Evaluating the association between acne vulgaris and diet: an exploratory study on patient beliefs and perceptions

Dr. Ramesh Munishamappa

MBBS, MD

Chamarajpet Skin and Laser Centre

 

The association between diet and acne has been a major focus of acne epidemiology research. Numerous studies have established that high-sugar diets and dairy products are significant risk factors. Elevated sugar intake (≥100 g/day), frequent consumption of soft beverages (≥7 times per week—including carbonated sodas, sweetened teas, and fruit-flavored drinks), and daily dark-chocolate intake have all been strongly linked to acne. Although recent studies highlight the relationship between diet and acne, patients’ beliefs and perceptions about these effects remain insufficiently explored. For example, one study reported that 75% of participants believed acne is influenced by diet. Patients primarily sought information from Instagram (63%), online forums (54%), and textbooks (46%), yet many felt their dietary changes were ineffective and that an information gap persists. In the study by Salemi et al., the authors specifically evaluated patients’ perceptions and beliefs regarding the diet–acne relationship.

This cross-sectional study was conducted over one year in a dermatology clinic and included patients with a confirmed diagnosis or history of acne vulgaris, aged 12–45 years. Exclusion criteria included lack of consent, inability to read or complete the questionnaire, and failure to cooperate with the physical examination. A questionnaire was designed for the study, consisting of three sections: demographic information, skin characteristics, and beliefs about the influence of diet on acne. The dermatologist completed the first two sections, while patients filled out the third. Acne severity was categorized as mild, moderate, or severe, and skin type was classified as normal, dry, oily, or mixed.

A total of 793 patients were included in the study. Of these, 328 (41.36%) were between 12 and 19 years old, and 482 (60.78%) were male. The analysis showed no significant associations between age, gender, BMI, or education level and patients’ overall perceptions regarding the impact of diet on acne (p=0.62, 0.57, 0.92, and 0.90, respectively). Most participants believed that sweets, chocolate, and fatty or fried foods worsened acne, while fruits, vegetables, vitamins, and supplements such as zinc, omega-3, selenium, and green tea helped improve it.

In contrast, acne severity and skin type demonstrated significant associations with patients’ beliefs about dietary effects. Among those with mild, moderate, and severe acne, 10.34%, 10.09%, and 0.5%, respectively, believed diet “absolutely” influenced acne exacerbation or improvement. Similarly, perceptions of a “very high” impact were reported by 14.38% of patients with mild acne, 15.01% with moderate acne, and 1.01% with severe acne (p=0.00). Skin type also played a role: 10.47% of participants with dry skin, 26.61% with mixed skin, 18.16% with normal skin, and 27.62% with oily skin believed that dietary changes “absolutely” affected their acne (p=0.01).

Many acne patients believe diet influences their condition, commonly viewing sweets and chocolate as aggravating factors and fruits/vegetables as beneficial. These beliefs correlate significantly with acne severity and skin type. BMI and education level also affect perceptions, particularly regarding fatty and fried foods. Overall, educating all acne patients about evidence-based dietary influences appears warranted.

Reference: Salemi M, Dadkhahfar S, Tehranchinia Z, et al. Evaluating the association between acne vulgaris and diet: An exploratory study on patient beliefs and perceptions. J Cosmet Dermatol. 2025;24(7):e70285