Is there a relationship between acne and diet?

Acne is one of the most common dermatological conditions. Millions of young adults worldwide suffer from this. It is generally believed that excess amounts of sebum, hormones and bacteria, along with skin cell buildup, are the main causative factors for acne. But what about nutrition?

Nutrition and diet have a major impact on general health, but can diet also affect acne?

At the moment there is still a lot of discussion about the relationship between diet and acne. However, an association between the two cases has been established.

Vitamins: inhibitory effect on acne?

Vitamin A (retinol) plays a very important role in skin health. This nutrient, which is stored in the liver, is also found in the skin. Particularly in the sebaceous glands, where retinoid receptors are also found. Furthermore, vitamins A and D have an important influence on the skin cells (keratinocytes), which is also crucial for acne. There are indications that vitamins A and D have an inhibitory effect on acne.

Vitamin E, the other major lipophilic vitamin, enters the skin through the sebaceous gland. This supply of sebum can make a difference in acne, reducing the inflammation of this condition.

Fatty acids: precursors of omega 6 and 3

As with vitamins, there are two fatty acids that cannot be synthesized in our bodies by human cells: linoleic acid and alpha-linolenic acid (αLA). These are important nutritional values ​​that must be obtained through the diet. They are therefore also called essential fatty acids. These two essential nutrients are precursors of the omega-6 and omega-3 fatty acid families, respectively. These nutrients are involved in several important physiological processes, including inflammation. We can therefore safely assume that the absence of these important nutrients in our diet has important implications for both acne and our overall health.

Deficiencies of omega-3

Western diets are often deficient in omega-3 and its precursor, αLA. In a typical Western diet, the ratio of omega-6 to omega-3 fatty acids can be as high as 10:1 to 20:1, compared to a ratio of 3:1 to 2:1 in non-Western diets or non-industrialized peoples .
Omega-6 fatty acids are thought to induce more inflammatory mediators. They are therefore associated with the development of acne. On the other hand, the intake of high amounts of omega-3 fatty acids is associated with the reduction of inflammatory factors.

Dry, itchy skin due to a lack of fatty acids

Several studies have already shown that clinical imbalances of specific essential fatty acids are associated with various skin problems. Dry, itchy and scaly skin is therefore a characteristic of a deficiency of fatty acids. What matters more to us, however, is a publication suggesting that the sebum of acne patients contains relatively little linoleic acid. More about dry skin

Part of the skin’s own ceramides

The precise purpose of these essential nutrients in human sebaceous cells is not yet fully understood. However, there is substantial evidence that linoleic acid is an essential structural component of skin ceramides, which are important for barrier function.

In a very recent nutritional study, two groups of women were given linseed oil or borage oil for twelve weeks. This showed that a daily intake of 2.2g αLA and linoleic acid or 2.2g linoleic acid and γ-linoleic acid provided a number of skin benefits. Skin irritation, redness and blood flow were reduced in both groups compared to the placebo group. This provides an important clue to the theory that skin features can be modulated through the intervention of dietary fats.

Milk and dairy products, causative agents of comedones

Recent studies have also shown a positive association between milk intake and acne. This suggests that milk consumption may alter insulin production. The most likely cause of this possible comedogenic effect of milk and dairy products is the production of hormones by cows.

The role of growth factors

It is believed that the constituent of milk that stimulates the sebaceous gland is the insulin-like growth factor 1 (IGF-1). The level of insulin-like growth factor 1 rises during puberty under the influence of growth hormone and correlates positively with the clinical course of acne.

Cow hormones stimulate sebum production and thicken the skin, blocking the sebaceous gland outlet

The milk on the shelves is not only rich in progesterone from the placenta, but also in other precursors of dihydrotestosterone (DHT), such as 5α-pregnanediol and 5α-androstanediol. Both testosterone precursors and 5α-reduced molecules likely contribute to the comedogenicity of milk. They stimulate sebum production and cause hyperkeratinization of the sebaceous gland duct.

Carbohydrate-rich food increases insulin level and thus indirectly also sebum production

A diet’s glycemic load (measures the amount of carbohydrates per serving — 10 or less is low and more than 20 is high) and glycemic index (an evaluation of how slowly or how quickly foods raise blood sugar levels) may contribute to the generation of acne vulgaris. The most vulnerable is the consumption of products based on high values. A diet based on products with a high glycemic index leads to hyperinsulinemia. An elevated insulin level stimulates the secretion of androgens and causes increased sebum production, which plays a fundamental role in causing acne vulgaris.

Relationship with increased production of male hormones: androgynes

Researchers Smith et al have studied glycemic load, insulin sensitivity, hormonal mediators and acne. They found that foods with a high glycemic index may contribute to acne by increasing serum insulin levels, suppressing levels of sex hormone binding globulin (SHBG), and increasing androgen levels. On the other hand, products with a low glycemic index increase SHBG levels and decrease androgen levels – this is important, as higher SHBG levels have been associated with less severe acne.

Insulin and the high glycemic index are perhaps the two most commonly associated factors with acne on a scientific and clinical level.

Supplements: zinc is useful

Zinc is a micronutrient essential for the development and functioning of human skin. It has been shown to be bacteriostatic against Propionibacterium acne, to counteract chemotaxis and to reduce the production of the inflammatory cytokine, tumor necrosis factor α (TNF-α). Because zinc reduces the absorption of copper, copper supplementation is recommended in patients with a chronic zinc deficiency.

Chocolate: no proof

Finally, we want to focus on the current state of chocolate. Chocolate has always been seen as a contributing factor to the spread of acne. However, studies on the effect of chocolate on the skin condition are controversial and inaccurate due to the additional ingredients such as milk and sugar in bars and other chocolate products.

The influence of diet on the severity of acne vulgaris is subject to much research, but it can no longer remain dermatological dogma to claim that any association between diet and acne is a myth.

This article was also posted on Beautyjournaal.nl.