The Role of Nutrition in Acne

BELU Ionela1, NICOLAESCU Oana Elena1, MOCANU Andreea Gabriela1

1 Pharmacy Department I, University of Medicine and Pharmacy, 2-4 Petru Rares Str., 200349 Craiova, (ROMANIA)

ionela.belu@umfcv.ro, oana.nicolaescu@umfcv.ro,  gabriela.mocanu@umfcv.ro, 

Abstract

Acne vulgaris is a chronic inflammatory condition that has a high prevalence among adolescents. Acne directly affects self-image in adolescents, thus impacting their quality of life. Furthermore, patients with acne may feel shame and have low self-esteem, anxiety, depression and even suicidal thoughts.

Several foods such as refined carbohydrates, milk product, soy and processed grains have been reported to produce a negative impact in acne. Contrarily, vitamins have anti-inflammatory effects and reduce premature cell senescence, thus improving skin rashes and acne inflammation.

Furthermore, goji berries contain the entire range of nutrients and may benefit patients with acne. Therefore, counseling acne patients regarding their diet may lead to a better management.

Keywords: acne vulgaris, testosterone, nutrition, diet, saw palmetto, burdock root, inflammation, vitamins

Introduction

Acne is a skin disease with a high prevalence in adolescents. It affects 9.4% of the world’s population [1]. Not only adolescents but all age groups may be affected. Acne vulgaris is a chronic inflammatory condition that impacts the pilosebaceous follicles. It is mainly located to the face and neck areas but it can also appear on the anterior thorax and upper back. Acne manifests with the emergence of both non-inflammatory lesions specifically microcomedones, open comedones and closed comedones and inflammatory lesions such as papules, pustules and nodules.

Neonatal acne appears as a result of a transplacental transfer of maternal androgens. It is characterized by the appearance of inflammatory comedones on nose and cheeks. Newborn babies between 1 and 6 weeks are affected. Infantile acne appears more frequently in boys rather than girls, aged 3-6 months. Furthermore, 85% of the teenagers have been affected by acne outbursts. These out-burst usually end with adolescence, but in a number of cases acne can manifest in adults. Acne has a higher incidence in adolescent boys rather than girls, but the ratio is inversed in adults [2].

Acne has a high psychosocial impact as it may be associated with emotional scars (anxiety and depression episodes). Both psyche and social life may be disturbed, thus the mental health of the patient may be affected. Furthermore, a study conducted on 82 subjects, aged 14-30 years, reported an anxiety prevalence of 68.3% in acne patients [3]. In addition, an Iranian study reported that the quality of life for 51.8% of the participants was affected by acne [4].

Acne is included in the first 5 skin diseases causing social stigma and the first 10 diseases that attract discrimination. Acne is also listed as a chronic condition by the World Health Organization due to its specific clinical characteristics. Therefore, researchers in the healthcare and pharma domains are committed to finding the best therapies in order to help acne patients.

Diet and acne

Researchers have been focused on determining the association between various foods such as sugar, refined carbohydrates, milk product and acne outbursts as well as the effectiveness of some nutrients in acne treatment [5].

Sugar modifies hormonal concentrations in the body. A high testosterone level is linked to acne.

Flour, white rice and also processed grains accelerate acne outbursts. Therefore nutritionists recommend foods with a low glycemic index.

Soy may disrupt the hormonal balance because its containing phytoestrogens act as natural estrogens when ingested. Therefore soy should be avoided by persons prone to acne.

Peanuts and peanut butter may precipitate acne because they contain an antinutrient, lectin, which triggers inflammation. Furthermore they are high in another proinflammatory molecule, omega 6 fatty acids.

Raw nuts such as cashew or almonds are recommended in acne because they do not modify androgen levels.

Milk products are often considered acne triggers due to their chemical concentration and high hormone levels. Milk raises the level of insulin like growth factor 1 (IGF-1) leading to earlier onset of puberty and increased sebum production. Furthermore, a persistence of acne in the third decade of life has been observed in milk consuming populations. An US study showed that at least 75% of commercial milk and milk product are obtained from pregnant cows, therefore they are high in dihydrotestosterone (DHT) precursors [6,7,8,9,19].

The consumption of water and water rich foods increases the skin hydration degree.

Vitamins

Spinach and green leafy vegetables that include scallion and arugula are rich in vitamin B complex and vitamin E. Their consumption improves skin health as they have an anti-inflammatory effect in acne and, moreover, certain proteins help restore collagen in the epidermis.

Pumpkin, sweet potatoes, and carrots are sources high in antioxidants, specifically beta-carotene also known as provitamin A. Beta-carotene has several effects such as reducing skin rashes and acne inflammation, slowing the corneal thinning process and alleviating cornea opacity, decreasing premature cell senescence, thus, improving skin and mucosa health.

Vitamin C also plays an important role in improving skin texture. Excellent sources of vitamin C are represented by: oranges, limes, lemons, carrots, tomatoes, spinach, arugula, zucchini, apples, raw dandelion greens [10]. Marine collagen, honey and Acer pseudopla tanus Seed Oil also has beneficial effects in acne [11,12,13,20].

Saw palmetto

Serenoa Repens commonly known as saw palmetto is a small palm similar to palm tree. It is endemic to North America and it was used by the Indigenous people of the Americas to treat urinary tract infections. Saw palmetto was highly studied in recent years for its anti-androgen effect. It has a high concentration of fatty acids, sterols, volatile oils, polysaccharides and phytosterols. Researchers found that saw palmetto extract blocks dihydrotestosterone. DHT is the active metabolite of testosterone which favors prostate growth, alopecia and acne. Saw palmetto extract also acts as an androgen receptor antagonist, blocking receptors located in hair follicles.

Moreover, it acts as an inhibitor for forms I and II of 5 alpha reductase.

Therefore, it is used to treat acne, prostate disorders and alopecia [14, 15].

Goji berries

Goji berries are high in amino acids (tryptophan and isoleucine), minerals (zinc, calcium, selenium, copper, phosphorus), beta-carotene (a higher concentration compared to carrots), vitamin B complex, vitamin E as well as a higher vitamin C concentration than found in oranges. Goji berries represent a source of all the nutrients required for a balanced diet which may benefit the patient with acne [16].

Burdock root

Burdock root contains polysaccharides (inulin), polyenes, sesquiterpene lactones, triterpenes, caffeic acid derivatives, tannins, mucilages and phytosterols. It helps restore the skin’s normal state. It is a bacteriostatic agent. Furthermore, it also has anti-inflammatory, antipruritic and trophic properties.

Thus, it is used to treat acne, seborrhea and furunculosis. [17,18].

Conclusions

In conclusion, both the treatment of papules and pustules as well as avoiding depressive episodes are equally important in acne patients. The topical treatment for acne recommended by the physician may be accompanied by an adequate diet.

Therefore, foods such as flour, sugar, white rice, soy or milk products should be avoided whereas products high in vitamins are recommended as they play an important role in reducing skin rashes and acne inflammation.

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