Document Type : Original Article


Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran



   Acne vulgaris is a prevalent skin disorder that affects millions of teens and young adults worldwide, but its link to dietary intake is still unclear and requires more research. This cross-sectional study investigated the relationship between diet and acne among 150 adolescents aged 12-18 in Tehran province. The participants reported their dietary intake using a 24-hour recall method. Their anthropometric data were measured using standard methods. Their acne severity was assessed using the Global Acne Scoring System (GAGS). Their diet quality was evaluated using the International Diet Quality Index (DQI-I) based on Kim et al. 2003. The mean GAGS scores for the whole sample and for girls and boys were 9.24±8.9, 8.79±8.9, and 9.7±7.13, respectively. The prevalence of acne was 71.5% for the whole sample, 93.3% for boys, and 69.1% for girls. The mean DQI-I score for the whole sample was 48.54. The regression analysis showed no association between acne severity and DQI-I score, food groups, or micro and macronutrients. This study found no evidence of a connection between diet quality and acne among adolescents. Further prospective studies are needed to verify or refute this finding.


  1. Penso L, Touvier M, Deschasaux M, Hercberg S, Ezzedine K, Sbidian E. Association between adult acne and dietary behaviors: findings from the NutriNet-Santé Prospective Cohort Study. JAMA Dermatology. 2020;156(8):854-62.
  2. Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. International Journal of Dermatology. 1997;36(6):416-8.
  3. Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2016;33(2):81-6.
  4. Ismail NH, Manaf ZA, Azizan NZ. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC Dermatology. 2012;12:1-8.
  5. WP B. Joshi SS. Shalita AR. Diet and acne. Journal of the American Academy of Dermatology. 2010;63:124-41.
  6. Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, Willett WC, Holmes MD. Milk consumption and acne in teenaged boys. Journal of the American Academy of Dermatology. 2008;58(5):787-93.
  7. Halvorsen JA, Dalgard F, Thoresen M, Bjertness E, Lien L. Is the association between acne and mental distress influenced by diet? Results from a cross-sectional population study among 3775 late adolescents in Oslo, Norway. BMC Public Health. 2009;9(1):1-8.
  8. Davallo P, Sobhani R, Hekmatdoost A. Association between dietary diversity and acne vulgaris among girls aged 13-18 of Tehran. Iranian Journal of Nutrition Sciences and Food Technology. 2015;10(2):29-36.
  9. Suppiah TS, Sundram TK, Tan ES, Lee CK, Bustami NA, Tan CK. Acne vulgaris and its association with dietary intake: a Malaysian perspective. Asia Pacific Journal of Clinical Nutrition. 2018;27(5):1141-5.
  10. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. The Journal of Nutrition. 2003;133(11):3476-84.
  11. LaRosa CL, Quach KA, Koons K, Kunselman AR, Zhu J, Thiboutot DM, Zaenglein AL. Consumption of dairy in teenagers with and without acne. Journal of the American Academy of Dermatology. 2016;75(2):318-22.
  12. Bondade S, Hosthota A, Basavaraju V. Stressful life events and psychiatric comorbidity in acne–a case control study. Asia‐Pacific Psychiatry. 2019;11(1):e12340.
  13. Aktan S, Özmen E, Sanli, B. Anxiety, depression, and nature of acne vulgaris in adolescents. International Journal of Dermatology. 2000;39(5):354-7.
  14. Burris J, Rietkerk W, Shikany JM, Woolf K. Differences in dietary glycemic load and hormones in New York City adults with no and moderate/severe acne. Journal of the Academy of Nutrition and Dietetics. 2017;117(9):1375-83.
  15. Anaba LE, Ogunbiyi OA, George OA. Adolescent facial acne vulgaris and body mass index: any relationship? West African Journal of Medicine. 2019;36(2):129-32.
  16. Sas K, Reich A. High body mass index is a risk factor for acne severity in adolescents: A preliminary report. Acta Dermatovenerologica Croatica. 2019;27(2):81-5.
  17. Halvorsen JA, Vleugels RA, Bjertness E, Lien L. A population-based study of acne and body mass index in adolescents. Archives of Dermatology. 2012;148(1):131-2.
  18. Tsai MC, Chen W, Cheng YW, Wang CY, Chen GY, Hsu TJ. Higher body mass index is a significant risk factor for acne formation in schoolchildren. European Journal of Dermatology. 2006;16(3):251-3.
  19. Zari S, Alrahmani D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clinical, Cosmetic and Investigational Dermatology. 2017:503-6.
  20. Yosipovitch G, Tang M, Dawn AG, Chen M, Goh CL, Chan YH, Seng LF. Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta Dermato-Venereologica. 2007;87(2):135-9.
  21. Smithard A, Glazebrook C, Williams HC. Acne prevalence, knowledge about acne and psychological morbidity in mid‐adolescence: A community‐based study. British Journal of Dermatology. 2001;145(2):274-9.
  22. Lu PH, Hsu CH. Body mass index is negatively associated with acne lesion counts in Taiwanese women with post‐adolescent acne. Journal of the European Academy of Dermatology and Venereology. 2015;29(10):2046-50.
  23. Kim BY, Choi JW, Park KC, Youn SW. Sebum, acne, skin elasticity, and gender difference–which is the major influencing factor for facial pores? Skin Research and Technology. 2013;19(1):e45-53.
  24. Anyachukwu CC, Onyeso OK, Ezema CI. Age, body mass and physical activity determinants of facial acne severity among Southern Nigerian adolescents and young adults. West Indian Medical Journal. 2018;5(2):66-71.
  25. Yang YC, Tu HP, Hong CH, Chang WC, Fu HC, Ho JC, Chang WP, Chuang HY, Lee CH. Female gender and acne disease are jointly and independently associated with the risk of major depression and suicide: A national population-based study. BioMed Research International. 2014;2014:504279.
  26. Afsar FS, Seremet S, Demirlendi Duran H, Elif Yildirim F, Mumcu Sönmez N, Karaca S. Social appearance anxiety in adult patients with acne: a cross-sectional study. Acta Dermatovenerologica Croatica. 2018;26(3):220-.
  27. Anaba LE, Ogunbiyi OA, George OA. Adolescent facial acne vulgaris and body mass index: any relationship? West African Journal of Medicine. 2019;36(2):129-32.
  28. Di Landro A, Cazzaniga S, Parazzini F, Ingordo V, Cusano F, Atzori L, Cutrì FT, Musumeci ML, Zinetti C, Pezzarossa E, Bettoli V. Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults. Journal of the American Academy of Dermatology. 2012;67(6):1129-35.
  29. Pamungkas AH, Prakoeswa FR. The relationship between skin phototype, gender, and stress level with the incidence of acne vulgaris among adolescents in Surakarta. Dermatology Reports. 2019;11(s1).
  30. Akpinar Kara Y, Ozdemir D. Evaluation of food consumption in patients with acne vulgaris and its relationship with acne severity. Journal of Cosmetic Dermatology. 2020;19(8):2109-13.
  31. Snast I, Dalal A, Twig G, Astman N, Kedem R, Levin D, Erlich Y, Leshem YA, Lapidoth M, Hodak E, Levi A. Acne and obesity: A nationwide study of 600,404 adolescents. Journal of the American Academy of Dermatology. 2019;81(3):723-9.
  32. Seleit I, Bakry OA, Abdou AG, Hashim A. Body mass index, selected dietary factors, and acne severity: are they related to in situ expression of insulin-like growth factor-1? Analytical and Quantitative Cytopathology and Histopathology. 2014;36(5):267-78.
  33. Mostafavi SA, Bidaki R, Shahmoradi H, Mirzaei A, Sayadi AR, Feriduni MJ. Evaluation of Major Psychiatric Disorders in Patients in Rafsanjan, Iran, with Acne Vulgaris. Internal Medicine and Medical Investigation Journal. 2017;2(4):143-8.
  34. Chiu A, Chon SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Archives of Dermatology. 2003;139(7):897-900.
  35. Barrea L, Donnarumma M, Cacciapuoti S, Muscogiuri G, De Gregorio L, Blasio C, Savastano S, Colao A, Fabbrocini G. Phase angle and Mediterranean diet in patients with acne: Two easy tools for assessing the clinical severity of disease. Journal of Translational Medicine. 2021;19(1):1-5.
  36. Kulkarni M, Keny D, Potey AV, Tripathi RK. A cross-sectional study to assess the incompatible dietary behavior of patients suffering from skin diseases: a pilot study. Journal of Ayurveda and Integrative Medicine. 2016;7(2):113-8.
  37. Yuan Y, Su J, Li J, Tao J, Kang X, Wu B, Shan S, Wang X, Chen X, Shen M, Jiang L. Behavior of nutritional supplements use in association with inflammatory skin diseases in Chinese college students. Frontiers in Nutrition. 2021;8:615462.