What is the relationship between diet and acne? Here’s the knowledge update you need

  The percentage of acne patients in outpatient clinics is over 60%, and almost 85% of the population will suffer from acne in their lifetime, but what bothers them most is the recurring flare-ups. Minor pimples and pimples, severe cystic nodules, these are collectively referred to as acne in medical terms. At the root of this, the most common reason for treatment failure is lack of time. Successful treatment requires months of topical medication (topical medications) and, in many cases, combined systemic therapy (oral medications).  But today to address a question that is asked a lot in clinical practice: “Dr. Zhang, what should I look for in my diet?”  The results of a systematic review of studies have shown that most of the information on the internet about diet and acne is unfounded and even misleading. Let’s start with whether acne patients need to avoid eating.  1. Should acne sufferers avoid eating?  If “avoiding food = absolutely not eating”, then acne patients do not need to avoid food! Spicy and stimulating foods, beef, lamb, chicken, duck, fish, shrimp, etc. can be eaten by acne patients, and there is no clear link between these foods and the onset and aggravation of acne.  However, there are some foods that patients should eat less of, such as high sugar and high calorie foods (sweets, chocolate, carbonated beverages, etc.), skim milk and whole milk, etc. Note that we are talking about eating less here, not not not eating at all.  After all, a happy mood is also beneficial to acne treatment, so it is better to “treat happily”!  In addition, poor bowel movements are also a clear trigger and aggravating factor for acne, so it is important for acne sufferers to eat more vegetables and exercise to keep their bowel movements smooth.  2. What do the existing scientific studies on the relationship between acne and diet say?  Some studies have shown that a low-glycemic diet, zinc, omega-3 fats and antioxidants can help fight acne.  Low glycemic index and glycemic load diets can reduce insulin-like growth factor in patients with moderate to severe acne, and insulin-like growth factor is closely related to the inflammatory response during acne development, thus low glycemic index and low glycemic load diets can reduce the inflammatory response to acne, which is beneficial for acne treatment recovery. It has also been found that metformin, a drug frequently used by diabetic patients to lower postprandial blood glucose, can be used as an adjunctive treatment drug for moderate to severe acne vulgaris.  There are also retrospective analyses showing that any milk-based dairy products, such as milk, yogurt and cheese, have insulin-like growth factor IGF-1, a hormone that promotes cell growth. Scientists speculate that this may lead to an overgrowth of cells in the pores and/or an increase in skin oil production, which can clog pores and in turn lead to acne or acne breakouts. Overall, however, there is little evidence of a correlation between dairy products and acne and no conclusions can be drawn.  Also, of the micronutrients, iodine is thought to contribute to acne vulgaris, but there is insufficient evidence to support this. Zinc and calcium deficiencies may also have some correlation with acne occurrence. Research evidence suggests that zinc has antibacterial and anti-inflammatory effects and may reduce sebum production. Therefore, in clinical practice, I often supplement patients with zinc, calcium and other trace elements at different times of acne. Relevant medications include procaine calcium pantothenate capsules and lysine glucose-zinc granules (please follow your doctor’s instructions for specific use).  In summary, the recommended diet for acne patients: colorful fruits and vegetables, low-sugar diet, oysters, deep-sea fish, zinc gluconate, etc.  And dairy products, chocolate, and iodine are controversial foods.  3. Having said so much about diet-related content, what is the real key to acne treatment?  Clinically, the treatment of acne is not really difficult, but regularity is the most crucial.  Patients should develop confidence and patience. Several authoritative dermatology societies or organizations around the world regularly update their acne treatment guidelines. The treatment recommendations that are included in the guidelines have been proven to be effective through rigorous clinical studies.  Therefore, I will choose the most appropriate treatment plan based on the specific presentation of the acne patient, the guidelines, and clinical experience. At the same time, we will closely follow up and make timely medication adjustments according to the response to treatment and changes in the condition. The treatment of acne is not a once-and-for-all or a set-it-and-forget-it treatment. It is necessary to follow the standard principles, make adjustments at the right time, and adhere to the treatment.  Do not blindly listen to various prescriptions or treatment in irregular institutions. Otherwise, not only will it be ineffective, but it will delay the best treatment time and cause serious acne sequelae, such as acne marks and scarring, which will make treatment more difficult.

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