Acne is one of the commonest skin disorders and affects nearly 80% of the population at some point in their lives.1 It has substantial and well-recognised effects on quality of life including low self-esteem and confidence.2 As a result, finding new and effective treatments remains of paramount importance. Questions about diet and its role in acne are extremely frequent in consultations; it is therefore important that healthcare practitioners understand and are able to explain the current evidence in this area.
Through the years, the relationship between diet and acne has been highly controversial. In the late 1800s and early 1900s, dermatology textbooks frequently recommended dietary restriction as part of the treatment of skin disease.3,4 At this time, we did not fully understand the pathogenesis of acne and any advice given was based on observational and anecdotal evidence.
Early research from 1931 reported that patients with acne had impaired glucose tolerance.5 Further studies demonstrated an improvement in acne severity following a restricted carbohydrate diet.6,7 In…
