More than 17 million Americans suffer from acne, mostly during their adolescent and young adult years. Acne influences quality of life, including social withdrawal, anxiety, and depression, making treatment essential. Since the late 1800s, research has linked diet to this common disease, identifying chocolate, sugar, and fat as particular culprits, but beginning in the 1960s, studies disassociated diet from the development of acne.

"This change occurred largely because of the results of two important research studies that are repeatedly cited in the literature and popular culture as evidence to refute the association between diet and acne," says Jennifer Burris, MS, RD, of the Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education, and Human Development, New York University. "More recently, dermatologists and registered dietitians have revisited the diet-acne relationship and become increasingly interested in the role of medical nutritional therapy in acne treatment."

Burris and colleagues, William Rietkerk, Department of Dermatology, New York Medical College, and Kathleen Woolf, of New York University's Department of Nutrition, Food Studies, and Public Health, conducted a literature review to evaluate evidence for the diet-acne connection during three distinctive time periods: early history, the rise of the diet-acne myth, and recent research.

Culling information from studies between 1960 and 2012 that investigated diet and acne, investigators compiled data for a number of study characteristics, including reference, design, participants, intervention method, primary outcome, results and conclusions, covariate considerations, and limitations.

They concluded that a high glycemic index/glycemic load diet and frequent dairy consumption are the leading factors in establishing the link between diet and acne. They also note that although research results from studies conducted over the last 10 years do not demonstrate that diet causes acne, it may influence or aggravate it.

The study team recommends that dermatologists and registered dietitians work collaboratively to design and conduct quality research. "This research is necessary to fully elucidate preliminary results, determine the proposed underlying mechanisms linking diet and acne, and develop potential dietary interventions for acne treatment," says Burris. "The medical community should not dismiss the possibility of diet therapy as an adjunct treatment for acne. At this time, the best approach is to address each acne patient individually, carefully considering the possibility of dietary counseling."

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Journal Reference:

1. Jennifer Burris, William Rietkerk, Kathleen Woolf. Acne: The Role of Medical Nutrition Therapy. Journal of the Academy of Nutrition and Dietetics, 2013; 113 (3): 416 DOI: 10.1016/j.jand.2012.11.016