Diet and acne: Facts and controversies

The role of diet and nutrition in acne pathogenesis has long been debated. Acne patients consistently report interest in how food may influence their disease, and observational studies have highlighted associations with high glycaemic load diets, skim/low-fat milk, whey protein supplements and an unbalanced omega-6/omega-3 fatty acid (FA) ratio. In this review, we discuss the potential role of diet on acne pathogenesis, including dairy, omega-3 FAs, low glycaemic load diet, vegan and Mediterranean diet. We present a comprehensive in-depth review of studies on diet in acne, provide insight into mechanistic pathways and share practical counselling strategies. There is a small number of controlled studies on dietary interventions for acne patients that are further hindered by the difficulty of controlling the various food components in everyday diets and the effect of body weight reduction with low glycaemic diets. According to current guidelines, further interventional studies are warranted to provide robust results on whether specific dietary modifications may be advised to acne patients. Although larger controlled trials are still needed, dermatologists can already provide relevant dietary information especially with the aim of balanced nutrition and healthy body weight while avoiding restrictive or potentially harmful regimens.