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    Data support acne dietary triggers

    Recent studies suggest management strategies worth considering

    Information from recent publications provides dermatologists with some helpful strategies for acne management, says Jonette Keri, MD, PhD., associate professor of dermatology and cutaneous surgery, University of Miami Miller School of Medicine, Miami, Fla., and chief, dermatology service, Miami VA Hospital.

    Speaking at the 14th Annual South Beach Symposium (Miami Beach, Fla., February 2016), she highlighted new findings on dietary modifications that can influence acne and discussed protocols for managing severe acne.

    Dietary triggers

    Acne patients often wonder whether their skin condition is affected by what they eat. Insight on this issue is provided by findings of a recent Cochrane review on complementary therapies for acne vulgaris and a second review article focusing on dietary impact on acne metabolomics, follicular inflammation, and comedogenesis.1,2 The conclusions of both studies indicate that a low-glycemic load diet is something worth considering.

    The Cochrane review considered two studies comparing low-glycemic load and high-glycemic load diets, of which one found a benefit of the low-glycemic low diet for reducing inflammatory lesion and total skin lesion counts.1 Authors of the review article cited results of several placebo- and case-controlled studies showing a high glycemic load diet can cause or aggravate acne as well as epidemiologic data linking dietary features to acne prevalence.2 They stated the mechanism involves the effect of carbohydrates on the bioactivity of free serum insulin growth factor 1 (IGF-1) and free serum androgens.

    “Now, if I see an overweight teenager with acne or an overweight adult woman with adult onset acne, I tell them there is evidence that foods causing a ‘blood sugar rush’ may worsen acne and suggest they consider avoiding these hyperglycemic carbohydrates,” Dr. Keri says.

    Information from a few papers appearing in the last several years also supports the idea that whey protein may be the fraction of dairy products promoting acne formation.3-5 Two of the publications each described five males who developed acne shortly after starting whey protein supplementation.3,4 Investigators in Brazil following 30 patients over a period of 60 days found progressive increases in lesion counts after the study participants started protein-calorie supplementation; whey protein supplement was used by 22 of the study participants.5 The purported underlying mechanism for the acnegenic effect of whey protein also involves effects on IGF-1 signaling.

    “Supplementation with whey protein is a popular practice for bodybuilding, and when I see a patient who looks like he or she is trying to bulk up, it is a red flag to me to discuss whey protein supplementation,” Dr. Keri says.

    NEXT: Controlling severe acne

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