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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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Kutlu Ö, Karadağ AS, Wollina U. Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment. An Bras Dermatol 2023; 98:75-83. [PMID: 36253244 PMCID: PMC9837660 DOI: 10.1016/j.abd.2022.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/02/2022] [Accepted: 01/17/2022] [Indexed: 01/21/2023] Open
Abstract
Acne vulgaris is one of the most common chronic inflammatory diseases and is characterized by papules, pustules, comedones, and nodules. Although adolescence is the preferential age group, acne may affect various age groups. Acne shares different properties in adults and adolescents. These differences extend from epidemiology to treatments. Increased awareness of these two subtypes will allow for better management of the disease. In this review, the authors examined all aspects of acne in adults and adolescents under the light of current literature.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey,Corresponding author.
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, Memorial Ataşehir Hospital, İstanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden, Dresden, Germany
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3
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Insulin Resistance and Acne: The Role of Metformin as Alternative Therapy in Men. Pharmaceuticals (Basel) 2022; 16:ph16010027. [PMID: 36678524 PMCID: PMC9862044 DOI: 10.3390/ph16010027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
The association between acne and insulin resistance has not been investigated as thoroughly in males as it has been in women, despite the fact that in adult men, acne prevalence has grown. On the face, sebaceous glands produce and secrete sebum, which lubricates the skin and protects it from friction. Metformin, an insulin-sensitizing medication, may modify the association between acne vulgaris and insulin resistance (IR). Individuals with IR, metabolic syndrome or with impaired glucose tolerance are sometimes treated 'off label' with Metformin. In these conditions, IR may be a leading factor in the pathogenesis of acne, and in men, Metformin treatment may reduce the Global Acne Grading System (GAGS) score by enhancing insulin sensitivity. However, additional clinical studies are required to corroborate these assumptions.
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4
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Kazandjieva J, Dimitrova J, Sankeva M, Yankov D, Bocheva V, Kircheva K, Gincheva V, Gospodinova K, Andasorova R, Milanova M, Jeleva D, Zlateva P, Vasileva I, Yankova R, Gotseva S, Dakova T, Zografova E, Marina S, Kateva M, Broshtilova V, Todeva V, Tsankov N, Mitova Z, Boyanova N, Milani M. Efficacy of a retinoid complex plus anti-inflammatory component cream alone or in combination with prebiotic food supplement in adult acne: A randomized, assessor-blinded, parallel-group, multicenter trial on 184 women. J Cosmet Dermatol 2022; 21:5716-5722. [PMID: 35545875 DOI: 10.1111/jocd.15074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Adult female acne (AFA) nowadays is a very common skin condition affecting mainly women aged between 25 and 40. The treatment of AFA could be challenging. STUDY AIM We evaluate and compare the efficacy and tolerability of a cream formulation containing two retinoid molecules (hydroxypinacolone/retinyl palmitate) combined with Iris Florentina root extract and a complex of three oligopeptides (C) applied twice a day (morning and evening) alone or in combination (C + O) with a food supplement containing a mixture of prebiotic molecules (FOS&GOS) zinc, lactoferrin, and niacinamide. SUBJECTS AND METHODS In a multicenter, randomized, assessor-blinded, 12-week trial, we assessed the efficacy of these two regimens in the evolution of AFA lesions (non-inflammatory: NI-L; inflammatory: IL; and total number of lesions: TL). Additional efficacy endpoints were the evolution of the 6-point (from 0 to 5) GEA and Adult Female Acne Scoring Tool (AFAST) scores. RESULTS One hundred and eighty-four women (mean age 32 ± 6 years) with AFA agreed to participate after obtaining informed consent. They were randomized (2:1) to the topical product (n = 123) (Group C) or to the combination (n = 61) (Group C + O) treatment. All enrolled patients concluded the trial with no drop-out. At baseline, NI-L, IL, and TL acne lesion count were 15 ± 9, 9 ± 5, and 24 ± 14 in the Group C and 19 ± 8, 9 ± 4, and 29 ± 10 in Group C + O. In comparison with the number of the acne lesions at the baseline, both treatment regimens induced a significant reduction (p = 0.0001, ANOVA test) at Week 12 in NI-L, IL, and TL by -54%, -63%, and - 59% in Group C and by -55%, -73%, and - 61% in the Group C + O, respectively. At Week 12, the absolute IL count reduction vs. baseline was significantly (p = 0.0158) greater in Group C + O (-7.0) in comparison with Group C (-5.5). The GEA absolute score reduction in Group C + O group was significantly greater in comparison with Group C (-1.5 vs. -1.1; p = 0.0097). In the Group C + O, a greater percentage of success treatment (defined as a GEA score of 0/1 at Week 12) was observed in comparison with Group C (39% vs. 27%; p = 0.06). AFAST score at baseline was 2.4 ± 0.5 in group C and 2.8 ± 0.6 in group C + O. AFAST score was reduced by 21% and by 51% after 6 and 12 weeks of treatment in group C and by 22% and 55% in group C + O, respectively. Both treatment regimens were well tolerated. Not relevant adverse events were recorded. CONCLUSION A cream containing retinoid molecules and Iris Florentina root extract is effective and well tolerated in the management of AFA. The treatment combination with a prebiotic and anti-inflammatory food supplement offers an additional clinical benefit mainly in reducing inflammatory lesions and improving the severity acne score.
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Affiliation(s)
| | - Jenya Dimitrova
- Acibadem City Clinic Varna, St. Marina Hospital, Varna, Bulgaria
| | | | | | | | - Kamelia Kircheva
- DERMAESTETIC Clinic, Varna, Bulgaria.,Private Practice Dermatologist, Dobrich, Bulgaria
| | | | | | | | - Maya Milanova
- Center for Skin and Venereal Diseases, Sliven, Bulgaria
| | | | - Petya Zlateva
- Diagnostic Consultative Center St. Anna, Sofia, Bulgaria
| | | | - Rumyana Yankova
- University Hospital for Active Treatment Pulmed Plovdiv, Plovdiv, Bulgaria.,Medical Center Mediderma, Plovdiv, Bulgaria
| | | | | | - Emiliya Zografova
- Dermatological Department Military Hospital, Plovdiv, Bulgaria.,Diagnostic Consultative Center 5, Plovdiv, Bulgaria
| | - Sonya Marina
- Department of Dermatology, Ministry of Interior Hospital, Sofia, Bulgaria.,Medical Center Ivan Rilski, Sofia, Bulgaria
| | - Marieta Kateva
- Medical Center Dermaspot, Sofia, Bulgaria.,Neoclinic, Sofia, Bulgaria
| | | | | | | | | | | | - Massimo Milani
- Medical Department Cantabria Labs Difa Cooper, Caronno P, Italy
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5
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Penso L, Touvier M, Deschasaux M, Szabo de Edelenyi F, Hercberg S, Ezzedine K, Sbidian E. Association Between Adult Acne and Dietary Behaviors: Findings From the NutriNet-Santé Prospective Cohort Study. JAMA Dermatol 2021; 156:854-862. [PMID: 32520303 DOI: 10.1001/jamadermatol.2020.1602] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance Acne is a chronic, multifactorial inflammatory disease. The association between consumption of dairy products and fatty and sugary foods and occurrence and progression of acne remains unclear. Objective To assess the association between dietary behavior and current acne in adults. Design, Setting, and Participants A cross-sectional study was performed as part of the NutriNet-Santé study, which is an ongoing observational, web-based cohort study that was launched in France in May 2009. The present study was conducted from November 14, 2018, to July 8, 2019. A total of 24 452 participants completed an online self-questionnaire to categorize their acne status: never acne, past acne, or current acne. Associations between dietary behavior (food intake, nutrient intake, and the dietary pattern derived from a principal component analysis) and current or past acne were studied in multinomial logistic regression models adjusted for potential confounding variables (age, sex, physical activity, smoking status, educational level, daily energy intake, number of dietary records completed, and depressive symptoms). Results The 24 452 participants (mean [SD] age, 57 [14] years; 18 327 women [75%]) completed at least 3 dietary records. Of these, 11 324 individuals (46%) reported past or current acne. After adjustment, there was a significant association between current acne and the consumption of fatty and sugary products (adjusted odds ratio [aOR], 1.54; 95% CI, 1.09-2.16), sugary beverages (aOR, 1.18; 95% CI, 1.01-1.38), and milk (aOR, 1.12; 95% CI, 1.00-1.25). An energy-dense dietary pattern (high consumption of fatty and sugary products) was associated with current acne (aOR, 1.13; 95% CI, 1.05-1.18). Conclusions and Relevance In this study, consumption of milk, sugary beverages, and fatty and sugary products appeared to be associated with current acne in adults. Further large-scale studies are warranted to investigate more closely the associations between diet and adult acne.
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Affiliation(s)
- Laetitia Penso
- Paris 13 University, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche Agronomique, Conservatoire National Des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Centre, University of Paris, F-93022 Bobigny, France
| | - Mathilde Touvier
- Paris 13 University, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche Agronomique, Conservatoire National Des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Centre, University of Paris, F-93022 Bobigny, France
| | - Mélanie Deschasaux
- Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris-Est University, Paris Est Créteil University, Département Infectieux/Immuno/Vaccin, F-94000 Créteil, France
| | - Fabien Szabo de Edelenyi
- Paris 13 University, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche Agronomique, Conservatoire National Des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Centre, University of Paris, F-93022 Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche Agronomique, Conservatoire National Des Arts et Métiers, Nutritional Epidemiology Research Team, Epidemiology and Statistics Research Centre, University of Paris, F-93022 Bobigny, France
| | - Khaled Ezzedine
- Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris-Est University, Paris Est Créteil University, Département Infectieux/Immuno/Vaccin, F-94000 Créteil, France.,Department of Dermatology, Mondor Hospital (Assistance Publique, Hôpitaux de Paris), Paris Est Créteil University, F-94000 Créteil, France
| | - Emilie Sbidian
- Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris-Est University, Paris Est Créteil University, Département Infectieux/Immuno/Vaccin, F-94000 Créteil, France.,Department of Dermatology, Mondor Hospital (Assistance Publique, Hôpitaux de Paris), Paris Est Créteil University, F-94000 Créteil, France.,Clinical Investigation Center 1430, Institut National de la Santé et de la Recherche Médicale, F-94000 Créteil, France
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6
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Park TH, Kim WI, Park S, Ahn J, Cho MK, Kim S. Public Interest in Acne on the Internet: Comparison of Search Information From Google Trends and Naver. J Med Internet Res 2020; 22:e19427. [PMID: 33104003 PMCID: PMC7652686 DOI: 10.2196/19427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 12/21/2022] Open
Abstract
Background Acne vulgaris is a common skin disease primarily affecting young adults. Given that the internet has become a major source of health information, especially among the young, the internet is a powerful tool of communication and has a significant influence on patients. Objective This study aimed to clarify the features of patients’ interest in and evaluate the quality of information about acne vulgaris on the internet. Methods We compared the search volumes on acne vulgaris with those of other dermatological diseases using Google Trends from January 2004 to August 2019. We also determined the search volumes for relevant keywords of acne vulgaris on Google and Naver and evaluated the quality of answers to the queries in KnowledgeiN. Results The regression analysis of Google Trends data demonstrated that the patients’ interest in acne vulgaris was higher than that for other dermatological diseases, such as atopic dermatitis (β=−20.33, 95% CI –22.27 to –18.39, P<.001) and urticaria (β=−27.09, 95% CI –29.03 to –25.15, P<.001) and has increased yearly (β=2.38, 95% CI 2.05 to 2.71, P<.001). The search volume for acne vulgaris was significantly higher in the summer than in the spring (β=–5.04, 95% CI –9.21 to –0.88, P=.018) and on weekends than on weekdays (β=–6.68, 95% CI –13.18 to –0.18, P=.044). The most frequently searched relevant keywords with “acne vulgaris” and “cause” were “stress,” “food,” and “cosmetics.” Among food, the 2 highest acne vulgaris–related keywords were milk and wheat in Naver and coffee and ramen in Google. The queries in Naver KnowledgeiN were mostly answered by a Korean traditional medicine doctor (53.4%) or the public (33.6%), but only 12.0% by dermatologists. Conclusions Physicians should be aware of patients’ interest in and beliefs about acne vulgaris to provide the best patient education and care, both online and in the clinic.
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Affiliation(s)
- Tae Heum Park
- Department of Dermatology, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Woo Il Kim
- Department of Dermatology, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Suyeon Park
- Department of Biostatistics, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Jaeouk Ahn
- Department of Medical IT Engineering, Soonchunhyang University, Asan, Republic of Korea
| | - Moon Kyun Cho
- Department of Dermatology, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Sooyoung Kim
- Department of Dermatology, Soonchunhyang University Hospital, Seoul, Republic of Korea
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7
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Dreno B, Shourick J, Kerob D, Bouloc A, Taïeb C. The role of exposome in acne: results from an international patient survey. J Eur Acad Dermatol Venereol 2020; 34:1057-1064. [DOI: 10.1111/jdv.16119] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/13/2019] [Indexed: 12/26/2022]
Affiliation(s)
- B. Dreno
- Department of Dermato‐Cancerology CHU Nantes‐Hôtel‐Dieu CRCINA Inserm 1232, CIC 1413 University of Nantes Nantes France
| | - J. Shourick
- Bio Informatics/statistics University of Paris Sud Paris France
| | - D. Kerob
- Vichy Laboratoire Internationale Levallois‐Perret France
| | | | - C. Taïeb
- EMMA Fontenay‐sous‐Bois France
- Santé Publique CHU Necker‐Enfants malades Paris France
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8
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Lim S, Shin J, Cho Y, Kim KP. Dietary Patterns Associated with Sebum Content, Skin Hydration and pH, and Their Sex-Dependent Differences in Healthy Korean Adults. Nutrients 2019; 11:E619. [PMID: 30875764 PMCID: PMC6471406 DOI: 10.3390/nu11030619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/10/2019] [Accepted: 03/11/2019] [Indexed: 01/17/2023] Open
Abstract
Sebum content, skin hydration and acidic skin pH are major factors in maintaining skin health. Various nutrients are reported to influence skin health, but the effect of dietary patterns (DPs) on skin health is unclear. In this study, we considered the DPs associated with these three skin health parameters in 84 healthy adults aged 19⁻37 years. Dietary intake was assessed using a food frequency questionnaire (FFQ) and skin health parameters were determined on the forehead of each subject. Among the four DPs extracted from the FFQ, DP2, characterized by a high intake of cereals, potatoes and starch, saccharides and fish and shellfish, was negatively associated with skin hydration. DP3, characterized by a high intake of potatoes and starch, seeds and nuts, fruits and eggs, was positively associated with acidic skin pH only before adjusting for potential confounders. On the other hand, DP4, characterized by a low intake of beans, and a high intake of meats, dairy products and beverages and alcohol, was negatively associated with acidic skin pH and positively associated with sebum content. The data stratified by sex revealed a negative association between skin hydration and DP2 in males and a negative association between sebum content and DP3 and a positive association between sebum content and DP4 in females. In conclusion, we demonstrated that specific DPs were associated with sebum content, skin hydration and pH in healthy Korean adults and that those associations were affected by sex.
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Affiliation(s)
- Sunhee Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin-si 17104, Korea.
| | - Jihye Shin
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin-si 17104, Korea.
| | - Yunhi Cho
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin-si 17104, Korea.
| | - Kun-Pyo Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin-si 17104, Korea.
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9
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Clatici VG, Voicu C, Voaides C, Roseanu A, Icriverzi M, Jurcoane S. Diseases of Civilization - Cancer, Diabetes, Obesity and Acne - the Implication of Milk, IGF-1 and mTORC1. MAEDICA 2018; 13:273-281. [PMID: 30774725 PMCID: PMC6362881 DOI: 10.26574/maedica.2018.13.4.273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Nutrition and food are one of the most complex aspects of human lives, being influenced by biochemical, psychological, social and cultural factors. The Western diet is the prototype of modern dietary pattern and is mainly characterized by the intake of large amounts of red meat, dairy products, refined grains and sugar. Large amounts of scientific evidence positively correlate Western diet to acne, obesity, diabetes, heart disease and cancer, the so-called "diseases of civilization". The pathophysiological common ground of all these pathologies is the IGF-1 and mTORC pathways, which will be disscussed further in this paper.
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Affiliation(s)
| | | | | | - Anca Roseanu
- Department of Ligand-Receptor Interaction, Institute of Biochemistry of the Romanian Academy, Bucharest, Romania
| | - Madalina Icriverzi
- Department of Ligand-Receptor Interaction, Institute of Biochemistry of the Romanian Academy, Bucharest, Romania
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10
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Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol 2018; 32:1631-1637. [PMID: 29633388 DOI: 10.1111/jdv.14998] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/15/2018] [Indexed: 12/28/2022]
Abstract
Acne is an inflammatory and multifactorial skin disease. Different external and internal factors, including air pollution, aggressive skincare products, medication, mechanical, hormonal and familial factors and, more recently, lifestyle and stress, have been suggested as having an impact on acne. Moreover, for many years nutrition was believed to cause or worsen acne. Over the last decades, however, it has become a dermatological doctrine that there is no direct association between diet and acne. Even if recent research has allowed to identify certain nutritional elements and behaviour that may impact on acne, including the excessive intake of dairy products and hyperglycaemic food, modern lifestyle nutrition, obesity and eating disorders, knowledge about the role of nutrition in the physiopathology of acne still remains sparse and hypotheses and myths continue to dominate the debate. Thus, further clinical and translational research is necessary to investigate and confirm the association between nutrition and acne.
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Affiliation(s)
| | | | - M T Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A Michallon, Grenoble, France
| | - F Poli
- Private Practice, Paris, France
| | - B Dréno
- Department of Dermatology, CIC 1413, CRCINA Inserm 1232, Nantes University Hospital, Nantes, France
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11
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Dréno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatol Venereol 2018; 32:812-819. [PMID: 29377341 PMCID: PMC5947266 DOI: 10.1111/jdv.14820] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/10/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acne vulgaris is one of the main reasons for dermatological consultations. Severity and response to treatment may be impacted by various external factors or exposome. AIM To assess the impact of environmental factors on acne and to provide a comprehensive overview of the acne exposome. METHODS Two consensus meetings of five European dermatologists and a comprehensive literature search on exposome factors triggering acne served as a basis for this review. RESULTS Acne exposome was defined as the sum of all environmental factors influencing the occurrence, duration and severity of acne. Exposome factors impact on the response and the frequency of relapse to treatments by interacting with the skin barrier, sebaceous gland, innate immunity and cutaneous microbiota. They may be classified into the following six main categories: nutrition, psychological and lifestyle factors, occupational factors including cosmetics, as well as pollutants, medication and climatic factors. Moreover, practical considerations for the dermatologist's clinical practice are proposed. CONCLUSION Exposome factors including nutrition, medication, occupational factors, pollutants, climatic factors, and psychosocial and lifestyle factors may impact on the course and severity of acne and on treatment efficacy. Identifying and reducing the impact of exposome is important for an adequate acne disease management.
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Affiliation(s)
- B Dréno
- Service de Dermatologie, CIC 1413, CRCINA Inserm 1232, University Hospital Nantes, Nantes, France
| | - V Bettoli
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - E Araviiskaia
- Department of Dermatology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - M Sanchez Viera
- Skin Health, Aging and Cancer, Institute for Dermatology, Madrid, Spain
| | - A Bouloc
- Laboratoires Vichy, Levallois Perret, France
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12
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13
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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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14
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Fung J, Berger A. Hyperinsulinemia and Insulin Resistance: Scope of the Problem. JOURNAL OF INSULIN RESISTANCE 2016. [DOI: 10.4102/jir.v1i1.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
No abstract available.
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Lauermann FT, Almeida HLD, Duquia RP, Souza PRMD, Breunig JDA. Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors. An Bras Dermatol 2016; 91:291-5. [PMID: 27438194 PMCID: PMC4938271 DOI: 10.1590/abd1806-4841.20164405] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/19/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. OBJECTIVES To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. METHODS A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. RESULTS A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. CONCLUSIONS There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring.
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Affiliation(s)
| | | | - Rodrigo Pereira Duquia
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - Porto Alegre (RS), Brazil
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Grossi E, Cazzaniga S, Crotti S, Naldi L, Di Landro A, Ingordo V, Cusano F, Atzori L, Tripodi Cutrì F, Musumeci ML, Pezzarossa E, Bettoli V, Caproni M, Bonci A. The constellation of dietary factors in adolescent acne: a semantic connectivity map approach. J Eur Acad Dermatol Venereol 2016; 30:96-100. [PMID: 25438834 DOI: 10.1111/jdv.12878] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/22/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Different lifestyle and dietetic factors have been linked with the onset and severity of acne. OBJECTIVE To assess the complex interconnection between dietetic variables and acne. METHODS This was a reanalysis of data from a case-control study by using a semantic connectivity map approach. 563 subjects, aged 10-24 years, involved in a case-control study of acne between March 2009 and February 2010, were considered in this study. The analysis evaluated the link between a moderate to severe acne and anthropometric variables, family history and dietetic factors. Analyses were conducted by relying on an artificial adaptive system, the Auto Semantic Connectivity Map (AutoCM). RESULTS The AutoCM map showed that moderate-severe acne was closely associated with family history of acne in first degree relatives, obesity (BMI ≥ 30), and high consumption of milk, in particular skim milk, cheese/yogurt, sweets/cakes, chocolate, and a low consumption of fish, and limited intake of fruits/vegetables. CONCLUSION Our analyses confirm the link between several dietetic items and acne. When providing care, dermatologists should also be aware of the complex interconnection between dietetic factors and acne.
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Affiliation(s)
- E Grossi
- Scientific Advisor, Bracco Foundation, Milano, Italy
| | | | - S Crotti
- Centro Studi GISED - FROM, Bergamo, Italy
| | - L Naldi
- Centro Studi GISED - FROM, Bergamo, Italy
- Department of Dermatology, Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy
| | | | - V Ingordo
- Military Hospital Center, Taranto, Italy
| | - F Cusano
- Dermatology Unit, G. Rummo Hospital, Benevento, Italy
| | - L Atzori
- Dermatology Clinic, University of Cagliari, Cagliari, Italy
| | | | - M L Musumeci
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Pezzarossa
- Dermatology Unit, Istituti Ospitalieri Hospital, Cremona, Italy
| | - V Bettoli
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - M Caproni
- I Dermatology Clinic ASF - S.O.S. Cutaneous Immunopathology and Rare Dermatological Diseases, University of Florence, Florence, Italy
| | - A Bonci
- Dermatology Unit, S. Maria Nuova Hospital, Reggio Emilia, Italy
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17
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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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18
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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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19
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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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20
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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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21
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Szabó K, Kemény L. Studying the genetic predisposing factors in the pathogenesis of acne vulgaris. Hum Immunol 2011; 72:766-73. [PMID: 21669244 DOI: 10.1016/j.humimm.2011.05.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 04/28/2011] [Accepted: 05/13/2011] [Indexed: 02/04/2023]
Abstract
Acne is one of the most common dermatologic diseases in the developed regions of the world, affecting a large percentage of the population. Despite the great improvement in the number and quality of studies of the molecular etiology of this disease in the past 3 decades, the detailed molecular pathogenesis and the cause of the large individual variations in severity of skin symptoms remain unknown. The roles of genetic inheritance and special genetic susceptibility and protective factors have been suggested for over 100 years, but their identification and determination started only in the 1990s. To date, only a small number of genetic polymorphisms affecting the expression and/or function of a handful of genes have been investigated. This review surveys the major findings of the classic and molecular genetic studies that have been conducted in this field, draws conclusions, and indicates how the available data help our current understanding of the pathogenesis of this common skin disease.
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Affiliation(s)
- Kornélia Szabó
- Dermatological Research Group of the Hungarian Academy of Sciences, Szeged, Hungary.
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