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Acne Vulgaris

Common condition characterized by Follicular papules or

comedones Inflammatory

papules & pustules

Severe cases Nodules & scarring

may occur

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Acne Vulgaris

Factors that contribute to the pathogenesis of acne include Infection with Propionibacterium acnes Tissue inflammation Plugging of hair follicles as a result of

epidermal hyper-proliferation Hormonal imbalances

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Conventional Therapies

Topical treatments (e.g., retinoids,

antibiotics, or benzoyl peroxide)

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Conventional Therapies

Systemic medications (e.g., antibiotics, oral contraceptives,

Isotretinoin [13-cis-retinoic acid]) Isotretinoin is highly effective for

patients with severe intractable acne Can cause many

adverse effects Teratogenic

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Dietary Factors Most

conventional texts & review articles Do not

consider diet to be an important factor in the etiology of acne

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Dietary Modificati

on

Can produce improvement or complete resolution of lesions Sizeable minority of patients

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Possible Role of Diet in the

Causation of Acne

Suggested by observations regarding Canadian Inuits (Eskimos) Prior to around 1950 – diet consisted

almost exclusively of fish & game with occasional vegetables & berries

After 1950 – changed to a typical Western diet Acne became common in

teenagers shortly after these dietary changes were made

Glickman FS, Silvers SH. Dietary factors in acne vulgaris. Arch Dermatol 1972; 106: 129.

Schaefer O. When the Eskimo comes to town. Nutr Today 1971 (Nov/Dec): 8-16.

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Refined Sugar

52 patients with acne assigned to consume Usual diet Restrict sugar intake by

Eliminating soft drinks, candy & cake Limiting sugar in coffee or tea to 2

teaspoons/day

Continued…

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Refined Sugar Substantial improvement or complete

clearing of lesions Seen in 84% of those consuming low-

sugar diet 74% of those in the control group

Results Consistent with the possibility that

reducing sugar intake is beneficial in some cases

Cornbleet T, Gigli I. Should we limit sugar in acne? Arch Dermatol 1961; 83: 968-969.

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Food Allergy/Sensitivity Numerous investigators have

reported Allergy or sensitivity to foods is a major

contributing factor in some cases of acne

Turnbull JA. Changes in the systems affected by allergenic foods. Am J Dig Dis 1944; 11: 329-336.

White C. Food sensitization dermatoses. J Allergy 1933; 4: 151-153.

Flood JM. The factor fo food allergy in acne. Penn Med J 1948; 51: 533-534.

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Food Allergy/Sensitivity Exacerbations of

acne could result from Allergenic reactions Effects of biologically

active substances in certain foods (e.g., hormones in

cow’s milk & possible amines or other chemicals in chocolate)

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Food Allergy/Sensitivity

Adult-onset acne Responds

more frequently to food elimination Vs. acne

that began during the teen years

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Food Allergy/Sensitivity Type of acne most likely to

respond to food elimination Characterized by delicate skin with

moderate degree of seborrhea & erythematous flares around pustular lesions

History of resistance to previous treatments

Cormia FE. Food sensitivity as a factor in the etiology of acne vulgaris. J Allergy 1940; 12: 34-41.

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Common symptom-evoking foods include Chocolate Milk Tomatoes Oranges Nuts Wheat Pork

Food Allergy/Sensitivity