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Kim HJ, Kim YH. Exploring Acne Treatments: From Pathophysiological Mechanisms to Emerging Therapies. Int J Mol Sci 2024; 25:5302. [PMID: 38791344 PMCID: PMC11121268 DOI: 10.3390/ijms25105302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Acne vulgaris is a common dermatological condition that can present across different ages but predominantly affects adolescents and young adults. Characterized by various lesion types, the pathogenesis of acne is complex, involving genetic, hormonal, microbial, and inflammatory factors. This review comprehensively addresses current and emerging acne management strategies, emphasizing both topical and systemic treatments, procedural therapies, and dietary modifications. Key topical agents include retinoids, benzoyl peroxide, antibiotics, and other specialized compounds. Systemic options like antibiotics, hormonal therapies, and retinoids offer significant therapeutic benefits, particularly for moderate to severe cases. Procedural treatments such as laser devices, photodynamic therapy, chemical peels, and intralesional injections present viable alternatives for reducing acne symptoms and scarring. Emerging therapies focus on novel biologics, bacteriophages, probiotics, and peptides, providing promising future options. This review underscores the importance of personalized approaches to treatment due to the multifaceted nature of acne, highlighting the potential of innovative therapies for improving patient outcomes.
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Affiliation(s)
- Hyun Jee Kim
- Department of Dermatology, International St. Mary’s Hospital, College of Medicine, Catholic Kwandong University, Incheon 22711, Republic of Korea;
| | - Yeong Ho Kim
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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2
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Affiliation(s)
- James Meixiong
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cristina Ricco
- Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey
| | - Chirag Vasavda
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Byron K. Ho
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Correspondence to: Byron K. Ho, MD, Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, JHOC 8072, Baltimore, MD 21287.
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Bungau SG, Tit DM, Vesa CM, Abid A, Szilagyi DV, Radu AF, Bungau AF, Tarce AG, Behl T, Stoicescu M, Brisc CM, Gitea D, Nechifor AC, Endres L. Non-conventional therapeutical approaches to acne vulgaris related to its association with metabolic disorders. Eur J Pharmacol 2022; 923:174936. [PMID: 35378101 DOI: 10.1016/j.ejphar.2022.174936] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/12/2022] [Accepted: 03/30/2022] [Indexed: 12/31/2022]
Abstract
The ever-increasing frequency of metabolic syndrome (MetS) is still a major challenge of the public health care system, worldwide. In recent years, researchers have been drawn to the uncommon (at first look) link between skin illnesses and MetS. Because of the pro-inflammatory mechanisms and insulin resistance (IR) that are upregulated in metabolic syndrome, many skin disorders are correlated to metabolic dysfunctions, including acne vulgaris. A comprehensive understanding of the link between MetS and acne vulgaris may contribute to the development of new treatment strategies. The current review focuses on dietary and therapeutic interventions and assesses the effect of various approaches such as improving diet by avoiding certain food products (i.e., milk and chocolate) or increasing the intake of others (i.e., food products rich in omega-3 fatty acids), metformin administration, therapy with plant extracts, plant essential oils, and probiotic supplementation on the improvement of certain acne vulgaris severity parameters. These therapeutic approaches, when combined with allopathic treatment, can improve the patients' quality of life.
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Affiliation(s)
- Simona Gabriela Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania; Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania; Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Cosmin Mihai Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | - Areha Abid
- Department of Food and Bioproduct Science, College of Agriculture and Bioresources, University of Saskatchewan, Canada.
| | - Denisa-Viola Szilagyi
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Andrei-Flavius Radu
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087, Oradea, Romania.
| | - Alexa Florina Bungau
- Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | | | - Tapan Behl
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India.
| | - Manuela Stoicescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | - Cristina Mihaela Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
| | - Daniela Gitea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania.
| | - Aurelia Cristina Nechifor
- Analytical Chemistry and Environmental Engineering Department, University Politehnica of Bucharest, 011061, Bucharest, Romania.
| | - Laura Endres
- Department of Psycho-neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania.
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Akpinar Kara Y. Evaluation of serum insulin-like growth factor-1, insulin, glucose levels in patients with adolescent and post-adolescent acne. J Cosmet Dermatol 2021; 21:1292-1296. [PMID: 34197685 DOI: 10.1111/jocd.14327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES There are many endogenous and exogenous factors that cause acne formation. This study aimed to determine whether the acne severity in patients with various age ranges is associated with serum insulin-like growth factor, insulin, and glucose and to identify how much they affect the acne severity. MATERIALS AND METHODS In this case-control prospective study, 44 patients with acne vulgaris and 44 age- and gender-matched control subjects without acne were evaluated. Patients and the control group were divided into two age-groups as adolescence and post-adolescence. According to the Global Acne Scoring System (GASS) of the acne group, the acne score grades between 0 and 44 were calculated. The correlations between the IGF-1, insulin, glucose levels, and acne grades were calculated in each group. RESULTS In our study, the acne scores and serum IGF-1 levels were found to be significantly higher in patients under the age of 21 than patients over the age of 21. There was a statistically significant difference in acne score between the two groups. However, there was no statistically significant difference between the serum IGF-1, insulin, and glucose levels of the acne group and the control group. CONCLUSION In this study, it has been revealed that IGF-1 is effective at the pathogenesis of acne in adolescence.
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Say YH, Heng AHS, Reginald K, Wong YR, Teh KF, Rawanan Shah SM, Sio YY, Ng YT, Matta SA, Pang SL, Chew FT. Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study. BMC Public Health 2021; 21:601. [PMID: 33773591 PMCID: PMC8005239 DOI: 10.1186/s12889-021-10681-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese. Methods A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel. Results Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne. Conclusions In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10681-4.
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Affiliation(s)
- Yee-How Say
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Anna Hwee Sing Heng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Kavita Reginald
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Yi Ru Wong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Keng Foo Teh
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Smyrna Moti Rawanan Shah
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Yang Yie Sio
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Yu Ting Ng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Sri Anusha Matta
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Sze Lei Pang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore.
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Aktar R, Gunes Bilgili S, Yavuz IH, Ozaydin Yavuz G, Aktar S, Ozturk M, Karadağ AS. Evaluation of hirsutism and hormonal parameters in acne vulgaris patients treated with isotretinoin. Int J Clin Pract 2021; 75:e13791. [PMID: 33099851 DOI: 10.1111/ijcp.13791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Although the effect of isotretinoin use on hormonal changes in acne pathogenesis is not fully known, there are limited studies on its effects on the development of hirsutism. In this study, it was aimed to evaluate the effect of isotretinoin use on hirsutism and hormonal parameters in patients with acne vulgaris. METHODS In this study, 30 female acne patients and 30 healthy females were evaluated prospectively. Menstrual irregularity, LH, FSH, prolactin, progesterone, 17-OH progesterone, oestradiol, total testosterone, DHEA-S, insulin, glucose, TSH levels, Ferriman-Gallwey (FG) score and ultrasonography (USG) findings of control group and patient group were recorded. RESULTS Pre-treatment progesterone (P = .007) and oestradiol (P = .001) levels of the patients were statistically lower than the control group. In the patient group, menstrual irregularity (P < 001) and FG hirsutism score at the third month of treatment were significantly higher than before treatment. In 10% of the patients, there were abnormal findings on pelvic USG in the third month of treatment. CONCLUSION In our study, it could not be revealed that isotretinoin has a significant effect on pituitary, adrenal hormones and insulin resistance. We found that 3 months of isotretinoin treatment caused an increase in menstrual irregularity and FG hirsutism score.
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Affiliation(s)
- Rojda Aktar
- Department of Dermatology, Kahta State Hospital, Adiyaman, Turkey
| | - Serap Gunes Bilgili
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Ibrahim Halil Yavuz
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Goknur Ozaydin Yavuz
- Department of Dermatology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - Siraç Aktar
- Department of Dermatology, Bismil State Hospital, Diyarbakir, Turkey
| | - Murat Ozturk
- Department of Dermatology, Health Sciences University, Van Training and Research Hospital, Van, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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Abstract
Our understanding of the pathogenesis of acne vulgaris is still evolving. It is known that multiple factors impact acne pathophysiology, including genetic, hormonal, inflammatory, and environmental influences. Because of its implications in many of these factors, diet has been a part of the acne discussion for decades. Several studies have evaluated the significance of the glycemic index of various foods and glycemic load in patients with acne, demonstrating individuals with acne who consume diets with a low glycemic load have reduced acne lesions compared with individuals on high glycemic load diets. Dairy has also been a focus of study regarding dietary influences on acne; whey proteins responsible for the insulinotropic effects of milk may contribute more to acne development than the actual fat or dairy content. Other studies have examined the effects of omega-3 fatty acid and γ-linoleic acid consumption in individuals with acne, showing individuals with acne benefit from diets consisting of fish and healthy oils, thereby increasing omega-3 and omega-6 fatty acid intake. Recent research into the effects of probiotic administration in individuals with acne present promising results; further study of the effects of probiotics on acne is needed to support the findings of these early studies. In this review, we discuss the current evidence regarding the diets of US patients with acne and how they may impact acne and acne treatment.
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8
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Kovács D, Fazekas F, Oláh A, Törőcsik D. Adipokines in the Skin and in Dermatological Diseases. Int J Mol Sci 2020; 21:ijms21239048. [PMID: 33260746 PMCID: PMC7730960 DOI: 10.3390/ijms21239048] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022] Open
Abstract
Adipokines are the primary mediators of adipose tissue-induced and regulated systemic inflammatory diseases; however, recent findings revealed that serum levels of various adipokines correlate also with the onset and the severity of dermatological diseases. Importantly, further data confirmed that the skin serves not only as a target for adipokine signaling, but may serve as a source too. In this review, we aim to provide a complex overview on how adipokines may integrate into the (patho) physiological conditions of the skin by introducing the cell types, such as keratinocytes, fibroblasts, and sebocytes, which are known to produce adipokines as well as the signals that target them. Moreover, we discuss data from in vivo and in vitro murine and human studies as well as genetic data on how adipokines may contribute to various aspects of the homeostasis of the skin, e.g., melanogenesis, hair growth, or wound healing, just as to the pathogenesis of dermatological diseases such as psoriasis, atopic dermatitis, acne, rosacea, and melanoma.
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Affiliation(s)
- Dóra Kovács
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., 4032 Debrecen, Hungary; (D.K.); (F.F.)
| | - Fruzsina Fazekas
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., 4032 Debrecen, Hungary; (D.K.); (F.F.)
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., 4032 Debrecen, Hungary;
| | - Dániel Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., 4032 Debrecen, Hungary; (D.K.); (F.F.)
- Correspondence: ; Tel.: +36-52-255-602
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Dopytalska K, Baranowska-Bik A, Roszkiewicz M, Bik W, Walecka I. The role of leptin in selected skin diseases. Lipids Health Dis 2020; 19:215. [PMID: 33008429 PMCID: PMC7532589 DOI: 10.1186/s12944-020-01391-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/24/2020] [Indexed: 12/13/2022] Open
Abstract
Leptin is an adipokine, adipocyte-derived compound, which acts both as a hormone and cytokine. It is mainly synthesized by adipocytes of white adipose tissue. Leptin possesses pleiotropic functions including, among others, stimulation of angiogenesis and production of proinflammatory cytokines. The various types of leptin activity are related to the wide distribution of leptin receptors. This adipokine acts by activating intracellular signaling cascades such as JAKs (Janus kinases), STATs (signal transducers and activators of transcription), and others.In a course of obesity, an increased serum level of leptin coexists with tissue receptor resistance. It has been reported that enhanced leptin levels, leptin receptor impairment, and dysfunction of leptin signaling can influence skin and hair. The previous studies revealed the role of leptin in wound healing, hair cycle, and pathogenesis of skin diseases like psoriasis, lupus erythematosus, and skin cancers. However, the exact mechanism of leptin's impact on the skin is still under investigation. Herein, we present the current knowledge concerning the role of leptin in psoriasis and selected skin diseases.
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Affiliation(s)
- Klaudia Dopytalska
- Department of Dermatology, Centre of Postgraduate Medical Education, Woloska 137, 02-507, Warsaw, Poland
| | - Agnieszka Baranowska-Bik
- Department of Endocrinology, Centre of Postgraduate Medical Education, Ceglowska 80, 01-809, Warsaw, Poland.
| | - Marek Roszkiewicz
- Department of Dermatology, Centre of Postgraduate Medical Education, Woloska 137, 02-507, Warsaw, Poland
| | - Wojciech Bik
- Department of Neuroendocrinology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813, Warsaw, Poland
| | - Irena Walecka
- Department of Dermatology, Centre of Postgraduate Medical Education, Woloska 137, 02-507, Warsaw, Poland
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Pektas SD, Cinar N, Duman DD, Kara A, Batu J, Karakas-Celik S, Aksoy DY. The relationship among androgens, insulin resistance and ghrelin polymorphisms in post-adolescent male patients with severe acne vulgaris. Postepy Dermatol Alergol 2020; 37:800-809. [PMID: 33240024 PMCID: PMC7675091 DOI: 10.5114/ada.2020.100492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/01/2019] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Ghrelin has anti-inflammatory and immunomodulatory activities. Data about the role of ghrelin and ghrelin polymorphisms in the development of acne vulgaris in post-adolescent male patients are limited. AIM To evaluate the role of serum androgens, insulin resistance, ghrelin and ghrelin polymorphisms in severe acne vulgaris. MATERIAL AND METHODS Thirty-five post-adolescent male patients with a mean age of 28.0 ±5.4 years and 33 age-and BMI-matched controls were enrolled. Serum androgens, lipids, insulin sensitivity parameters and ghrelin levels were determined. The PCR method was used for GHRL polymorphisms (rs27647, rs696217 and rs34911341 genotypes). RESULTS Patients had similar anthropometric measures to controls, except a significantly higher WHR in patients (0.92 ±0.06 vs. 0.86 ±0.08, p < 0.05). Also, FPG, HOMA-IR values, lipid profile and serum androgen levels were similar. Interestingly, patients had significantly lower ghrelin levels than controls (4.5 ±5.8 vs. 101.2 ±86.5 pg/ml, p < 0.001). The frequencies of rs696217 and rs34911341 genotypes were similar whereas the distribution of rs27647 alleles was significantly different between the groups (p < 0.05). GA and GG genotypes of GHRL rs27647 polymorphism indicated an increased risk of developing acne vulgaris (OR = 11.156, 95% CI: 2.864-43.464, OR = 5.312, 95% CI: 1.269-22.244, respectively; p < 0.05). Patients with rs27647-AA polymorphism had significantly lower GAGS scores than other groups (AA genotype 6.7 ±14.1 vs. GA genotype 24.6 ±15.7 and GG genotype 19.4 ±17.9, p < 0.001). None of the polymorphisms had a significant effect on metabolic parameters, insulin sensitivity and serum ghrelin levels. CONCLUSIONS Decreased ghrelin levels and GA and GG genotypes of GHRL gene rs27647 polymorphism may have a role in the pathogenesis of acne vulgaris.
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Affiliation(s)
- Suzan Demir Pektas
- Department of Dermatology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Nese Cinar
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | | | - Ahmet Kara
- Department of Family Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | | | - Sevim Karakas-Celik
- Department of Molecular Biology and Genetic, Faculty of Science, Bulent Ecevit University, Zonguldak, Turkey
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11
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Aktaş Karabay E, Saltık ZA, Unay Demirel Ö. Evaluation of serum
FoxO1
,
mTORC1
,
IGF
‐1,
IGFBP
‐3 levels, and metabolic syndrome components in patients with acne vulgaris: A prospective case‐control study. Dermatol Ther 2020; 33:e13887. [DOI: 10.1111/dth.13887] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Ezgi Aktaş Karabay
- Faculty of Medicine, Department of Dermatology and Venereology Bahçeşehir University Istanbul Turkey
| | | | - Özlem Unay Demirel
- Faculty of Medicine, Department of Clinical Biochemistry Bahçeşehir University Istanbul Turkey
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12
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Rodighiero E, Bertolani M, Saleri R, Pedrazzi G, Lotti T, Feliciani C, Satolli F. Do acne treatments affect insulin-like growth factor-1 serum levels? A clinical and laboratory study on patients with acne vulgaris. Dermatol Ther 2020; 33:e13439. [PMID: 32306454 DOI: 10.1111/dth.13439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/14/2020] [Indexed: 01/09/2023]
Abstract
Acne is a chronic inflammatory disease affecting sebaceous gland follicles. Lately, acne has considered an insulin-like growth factor-1 (IGF-1) mediated disease. Recent research demonstrated that IGF-1 levels decrease after 3 months of isotretinoin. The purpose of our study is evaluating the influence of acne treatments on IGF-1 serum levels. Forty-six subjects with acne vulgaris aged 14 to 30 years were subdivided into three groups according to their severity of acne and treated following the European Dermatology Forum guidelines. IGF-1 was measured in patients before and after the treatment and then compared to the IGF-1 of a healthy population of the same age. IGF-1 resulted higher in patients than in controls but there was not a statistically significant variation after treatment. To the best of our knowledge, this is the first study evaluating the influence of topical and systemic acne treatment on IGF-1 serum levels. In contrast with the literature, our results suggest that common therapies for acne are not able to significantly modify IGF-1 serum levels.
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Affiliation(s)
- Eleonora Rodighiero
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mariabeatrice Bertolani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Saleri
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery, Unit of Neuroscience and Interdepartmental Centre of Robust Statistics (Ro.S.A.) University of Parma, Parma, Italy
| | - Torello Lotti
- University Unit of Dermatology and Regenerative Medicine, University of Rome G. Marconi, Rome, Italy
| | - Claudio Feliciani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Satolli
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Savo I, Jorgaqi E, Fida M, Vasili E, Kuci M, Doci X, Toci E, Jafferany M. Therapeutic considerations and clinical characteristics of a sample of adolescent patients with acne vulgaris in Tirana, Albania: A cross‐sectional study. Dermatol Ther 2020; 33:e13384. [DOI: 10.1111/dth.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Irena Savo
- Dermatology Unit American Hospital Tirana Albania
| | - Ekleva Jorgaqi
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Monika Fida
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Ermira Vasili
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Maurizia Kuci
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Xhiliola Doci
- Dermatology Unit Regional Hospital of Durres Durres Albania
| | - Ervin Toci
- Institute of Public Health Tirana Albania
| | - Mohammad Jafferany
- Division of Psychodermatolog Central Michigan University Saginaw Michigan USA
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Markovic M, Soldatovic I, Bjekic M, Sipetic-Grujicic S. Adolescents' self perceived acne-related beliefs: from myth to science. An Bras Dermatol 2019; 94:684-690. [PMID: 31789254 PMCID: PMC6939091 DOI: 10.1016/j.abd.2019.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/19/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Acne vulgaris is recognized as the third most prevalent skin disease worldwide, with highest prevalence among adolescents. Beliefs and perceptions of adolescents about acne are incoherent in the literature. OBJECTIVES To assess the most frequently reported acne-related beliefs in adolescents in order to focus on misconceptions and develop proper recommendations. METHODS A cross-sectional community-based study on representative sample of 2516 schoolchildren was conducted in six randomly selected secondary schools in Belgrade, Serbia. Only schoolchildren with present or past acne history participated. Factors believed to aggravate or ameliorate acne were recorded and analyzed, and the comparisons between girls and boys were evaluated using Pearson's chi-squared test. RESULTS A total of 1452 schoolchildren with acne participated, aged 14-18 years, among them 801 (55.2%) girls and 651 (44.8%) boys. Boys significantly more frequently believed that sweating, exercise, and dairy foods aggravate acne, whereas girls significantly more frequently blamed emotional stress, sweets, fatty foods, sun, and lack of sleep. The top four amelioration factors were as follows: comedone extraction, healthy diet, sun exposure, and increased water consumption. Acne regression was more frequently perceived to be linked with cigarettes in boys, but with sun exposure and weight loss in girls. STUDY LIMITATIONS The narrow age span of adolescents (14-18 years) and exclusion of acne-free adolescents are limitations due to study design. CONCLUSION This survey is part of the first epidemiological study on a representative sample in the Western Balkan region. The significance of the most frequent acne-related beliefs is discussed and myths about acne are highlighted.
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Affiliation(s)
- Milica Markovic
- Department for Facial Dermatoses, City Institute for Skin and Venereal Diseases, Belgrade, Serbia.
| | - Ivan Soldatovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Bjekic
- Department of General Dermatovenereology, City Institute for Skin and Venereal Diseases, Belgrade, Serbia
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Serum ghrelin and obestatin levels in patients with acne vulgaris: are they important for the severity? Postepy Dermatol Alergol 2019; 36:412-418. [PMID: 31616214 PMCID: PMC6791148 DOI: 10.5114/ada.2019.87445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 04/13/2018] [Indexed: 01/26/2023] Open
Abstract
Introduction Acne vulgaris (AV) is a chronic, inflammatory disease of the pilosebaceous unit. Recently, three peptide-structured hormones, products of a single gene, have been discovered. These hormones are acylated ghrelin, des-acyl ghrelin and obestatin. Aim To demonstrate the association of serum acylated ghrelin, des-acyl ghrelin, and obestatin levels with acne severity. Material and methods A total of 63 patients grouped as mild (n = 22), moderate (n = 21) and severe (n = 20) acne according to the Global Acne Grading System and 20 medically healthy volunteers were included in the study. Serum ghrelin and obestatin levels obtained from the participants were examined. Results When mean ghrelin, des-acyl-ghrelin and obestatin values of the acne-group (AG) were compared with the control group (CG), they were found be lower in the AG, but were not statistically significant. Among the patient groups, while acylated ghrelin values were highest in the severe AG, des-acyl ghrelin values were highest in mild severe AG and mean obestatin values were highest in moderate severe AG (p > 0.05). When the groups were compared for obestatin values; the highest average value was detected in the CG. However, it was not significant when the groups were compared. Conclusions It has been suggested that there may be a link between acne and the levels of acylated ghrelin, des-acyl ghrelin and obestatin which are decreased in the serum of acne patients. Because of the decrease observed in the levels of these hormones which have antimicrobial features, we suggest that inflammation in acne cannot be suppressed and the reproduction of the microorganisms that play a role in the aetiology of the disease cannot be prevented. The replacement of these hormones at physiologic concentrations may contribute to the acne treatment.
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Barbieri JS, Spaccarelli N, Margolis DJ, James WD. Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments. J Am Acad Dermatol 2019; 80:538-549. [PMID: 30296534 PMCID: PMC6333507 DOI: 10.1016/j.jaad.2018.09.055] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/21/2022]
Abstract
Acne is one of the most common diseases worldwide and affects ∼50 million individuals in the United States. Oral antibiotics are the most common systemic agent prescribed for the treatment of acne. However, their use might be associated with a variety of adverse outcomes including bacterial resistance and disruption of the microbiome. As a result, multiple treatment guidelines call for limiting the use of oral antibiotics in the treatment of acne, although actual prescribing often does not follow these guidelines. In this review, the rationale for concerns regarding the use of oral antibiotics for the management of acne is reviewed. In addition, we will discuss our approach to complying with the intent of the guidelines, with a focus on novel topical agents, dietary modification, laser and light-based modalities, and systemic medications, such as spironolactone, combined oral contraceptives, and oral isotretinoin.
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Affiliation(s)
- John S Barbieri
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Natalie Spaccarelli
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - David J Margolis
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - William D James
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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El-Tahlawi S, Ezzat Mohammad N, Mohamed El-Amir A, Sayed Mohamed H. Survivin and insulin-like growth factor-I: potential role in the pathogenesis of acne and post-acne scar. Scars Burn Heal 2019; 5:2059513118818031. [PMID: 30675395 PMCID: PMC6330724 DOI: 10.1177/2059513118818031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDS/OBJECTIVES Acne is an inflammatory disease of the pilosebaceous unit (PSU). The over-expression of survivin and insulin-like growth factor (IGF)-I in some fibrotic disorders suggests a possible implication in the pathogenesis of acne and or post-acne scar. We aimed to evaluate their potential role in pathogenesis in acne and post-acne scar. METHODS Serum survivin and IGF-I levels were estimated in 30 patients with acne and post-acne scar compared to 30 controls. RESULTS There was a statistically significant difference in survivin and IGF-I levels between controls and patients (P < 0.05). However, there was no linear correlation between survivin and IGF-I. CONCLUSIONS Survivin and IGF-I could have a possible role in the pathogenesis of active acne and in post-inflammatory acne scar.
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Dall'Oglio F, Milani M, Micali G. Effects of oral supplementation with FOS and GOS prebiotics in women with adult acne: the "S.O. Sweet" study: a proof-of-concept pilot trial. Clin Cosmet Investig Dermatol 2018; 11:445-449. [PMID: 30349341 PMCID: PMC6181472 DOI: 10.2147/ccid.s179627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background We evaluated the effects of 3-month prebiotic oral supplementation with fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS) on glucose and lipid metabolic parameters in women with adult acne (female adult acne). Methods Twelve women, mean age 35 years, with mild to moderate acne were enrolled. Exclusion criteria were severe acne, body mass index (BMI) >25, history of diabetes mellitus, polycystic ovary syndrome, regular intake of prebiotics or probiotics, and history of inflammatory intestinal diseases. At baseline visit (T0), at month 1 (T1), and at month 3 (T2) fasting glucose, blood insulin, glycated hemoglobin (HbA1c), C-peptide, triglycerides, total cholesterol levels, and BMI were measured. Subjects were treated with a food supplement containing FOS (100 mg) and GOS (500 mg), one sachet daily, for 3 months. Subjects were instructed to follow their regular diet, and no dietary restrictions were suggested. Results At baseline, the BMI, mean ± SD, was 23±0.7. No modification of BMI was observed during the study. At baseline, fasting blood glucose levels were 92±7 mg/dL. A significant (P=0.02) reduction was observed at month 1 (86±5 mg/dL) and at month 3 (85±7 mg/dL) (–10%). Total cholesterol levels were reduced significantly (P=0.018) from 184±19 to 161±10 mg/dL (–13%) at the end of the study. Triglycerides at baseline were 51 mg/dL and were reduced to 46 mg/dL (P=0.05). Insulin and C-peptide plasma levels showed a nonsignificant reduction trend from baseline to the end of the study. In subjects with baseline insulin level >6 µUI/mL (n=6) the FOS/GOS supplementation induced a significant (P=0.03) reduction from 7.8 to 4.3 µUI/mL at day 90 (–45%). C-peptide was reduced from 2.1 to 1.6 ng/mL (month 3). HbA1c at baseline was 35 mg/dL and 32 mg/dL at the end of the study (NS). Conclusion In adult female acne, supplementation with prebiotic FOS and GOS was associated with positive effects on glycemic and lipid metabolic parameters.
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Affiliation(s)
| | - Massimo Milani
- Medical Department, Cantabria Labs Difa Cooper, Caronno Pertusella (VA), Italy,
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19
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Abstract
PURPOSE OF REVIEW Acne vulgaris is a global disease with increasing prevalence in adolescents. It has a profound impact on their quality of life, especially when endocrine disorders are also involved. Recent concerns regarding antibiotic stewardship, failures with antibiotic usage, and the development of antibiotic-resistant Propionibacterium acnes have led clinicians to consider other therapeutic options for acne treatment. The present review explores hormonal therapies for the treatment of acne vulgaris. RECENT FINDINGS There are now four different combined oral contraceptive pills that are FDA approved for the treatment of acne since its first introduction in 1960. Recent literature has provided more information on the efficacy of different generations of combined oral contraceptive pills, their side-effects, and cancer risks. Furthermore, spironolactone has been gaining wider use among dermatologists in adolescents with endocrine dysfunction. New diagnostic guidelines and treatment recommendations have also been suggested. SUMMARY Hormonal therapies are effective and well tolerated options for the treatment of acne vulgaris in adolescents with and without endocrine disorders. They can be used as monotherapy or in conjunction with benzoyl peroxide, topical retinoic acid, or antibiotics.
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Burris J, Rietkerk W, Shikany JM, Woolf K. Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne. J Acad Nutr Diet 2017; 117:1375-1383. [PMID: 28606553 DOI: 10.1016/j.jand.2017.03.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 03/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Glycemic index (GI) and glycemic load (GL) may be implicated in acne pathogenesis. OBJECTIVE This cross-sectional study examined differences between GI/GL and biological factors associated with acne among adults with and without moderate/severe acne. Secondary objectives included examining differences between food-aggravated acne beliefs and acne-specific quality of life among adults with and without moderate/severe acne. DESIGN As part of a cross-sectional study, participants completed a 5-day food record; blood draw to measure biological factors associated with acne (ie, glucose, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3, and sex hormone-binding globulin concentrations); body composition assessment; and questionnaire to evaluate food-aggravated acne beliefs and acne-specific quality of life. Food records were analyzed using Nutrition Data Services for Research. PARTICIPANTS Sixty-four participants (no acne, n=32; moderate/severe acne, n=32) from New York City, NY, were included in this study. STATISTICAL ANALYSIS Independent sample t tests and Mann-Whitney tests examined differences in anthropometric measurements, dietary intakes, biological factors associated with acne, insulin resistance, and acne-specific quality of life between acne groups. A χ2 test for independence assessed differences in food-aggravated acne beliefs between acne groups. RESULTS Participants with moderate/severe acne consumed greater total carbohydrate (P=0.003), available carbohydrate (P<0.001), percent energy from carbohydrate (P<0.001), and GL (P<0.001) compared to participants without acne. Participants with moderate/severe acne had greater insulin (P=0.002) and insulin-like growth factor-1 (P=0.009) concentrations, greater insulin resistance (P=0.001), and lower sex hormone-binding globulin (P=0.015) concentrations compared to participants without acne. Although there were no differences between groups, 61% of participants reported food-influenced acne. Participants with moderate/severe acne reported a lower quality of life compared to participants without acne (P<0.001). CONCLUSIONS The results from this cross-sectional study suggest a relationship between dietary carbohydrate, including GL, and acne. Future research is necessary to determine the effect of medical nutrition therapy on biological factors associated with acne and acne severity.
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Ozuguz P, Kacar SD, Asik G, Ozuguz U, Karatas S. Evaluation of leptin, adiponectin, and ghrelin levels in patients with acne vulgaris. Hum Exp Toxicol 2016; 36:3-7. [PMID: 26860691 DOI: 10.1177/0960327116630355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The research evaluating adipokines are very few in patients with acne vulgaris. The hypothesis that hyperinsulinemic and high glycemic index diet plays a role in the pathogenesis of acne is still controversial. In this study, we aimed to evaluate adipokines such as leptin (L), adiponectin (A), ghrelin and A levels, and A/L rates that indicate insulin resistance in nonobese patients with severe acne vulgaris. MATERIAL AND METHOD Thirty patients who are nonobese with moderate acne vulgaris, aged 18 to 25 years, and 15 age-sex compatible controls were included in our study. The acne lesions were assessed using the Global Acne Grading Scale (GAGS). All participants were evaluated for the parameters that may affect the metabolism of serum L, A, and ghrelin levels in blood, and their body mass index were calculated. The significance level was determined as p ≤ 0.05. RESULTS Of the 30 patients, 17 were women and 13 were men. The mean age was 20.60 years and the mean duration of the disease were 2.8 years. All of patients had moderate acne vulgaris (GAGS 19-30). Of the 15 controls, 11 were women and 4 were men. The mean age was 21.20 years. There were not a statistically significant difference in L, ghrelin, A levels, and A/L ratio between the two groups. CONCLUSIONS Adipokines may have a role in the pathogenesis of acne vulgaris. L, A, ghrelin, and insulin resistance may not participate in the responsible mechanisms in nonobese patients with moderate acne vulgaris.
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Affiliation(s)
- P Ozuguz
- 1 Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - S D Kacar
- 1 Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - G Asik
- 2 Department of Microbiology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - U Ozuguz
- 3 Department of Endocrinology and Metabolism, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - S Karatas
- 1 Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
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Significance of diet in treated and untreated acne vulgaris. Postepy Dermatol Alergol 2016; 33:81-6. [PMID: 27279815 PMCID: PMC4884775 DOI: 10.5114/ada.2016.59146] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 09/23/2014] [Indexed: 01/17/2023] Open
Abstract
The relationship between diet and acne is highly controversial. Several studies during the last decade have led dermatologists to reflect on a potential link between diet and acne. This article presents the latest findings on a potential impact that diet can have on pathogenesis of acne vulgaris. The association between diet and acne can no longer be dismissed. Compelling evidence shows that high glycemic load diets may exacerbate acne. Dairy ingestion appears to be weakly associated with acne and the roles of omega-3 fatty acids, dietary fiber, antioxidants, vitamin A, zinc and iodine remain to be elucidated. The question of what the impact of diet is on the course of acne vulgaris still remains unclear.
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Agamia N, Abdallah D, Sorour O, Mourad B, Younan D. Skin expression of mammalian target of rapamycin and forkhead box transcription factor O1, and serum insulin‐like growth factor‐1 in patients with acne vulgaris and their relationship with diet. Br J Dermatol 2016; 174:1299-307. [DOI: 10.1111/bjd.14409] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2016] [Indexed: 01/11/2023]
Affiliation(s)
- N.F. Agamia
- Department of Dermatology, Venereology and Andrology Faculty of Medicine Alexandria University Alexandria Egypt
| | - D.M. Abdallah
- Department of Pathology Faculty of Medicine Alexandria University Alexandria Egypt
| | - O. Sorour
- Department of Dermatology, Venereology and Andrology Faculty of Medicine Alexandria University Alexandria Egypt
| | - B. Mourad
- Department of Dermatology, Venereology and Andrology Faculty of Medicine Tanta University Tanta Egypt
| | - D.N. Younan
- Department of Clinical Pathology Faculty of Medicine Alexandria University Alexandria Egypt
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Çerman AA, Aktaş E, Altunay İK, Arıcı JE, Tulunay A, Ozturk FY. Dietary glycemic factors, insulin resistance, and adiponectin levels in acne vulgaris. J Am Acad Dermatol 2016; 75:155-62. [PMID: 27061046 DOI: 10.1016/j.jaad.2016.02.1220] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 02/21/2016] [Accepted: 02/23/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is increasing evidence to support the relationship between acne vulgaris and diet. OBJECTIVE The aim of this study was to investigate possible associations among dietary glycemic index, glycemic load, milk consumption, insulin resistance, and adiponectin levels in the pathogenesis of acne vulgaris. METHODS The dietary glycemic index, glycemic load, milk consumption, fasting glucose, insulin, insulin-like growth factor)-1, insulin-like growth factor binding protein-3, adiponectin, and homeostasis model assessment of insulin resistance values of 50 patients with acne vulgaris and 36 healthy control subjects were measured. RESULTS Glycemic index and glycemic load levels were significantly higher (P = .022 and P = .001, respectively) and serum adiponectin levels were significantly lower (P = .015) in patients with acne than in the control subjects. There was an inverse correlation between serum adiponectin concentration and glycemic index (P = .049, r = -0.212). LIMITATIONS This study used a cross-sectional design and the study population was limited to young, nonobese adults. CONCLUSION A high-glycemic-index/-load diet was positively associated with acne vulgaris. Adiponectin may be a pathogenetic cofactor contributing to the development of the disease. Further research on adiponectin levels in patients with acne in terms of development of insulin resistance might be important in this possible relationship.
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Affiliation(s)
- Aslı Aksu Çerman
- Dermatology Department, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
| | - Ezgi Aktaş
- Dermatology Department, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - İlknur Kıvanç Altunay
- Dermatology Department, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Janset Erkul Arıcı
- Dermatology Department, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Aysın Tulunay
- Immunology Department, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Feyza Yener Ozturk
- Endocrinology Department, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Okoro EO, Ogunbiyi AO, George AO, Subulade MO. Association of diet with acne vulgaris among adolescents in Ibadan, southwest Nigeria. Int J Dermatol 2016; 55:982-8. [PMID: 26749364 DOI: 10.1111/ijd.13166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 06/15/2015] [Accepted: 07/23/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acne vulgaris is a chronic inflammatory disease of the pilosebaceous units that affects 85% of the world's population aged 11-30 years. Diet is believed to affect the severity of acne vulgaris. OBJECTIVES This study was designed to identify possible associations of diet with acne vulgaris in Nigeria. METHODS A cross-sectional study was conducted among adolescents in Ibadan in 2011. Students were interviewed for demographic data, history of acne, and frequency of intake of specific foods in the previous 12 months. Each participant was examined for facial acne. Body mass index (BMI) was calculated for each participant. RESULTS Data for 464 students were analyzed. The mean ± standard deviation age of all subjects was 13.6 ± 3.6 years, and the mean BMI was 17.8 kg/m(2) . A total of 299 (64.4%) students were found to have acne vulgaris. Frequencies of intake of various foods varied widely. Prevalences of acne were higher among those who reported an at least daily intake of milk as beverage (72.6% vs. 62.0%; P = 0.035), corn (76.6% vs. 62.3%; P = 0.016), fried beef (75.0% vs. 62.1%; P = 0.042), and cake (77.8% vs. 62.3%; P = 0.012), and less common among those students who reported an at least daily intake of bananas (55.3% vs. 67.6%; P = 0.032). CONCLUSIONS The present findings suggest associations between some foods and acne in the Nigerian context. An interventional dietary study will be required to further ascertain the effects of these foods on acne vulgaris.
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Affiliation(s)
- Emeka O Okoro
- Department of Dermatology, Federal Medical Center, Keffi, Nasarawa State, Nigeria.,Department of Dermatology, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Adebola O Ogunbiyi
- Department of Dermatology, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Adekunle O George
- Department of Dermatology, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Mobolaji O Subulade
- Department of Nutrition and Dietetics, University College Hospital, Ibadan, Oyo State, Nigeria
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Abstract
Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.
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Insulin resistance in severe acne vulgaris. Postepy Dermatol Alergol 2015; 32:281-5. [PMID: 26366152 PMCID: PMC4565837 DOI: 10.5114/pdia.2015.53047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 09/02/2014] [Accepted: 11/12/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Acne vulgaris is a pilosebaceous gland disease that usually affects people from puberty to young adulthood. It is seen especially on the face, neck, trunk and arms. Its severity differs from patient to patient and its pathogenesis is multifactorial. The main pathogenic factors of acne are high sebaceous gland secretion, follicular hyperproliferation, high androgen effects, propionibacterium acnes colonization and inflammation. Diet is always thought a probable reason for acne and many studies are done about acne and diet. Aim To determine the effect of insulin resistance in severe acne vulgaris. Material and methods Two hundred and forty-three acne vulgaris patients and 156 healthy controls were enrolled into the study. The blood levels of insulin and glucose were measured. Homeostasis Model Assessment (HOMA) Index was calculated. The values were compared with the control group. Results All of the patients were in the severe acne group according to their scores on the global acne scoring scale. While fasting blood glucose levels were not different between the groups (p > 0.05, 82.91 ±9.76 vs. 80.26 ±8.33), the fasting insulin levels were significantly higher in the patient group than in the control group (p < 0.001, 14.01 ±11.94 vs. 9.12 ±3.53). Additionally, there was a highly significant difference between the patient and control groups in terms of HOMA values (p < 0.001, 2.87 ±2.56 vs. 1.63 ±0.65). Conclusions These results suggest that insulin resistance may have a role in the pathogenesis of acne.
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Törőcsik D, Kovács D, Camera E, Lovászi M, Cseri K, Nagy GG, Molinaro R, Rühl R, Tax G, Szabó K, Picardo M, Kemény L, Zouboulis CC, Remenyik É. Leptin promotes a proinflammatory lipid profile and induces inflammatory pathways in human SZ95 sebocytes. Br J Dermatol 2014; 171:1326-35. [PMID: 24975960 DOI: 10.1111/bjd.13229] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Leptin, the adipocyte-secreted hormone that regulates weight, is known to link lipid metabolism with inflammation in various cell types. However, its role in human sebocytes has not yet been investigated. OBJECTIVES The purpose of this study was to investigate the effects of leptin in human sebaceous gland biology. METHODS Expression of the long form of the leptin receptor (Ob-Rb) was detected by real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and immunochemistry. Lipid analysis was by high-performance thin-layer chromatography, gas chromatography-mass spectrometry and time-of-flight mass spectrometer mass detection. Lipid bodies were visualized by BODIPY staining using fluorescent microscopy and measured by flow cytometry. Interleukin (IL)-6 and IL-8 mRNA levels were assessed by real-time qRT-PCR and their release was evaluated by enzyme-linked immunosorbent assay. Cyclooxygenase (COX)-2 and 5-lipooxygenase (LOX) protein expression and phosphorylation of p65 and signal transducer and activator of transcription (STAT)-3 were determined by Western blot analysis. RESULTS Expression of Ob-Rb was detected in human sebaceous glands and in cultured human SZ95 sebocytes. The treatment of SZ95 sebocytes with leptin led to enlarged intracellular lipid bodies, increased ratios of unsaturated/saturated fatty acids and decreased vitamin E levels. Further supporting a proinflammatory role, leptin induced COX-2 and 5-LOX expression in SZ95 sebocytes and augmented the production of IL-6 and IL-8 cytokines. On leptin treatment, the STAT-3 and nuclear factor-κB pathways were activated, indicating that these known leptin signalling pathways are active in human sebocytes. CONCLUSIONS Our findings suggest that leptin signalling may be involved in the proinflammatory regulation of sebaceous lipid metabolism and the induction of inflammatory enzymes and cytokines.
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Affiliation(s)
- D Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, H4032, Hungary
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Bronsnick T, Murzaku EC, Rao BK. Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer. J Am Acad Dermatol 2014; 71:1039.e1-1039.e12. [PMID: 25454036 DOI: 10.1016/j.jaad.2014.06.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 06/04/2014] [Accepted: 06/05/2014] [Indexed: 01/12/2023]
Abstract
Patients commonly inquire about dietary modifications as a means to prevent or manage skin disease. Answering these questions is often challenging, given the vast and conflicting evidence that exists on this topic. This 2-part continuing medical education article summarizes the evidence to date to enable physicians to answer patients' questions in an evidence-based manner. Part I includes atopic dermatitis, acne, and nonmelanoma skin cancer. The role of dietary supplementation, dietary exclusion, food allergy, maternal diet, and breastfeeding in the development and/or prevention of atopic dermatitis is summarized. The dermatoendocrinologic mechanism for the effects of glycemic index/glycemic load and milk on acne is described, as well as related clinical evidence for dietary modifications. Finally, evidence and recommendations for restriction or supplementation of dietary factors in the prevention of nonmelanoma skin cancer, including fat, vitamins A, C, D, and E, and selenium, are reported.
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Affiliation(s)
- Tara Bronsnick
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey.
| | - Era Caterina Murzaku
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Babar K Rao
- Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
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Balta I, Ekiz O, Ozuguz P, Ustun I, Karaca S, Dogruk Kacar S, Eksioglu M. Insulin resistance in patients with post-adolescent acne. Int J Dermatol 2014; 54:662-6. [PMID: 24961925 DOI: 10.1111/ijd.12426] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 04/20/2013] [Accepted: 07/16/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Post-adolescent acne has been defined as acne in a patient aged >25 years. Acne vulgaris first develops at the onset of puberty as a result of hormonal changes. During puberty, there is a transient decline in insulin sensitivity. We hypothesized that insulin resistance might persist after puberty in patients with post-adolescent acne. OBJECTIVES This study was conducted in order to investigate the relationship between post-adolescent acne and insulin resistance. METHODS The study population comprised 35 patients with post-adolescent acne and 35 healthy control subjects. The parameters measured were fasting blood glucose, insulin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). The homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated for each individual. RESULTS No significant differences were observed between patients with post-adolescent acne and control subjects in fasting blood glucose, fasting insulin, AST, ALT, triglyceride and HDL-C levels, and HOMA-IR index. There were also no correlations between these parameters and the severity of acne. CONCLUSIONS This study suggests that insulin resistance may not play a major role in the pathogenesis of post-adolescent acne. Hormonal changes, genetic susceptibility, stress, the use of cosmetics, drugs, and environmental factors should be considered in the development of post-adolescent acne.
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Affiliation(s)
- Ilknur Balta
- Department of Dermatology, Kecioren Training and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Ozlem Ekiz
- Department of Dermatology, Tayfur Ata Sokmen School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Pınar Ozuguz
- Department of Dermatology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Ihsan Ustun
- Department of Endocrinology, Tayfur Ata Sokmen School of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Semsettin Karaca
- Department of Dermatology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Seval Dogruk Kacar
- Department of Dermatology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Meral Eksioglu
- Ankara Training and Research Hospital, Ministry of Health, Department of Dermatology, Ankara, Turkey
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Relationships of Self-Reported Dietary Factors and Perceived Acne Severity in a Cohort of New York Young Adults. J Acad Nutr Diet 2014; 114:384-392. [DOI: 10.1016/j.jand.2013.11.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 10/28/2013] [Indexed: 01/02/2023]
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Gene polymorphism and serum levels of insulin-like growth factor-I in Egyptian acne patients. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2014. [DOI: 10.1097/01.ewx.0000436494.96166.ed] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Karciauskiene J, Valiukeviciene S, Gollnick H, Stang A. The prevalence and risk factors of adolescent acne among schoolchildren in Lithuania: a cross-sectional study. J Eur Acad Dermatol Venereol 2013; 28:733-40. [DOI: 10.1111/jdv.12160] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 03/18/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J. Karciauskiene
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - S. Valiukeviciene
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - H. Gollnick
- Department of Dermatology and Venereology; Otto-von-Guericke-University; Magdeburg Germany
| | - A. Stang
- Institute of Clinical Epidemiology; Martin-Luther-University; Halle Germany
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Burris J, Rietkerk W, Woolf K. Acne: The Role of Medical Nutrition Therapy. J Acad Nutr Diet 2013; 113:416-430. [DOI: 10.1016/j.jand.2012.11.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 11/20/2012] [Indexed: 02/02/2023]
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Ismail NH, Manaf ZA, Azizan NZ. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC DERMATOLOGY 2012; 12:13. [PMID: 22898209 PMCID: PMC3470941 DOI: 10.1186/1471-5945-12-13] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 08/09/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of dietary factors in the pathophysiology of acne vulgaris is highly controversial. Hence, the aim of this study was to determine the association between dietary factors and acne vulgaris among Malaysian young adults. METHODS A case-control study was conducted among 44 acne vulgaris patients and 44 controls aged 18 to 30 years from October 2010 to January 2011. Comprehensive acne severity scale (CASS) was used to determine acne severity. A questionnaire comprising items enquiring into the respondent's family history and dietary patterns was distributed. Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Anthropometric measurements including body weight, height and body fat percentage were taken. Acne severity was assessed by a dermatologist. RESULTS Cases had a significantly higher dietary glycemic load (175 ± 35) compared to controls (122 ± 28) (p < 0.001). The frequency of milk (p < 0.01) and ice-cream (p < 0.01) consumptions was significantly higher in cases compared to controls. Females in the case group had a higher daily energy intake compared to their counterparts in the control group, 1812 ± 331 and 1590 ± 148 kcal respectively (p < 0.05). No significant difference was found in other nutrient intakes, Body Mass Index, and body fat percentage between case and control groups (p > 0.05). CONCLUSIONS Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris.
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Affiliation(s)
- Noor Hasnani Ismail
- Dietetic Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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Paoli A, Grimaldi K, Toniolo L, Canato M, Bianco A, Fratter A. Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol 2012; 25:111-7. [PMID: 22327146 DOI: 10.1159/000336404] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 01/03/2012] [Indexed: 12/14/2022]
Abstract
The influence of nutrition on skin health is a growing research area but the findings of various studies on the effect of diet on the development of acne have often been contradictory. The general opinion among researchers has oscillated between two different, opposing positions: that diet either is or is not a key factor for acne development. This review examines the evidence supporting an influence of various dietary components on the development of acne particularly focusing on the role played by carbohydrates. The physiological and biochemical effects of the ketogenic diet are examined from this perspective and mechanisms will be proposed via which this type of diet could have a role in the treatment of acne.
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Affiliation(s)
- A Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy.
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Capitanio B, Sinagra JL, Bordignon V, Cordiali Fei P, Picardo M, Zouboulis CC. Underestimated clinical features of postadolescent acne. J Am Acad Dermatol 2010; 63:782-8. [DOI: 10.1016/j.jaad.2009.11.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 11/09/2009] [Accepted: 11/13/2009] [Indexed: 01/22/2023]
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Costa A, Lage D, Moisés TA. Acne e dieta: verdade ou mito? An Bras Dermatol 2010; 85:346-53. [DOI: 10.1590/s0365-05962010000300008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 09/21/2009] [Indexed: 11/22/2022] Open
Abstract
Nos últimos 50 anos, foram publicados inúmeros estudos com a finalidade de comprovar se a dieta está relacionada à etiologia da acne. Embora existam estudos antigos, que são bem difundidos entre os dermatologistas e negam a associação entre acne e dieta, seu delineamento científico é pobre. Recentemente, novos artigos demonstraram evidências contrárias às publicações anteriores. Sendo assim, os autores realizaram esta revisão bibliográfica com o intuito de averiguar se a dieta influencia direta ou indiretamente um ou mais dos quatro pilares etiopatogênicos fundamentais da acne: (1) hiperproliferação dos queratinócitos basais, (2) aumento da produção sebácea, (3) colonização pelo Propionibacterium acnes e (4) inflamação.
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Affiliation(s)
- Adilson Costa
- Pontifícia Universidade Católica de Campinas, Brasil
| | - Denise Lage
- Pontifícia Universidade Católica de Campinas, Brasil
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Bowe WP, Joshi SS, Shalita AR. Diet and acne. J Am Acad Dermatol 2010; 63:124-41. [PMID: 20338665 DOI: 10.1016/j.jaad.2009.07.043] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 06/16/2009] [Accepted: 07/09/2009] [Indexed: 11/19/2022]
Abstract
Historically, the relationship between diet and acne has been highly controversial. Before the 1960s, certain foods were thought to exacerbate acne. However, subsequent studies dispelled these alleged associations as myth for almost half a century. Several studies during the last decade have prompted dermatologists to revisit the potential link between diet and acne. This article critically reviews the literature and discusses how dermatologists might address diet when counseling patients with acne. Dermatologists can no longer dismiss the association between diet and acne. Compelling evidence exists that high glycemic load diets may exacerbate acne. Dairy ingestion appears to be weakly associated with acne, and the roles of omega-3 fatty acids, antioxidants, zinc, vitamin A, and dietary fiber remain to be elucidated. This study was limited by the lack of randomized controlled trials in the literature. We hope that this review will encourage others to explore the effects of diet on acne.
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Affiliation(s)
- Whitney P Bowe
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
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Abstract
Acne is the most common disease of the skin. It affects 85% of teenagers, 42.5% of men, and 50.9% of women between the ages of 20 and 30 years.96,97 The role of hormones, particularly as a trigger of sebum production and sebaceous growth and differentiation, is well known. Excess production of hormones, specifically androgens, GH, IGF-1, insulin, CRH, and glucocorticoids, is associated with increased rates of acne development. Acne may be a feature in many endocrine disorders, including polycystic ovary disease, Cushing syndrome, CAH, androgen-secreting tumors, and acromegaly. Other nonendocrine diseases associated with acne include Apert syndrome, SAPHO syndrome, Behçet syndrome and PAPA syndrome. Acne medicamentosa is the development of acne vulgaris or an acneiform eruption with the use of certain medications. These medications include testosterone, progesterone,steroids, lithium, phenytoin, isoniazid, vitamins B2, B6, and B12, halogens, and epidermal growth factor inhibitors. Management of acne medicamentosa includes standard acne therapy. Discontinuation of the offending drug may be necessary in recalcitrant cases. Basic therapeutic interventions for acne include topical therapy, systemic antibiotics,hormonal agents, isotretinoin, and physical treatments. Generally, the severity of acne lesions determines the type of acne regimen necessary. The emergence of drug-resistant P acnes and adverse side effects are current limitations to effective acne management.
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Affiliation(s)
- Margarita S Lolis
- Department of Dermatology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
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Berra B, Rizzo AM. Glycemic Index, Glycemic Load: New Evidence for a Link with Acne. J Am Coll Nutr 2009; 28 Suppl:450S-454S. [DOI: 10.1080/07315724.2009.10718111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berra B, Rizzo AM. Glycemic index, glycemic load, wellness and beauty: the state of the art. Clin Dermatol 2009; 27:230-5. [DOI: 10.1016/j.clindermatol.2008.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Webster GF. Commentary: Diet and acne. J Am Acad Dermatol 2008; 58:794-5. [DOI: 10.1016/j.jaad.2008.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 12/28/2007] [Accepted: 01/07/2008] [Indexed: 11/26/2022]
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Abstract
There is widespread misunderstanding of acne amongst both the medical and lay community, who often perceive the condition to be a simple, self-limited affliction of adolescents. Because many think that the disease "will go away on its own," they do not feel an urgency to aggressively treat acne. However, very often the reality is that acne treatment can be quite difficult. Furthermore, acne can be a devastating disease for the patient, since it manifests on visible body parts and in children near puberty, who are vulnerable both socially and psychologically. Most typically, acne is not an acute disease but rather a condition that continuously changes in its distribution and severity. Usually, acne treatment is necessary for many months and sometimes years. Despite treatment, acne may cause scarring and associated negative psychological effects. It is important for both patients and physicians to be aware that very effective treatments are available. It is also important to realize that new studies have proven the benefit of maintenance therapy with topical retinoids; these agents can minimize the potential for relapse, which is part of the natural history of acne. This article reviews the evidence suggesting that acne is a chronic disease in at least a subset of individuals. The members of the Global Alliance to Improve Outcomes in Acne believe that acne should be recognized and investigated as a chronic disease. This will change expectations of clinical trial design and treatment and will highlight gaps in the knowledge of acne epidemiology. The result should be an improvement in patient outcomes.
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Affiliation(s)
- Harald P M Gollnick
- Department of Dermatology and Venereology, Otto von Guericke University, Magdeburg, Germany
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Treloar V, Logan AC, Danby FW, Cordain L, Mann NJ. Comment on acne and glycemic index. J Am Acad Dermatol 2008; 58:175-7. [DOI: 10.1016/j.jaad.2007.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2007] [Revised: 08/04/2007] [Accepted: 10/09/2007] [Indexed: 12/30/2022]
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