20 to 19 year old participants were asked how severe acne they had had the last week and what their height and weight was when last measured, to be able to calculate BMI.

No statistical assosication between low female BMI and acne.

1

Cross Sectional

3584

18 to 19, 50 % male, 50 % female

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Moderate to severe acne was strongly associated with a family history. The risk was reduced in people with lower body mass index with a more pronounced effect in male compared with female individuals.

0.78

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Acne risk was reduced in people with lower body mass index with a more pronounced effect in male compared with female individuals.

0.65

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

21 to 19 year old participants were asked how severe acne they had had the last week and what their height and weight was when last measured, to be able to calculate BMI. Only participants with a lot or very much acne were selected.

No statistical assosication between male bmi and acne.

1

Cross Sectional

3584

18 to 19, 50 % male, 50 % female

To determine is acne is associtated with hyperandrogenemia, acneic participants with no hirsutism were tested for acne incidence and hormone levels.

No correlation between BMI and acne.

na

1

Prospective Cohort

54

Acne severity, ultrasonographic data on polycystic ovaries and hormonal parameters were measured in participants

No significant correlation between acne and BMI.

na

1

Cross Sectional

129

Only 9 patients had BMI > 25, BMI under 18.5 was not investigated

18 to 19 year old participants were asked how severe acne they had had the last week and what their height and weight was when last measured, to be able to calculate BMI. Only participants with a lot or very much acne were selected.

Overweight BMI > 25 girls more often have acne than those with BMI between 18.5 and 23

na

1.07

Cross Sectional

3584

18 to 19, 50 % male, 50 % female

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Women with BMI > 25 had slightly lower odds of acne than those with BMI between 18.5 and 25

0.85

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Participants were recurited and photographed for acne analysis, measurements were taken of sebum extrection and pore size, survey data about BMI, smoking habits, income, education and menopause collected.

Acne sufferers has 1.8 points higher BMI on average than controls without acne.

Cross Sectional

2895

Four groups of adolescent females: obese with acne, obese without acne, non-obese with acne, non-obese without acne were tested for fasting serum lipid profile, testosterone, insulin, leptin and interleukin 1-Beta.

There study indicates a relationship of increased incidence of acne in females with BMI > 27.

Case Control

60 days

60

Elevated Serum IL-1Beta could increase risk of acne.Study looked at BMI > 27

19 to 19 year old participants were asked how severe acne they had had the last week and what their height and weight was when last measured, to be able to calculate BMI. Only participants with a lot or very much acne were selected.

No statistical assosication

1

Cross Sectional

3584

18 to 19, 50 % male, 50 % female

Unselected soliders were surveyed for their acne history.

No have any association between acne incidence and weight.

1

Retrospective Cohort

2720

Possibly because serum levels of IGF-1 are highest during periods of the adolescent growth spurt and taper off in the 20s.In men over 20, BMI is correlated with acne incidence. Men with acne had a mean weight ot 10lb extra, wheares those without had a mean weight of 2.5lb under the mean.

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Moderate to severe acne was strongly associated with a family history. The risk was reduced in people with lower body mass index with a more pronounced effect in male compared with female individuals

1.16

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Participants consumed either capsules with unsweetened 100 percent coca, hydrolyzed geletain powder, or a combination of the two. Lesions were assessed through photographs.

A statistically significant increase in acne lesions, but not controlled for calories consumed.

6 oz / day

60 %

Randomized Controlled NP

7 days

13

Half of participants ate a isocaloric candy bar with a high chocolate content, the other half ate a bar with no chocolate. Lesion count and sebum production was then measured.

No difference between the two groups. On average eating either bar did not increase lesion count or sebum production.

4 oz / day

Randomized Controlled

28 days

65

Adolescents & young adults, 78 % male, 22 % female

5 patients ate two bars a day, gaining weight in the process, but no discernable effect on sebum production was seen. Note that chocolate could aggrevate acne in people with sensitivity, which is not captured by averages.

Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Body weight, height and body fat percentage were measured. Acne severity was assessed by a dermatologist according to the CASS scale.

No difference between case and control groups

na

1

Case Control

120 days

88

20 to 30, 50 % male, 50 % female

5 days of food records over 4 months

Participants was diveded in three groups that washed their face four times, two times and one time a day with a water based cleanser. Number of open comedones was measured.

All groups saw a decrease in open comedones, washing twice a day was best.

2/day

-39 %

Randomized Controlled NP

42 days

37

A small sample size, the study cleanser contained no anti-acne components, as patients washed their faces more often, they used less cleanser per instance of face washing.

Half of participants used an abrasive cleanser, the other half a non abrasive one. Lesion count was measured.

Lesion count decreased significantly in both groups. No statistical difference between the groups.

-31 %

Randomized Controlled NP

56 days

44

14 to 34, 34 % male, 66 % female

Cleanser was medicated with 2% sulfur and 1.5% salicylic acid. No placebo control.

Participants were diveded in two groups, one receiving a low glycemic load diet composed of 25% energy from protein and 45% energy from low GI carbs, the control group ate carbohydrate dense foods. Acne lesion counts were assessed during monthly visits and insulin sensitivity was measured at baseline and 12 weeks.

Reduced lesion count in both low glycemic load group and control group, presumably due to both groups using a noncomedogenic cleanser

1/day

-12 %

Randomized Controlled NP

84 days

43

Participants had mild to moderate acne -18 % inflamed lesion count (could stratefy)

A cleanser was exclusively applied twice a day for 6 weeks. The efficacy was judged by a dermatologist according to the Leeds score after 3 and 6 weeks. In addition, efficacy and tolerability were judged subjectively by physician and patients.

Mild acne improved significantly after 6 weeks (baseline: 0.699 vs. day 42: 0.602; P < 0.001). Efficacy and tolerability were judged better by physician as compared with patients' assessment.

2/day

-16.11 %

Open Uncontrolled

42 days

59

26 +- 8.4, 46 % male, 54 % female

4 week wash out phase before study for patients using medicated acne treatments. Necessary to go 42 weeks to see full reslts. 23 1 point, 6 0.25, 13 0.25, 4 0.25 46 patients saw 0.25 or more points of improvement 78% saw improvement of 29% or better.

Participants responded to a food questionnaire, and split in two groups, one with acne cases and one without.

Found a positive association between intake of milk and acne.

Daily

1.13

Case Control

182

Teenagers, 50 % male, 50 % female

Participants reported dietary intake on up to 3 food frequency questionnaires. Prevalence ratios for acne comparing highest with lowest intake categories were computed.

Found a positive association between low fat milk and acne.

>= 2 cup/day

1.17

Prospective Cohort

1095 days

4

Results were controlled for height and energy intake, comparing higest intake with lowest. BMI did not influence the result. Noticed small 1.08 positive correlation with Vitamin D intake.

Participants were asked how frequently on average they consumed dairy between the ages 13 and 18 years and their acne history.

Intake of milk during adolescence was associated with history of teenage acne. This association was more marked for skim milk than for other forms of milk. Milk intake has also been associated with increased plasma IGF-1 levels and may be related to acne through this pathway.

3 cups/day

1.14

Cross Sectional

47

Women who did not report their high school diet had slightly lower prevalence of acne than those who did but were otherwise similar. A distant in the past may be imprecise.

Participants responded to a food questionnaire, and split in two groups, one with acne cases and one without.

Found a positive association between intake of milk and acne.

Daily

1.2

Case Control

182

Teenagers, 50 % male, 50 % female

Cases with acne and controls without were given a dietary questionnaire. Severity of acne was evaluated by a dermatologist.

Incidence of milk consumpton significantly higher in acneinc group.

na

1.23

Case control

140

Assumed low fat milk since milk type not mentioned.

Participants reported dietary intake on up to 3 food frequency questionnaires. Prevalence ratios for acne comparing highest with lowest intake categories were computed.

Found a positive association between intake of milk and acne.

>= 2 cup/day

1.17

Prospective Cohort

730 days

6

The group drinking less than one glass of milk a day on average consumed 1736 vs 2217 calories in the 2 or more a day group. This 21% difference could indicate that the study did not adequately factor in energy intake, even though BMI was not different between groups.

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Increased risk with skim milk consumption.

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Body weight, height and body fat percentage were measured. Acne severity was assessed by a dermatologist according to the CASS scale.

Acneic case group had higher glycemic load, milk and ice cream consumption. BMI and body fat was the same.

>= 1 cup / week

1.25

Case Control

120 days

88

18 to 30, 34 % male, 66 % female

Boys and girls mixed. 3 days of food records sampled.

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Increased risk with skim milk consumption.

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Body weight, height and body fat percentage were measured. Acne severity was assessed by a dermatologist according to the CASS scale.

Acneic case group had higher glycemic load, milk and ice cream consumption. BMI and body fat was the same.

>= 1 cup / week

1.25

Case Control

120 days

88

18 to 30, 34 % male, 66 % female

Boys and girls mixed. 3 days of food records sampled.

Participants were asked how frequently on average they consumed dairy between the ages 13 and 18 years and their acne history.

Intake of milk during adolescence was associated with history of teenage acne. This association was more marked for skim milk than for other forms of milk. Milk intake has also been associated with increased plasma IGF-1 levels and may be related to acne through this pathway.

3 cups/day

1.44

Prospective Cohort

47

Participants reported dietary intake on up to 3 food frequency questionnaires. Prevalence ratios for acne comparing highest with lowest intake categories were computed.

Found a positive association between intake of milk and acne.

>= 2 cup/day

1.19

Prospective Cohort

730 days

6

The group drinking less than one glass of milk a day on average consumed 1736 vs 2217 calories in the 2 or more a day group. This 21% difference could indicate that the study did not adequately factor in energy intake, even though BMI was not different between groups.

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Increased risk with whole milk consumption, less than with skim milk.

> 3 cups/day

1.1

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Participants reported dietary intake on up to 3 food frequency questionnaires. Prevalence ratios for acne comparing highest with lowest intake categories were computed.

Found a positive association between intake of whole milk and acne.

>= 2 cup/day

1.1

Prospective Cohort

1095 days

4

Results were controlled for height and energy intake, comparing higest intake with lowest. BMI did not influence the result. Noticed small 1.08 positive correlation with Vitamin D intake.

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Increased risk with whole milk consumption, less than with skim milk.

> 3 cups/day

1.1

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Participants reported dietary intake on up to 3 food frequency questionnaires. Prevalence ratios for acne comparing highest with lowest intake categories were computed.

Found a positive association between intake of milk and acne.

>= 2 cup/day

1.19

Prospective Cohort

730 days

6

The group drinking less than one glass of milk a day on average consumed 1736 vs 2217 calories in the 2 or more a day group. This 21% difference could indicate that the study did not adequately factor in energy intake, even though BMI was not different between groups.

n=9 with food allergies underwent resitriction diet.

Intervention diet made no difference.

Open Uncontrolled

90 days

120

Only abstract available. =0.3*0.2

Elimination diet of patients with suspected food sensitivities, then counting the lesions

20% of the patients with acne in the practice of the author showed clinical evidence of food sensitivity ; 70 per cent of this group were greatly improved or cured by food eliminations.

50 %

Open Uncontrolled

? days

32

?, 31 % male, 69 % female

Required at least five papular or papulopustular extra lesions to say a food caused aggrevation of acne. Two strong reactions to mil, generation eight and ten extra lesion, the rest saw improvement on a strict milk diet (saturated fatty acid good?).

Participants were given either 1000 mg EPA + 1000 mg DHA per day, or 200 mg GLA. Acne severity, ultrasonographic data on polycystic ovaries and hormonal parameters were measured in participants

All lesions types decreased significantly with both EPA and GLA.

400 mg GLA / day

-32 %

Randomized Controlled

70 days

45

17 to 33, 80 % male, 20 % female

Participants had mild to moderate acne. Looking at inflammatory lesion count, less improvement for non inflammatory lesions. No significant diff between Omega 3 and GLA supplementation. Start seeing significant resutls afte 1 month.

Half of participants was put on a low glycemic load diet, half on a high glycemic load diet. Insulin resistance (HOMA-IR), sex hormone binding globulin (SHBG), free androgen index (FAI), insulin-like growth factor-I (IGF-I), and its binding proteins (IGFBP-I and IGFBP-3) was measured.

The LGL group saw a significant decrease in HOMA-IR, a measure of insulin resistance, whereas the HGL group saw an increase. The HGL group saw a significant decrease in sex hormone binding globulin level, indicating high levels of insulin, growth hormone or insulin-like growth factor 1 (IGF-1). The LGL group saw a significant increase in insulin like growth binding proteins. Increases in dietary glycemic load may increase the biological activity of sex hormones and IGF-I, which may facilitate acne development.

GI 36 vs GI 71 HL 175 vs 254

Randomized Controlled

7 days

12

Subjects could eat ad libitum, HGL group ate 1300 kJ more per day probably reflecting that carbs give less satiety.

Half of participants was put on a low glycemic load diet, the rest on a normal diet, and acne lesion count was counted. All participants used Cetaphil gentle skin cleanser instread of soap 2 weeks before baseline and asked to keep continue use.

Both groups showed significant lesion count reduction, the LGL group saw a larger effect, but also significant weight reduction, indicating that the study was not isocaloric. Cleansing seems effective at reducing lesion count.

How large energy deficit?

-23 %

Randomized Controlled

84 days

43

Subjects aged < 18 did not see a correlation between BMI and lesion count. Study was not isocaloric P = 0.001, -8255 kJ/d vs + 80 kJ/d by the control group. Check for BMI correlation

Participants were split in two groups and given high or low glycemic index diets. Severity of inflammatory lesions on the face, insulin sensitivity, androgens and insulin like growth factor 1 and its binding proteins were measured at baseline and 8 weeks. Subjects were asked to maintain their current washing regime.

Both diets lead to reduced severity of acne, the low glycemic diet group saw a larger, but not significant improvement. Change of insulin sensitivity was not different.

51 Glycemic Load Diet

-26 %

Randomized Controlled

56 days

43

High GI group consumed 1200 calories more per week. whereas low GI group lost.Higher protein count in the low GI group could have facilitated this. Control group also saw 12% decrease in lesion count.

Participants were randomly assigned to either low glycemic or control groups. The low GI diet consisted of 25% energy from protein and 45% energy from low GI carbohydrates. The control group received no dietary instruction. The efficacy of dietary treatment versus control was clinically assessed by a dermatologist using a modified Cunliffe-Leeds acne scale. The dermatologist assessed facial acne by means of lesion counts and was blinded to the subject's group.

Intake of high GI carbohydrate, milk, yogurt and ice cream was significantly higher in the cases than in the controls.

25% energy from protein 45% low gi carbs

-23.1 %

Randomized Controlled

43

Control group saw 12% recuded lesion count, and was not givien any dietary recommendations.

Participants with acne and healthy controls were measured for fasting glucose, insulin, insulin like growth factor 1, insulin like growth factor binding protein 3 and leptin levels. A questionnaire was issued asking how much they consumed specificed foodstuffs. Glycemic index and glycemic load were calculated.

No siginificant difference between acne and control subjects in serum glucose, insulin, lepetin, overall glycemic index or dietary glycemic load.

1,00

Cross Sectional

91

19 to 34, 40 % male, 60 % female

Based on self report of diets. This might show that there is little variance in the average glycemic load for this group of people, not capturing the reduction in GL necessary to reduce lesion count.

Cases with acne and controls without were given a dietary questionnaire. Severity of acne was evaluated by a dermatologist.

Intake of high GI carbohydrate, milk, yogurt and ice cream was significantly higher in the cases than in the controls.

GI food average <= 55

0.88

Case control

140

Also looks at ice cream and dairy

Chinese adolescents received questionnaires and physician examinations. The prevalence of acne vulgaris was calculated from the collected data. .

Lack of sleep and cosmetic make-up use was associated with significantly higher risk of acne.

Cross Sectional

3163

19 to 20, ? % male, ? % female

Potential risk factors including age, gender, diet, skin type, sleeping habits, and facial make-up use were analyzed using stepwise logistic regression

Participants received a questionnaire, validated by three dermatologists.

Make up users have 3% higher incidence of acne

1.03

Cross Sectional

3305

Also saw a small negative effect of makeup and benzodiazepine use.

Subjects were given 3g of fish oil to their diet, then acne was assessed using overall severity grading, total inflammatory lesion count and colorimetry.

Acne severity improved in 8 subjects, worsened in 4 and remained unchanged in 1. Not enough participants to reach significannce. 7 of in the improvement group had moderate to severe acne, whereas 3 og the worsened group had mild acne.

930 mg EPA + 720 mg DHA / day

Open Uncontrolled

84 days

13

3 g Omega 3 / day contained 930 mg EPA, unknown what other fatty acids the supplement contained. Seems lik

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Fish consumption correlated with less acne.

>= 1 serving / day

0.86

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

Participants were given either 1000 mg EPA + 1000 mg DHA per day, or 200 mg GLA. Acne severity, ultrasonographic data on polycystic ovaries and hormonal parameters were measured in participants

All lesions types decreased significantly with both EPA and GLA.

1000 mg EPA + 1000 mg DHA / day

-42 %

Randomized Controlled

70 days

45

18 to 33, 80 % male, 20 % female

Participants had mild to moderate acne. Looking at inflammatory lesion count, less improvement for non inflammatory lesions. No significant diff between Omega 3 and GLA supplementation. Start seeing significant resutls afte 1 month.

5 subjects with acne were 250 mg of EPA, 3.75 mg of zinc gluconate, 50 mcg of selenium, 50 mcg of chromium and 50 mg of EGCG from green tea extract per day for at least two months. Did objective and subjective measure of acne lesions.

Four of the subjects had reduced total lesion count, mostly effective against inflammatory lesions.

250 mg EPA / day

-66 %

Open Uncontrolled

60 days

5

18 to 23, 60 % male, 40 % female

Participants also received 3.75 mg of zinc gluconate, 50 mcg of selenium, 50 mcg of chromium and 50 mg of EGCG from green tea extract daily.

Participants were given either 1000 mg EPA + 1000 mg DHA per day, or 200 mg GLA. Acne severity, ultrasonographic data on polycystic ovaries and hormonal parameters were measured in participants

All lesions types decreased significantly with both EPA and GLA.

1000 mg EPA + 1000 mg DHA / day

-24.34 %

Randomized Controlled

70 days

45

18 to 33, 80 % male, 20 % female

Participants had mild to moderate acne. Looking at inflammatory lesion count, less improvement for non inflammatory lesions. No significant diff between Omega 3 and GLA supplementation. Start seeing significant resutls afte 1 month.

Cases with moderate to severe acne from dermatologic outpatient clinics in Italy was compared to control subjects coming from dermatologic consultations other than for acne.

Fish consumption correlated with less acne.

>= 1 serving / day

0.86

Case Control

563

17.2 +- 3.1, 50 % male, 50 % female

No control for energy intake

5 subjects with acne were 250 mg of EPA, 3.75 mg of zinc gluconate, 50 mcg of selenium, 50 mcg of chromium and 50 mg of EGCG from green tea extract per day for at least two months. Did objective and subjective measure of acne lesions.

Four of the subjects had reduced total lesion count, mostly effective against inflammatory lesions.

250 mg EPA / day

-26.67 %

Open Uncontrolled

60 days

5

18 to 23, 60 % male, 40 % female

Participants also received 3.75 mg of zinc gluconate, 50 mcg of selenium, 50 mcg of chromium and 50 mg of EGCG from green tea extract daily.

Subjects were given 3g of fish oil to their diet, then acne was assessed using overall severity grading, total inflammatory lesion count and colorimetry.

Acne severity improved in 8 subjects, worsened in 4 and remained unchanged in 1. Not enough participants to reach significannce. 7 of in the improvement group had moderate to severe acne, whereas 3 og the worsened group had mild acne.

930 mg EPA + 720 mg DHA / day

Open Uncontrolled

84 days

13

3 g Omega 3 / day contained 930 mg EPA, unknown what other fatty acids the supplement contained. Seems lik

Participants with acne were randomly assigned to one of thee groups. Group A received probiotic supplementation, group B received only minocycline. Group C was treated with both. Clinical and subjective assessments were completed at baseline and during follow-up visits.

Minocycline and probiotics are effective at reducing acne, the combintation most effective, then minocylcine then probiotics alone.

Open Uncontrolled

84 days

45

Poster, study not available

Intestinal microflora in 114 patients with acne vulgaris (94 and 20 with its papulopustular and nodulocystic forms). Sixty-one (54%) patients have either the first (21%) or second (78.7%) impaired bacterial microflora. no great differences in the content of the intestinal microflora in different forms of acne.

Adding intestinal microflora-correcting agents to combined therapy in patients with papulopustular acne vulgaris and verified dysbacteriosis reduces the duration of treatment by over twice and makes its duration the same as that in patients without dysbacteriosis

Open Uncontrolled

? days

114

Combined theraphy, need paper to judge results of probiotics

Participants received a questionnaire, validated by three dermatologists.

A small difference in quality of sleep was recorded betwen the acne and non acne group.

1.03

Cross Sectional

3305

Also saw a small negative effect of makeup and benzodiazepine use.

Chinese adolescents received questionnaires and physician examinations. The prevalence of acne vulgaris was calculated from the collected data. Potential risk factors including age, gender, diet, skin type, sleeping habits, and facial make-up use were analyzed using stepwise logistic regression.

Lack of sleep and cosmetic make-up use was associated with significantly higher risk of acne.

Cross Sectional

3163

18 to 20, 50 % male, 50 % female

German subjects received questionnaires and dermatologist evaluations. The prevalence and severity of acne were recorded and information on medical history, alcohol and cigarette consumption analzyed.

Men and women smoking more than 20 cigarettes a day had 19% higher incidence of acne than non smokers.

> 20 cigarettes / day

1.19

Cross Sectional

896

42, 49.2 % male, 50.8 % female

Result not affected by gender, age or social status.

Men discharged from military service were interviewed about family history, havits, and tobacco smoking. Data was correlated with severe acne status.

Men smoking more than 20 cigarettes a day had a 82% less acne than non smokers.

20 to 30 cigarettes / day

0.18

Cross Sectional

27083

Similar result for > 30 / day

Women with acne were examined by dermatologist for acne lesions and type, and asked about smoking history and habits.

Women smoking more than 20 cigarettes a day had 17% less acne than non smokers

> 20 / day

0.83

Case Control

226

German subjects received questionnaires and dermatologist evaluations. The prevalence and severity of acne were recorded and information on medical history, alcohol and cigarette consumption analzyed.

Significantly higher acne prevalence in active smokers compared to non smokers, a linear relationship between acne prevalence plus severity and number of cigarettes smoked daily was obtained.

1 to 10 cigarettes / day

1.07

Cross Sectional

896

42, 49.2 % male, 50.8 % female

Men discharged from military service were interviewed about family history, havits, and tobacco smoking. Data was correlated with severe acne status.

Moderate smoking was correlated with 27% higher risk of acne

1 to 10 cigarettes / day

1.27

Cross Sectional

27083

Only looks at SEVERE acne, only see benefit when smoking more than 20 a day. Could be that nicotine in protective in a dose dependent manner, as it is an anti inflammatory.

Women with acne were examined by dermatologist for acne lesions and type, and asked about smoking history and habits.

Comedonal, but not inflammatory pustular acne was positively correlated with smoking. Smokers has a higher prevalence of late onset acne, compared with persistent acne.

1 - 20 / day

1.14

Case Control

226

25 to 50, 1 % male, 100 % female

1 to 10 and 10 to 20 cigarette a day groups pooled. 1 to 10 saw little increased incidence, but 10 to 20 has 20% more acne cases.

Participants were assessed dermatologically for acne and questioned about ther smoking habits and family history of acne. Smoking was defined as smoking > 3 cigarettes a day for 6 months or more. Acne was defined as having > 20 retentional andor inflammatory lesions.

Smoking was significantly protective in the development of inflammatory acne in girls, no siginifcant correlation found in boys.

>= 3 cigarettes / day

0.61

Cross Sectional

594

14 to 18, 50 % male, 50 % female

Chinese participants were examined for acne severity and yin and yang scores. Diet and acne relationship was investigated.

Statistically significant relationship between soy and dairy consumption and protection against acne.

>=1 cup / day

Cross Sectional

322

19, 53 % male, 47 % female

Separated participants into yin and yang groups, saw statistically significant improvement of acne in yang group with milk and soy consumption.

Participants with a minimum acne severity level of 0.5 on the Leeds acne scale were graded and had their subjective stress levels assessed with the Perceived Stress Scale questionnaire during nonexamination and examination periods.

Subjects had more severe acne and perceived stress during examination periods. Adjusting for sleep hours, quality, diet quality and number of meals, acne severity was significantly associated with increased stress levels.

1.36

Prospective Cohort

22

22.25, 30 % male, 70 % female

Close to significant p=0.06 association between acne and sleep quality.

Students in singapore were evaluated for stress using the Perceived Stress Scale, sebum level and acne severity, during the high stress exam season and the summer holidays. ~93% of student self reported as having acne.

Statistically significant relationship between stress levels and severity of inflamed acne, not for comedogenic acne. No difference in sebum production.

1.16

Prospective Cohort

94

14.9, 50 % male, 50 % female

Possible that female students are better prepared and hence less stressed before exams. Looks at sebum levels, and find that they are alone not responsible for acne

Participants received a questionnaire, validated by three dermatologists.

No difference was observed

1

Cross Sectional

3305

Also saw a small negative effect of makeup and benzodiazepine use. Questionaire based. No determination by dermatologist of acne severity

Not available.

Emotional stress was accompanied by an exacerbation of acne vulgaris lesions and an increase in skin surface free fatty acids (ffa).

Cross Sectional

Surface total lipids did not show a statistically significant change during the period of stress.

Subjects with mild to moderate acne were treated with full spectrum, green and violet light sources, 3 times a week, for 20 minutes, for 7 weeks.

All the light sources lead to significant improvement of acne.

14 %

Open Uncontrolled

49 days

30

?, 50 % male, 50 % female

Blue and violet light more efficinet