No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Chocolate and acne: How valid was the original study?
... The Chocolate Manufacturers Association of the USA sponsored the Fulton study and the study subjects were prisoners. 3 There were no baseline data or quantitative analysis, and no difference in the sugar and fat content between the chocolate bar and the control bar. 3 The link of chocolate to acne vulgaris was replaced by the theory that a high glycemic index may contribute to acne vulgaris. [4][5][6] In this study, we attempted to revisit the controversial topic by assessing the development of new acne lesions following ingestion of chocolate versus a nonchocolate candy with a similar glycemic load. ...
... 3 There were no baseline data or quantitative analysis, and no difference in the sugar and fat content between the chocolate bar and the control bar. 3 The link of chocolate to acne vulgaris was replaced by the theory that a high glycemic index may contribute to acne vulgaris. [4][5][6] In this study, we attempted to revisit the controversial topic by assessing the development of new acne lesions following ingestion of chocolate versus a nonchocolate candy with a similar glycemic load. ...
... A confirmed diagnosis is imperative to avoid unnecessary systemic antifungal treatments and potential toxicity. 1,2 Periodic acideSchiff (PAS) staining of nail plate fragments is generally considered to be more sensitive than potassium hydroxide (KOH) preparation 3 and culture, although less sensitive, and remains an important method for the identification of challenging or treatment-resistant cases. Reported sensitivities and specificities are listed in Table I. ...
... However, researchers have recently re-examined this issue and found methodological flaws in previous studies. In fact, more recent data have provided strong support for the notion that a specific diet may be a potential cause of exacerbating or alleviating acne symptoms [36]. The role of certain foods, such as dairy products, as well as a high glycemic load diet in acne has been confirmed. ...
Allergic contact dermatitis is one of the most common recorded occupational diseases. There are many different substances that the skin comes into contact with on a daily basis and that can cause ACD, e.g., preservatives, surfactants, and antimicrobial agents. The development of a mouse model of ACD has provided insight into the immune mechanisms involved. Drugs used in the treatment of skin diseases have many side effects. Therefore, alternative methods of suppressing the immune response to reduce the symptoms of skin diseases are being sought. In recent years, high hopes have been placed on dietary modulation and supplementation to affect the intestinal microbial composition and promote anti-inflammatory responses. In addition, other studies have shown the crucial role of intestinal microbiota in many immune-mediated diseases. Recognition and characterization of pro- and anti-inflammatory nutrients and supplements may be crucial to support the treatment of diseases such as atopic dermatitis, acne vulgaris, psoriasis, and allergic contact dermatitis.
... However, later researchers noted methodological flaws in the original study, including the fact that the placebo bar contained a similar total sugar and fat content as the chocolate bar [3]. Further studies have now correlated a number of dietary factors and acne. ...
Background:
In the past, medical literature reflected that diet was not a proven cause of acne. However, studies in recent years have substantiated a link between certain dietary factors and acne. It is unclear whether patients are aware of recent research findings.
Objectives:
Acne patients were surveyed to explore beliefs regarding the link between diet and acne, to determine whether these beliefs translated into behavior change and to identify health information sources.
Patients/methods:
Upon Institutional Review Board (IRB) approval, surveys were administered to 50 acne patients at an academic dermatology clinic in 2014, with 49 completed in full and included in this analysis.
Results:
Ninety-two percent of respondents believed that diet could affect acne. Seventy-one percent attempted to change their diet to improve acne. Seventy-one percent believed acne to be caused by fried or greasy foods, although chocolate (53%), dairy (47%), and soda drinks (35%) were highly implicated. Patients obtained information from Google searches (49%), dermatologists (43%), family members and TV (41% each), and medical websites (31%).
Conclusions:
In this exploratory study, patients reported utilizing a diversity of information sources, a majority from the Internet. In those surveyed, there was a persistence of long-held belief that fried/greasy foods and chocolate may serve as acne triggers, and less belief in trigger foods supported by recent research, including refined carbohydrates and sugar. Given the multiplicity of beliefs and utilized sources among acne patients in our survey, there is a need to establish up-to-date and reliable methods to educate patients on diet and acne.
... Fulton's trial from 1969 was the first clinical trial regarding dietary habits and acne (18). This study has later been criticized (18,22). The second, more recent, study that tested the hypothesis of chocolate as a cause of acne (18) presented contrary results, indicating that cacao might aggravate acne. ...
is missing (Short communication).
... Researchers recently re-examined this study, however, and found methodological flaws. 2 In fact, more recent research has provided strong support for diet as a potential cause of acne. Research has substantiated the role of specific foods, such as dairy products, as well as dietary patterns, including the high glycemic load diet typical of the Western diet. ...
For decades, it was thought that many common dermatological conditions had no relationship to diet. Studies from recent years, however, have made it clear that diet may influence outcome. In this review, the authors focus on conditions for which the role of diet has traditionally been an underappreciated aspect of therapy. In some cases, dietary interventions may influence the course of the skin disease, as in acne. In others, dietary change may serve as one aspect of prevention, such as in skin cancer and aging of the skin. In others, dermatological disease may be linked to systemic disease, and dietary changes may affect health outcomes, as in psoriasis. Lastly, systemic medications prescribed for dermatological disease, such as steroids, are known to raise the risk of other diseases, and dietary change may reduce this risk.
The field of integrative medicine is rapidly advancing and, given the multidisciplinary approach as well as influences from many parts of the world, brings together many facets of immunology and immunomodulation. The diverse origins of therapies, including herbal, botanical, spice roots, and other natural sources, give rise to many applications as anti-inflammatory agents. Dermatologists incorporate integrative therapies in diseases such as acne, rosacea, atopic dermatitis, psoriasis, and hidradenitis suppurativa among others, attempting to modulate the actions of neurotransmitters, cytokines, and cellular balances. More importantly, the advances in the field are highlighting combination therapies as well as alternatives to prescription medicines to accomplish therapeutic benefits. This chapter will outline the impact of diet and nutrition, supplementation, and probiotics, used in conjunction with or without conventional immunomodulators to modify a disease process and bring benefits to patients who might have been previously out of options.
The purpose of the review was to study the data of the modern literature on the effect of diet on the skin condition and the course of some dermatological diseases. Recent studies have shown a strong link between diet and a number of dermatological conditions. Food allergies and Western eating patterns can dramatically alter microbiome composition and intestinal permeability. In conditions of disturbed microbial balance and changes in the barrier function of the intestine, the penetration of immunogenic molecules into the systemic circulation, including food antigens, bacterial toxins and pathogens, which can accumulate in the skin, disrupt the epidermal barrier and contribute to chronic inflammation, increase. However, in children with atopic dermatitis, elimination diets did not show a significant advantage in reducing the severity of the disease; on the contrary, adverse events associated with malnutrition, lack of vitamins and minerals were more often recorded. Despite the fact that dietary intervention is an important aspect of the treatment and prevention of a wide range of dermatological diseases, many questions remain open today.
The association between chocolate consumption and acne vulgaris is a historical enigma. This study sought to investigate the effect of dark and white chocolate consumption on acne lesions. In this case-control, clinical trial, 57 volunteers with mild-to-moderate acne vulgaris were randomized in three groups, receiving 100 g of either white or dark (100%) chocolate bars daily for 30 consecutive days (case groups) or no chocolate (control group) during the study period. Facial acne noninflamed, inflamed and total lesions were counted at baseline, on week 2 and at endpoint (day 30). In white chocolate group, there were 11 males (61.1%) and 7 females (38.9%) with a mean age of 17.9±7.2 years (range: 12-29). In dark chocolate group, there were 14 males (73.7%) and 5 females (26%) with a mean age of 17.6±6.0 years (range: 12-29). In control group, there were 13 males (65%) and 7 females (35%) with a mean age of 17.7±6.6 years (range: 12-29). The three groups were comparable for sex (p = 0.71) and age (p = 0.99). No significant difference was found between the patients in dark chocolate group and those served as controls in terms of changes in acne lesions (p>0.05). All noninflamed (p = 0.02), inflamed (p = 0.04) and total (p = 0.02) acne lesions in white chocolate group, however, increased significantly in comparison with the two other groups. According to this study, white but not dark chocolate consumption is associated with exacerbation of acne lesions.
Superficial subcutaneous lipomas are common benign tumors of the subcutaneous adipose tissue. Removal of superficial subcutaneous lipomas is achieved with simple surgical excision for the purposes of improved cosmesis, removing painful lipomas, or for the removal of a lipoma affecting function through mass effect. As research in localized fat reduction has improved, therapies successful in this domain have been applied to the management of lipomas as a surgical alternative. In this review article, the authors review the basic science of injection therapies used in the management of lipomas as well as their potential efficacy and limitations.
There are significant data supporting the role of diet in acne. Our Western diet includes many dairy sources containing hormones.. The natural function of milk being to stimulate growth, it contains anabolic steroids as well as true growth hormones and other growth factors. The presence of 5α-pregnanedione, 5α-androstanedione, and other precursors of 5α-dihydrotestosterone add to the potency of milk as a stimulant of acne. In addition, foods with significant sugar content and other carbohydrates yielding high glycemic loads affect serum insulin and insulin-like growth factor-1 levels, both of which promote increased production of available androgens and the subsequent development of acne.
Acne is the most prevalent skin condition. It has a substantial effect on the quality of life of teenagers worldwide. Among acne patients from different societies and cultures, diet is uniformly regarded as a major cause in the pathogenesis of acne. We reviewed the up-to-date literature regarding acne and culprit foods such as dairy products, chocolate, and fatty foods. Unfortunately, after reviewing the existing data, there are no answers but there are definitely more questions, because there is no clear proof about whether these issues are facts or misconceptions.
Lay perceptions that diet, hygiene and sunlight exposure are strongly associated with acne causation and exacerbation are common but at variance with the consensus of current dermatological opinion.
The objective of this study was to carry out a review of the literature to assess the evidence for diet, face-washing and sunlight exposure in acne management.
Original studies were identified by searches of the Medline, EMBASE, AMED (Allied and Complementary Medicine), CINAHL, Cochrane, and DARE databases. Methodological information was extracted from identified articles but, given the paucity of high quality studies found, no studies were excluded from the review on methodological grounds.
Given the prevalence of lay perceptions, and the confidence of dermatological opinion in rebutting these perceptions as myths and misconceptions, surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne. Much of the available evidence has methodological limitations.
Based on the present state of evidence, clinicians cannot be didactic in their recommendations regarding diet, hygiene and face-washing, and sunlight to patients with acne. Advice should be individualized, and both clinician and patient cognizant of its limitations.
Thomson Reuters Available at: http://apps. isiknowledge.com/summary.do?qid=6&product=UA&SID= 1CGmO42mppk9a7Ji115&search_mode=GeneralSearch
- Isi
- Web
- Knowledge
ISI Web of Knowledge. Thomson Reuters. Available at: http://apps. isiknowledge.com/summary.do?qid=6&product=UA&SID= 1CGmO42mppk9a7Ji115&search_mode=GeneralSearch. Accessed 1/24/2011.