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Eating low GI foods and avoiding processed sugars may therefore reduce acne flares in patients with and without concurrent PCOS,10,19,20 and one study showed that women with elevated IGF-1 levels are more likely to experience acne compared to men.19 I use an inDermatology nurse practitioner Emma Coleman depth consultation with acne patients to identify possible dietary issues alongside first-line topical explains how one’s diet can influence skin and preparations. Studies have shown that soybean isoflavones hair and presents a supporting case study (a type of phytoestrogen) exert an antiThe effects of diet on skin is a controversial subject due to a androgenic effect, altering disease pathways and skin health.13,21 lack of strong evidence justifying this as an effective element Furthermore, there is data supporting a positive correlation in dermatology treatment. However, there is growing support for between eating foods rich in soybean isoflavone and acne multi-disciplinary approaches to the management of skin disease lesion reduction, due to inhibition of the steroidogenic due to evidence of higher success and faster discharge rates.1,2 This hormone-inducing enzymes 3ß-hydroxysteroid dehydrogenase, approach is something I incorporate into my daily practice. 17ß-hydroxysteroid dehydrogenase and 5α-reductase.13,21 In this article, I discuss the benefits of combining dietary and oral/ One study found that combining soybean supplementation topical preparations in management of four endocrine-induced skin (160mg daily) with 0.025% tretinoin cream and SPF 15 sunscreen conditions: acne vulgaris, hirsutism, menopausal skin ageing and over 12 weeks significantly reduced acne lesion number in female female pattern hair loss (FPHL). patients.21 Such dermatology conditions may cause psychological disruption to Isoflavones contain antioxidant and antifungal properties. sufferers, resulting in feelings of shame, humiliation and depression.3,4 Soybeans have four chemical types; aglycone, glucosides, One study reported that 5.6% of acne vulgaris patients have suicidal acetyl glucosides and aminoglycosides, containing the three ideation.3 There is also evidence that diet may influence hormonal isoflavones daidzein, genistein and glycitein. Soybean isoflavone homeostasis in those who are experiencing these skin conditions, foods can be eaten in the fermented form; miso, tempeh, natto, imparting skin and hair changes. Diet as a management tool may be soy sauce for instance or non-fermented; soy milk, tofu, soybean used in conjunction with appropriate oral or topical preparations to sprouts. There is insufficient evidence to support that soy help accelerate symptom control. 5-16 products negatively affect hormone function in men and women22 and some studies have shown that soy exerts positive effects Acne vulgaris on oxidative stress, cholesterol and bone density in men and There is evidence to suggest that acne vulgaris is very common post-menopausal women.23,24 Some of these foods can exert an in western populations, with statistics showing that 79-95% of additional probiotic effect.25 adolescents of both sexes are affected, and 40-54% of women and men aged over 25 years.5 Acne is caused when sebaceous Hirsutism glands become widened due to androgen targeting, stimulating Mild to moderate androgen abnormality and PCOS is associated prolific sebum production.17 This often commences during with approximately 65% of hirsutism cases, where prolific hair adolescence when the production of the sex hormone precursor growth can commonly be seen on the upper lip, chin, chest and dehydroepiandrosterone sulphate by the adrenal glands is areola in female patients.5 It is thought to occur largely due to hair heightened. There is some data supporting presence of higher follicle hyper-sensitivity to androgens, enlarging dermal papillae androgen-receptor sensitivity and density in acne-prone skin.5-7 and altering duration of hair growth during adolescence, often Acne is less common amongst Asian populations, thought to be due increasing with age.26 It is reported that 20% of cases are idiopathic, not only to genetic factors, but also the dairy-driven western diet characterised by prevalence of dihydrotestosterone (DHT) induced in comparison to low dairy consumption seen in Asian countries.7 thickened hair growing on androgen-sensitive skin parts.25 Similar Evidence suggests that daily consumption of two glasses of full fat or to acne in its signalling and pathways, hirsutism often occurs as skimmed milk leads to significantly greater glycaemic index (GI) and a result of insulin-induced IGF1 release, and subsequently lowers glycaemic load (P = .022 and P = .001, respectively), in patients with sex hormone-binding globulin, increasing levels of circulating acne compared to controls, whilst a low body mass index (BMI) and testosterone.14 8 eating fish three times weekly appears to exert a protective effect. A weight loss programme combined with oral metformin to One Turkish paper describes a positive correlation between high stabilise insulin, the combined contraceptive pill and, in some GI diet and acne development in 50 subjects.9 Consuming milk and cases, spironolactone can improve PCOS and reduce symptoms of hyperglycaemic foods may induce insulin production, leading to hirsutism by reducing androgen levels.27,28 sebocyte and keratinocyte proliferation plus sebaceous lipogenesis, As an adjuvant therapy, there are some dietary elements which significantly increasing acne lesions.10 I include for my hirsutism patients. One small scale study found A significant proportion of females aged 17 to 40 years with resistant that women who drank spearmint tea twice daily for five days had acne vulgaris have polycystic ovary syndrome (PCOS).11,12 Insulin decreased free testosterone levels and increased serum levels of production heightens androgen production by stromal cells of the luteinising and follicle-stimulating hormones as well as estradiol.29 As ovaries; hyperinsulinemia increases hepatic insulin growth factor 1 there is some evidence to suggest that dietary soy-phytoestrogens (IGF-1) production, stimulating sebum gland activity and increasing reduce plasma testosterone levels by approximately 50%,15 I would 10,18 keratinocyte proliferation, leading directly to comedo formation. also recommend inclusion of these food groups and reduced sugar
Diet and Endocrine-induced Skin Conditions
Reproduced from Aesthetics | Volume 7/Issue 2 - January 2020