Acne Vulgaris and Diet: Influence of the Environment

Acne Vulgaris and Diet: Influence of the Environment

History

• Until 1969, it was commonly admitted that dietary (and Behavioural) factors were implicated in the exacerbation of acne vulgaris. Such foods included chocolate, fats, sweets as well as sparkling soft drinks (such as Coca Cola).
• In 1969, a study on a small number of subjects concludes to a lack of evidence of the role of chocolate in acne vulgaris (Fulton, Plewig, Kligman).
• In 2005, Adebamewo incriminates dairy products (especially skimmed milk).
• In 2007, hyperglyaemic states (high blood sugar) are then accused and a molecular hunt by Melnik attibutes acne vulgaris exacerbation to be due to sebaceous gland stimulation by IGF-1 (Insulin-like growth Factor 1).
• This leads to Shalita doing a literature review of acne vulgaris and diet and publishing it in the Blue Journal(Diet and acne. Bowe WP, Joshi SS, Shalita AR. J Am Acad Dermatol. 2010 Jul;63(1):124-41. Epub 2010 Mar 24. Review.)

What are the Problems with all of these conclusions ?

• The issues with the research done is that:

1. they are small studies
2. they extrapolate and conclude in an unproven way
3. they mix up the types of acne vulgaris

Today’s Renewed Interest

• Nowadays, there is a return of the interest to study:

1. the role of diet and the environment in acne vulgaris
2. the role of “bioactive foods” beyond their action on the sugar levels in the blood (glycaemia)
3. the mechanism of action of bioactive foods in the induction of acne vulgaris lesions

• Natural AhR (Aryl Hydrocarbon Receptor=Dioxin Receptor) Agonists = NAhRa

1. The stimulation of AhR receptor by intraperitoneal injection in mice induces metabolisation of the injected substance in the sebaceous gland.
2. The sebaceous gland produces sebum (wax) with two enzymes taking part: FADS 2 (Fatty Acid Desaturase 2) et Awat (Acyl-CoA Wax Alcohol Transferase or DGA T2L3) and their production is stimulated by NahRa through their action on AhR.
3. NahRa include flavanoids: Brussel Sprouts, Broccoli…Cabbage: “a diet of cabbage has been shown to stimulate the AhR” (Journal of Exposure Science and Environmental Epidemiology (2008, 18(4)))

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: JH Saurat, Tribune Libre. Journées Dermatologiques de Paris 2011 – Paris, France