Common condition characterized by Follicular papules or comedones Inflammatory papules & pustules ...
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Transcript of Common condition characterized by Follicular papules or comedones Inflammatory papules & pustules ...
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Acne Vulgaris
Common condition characterized by Follicular papules or
comedones Inflammatory
papules & pustules
Severe cases Nodules & scarring
may occur
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Acne Vulgaris
Factors that contribute to the pathogenesis of acne include Infection with Propionibacterium acnes Tissue inflammation Plugging of hair follicles as a result of
epidermal hyper-proliferation Hormonal imbalances
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Conventional Therapies
Topical treatments (e.g., retinoids,
antibiotics, or benzoyl peroxide)
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Conventional Therapies
Systemic medications (e.g., antibiotics, oral contraceptives,
Isotretinoin [13-cis-retinoic acid]) Isotretinoin is highly effective for
patients with severe intractable acne Can cause many
adverse effects Teratogenic
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Dietary Factors Most
conventional texts & review articles Do not
consider diet to be an important factor in the etiology of acne
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Dietary Modificati
on
Can produce improvement or complete resolution of lesions Sizeable minority of patients
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Possible Role of Diet in the
Causation of Acne
Suggested by observations regarding Canadian Inuits (Eskimos) Prior to around 1950 – diet consisted
almost exclusively of fish & game with occasional vegetables & berries
After 1950 – changed to a typical Western diet Acne became common in
teenagers shortly after these dietary changes were made
Glickman FS, Silvers SH. Dietary factors in acne vulgaris. Arch Dermatol 1972; 106: 129.
Schaefer O. When the Eskimo comes to town. Nutr Today 1971 (Nov/Dec): 8-16.
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Refined Sugar
52 patients with acne assigned to consume Usual diet Restrict sugar intake by
Eliminating soft drinks, candy & cake Limiting sugar in coffee or tea to 2
teaspoons/day
Continued…
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Refined Sugar Substantial improvement or complete
clearing of lesions Seen in 84% of those consuming low-
sugar diet 74% of those in the control group
Results Consistent with the possibility that
reducing sugar intake is beneficial in some cases
Cornbleet T, Gigli I. Should we limit sugar in acne? Arch Dermatol 1961; 83: 968-969.
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Food Allergy/Sensitivity Numerous investigators have
reported Allergy or sensitivity to foods is a major
contributing factor in some cases of acne
Turnbull JA. Changes in the systems affected by allergenic foods. Am J Dig Dis 1944; 11: 329-336.
White C. Food sensitization dermatoses. J Allergy 1933; 4: 151-153.
Flood JM. The factor fo food allergy in acne. Penn Med J 1948; 51: 533-534.
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Food Allergy/Sensitivity Exacerbations of
acne could result from Allergenic reactions Effects of biologically
active substances in certain foods (e.g., hormones in
cow’s milk & possible amines or other chemicals in chocolate)
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Food Allergy/Sensitivity
Adult-onset acne Responds
more frequently to food elimination Vs. acne
that began during the teen years
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Food Allergy/Sensitivity Type of acne most likely to
respond to food elimination Characterized by delicate skin with
moderate degree of seborrhea & erythematous flares around pustular lesions
History of resistance to previous treatments
Cormia FE. Food sensitivity as a factor in the etiology of acne vulgaris. J Allergy 1940; 12: 34-41.