Skin and Diet: An Update on the Role of Dietary Change as a Treatment Strategy for Skin Disease

Rajani Katta, MD; Mary Jo Kramer, BSc


Skin Therapy Letter. 2018;23(1) 

In This Article

Diet and Acne


The strongest evidence to date on dietary triggers for acne is for high-glycemic-load diets. In a randomized controlled trial (RCT), acne patients demonstrated significant improvement after 12 weeks of a low-glycemic-load diet.[1] Later studies documented that this dietary pattern resulted in lower androgen bioavailability and altered skin sebum production.[2,3] In another RCT, a 10-week low-glycemic-load diet improved acne, and histopathological exam revealed decreased skin inflammation and reduced sebaceous gland size.[4]

Some studies have demonstrated an epidemiologically weak association between acne and dairy consumption, possibly more so with skim milk.[5–7] While further research is needed, it may play a role in some patients, as in a report of five teenagers who developed treatment-resistant acne after starting whey protein supplements.[8]

Beneficial Measures

Studies in humans are limited and, therefore, despite promising in vitro, animal, or anecdotal reports, recommendations for foods or supplements containing probiotics, omega-3 fatty acids, zinc, antioxidants, fiber, and vitamin A cannot be made with certainty at this time.[9] Omega-3 fatty acids warrant further study; in one 10-week RCT, omega-3 fatty acid supplements and gammalinolenic acid supplements both resulted in clinical and histopathological improvement in acne lesions.10 Probiotics warrant further study as well; in one RT, minocycline with probiotic supplementation resulted in a lower total lesion count as compared to antibiotics alone.[11]

Zinc bears special mention, as it has been studied in several RCTs. While some trials have not been successful, others have demonstrated efficacy in acne treatment.[12,13] Further research is warranted, as published trials have utilized multiple dosages and forms of zinc, including zinc gluconate, zinc sulphate, and methionine-bound zinc, among others. Some formulations have better absorption and result in less gastrointestinal side effects. Other factors that impact zinc absorption include age and meal components.[14] In addition, some successful trials have utilized zinc in combination with other components, such as antioxidants and lactoferrin.[15,16] Future research must account for these multiple factors.