10.1016/j.eng.2019.07.026.

Zaenglein, A.L. (2018) 'Acne vulgaris,' New England Journal of Medicine, 379(14), pp. 1343–1352. https://doi.org/10.1056/nejmcp1702493.

Zouboulis, C.C. (2020) 'Endocrinology and immunology of acne: Two sides of the same coin,' Experimental Dermatology, 29(9), pp. 840–859. https://doi.org/10.1111/exd.14172.

THE ROLE OF DIET IN THE PATHOGENESIS AND TREATMENT OF ACNE VULGARIS

Abstract

References

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