Acne is the most common skin disorder world-wide. It is considered to be a disease of western civilization with the typical Western diet playing an important role in its development and severity.
A high intake of sugar that's often hidden in industrial foods, the consumption of processed meals, and large amounts of pasteurized milk and dairy products can promote acne. These dietary components can cause a significant release of insulin and insulin-like growth factor (IGF-1). This promotes signaling pathways that increase the skin's oil production and induce the release of inflammatory mediators, leading to acne outbreaks.
Dietary changes with potentially preventive and therapeutic effects are currently being investigated in clinical trials as a complementary measure for pharmacotherapy. Omega-3 fatty acids (ω-3 FA) appear most promising due to their anti-inflammatory effects. ω-3 FA can be found in linseed oil, walnuts, algae, and seeds – particularly chia seeds, hemp seeds, and coarsely ground linseeds.
Probiotics are also being studied as an adjunctive option, due to their regulating effects on the gut and skin microbiota. Probiotics are defined as living organisms with a beneficial health effect, including lactobacillus bacteria. Fermented foods such as sauerkraut, kimchi, miso and kombucha naturally contain probiotics and are a great addition to a varied diet.
As a basic principle, nutritional recommendations should not focus on single foods nor “superfoods”, but rather, promote a long-term and sustainable lifestyle that incorporates plant-derived, unprocessed, and seasonal nutrients.
When it comes to both skin health and our overall health, we need more unprocessed foods (i.e. food without ingredient labels), whole grains, omega-3 fatty acids (e.g. algae, nuts, seeds, and avocado), and more seasonal fruit and vegetables (especially legumes and pulses). We need less industrial, highly processed, hyperglycemic foods, white flour products, fast food/deep-fried foods, and pasteurized milk and dairy proteins.
Tan, J.K. & Bhate, K. A global perspective on the epidemiology of acne. Br J Dermatol 172 Suppl 1, 3-12 (2015).
Cordain, L., et al. Acne vulgaris: a disease of Western civilization. Arch Dermatol 138, 1584-1590 (2002).
Melnik, B.C. Acne vulgaris: The metabolic syndrome of the pilosebaceous follicle. Clin Dermatol 36, 29-40 (2018).
Baldwin, H. & Tan, J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol 22, 55-65 (2021).
Gurtler, A. & Laurenz, S. The impact of clinical nutrition on inflammatory skin diseases. J Dtsch Dermatol Ges 20, 185-202
Guertler, A., et al. Clinical effects of omega-3 fatty acids on acne vulgaris. J Dtsch Dermatol Ges (2022).
Yu, Y., Dunaway, S., Champer, J., Kim, J. & Alikhan, A. Changing our microbiome: probiotics in dermatology. Br J Dermatol
182, 39-46 (2020).