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Article

The Impact of Diet Composition on the Reduction of Acne Vulgaris: A Crossover Study

by
Magdalena Daszkiewicz
1,
Dorota Różańska
2,* and
Bożena Regulska-Ilow
2
1
“5D” Cosmetology and Aesthetic Medicine Clinic, 53-674 Wroclaw, Poland
2
Department of Dietetics and Bromatology, Wroclaw Medical University, 50-556 Wroclaw, Poland
*
Author to whom correspondence should be addressed.
Cosmetics 2026, 13(3), 115; https://doi.org/10.3390/cosmetics13030115
Submission received: 20 March 2026 / Revised: 27 April 2026 / Accepted: 2 May 2026 / Published: 6 May 2026
(This article belongs to the Section Cosmetic Dermatology)
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Abstract

Introduction: Many studies suggest that dietary factors may significantly influence the development and severity of acne lesions. Objective: The aim of this study was to evaluate the effect of an anti-inflammatory diet on acne severity in patients with acne vulgaris. Methods: This study included 92 participants who followed an individualized dietary intervention tailored to their energy requirements. Acne severity was assessed at baseline and after four weeks of dietary intervention using the Investigator’s Static Global Assessment scale. Results: After four weeks, a reduction in acne severity was observed in 68 of 92 participants (73.91%). The mean acne severity score decreased from 3.3 ± 0.6 to 2.4 ± 0.7 points. The dietary intervention also resulted in statistically significant reductions in body weight (p < 0.0001), body mass index (p < 0.0001), fat mass (p < 0.0001), visceral fat (p = 0.0386), and metabolic age (p = 0.0004). Conclusions: The balanced diet characterized by a low glycemic index and anti-inflammatory properties, combined with reduced intake of saturated fatty acids, sugar, and salt, as well as the elimination of dairy products and highly processed and high glycemic index foods, presumably through the synergistic effect of all the components of the diet, was found to be effective in the reduction of acne severity in the study group. This study supports the feasibility of the applied dietary pattern and suggests possible benefit for patients with acne. Considering the promising results obtained in this study, further research conducted in larger patient populations would be valuable.

1. Introduction

Acne vulgaris is one of the most common dermatological conditions, affecting between 35% and more than 90% of adolescents worldwide [1]. Previous studies have indicated that acne occurs particularly frequently among young individuals and women [1,2]. However, these findings are not entirely consistent with the results of a systematic review published in 2020, which reported a similar prevalence of acne in men and women [3]. Acne lesions most commonly appear on the face, back, chest, and buttocks. Typical manifestations include open and closed comedones, papulopustular lesions, and nodulocysts [3,4]. Acne is considered a multifactorial disease with a genetic background and is associated with alterations in androgen receptors located in sebaceous gland cells. These changes are primarily triggered by dihydrotestosterone, a testosterone derivative. The activation of sebaceous glands by androgens leads to gland hypertrophy and excessive sebum production. Even when circulating androgen level is within the normal range, their activity may still contribute to the exacerbation of acne lesions [5,6]. Several external factors may aggravate acne. These include certain medications such as glucocorticosteroids, anabolic steroids, vitamin B12, antidepressants, antiepileptic drugs, and barbiturates [7]. In women, acne exacerbations frequently occur during the perimenstrual period, when progesterone level peak [8,9]. Psychological stress and emotions may also worsen acne symptoms, as elevated cortisol level can stimulate the hypothalamic–pituitary–adrenal axis and indirectly affect sebaceous gland activity [10,11].
In recent years, increasing attention has been paid to the role of dietary factors that may enhance or reduce the severity of acne lesions. Certain foods, including sweets, chocolate, dairy products, and high-fat foods, have been suggested to contribute to the occurrence or exacerbation of acne lesions [12]. Ismail et al. [13] demonstrated a relationship between acne and the consumption of foods with a high glycemic index (GI) and insulin resistance. Carbohydrate consumption leads to elevated blood glucose levels; however, different foods produce varying glycemic responses. Moradi Tuchayi et al. [14] corelated milk consumption with acne severity, emphasizing the role of insulin-like growth factor-1 (IGF-1), which may stimulate sebaceous gland activity and comedogenesis. The relationship between chocolate consumption and acne remains controversial and is still disputable [15,16,17].
Since inflammation is one of the major factors in the pathogenesis of acne vulgaris, dietary patterns that reduce inflammatory processes may be beneficial. Cavicchia et al. [18] and Shivappa et al. [19], drawing on 60 years of medical literature, identified several dietary components associated with the levels of six known markers of inflammation. Nutrients such as vegetables, fruits, herbs, spices, dietary fiber, unsaturated fatty acids (n-3 polyunsaturated and n-9 monounsaturated fatty acids), magnesium, polyphenols, and carotenoids are associated with lower inflammatory marker concentration in serum. In contrast, saturated and trans fatty acids, as well as high GI, and a high n-6/n-3 PUFA ratio may promote inflammation [20].
The aim of this study was to evaluate the influence of an anti-inflammatory diet on the severity of acne lesions in patients with acne vulgaris. The novelty is that this study assesses the synergistic effect of the overall diet (not a single component) with elimination of known dietary compounds with pro-acne properties, including dietary compounds with anti-acne properties. Moreover, it is an interventional not observational study, and, to our knowledge, it is the first interventional dietary study in this topic conducted in Poland.

2. Materials and Methods

2.1. Study Design and Participants

Participants were recruited as part of a broader study investigating the influence of chocolate consumption on acne severity, the results of which have been published previously [21]. During the analysis of the results, it was observed that a balanced control diet, which excluded foods reported in the literature to exacerbate acne and included products with anti-inflammatory properties, had a positive effect on skin condition. Therefore, the present analysis focuses on the effects of diet itself on acne severity. The flow chart showing the crossover study design is shown in Figure 1.
This study included 92 participants (88 women and 4 men) recruited from “5D” Cosmetology and Aesthetic Medicine Clinics located in Wrocław, Katowice, Kraków, and Łódź. All individuals signed written informed consent forms before this study began. The study protocol received approval from the Bioethics Committee (No. KB-821/2020). Prior to dietary intervention, participants completed a questionnaire assessing acne-related characteristics, including the presence and duration of symptoms, the anatomical distribution of lesions, and the perceived influence of factors such as stress, dietary changes, and alcohol consumption on the exacerbation of skin lesions. The questionnaire also included questions regarding previous acne management strategies, their perceived effectiveness, and any prior dietary interventions undertaken by the participants.
The inclusion criteria were as follows:
(a)
presence of acne lesions
(b)
age ≥ 18 years
(c)
no antibiotic or steroid therapy within the previous six months
(d)
no retinoid treatment within the previous six months
(e)
no use of dietary supplements affecting skin condition
(f)
absence of significant comorbidities
The exclusion criteria were as follows:
(a)
absence of acne lesions
(b)
age < 18 years
(c)
antibiotic or steroid therapy within the previous six months
(d)
retinoid treatment within the previous six months
(e)
use of dietary supplements affecting skin condition
(f)
presence of significant comorbidities
The Investigator’s Static Global Assessment scale (from 0 to 5 points) was used to classify individuals according to acne lesion severity, where Grade 0 means “Normal, clear skin, no evidence of acne vulgaris” and Grade 5 means “Highly inflammatory lesions predominate: variable number of comedones, many papules/pustules and nodulocystic lesions” [22]. Qualified dermatologists working in the mentioned clinics were responsible for the diagnosis and classification of acne severity. Acne severity was evaluated at baseline and after four weeks of dietary intervention. The participants were informed not to use any cosmetic procedures associated with skin conditions during the study period.

2.2. Dietary Intervention

Participants were informed about the study objectives, signed consent and received individualized dietary plans based on their estimated energy requirements. Three caloric variants were prepared: 1800 kcal, 2000 kcal, and 2200 kcal. Each participant received a 10-day dietary plan that was repeated three times during the four-week intervention period. Nutrient content and the percentage of energy from macronutrients in the diets used in this study, arranged for the three energy values, are shown in Table 1.
The composition of the diets has been developed with the assumption that the content of macronutrients and micronutrients, as well as the percentage of energy from macronutrients and the sum of individual groups of fatty acids, should be in accordance with the current standards and recommendations [23].
The dietary intervention was designed to emphasize foods with anti-inflammatory properties and a low glycemic index. The diet included five meals per day consumed at intervals of approximately three to four hours. In addition, the materials provided to the study participants included a list of substitute products for certain dietary components.
Participants prepared meals themselves according to the dietary plans provided. Cooking methods used in the diet plan were mainly based on cooking, stem cooking, stewing, grilling on an electric grill and baking, whereas fruits and vegetables were included mainly as raw products according to the higher content of vitamins compared to the processed products. A detailed list of food products that were used in the 10-day dietary plan is presented in Table 2. An example of the one-day menu for 2000 kcal is presented in Table 3. Compliance with the dietary intervention was monitored through telephone contact and a follow-up visit after two weeks, during which a 24-h dietary recall was collected.

2.3. Body Composition Assessment

The primary endpoint was to assess changes in acne severity. However, body composition parameters were assessed (secondary endpoint) to monitor the nutritional status of the participants. Each participant underwent a body composition assessment with a Tanita BC-420 S MA analyzer (TANITA, Tokyo, Japan), which enables the quantitative evaluation of body composition parameters using a bioelectrical impedance analysis. The following variables were measured: metabolic age (years), total body water (%), body weight (kg), body mass index (BMI, kg/m2), body fat (%, kg), and visceral fat level. Measurements were taken prior to intervention diet implementation and were repeated after four weeks of intervention.
Energy requirements were computed for each participant individually. For those with a BMI 18.5–24.99 kg/m2, basal metabolic rate (BMR) was estimated using the Harris–Benedict equation [24]. For participants with BMI ≥ 25 kg/m2, BMR was calculated using the Mifflin–St Jeor equation [25]. Total energy expenditure was calculated, taking into account physical activity level (PAL) 1.6 for participants with a normal BMI and 1.4 for those with excess body weight (BMI ≥ 25 kg/m2). The dietary intervention was designed to maintain stable body weight throughout the study period.

2.4. Statistical Analysis

Continuous variables were presented as mean ± standard deviation (SD). The Shapiro–Wilk test was used to verify the normality of the data distribution. As the variables did not follow a normal distribution, the Wilcoxon signed-rank test was used for comparisons of paired measurements (before and after dietary intervention). A significance level of p < 0.05 was applied to all analyses. Statistical analyses were performed using STATISTICA version 13 (TIBCO Software Inc., Palo Alto, CA, USA).

3. Results

3.1. Characteristics of the Study Group

The majority of participants were aged 18–25 years (n = 62). A total of 34 participants reported a history of acne lasting longer than six years. Table 4 presents the characteristics of the study group.

3.2. Effect of Dietary Intervention on Anthropometric Parameters and Acne Severity

Table 5 presents a comparison of selected anthropometric parameters and acne severity before and after the dietary intervention in the study group. At baseline, the mean acne severity score among participants was 3.3 ± 0.6 on the six-point (0–5 points) Investigator’s Static Global Assessment scale, where 5 indicated severe acne. Four weeks after the initial assessment, the mean acne severity score decreased to 2.4 ± 0.7 (<0.0001).
Although participants were instructed to maintain stable body weight throughout the study period, the four-week dietary intervention was linked to significant decreases in BMI (p < 0.0001), body mass (p < 0.0001), fat mass (p < 0.0001), and visceral fat (p = 0.0386). Moreover, a statistically significant decrease in metabolic age was observed. An increase in total body water content was also noted (Table 5).
Table 6 shows changes in the number of study participants in age groups categorized by acne severity after the four-week dietary intervention. Following the anti-inflammatory dietary intervention, a reduction in acne severity was observed in 68 participants (73.91%). One participant experienced a three-point decrease in acne severity, from Grade 4 to the “almost clear” category. Fifteen participants (16.30%) demonstrated a two-point reduction on the severity scale, whereas the largest group (56.52%) showed a one-point decrease. Although 24 participants (26.09%) did not present a change of at least one point on the severity scale, all participants reported an improvement in overall skin appearance. Examples of skin condition in three selected patients before and after the dietary intervention are presented in Figure 2.

4. Discussion

Acne is a common skin condition affecting populations of all ages. The results of this study showed that an anti-inflammatory diet has potentially beneficial effects on the reduction of acne severity. Many other researchers have demonstrated that certain food products and dietary components may be associated with the exacerbation of acne lesions. Particularly useful was the publication by Dall’Oglio et al. [26], in which the authors systematically reviewed the literature from 2009 to 2020.
Taking into account the findings reported by other authors, the intervention diet was designed to exclude products associated with the exacerbation of acne lesions, such as fast food and salty snacks [27,28], fatty foods [26], milk and dairy products [29,30], industrially processed products (e.g., burgers) [27,28,31], high-GI foods and sugars [28,32,33], and saturated fatty acids [34,35]. On the other hand, the intervention diet included products and nutrients with potential anti-acne effects, such as mono- and polyunsaturated fatty acids, vegetables (yellow vegetables, leafy greens, and cruciferous plants), fruits, fish, and low-GI foods [26,36,37,38]. The ratio between n-6 and n-3 PUFA, as well as long chain n-3 PUFA were also found to be associated with acne [39,40]; therefore, it was also taken into account in this study.
The results of our study suggest that eliminating pro-acne foods from the diet and consuming foods with anti-acne properties, whose components may act synergistically, can contribute to a reduction in acne lesions. It is worth noting that the clinical significance of this study may go beyond acne itself. Improvements in skin condition as a result of a diet may contribute to lower medication use. Also, benefits other than dermatological benefits are possible. Chen at al. [41] observed a high prevalence of depression, anxiety and suicidal thoughts among patients with acne (22%, 29% and 12%, respectively). Other authors observed that higher adherence to an antioxidant diet reduces the risk of acne vulgaris impacts on quality of life and the risk of depression among young women [42]. Therefore, appropriate dietary habits associated with decreases in acne severity could also be beneficial for mental health.
Researchers of other studies emphasize the role of gene expression, the concentration of inflammatory mediators, and alterations in the pilosebaceous unit microbiome in the development of acne [43,44]. Milk and dairy products, as well as hyperglycemic carbohydrates, appear to have the greatest negative impact on the occurrence and severity of acne lesions [45]. Moreover, according to Moradi Tuchayi et al. [14], the comedogenic effect of milk and insulin-like growth factor 1 (IGF-1) should be emphasized. Elevated circulating levels of IGF-1 promote sebaceous cell proliferation and, therefore, the progression of acne [46]. According to Melnik et al. [47,48], proteins that promote anabolic mTORC1 (mammalian target of rapamycin complex 1) signaling are responsible for the aggravation of skin lesions. This signaling pathway increases IGF-1 secretion and stimulates its activity during puberty. Increased IGF-1 secretion is associated with enhanced hepatic synthesis of IGF-1 via amino acid transfer. Tryptophan, which is a predominant component of the whey fraction, is responsible for hepatic IGF-1 synthesis. In addition, the insulinotropic effect of milk is related to the content of branched-chain amino acids (BCAA: valine, leucine, isoleucine) and glutamine, which promote the synthesis and secretion of insulin and IGF-1 via mTORC1. The same researchers also highlighted the correlation between milk protein intake and high blood glutamine concentrations, an important factor in mTORC1 activation, which further promotes sebaceous lipogenesis and sebaceous gland hypertrophy. La Rosa et al. [49] demonstrated a statistically significant correlation between dairy consumption and acne lesions in a group of 120 subjects aged 14–19 years compared with a control group. Bioactive compounds present in milk, such as hormone precursors, transforming growth factor beta (TGF-β), and leucine, may also contribute to the exacerbation of acne lesions by stimulating sebocyte growth. Reduced forms of steroids and non-steroidal growth factors may also contribute to increased insulin-like growth factor level. Furthermore, the conversion of 5α-pregnanedione and 5α-androstanedione to dihydrotestosterone increases sebum production and accelerates keratinization within the pilosebaceous unit, thereby contributing to the comedogenic potential of milk [44].
Cordain et al. [50] analyzed diet and acne prevalence among Western and non-Western populations, including inhabitants of the Kitavan Islands (Papua New Guinea) and the Ache population (Paraguay). The diets of these non-Western populations were rich in unprocessed foods with a low glycemic index. The Kitavan diet consisted mainly of vegetables, fruits, fish, and coconuts, whereas the Ache diet included local foods such as cassava, peanuts, maize, rice, and venison. The consumption of Western foods such as coffee, dairy products, alcohol, salt, sugar, and flour was minimal. These researchers emphasized the negative association between low-fat, low-GI diets and acne incidence. Conversely, Taha et al. [51] conducted a meta-analysis where higher adherence to the Mediterranean diet was found to be correlated with less severe acne. These observations are consistent with the findings of the present study. Our results indicate that a properly balanced diet characterized by low GI, reduced intake of saturated fatty acids, milk, sugar, highly processed foods, salt, and high-GI products, and balanced in terms of macro- and micronutrient content, as well as the inclusion of anti-inflammatory foods, may significantly reduce acne lesions. According to the acne severity scale, the mean acne severity score decreased from 3.3 ± 0.6 to 2.4 ± 0.7 points after the dietary intervention.
Cocoa is another dietary component that may influence the occurrence of acne vulgaris. Capetron et al. [52] demonstrated a statistically significant worsening in skin condition on day 4 and day 7 after participants consumed capsules containing 100% cocoa. Cocoa consumption was associated with increased severity of acne lesions in men.
Carbohydrates represent another group of dietary components that may aggravate acne-like skin lesions due to their effect on postprandial blood glucose levels. Blood glucose concentration is influenced by both the GI of foods and the content of available carbohydrates [12]. The glycemic index classifies foods according to their effect on postprandial glucose levels. Meixiong et al. [12] demonstrated a positive correlation between a high-GI diet and the occurrence of acne. A diet rich in high-GI foods, such as white bread, baguettes, sugar, chips, and fries, may lead to postprandial hyperglycemia and hyperinsulinemia, which significantly affect skin condition. This process results in an imbalance between IGF-1 and IGFBP-3 binding protein, which regulates epidermal cell proliferation. Increased insulin levels stimulate IGF-1 secretion and decrease IGFBP-3 level. In addition, insulin disrupts the retinoid signaling pathway, altering the rate of apoptosis of epidermal cells. The resulting hormonal imbalance contributes to increased keratinocyte proliferation within hair follicles and reduces the effectiveness of retinoids in the body. Elevated IGF-1 levels significantly influence comedogenic factors such as glucocorticoids, androgens, and growth hormones. Consequently, IGF-1 level rise further, androgen secretion increases, sebum production is enhanced, and acne lesions are aggravated. Burris et al. [36] reported an association between a low-GI diet and decreased IGF-1 levels, which correlated with a lower occurrence of acne lesions. Çerman et al. [53] demonstrated an inverse linear relationship between elevated blood glucose and insulin levels and adiponectin concentrations. Adiponectin exhibits anti-inflammatory, antidiabetic, and antioxidant effects, increases insulin sensitivity, and inhibits pro-inflammatory cytokines. Therefore, low adiponectin concentration could influence the development and severity of acne. After analyzing the participants’ diets, the researchers observed that acne lesions were more likely to occur in individuals whose diets were rich in high-GI foods. Serum adiponectin levels were lower in the study group compared with the control group. A positive correlation was also observed between IGF-1 and IGFBP-3 concentrations and acne severity, as well as between GI values and acne severity.
Dietary fat is another compound that may be a potential risk factor for the development of acne lesions. However, according to Wolf et al. [54], existing studies do not provide unequivocal evidence supporting this assumption. Melnik et al. [47] and Tan et al. [55] emphasize the role of high intake of trans fatty acids and SFA in exacerbating acne lesions. This effect is associated with an intensified inflammatory process. A diet rich in SFA may promote comedogenesis and inflammation by stimulating the synthesis of inflammatory cytokines such as interleukins 1β and α. This process is activated by increased availability of free palmitic acid within the pilosebaceous unit. Yasuda et al. [56] highlighted the activation of the mTORC1 kinase complex by palmitic acid and its inhibition by eicosapentaenoic acid (EPA) and oleic acid. In addition, free palmitate stimulates keratinocyte proliferation, thereby contributing to comedogenesis. Many foods contain substantial amounts of saturated and trans fatty acids, which may influence acne development through metabolic and nutrigenomic mechanisms.
El Darouti et al. [57] demonstrated an association between sodium chloride intake and the exacerbation of acne lesions. Among 200 participants in their study, 44% had mild acne, 40% had moderate acne, and 16% had severe acne. Individuals with acne lesions had significantly higher sodium intake compared with the control group, with 76% consuming more than 2400 mg (120% of the recommended daily allowance) of sodium. Thirty-four percent of participants subjectively reported an increase in acne severity after consuming salty foods. The same researchers also investigated the effect of spicy food consumption on skin deterioration. Although the results were inconclusive, 21% of participants reported increased acne lesions after consuming spicy foods. Similar findings were reported by El-Fetoh et al. [58], where 23.3% of a study group of 400 men confirmed acne aggravation after consuming spicy foods. Faiz et al. [59] also demonstrated a statistically significant higher prevalence of acne among individuals who consumed spicy foods, although in subjective assessments, only 28% of participants confirmed this observation.
The summary of metabolic impact of dietary compounds on acne severity is presented on Figure 3.
The results of the present study indicate that a diet based on low-GI and anti-inflammatory foods, combined with the elimination of products that exacerbate acne severity, may be beneficial in the dietary management of acne. However, this study has several limitations. The study population consisted mainly of women, as women more frequently sought treatment for acne at the participating clinics. Nevertheless, available data regarding differences in acne prevalence between genders remain inconsistent [1,2,3]. However, based on the Global Burden of Disease study, there was an increase in the age-standardized rate of post-adolescent acne from 1990 to 2021, affecting women more than men [60]. Another limitation is the absence of a control group. However, the crossover study does not require a control group because the patients receive two therapies alternately (in the present study: a diet with and without chocolate), acting as controls for themselves. Moreover, before the intervention, all participants completed a questionnaire regarding their previous dietary habits. None of the participants reported following a diet consistent with the anti-acne dietary principles applied in the present study (low-GI diet, elimination of dairy products, and elimination of highly processed foods). The intervention period could be longer than four weeks; however, it should be noted that during the second part of this study, participants consumed a diet with chocolate, associated with the exacerbation of acne lesions (data published previously [21]). Despite that fact, the four-week dietary intervention which was implemented allowed us to assess changes in acne severity. Another limitation is possible center effects. Moreover, despite the fact that participants received a diet appropriate for their total energy requirement, with the assumption that this maintained a stable body mass, we observed a reduction in body mass. It was an unblinded, but in nutritional intervention studies where the whole diet is taken into account, blinding is impossible.

5. Conclusions

The findings of this study suggest that an appropriate dietary intervention may be beneficial in the management of acne by contributing to improved skin condition and reduced acne severity. The anti-acne diet applied in this study was based on low-GI and anti-inflammatory foods, with reduced intake of saturated fatty acids, sugar, and salt, and the elimination of dairy products, highly processed foods, and high-GI products. This study supports the feasibility of the applied dietary pattern and suggests possible benefits for patients with acne. Considering the promising results obtained in this study, further research conducted in larger patient populations would be valuable.

Author Contributions

Conceptualization, M.D. and B.R.-I.; methodology, M.D., D.R. and B.R.-I.; formal analysis, D.R.; investigation, M.D.; resources, M.D. and D.R.; data curation, M.D., D.R. and B.R.-I.; writing—original draft preparation, M.D.; writing—review and editing, D.R. and B.R.-I.; project administration, M.D., D.R. and B.R.-I. All authors have read and agreed to the published version of the manuscript.

Funding

The APC was funded by De Luxo service sp z o o.

Institutional Review Board Statement

This study was conducted in accordance with the Declaration of Helsinki and was approved by the Wroclaw Medical University Bioethics Committee (No. KB-821/2020, 19 January 2021).

Informed Consent Statement

Informed consent was obtained from all subjects involved in this study. Informed consent for publication was obtained from all identifiable human participants.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors on request.

Acknowledgments

The authors would like to thank the staff of the participating cosmetology and aesthetic medicine clinics for their assistance in recruiting study participants and conducting dermatological assessments.

Conflicts of Interest

Author M.D. was employed by the company De Luxo service sp z o o. This author declares that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declare that this study received funding from De Luxo service sp z o o only to cover APC. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. The funder did not affect the experimental process or the results of this study. The funding relationship does not affect the scientific quality of the manuscript.

Abbreviations

The following abbreviations are used in this manuscript:
BCAABranched-chain amino acid
BMIBody mass index
BMRBasal metabolic rate
EPAEicosapentaenoic acid
GIGlycemic index
IGF-1Insulin-like growth factor-1
ILInterleukin
mTORC1Mammalian target of rapamycin complex 1
MUFAMonounsaturated fatty acid
PALPhysical activity level
PUFAPolyunsaturated fatty acid
SDStandard deviation
SFASaturated fatty acid
TGF-βTransforming growth factor beta
TNF-αtumor necrosis factor-α

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Figure 1. Flow chart showing the crossover study design.
Figure 1. Flow chart showing the crossover study design.
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Figure 2. Skin condition in selected patients before (1A–3A) starting the dietary intervention and after (1B–3B) the intervention.
Figure 2. Skin condition in selected patients before (1A–3A) starting the dietary intervention and after (1B–3B) the intervention.
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Figure 3. Metabolic impact of dietary compounds on acne severity.
Figure 3. Metabolic impact of dietary compounds on acne severity.
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Table 1. Nutrient content and percent of energy from macronutrients (mean ± SD) in the decadal diets used in this study, arranged for the three energy values.
Table 1. Nutrient content and percent of energy from macronutrients (mean ± SD) in the decadal diets used in this study, arranged for the three energy values.
Energy and Nutrients1800 kcal *2000 kcal *2200 kcal *
Energy (kcal)1804.4 ± 13.81997.7 ± 15.02187.6 ± 11.9
Protein (g)83.8 ± 2.291.5 ± 498.9 ± 4.2
Protein (%E)18.6 ± 0.518.3 ± 0.818.1 ± 0.7
Carbohydrates (g)236.9 ± 3.7262.8 ± 7.1288.6 ± 5
Carbohydrates (%E)48.1 ± 0.748.3 ± 1.348.8 ± 0.8
Dietary Fiber (g)39.8 ± 5.743.4 ± 5.743.3 ± 3.3
Fat (g)66.7 ± 1.274.0 ± 1.380.3 ± 2.1
Fat (%E)33.3 ± 0.633.3 ± 0.633.0 ± 0.9
SFA (g)18.8 ± 1.019.7 ± 1.220.5 ± 1.1
SFA (%E)9.4 ± 0.58.9 ± 0.58.4 ± 0.4
MUFA (g)26.2 ± 2.528.6 ± 2.731.7 ± 3.2
MUFA (%E)13.1 ± 1.212.9 ± 1.213.0 ± 1.3
PUFA (g)15.9 ± 2.219.3 ± 2.521.1 ± 2.7
PUFA (%E)7.9 ± 1.18.7 ± 1.18.68 ± 1.1
Cholesterol (mg)314.2 ± 127.7339.9 ± 157.1349.2 ± 149.8
Lactose (g)0.1 ± 00.1 ± 00.1 ± 0
Vitamin A—RE (µg)2415.5 ± 911.52432.1 ± 897.32454.2 ± 899.8
Retinol RE (µg)380.9 ± 132.3396.6 ± 165.5415.7 ± 167.5
Beta-Carotene Equiv (µg)12,233.4 ± 542612,238.7 ± 572712,265.6 ± 5728
Vitamin B1 (mg)1.4 ± 0.31.5 ± 0.31.6 ± 0.3
Vitamin B2 (mg)1.5 ± 0.21.6 ± 0.31.7 ± 0.3
Vitamin B3 (mg)26.8 ± 8.228.2 ± 8.429.9 ± 8.6
Vitamin B6 (mg)3.1 ± 0.63.3 ± 0.63.5 ± 0.6
Vitamin B12 (µg)4.5 ± 3.44.6 ± 3.44.8 ± 3.6
Vitamin C (mg)324.2 ± 121.6325.0 ± 121.5355.1 ± 121.3
Vitamin D (µg)7.6 ± 9.07.7 ± 9.08.2 ± 9.0
Vitamin E (mg)16.4 ± 2.117.7 ± 1.519.1 ± 2.5
Folate (µg)544.5 ± 147.2573.7 ± 141.5586.6 ± 141.9
Calcium (mg)990.8 ± 141.21019.5 ± 145.81064.7 ± 157.3
Copper (mg)2.0 ± 0.22.1 ± 0.22.3 ± 0.2
Iodine (µg)42.3 ± 17.044.1 ± 16.945.7 ± 19.1
Iron (mg)15.9 ± 1.217.3 ± 1.818.4 ± 2.3
Magnesium (mg)512.5 ± 80.0562.0 ± 89.2591.1 ± 97.7
Manganese (mg)7.1 ± 1.08.2 ± 1.08.7 ± 1.2
Phosphorus (mg)1464.4 ± 132.41618.4 ± 161.71735.5 ± 151.8
Potassium (mg)4517.3 ± 322.04765.9 ± 342.94948.5 ± 330.4
Sodium (mg)1460.3 ± 458.31598.6 ± 461.91701.7 ± 537.0
Zinc (mg)11.0 ± 1.312.2 ± 1.712.9 ± 1.9
* mean ± SD in the decadal diets used in this study, arranged for three energy values; %E—percent of energy; SD—standard deviation; SFAs—saturated fatty acids; MUFAs—monounsaturated fatty acids; PUFAs—polyunsaturated fatty acids; n—number of days.
Table 2. Detailed list of food products that were used in the 10-day dietary plan and a list of food products excluded from the diet as those that exacerbate acne lesions.
Table 2. Detailed list of food products that were used in the 10-day dietary plan and a list of food products excluded from the diet as those that exacerbate acne lesions.
Food Products Excluded from 10-Day
Dietary Plan		Food Products Used in 10-Day
Dietary Plan
  • milk and dairy products,
  • saturated fatty acids,
  • sugar,
  • highly processed foods rich in salt and sugar,
  • maximum iodized salt intake up to 2 g/day (as a source of iodine),
  • foods with a high GI,
  • pro-inflammatory food: sources of SFAs (lard, coconut and palm oils); sources of n-6 PUFAs (sunflower, grape seed, corn oils, and margarines made from these oils) offal, sources of salt and added sugars (processed meats, salty snacks, sweets, juices, fruit drinks).
  • whole grains products with a low GI,
  • sources of MUFAs: olive and rapeseed oil, almonds, hazelnuts, avocado, olives,
  • sources of PUFAs: pumpkin and sesame seeds, rapeseed oil, walnuts, flax, sunflower seeds, as well as fish, such as salmon, mackerel, trout, tuna, and cod,
  • sources of anti-inflammatory compounds: vitamin E: nuts, oil seeds, olive and rapeseed oil; vitamin C, β-carotene, flavonoidscitrus fruits (oranges, tangerines, lemon, grapefruit, lemon juice), other fruits (dried apricots, raspberries, strawberries, apples, bananas, pineapple, pear), leafy vegetables (lettuce, spinach, chives, celery), non-starchy vegetables (red peppers, carrots, cucumbers, tomatoes, parsley root, zucchini, broccoli, radishes, mushrooms, sauerkraut, canned corn), legumes (red lentils, white beans),
  • sources of fiber: fruits, vegetables, and whole grains,
  • sources of magnesium: high magnesium-calcium mineral water, nuts and seeds,
  • fresh spices as a source of bioactive compounds: garlic, onion, dill, and parsley leaves.
GI—glycaemic index; SFA—saturated fatty acids; MUFA—monounsaturated fatty acids; PUFA—polyunsaturated fatty acids.
Table 3. One day menu example for 2000 kcal.
Table 3. One day menu example for 2000 kcal.
MealDescription of Meal Preparation
Breakfast 461 kcal
Whole meal rye bread (3 slices) 90 g
Butter 20 g
Tuna (in water, canned) 50 g
Tomato 60 g
Lettuce 20 g
Olive oil 5 g		Tuna paste: mix tuna with olive oil; add tiny chopped tomato; season with allowed herbs.
Put lettuce and tuna paste on the slices of bread.
Second Breakfast 320 kcal
Walnuts 30 g
Dried apricots 40 g		Eat walnuts and dried apricots as a morning snack.
Lunch 554 kcal
Pearl barley groats 75 g
Red lentil seeds dry 25 g
Turkey drumstick meat without skin 100 g
Onion 20 g
Red pepper 50 g
Broccoli 150 g
Olive oil 5 g		Cook the groats. Cut meat into strips and stew in a pan with olive oil, add lentils and chopped onion and red pepper. Mix everything and season with allowed herbs and spices as desired. Cook the broccoli and eat it with groats and prepared meat.
Prepare the dish from a double portion, divide it and serve some for dinner.
Afternoon Snack 242 kcal
Frozen raspberries 200 g
Pumpkin seeds 10 g
Soy yogurt 150 g 		Add raspberries and pumpkin to yogurt.
Dinner 419 kcal
Pearl barley groats 50 g
Red lentil seeds dry 25 g
Turkey drumstick meat without skin 50 g
Onion 20 g
Red pepper 50 g
Broccoli 150 g
Olive oil 5 g		The dish is ready from lunch.
High-calcium mineral water 1.5 L
Total 1996 kcal
Table 4. Characteristics of the study group (n = 92).
Table 4. Characteristics of the study group (n = 92).
Characteristics of the Study GroupParticipants
n (%)
Age groups18–25 years old62 (67.39)
26–35 years old24 (26.09)
36–40 years old6 (6.52)
Time of acne durationless than 1 year6 (6.52)
1–3 years16 (17.39)
3–6 years29 (31.52)
more than 6 years34 (36.96)
other7 (7.61)
Table 5. Pre- and post-dietary intervention comparison of anthropometric parameters and acne lesion severity in the study group.
Table 5. Pre- and post-dietary intervention comparison of anthropometric parameters and acne lesion severity in the study group.
VariablesBefore Intervention (n = 92)After Intervention (n = 92)p
Mean ± SDMean ± SD
Body mass (kg)62.4 ± 12.661.8 ± 12.6<0.0001
BMI (kg/m2)22.3 ± 4.222.0 ± 4.2<0.0001
Percent body fat (%)24.9 ± 8.424.0 ± 8.7<0.0001
Body fat mass (kg)16.5 ± 8.915.8 ± 9.0<0.0001
Visceral fat2.2 ± 1.92.1 ± 1.80.0386
TBW (%)52.9 ± 5.453.4 ± 5.5<0.0001
Metabolic age (year old)21.6 ± 10.820.8 ± 10.60.0004
Severity of acne lesions (points)3.3 ± 0.62.4 ± 0.7<0.0001
SD—standard deviation, BMI—body mass index; TBW—total body water; n—number of participants.
Table 6. Change in the number of study participants categorized by acne severity after the four-week dietary intervention.
Table 6. Change in the number of study participants categorized by acne severity after the four-week dietary intervention.
Acne
Severity Score		Number of Study Participants
Before Intervention
n (%)		Who Experienced a Change in Acne Severity by a Specified Number of Points After Intervention
No Change
n (%)		- 1 Point
n (%)		- 2 Points
n (%)		- 3 Points
n (%)
00
10
27 (7.61)2 (28.6)5 (71.4)
350 (54.35)20 (40)25 (50)5 (10)
435 (38.04)2 (5.71)22 (62.86)10 (28.57)1 (2.86)
50
total number of participants with acne9224 (26.09)52 (56.52)15 (16.30)1 (1.09)
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Daszkiewicz, M.; Różańska, D.; Regulska-Ilow, B. The Impact of Diet Composition on the Reduction of Acne Vulgaris: A Crossover Study. Cosmetics 2026, 13, 115. https://doi.org/10.3390/cosmetics13030115

AMA Style

Daszkiewicz M, Różańska D, Regulska-Ilow B. The Impact of Diet Composition on the Reduction of Acne Vulgaris: A Crossover Study. Cosmetics. 2026; 13(3):115. https://doi.org/10.3390/cosmetics13030115

Chicago/Turabian Style

Daszkiewicz, Magdalena, Dorota Różańska, and Bożena Regulska-Ilow. 2026. "The Impact of Diet Composition on the Reduction of Acne Vulgaris: A Crossover Study" Cosmetics 13, no. 3: 115. https://doi.org/10.3390/cosmetics13030115

APA Style

Daszkiewicz, M., Różańska, D., & Regulska-Ilow, B. (2026). The Impact of Diet Composition on the Reduction of Acne Vulgaris: A Crossover Study. Cosmetics, 13(3), 115. https://doi.org/10.3390/cosmetics13030115

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