Diet: Emerging evidence
Diet’s role in acne remains controversial but represents an exciting area of research.
“I think the emerging data on diet and acne is fascinating. And while we don’t have the rigorous data required yet to make specific recommendations to patients, I look forward to seeing what emerges over the next few years,” Dr. Zaenglein says.
The role of a high glycemic diet in acne is particularly interesting, according to Dr. Zaenglein.
INTERESTING: Acne a growing problem in pre-teens
“We have good, preliminary evidence that especially in those with known abnormal glucose metabolism (metabolic syndrome), changes in diet can result in notable improvement in acne as well as their cholesterol, insulin levels and other metabolic parameters. Longer term, prospective studies are needed, however, prior to making specific dietary recommendations to acne patients with normal metabolic profiles,” Dr. Zaenglein says.
There is also research to suggest dairy — particularly skim milk — could be linked to acne. But this data, too, is inadequate to make a sweeping recommendation, Dr. Schlosser says.
Where judgement comes in
Although it’s not emphasized in the guidelines, Dr. Schlosser says dermatologists should make sure their acne patients are being treated appropriately for their acne severity.
“We don’t want practitioners to shy away from using oral agents if patients have adequate degree of severity in terms of their inflammatory acne. For instance, we don’t want someone with moderate inflammatory acne, with mild scarring, to just be treated with a topical agent because the practitioner is hesitant to utilize an oral agent,” she says. “It’s important to emphasize that patients should be treated as aggressively as needed for the severity of their acne.”