Diet and acne: review of the evidence from 2009 to 2020

A cross-sectional, community-based study was performed to determine the prevalence and severity of acne vulgaris in adolescents and of factors influencing the acne severity risk. The presence of acne was clinically determined and the secondary outcome measures of family acne history and the relation of acne to nutrition habits, emotional stress, menstruation, and smoking were recorded in a questionnaire. A representative sample of 1,002 pupils aged 16+/-0.9 years was enrolled. The overall acne prevalence was 93.3, 94.4% for boys and 92.0% for girls. Moderate to severe acne was observed in 14%. The prevalence of moderate to severe acne was 19.9% in pupils with and 9.8% in those without a family history of acne (P<0.0005; OR: 2.3). Acne severity risk increased with the number of family members with acne history. A mother with acne history influenced the severity of acne the most. Increasing pubertal age, seborrhea, the premenstrual phase, mental stress, and sweet and oily foods were recognized as risk factors for moderate to severe acne. In contrast, gender, spicy foods, and smoking were not associated with acne severity. In conclusion, acne is a common disorder in Iranian adolescents, with a low rate of moderate to severe acne. A genetic background is suggested, with mother's acne history being the most important prognostic factor. Skin quality and certain nutrition habits may affect acne severity.

We sought to examine the association between dietary dairy intake and teenaged acne among boys. This was a prospective cohort study. We studied 4273 boys, members of a prospective cohort study of youths and of lifestyle factors, who reported dietary intake on up to 3 food frequency questionnaires from 1996 to 1998 and teenaged acne in 1999. We computed multivariate prevalence ratios and 95% confidence intervals for acne. After adjusting for age at baseline, height, and energy intake, the multivariate prevalence ratios (95% confidence interval; P value for test of trend) for acne comparing highest (>2 servings/d) with lowest (<1/wk) intake categories in 1996 were 1.16 (1.01, 1.34; 0.77) for total milk, 1.10 (0.94, 1.28; 0.83) for whole/2% milk, 1.17 (0.99, 1.39; 0.08) for low-fat (1%) milk, and 1.19 (1.01, 1.40; 0.02) for skim milk. Not all members of the cohort responded to the questionnaire. Acne assessment was by self-report and boys whose symptoms might have been part of an underlying disorder were not excluded. We did not adjust for steroid use and other lifestyle factors that may affect occurrence of acne. We found a positive association between intake of skim milk and acne. This finding suggests that skim milk contains hormonal constituents, or factors that influence endogenous hormones, in sufficient quantities to have biological effects in consumers.