Dermatology Online Journal

The relationship of diet and acne
Barbara Burrall MD
Dermatology Online Journal 12 (4): 25

Department of Dermatology, University of California Davis

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Questions concerning the relationship of diet and acne are some of the most common ones that dermatologists hear during outpatient work. How many times have mothers looked at us expectantly, hoping that we will tell their teenager to avoid all sodas, potato chips, or pizza (only to be disappointed)? Now must we tell them to avoid milk, the one thing they were probably consuming with full parental approval? It is fascinating that acne afflicts 79-95 percent of western adolescents and yet teens from two remote societies have been shown to have no acne at all [1]. Yet these societies differ from ours in so many ways that one cannot really conclude that diet is the predominant difference affecting acne incidence. Dietary influences must be evaluated, but these studies are very difficult. Retrospective studies that require participants to remember what they have eaten are fraught with the same problems as those evaluating skin cancer and the use of sunscreen. The preceding study by Adebamowo et al. is an important move in the right direction. This prospective study does, however, rely on a questionnaire regarding the usual diet over the preceding year. Milk products are nearly ubiquitous additives in processed foods, even those that put "soy" in the title. In addition, could acne sufferers be drowning their sorrows in milk and ice cream as a result of their acne? The study also relies upon patient self-evaluation of whether they sometimes have a few pimples or usually have pimples. Patients have different definitions of "pimples." Some consider comedones to be pimples and some would count only inflammatory lesions. Nevertheless, the patient sample is large, the information gathered has been thoroughly evaluated, and a sincere attempt was made to assess confounding factors. A small but highly significant increase in acne and acne severity was discerned in frequent milk drinkers. Additional prospective studies are required. Perhaps a design with dermatologist evaluations of acne over 3-6 months in patients on different pre-packaged diets would be a start. No doubt, students could easily be recruited for the free food.

References

1. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002 Dec;138(12):1584-90. PubMed

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