DERMATOLOGY NUTRITION

RAHMANIA, S.GZ, MPH

NUTRITION AND SKIN?

 While some of concern unfounded, some dietary consideration indeed

important in some dermatological condition
 Intervention  acne theraphy
 Prevention  skin cancer, skin aging
 Affect health outcomes  psoriasis, reduce risk of diseases caused by
medications like steroids
NUTRITION AND SKIN

 Epidermis and dermis function is affected by nutrition adequacy 

deficiency of essential fatty acids (EFA) is shown to increase epidermal
permeability and transepidermal water loss.
 Dietary imbalance disturb the equilibrium of the skin  cutaneous
manifestations.
 Skin diseases lead to metabolic imbalances and nutritional deficiencies 
demand for nutrients in skin is altered under stress conditions.
 Excessive inflammation of the skin increase the requirements of specific
nutrients like folic acid and protein.
DIETARY NUTRIENTS INVOLVED IN VARIOUS DERMATOLOGIC
CONDITIONS
VITAMIN A

 Vitamin A influence skin in

 promoting differentiated epithelia
 Modulating dermal growth factors
 Inhibiting seceous glands activity
 Supressing androgen formation
 Vit A promote skin turnover  prevent comedones
 VITAMIN A

 Deficiency results in hyperkeratinization with reduced number of sebaceous

glands and blockage of sweat glands  rough, dry skin
 Synthetic retinoids  acne, eczema, psoriasis, wounds, burn, sunburn, ichtyosis
 Hypovitaminosis A also affects the skin by causing xerosis, generalized
hyperpigmentation, and sparse and fragile hair.
 Source : liver, cod liver oil, kidney, cream & butter, egg yolks
VITAMIN B12

 Cutaneous manifestations associated with vitamin B12 deficiency are skin

hyperpigmentation, vitiligo, angular stomatitis, and hair changes.
 Malabsorption is the most common cause of vitamin B12 deficiency.
 A detailed history of food and dietary habits has been suggested to
evaluate skin lesions.
NIACIN/B3

 Niacin plays a vital role in cell metabolism as a coenzyme in energy

producing reactions involving the breakdown of carbohydrate, fats, and
proteins, as well as anabolic reactions such as fatty acid and cholesterol
synthesis
 Classic pellagra is a nutritional disease characterized by the combined
deficiency of the essential amino acid tryptophan and the vitamin niacin.
 Other factors : mycotoxins, excessive dietary leucine intake, estrogens
and progesterone, chronic alcoholism, and various medications
 Source : meat, poultry, red fishes, milk, green vegetables, coffee, tea
VITAMIN C

 Vitamin C is a cofactor for procollagen proline / lysine hydroxylase 

important in the synthesis of the collagen and extracellular matrix 
extracellular stability of skin  dry skin & trans-epidermal water loss
 It also associated with better skin appearance, less wrinkle, prevent &
help UV-induced photodamage
 Vitamin C also aids in iron absorption and increases the conversion of
cholesterol to bile acid and increases the bioavailability of selenium.
VITAMIN C

 Scurvy  decreased production and increased fragility of collagen.

 Dermatologic signs that appear early in the disease include petechiae,
echymoses, corkscrew or swan-neck hairs, follicular hyperkeratosis, and
perifollicular hemorrhage.
 Source : bell peppers, guava, dark leafy green vegetables, broccoli, brussels
sprouts, kiwi, citrus fruits, strawberries, cilantro, chives, thyme, basil,
parsley
OMEGA-3 FATTY ACIDS

 Omega3 FA  anti-inflammatory  reduction in acne or psoriasis

 Reduce risk of acne  decreasing insulin-like growth factor (IGF-1),
preventing sebaceous follicles hyperkeratinization
 Source : tuna, sardines, salmon, mackarel, anchovies (cold water fish),
OMEGA6 FATTY ACIDS

 prolonged dietary deficiency of (n-6)-fatty acids, e.g. Increased trans-

epidermal water loss, scaly skin, hair loss and poor growth
 Omega6 to mantain the integrity of water permeability barrier of skin
 Topical aplication said to have whitening effectson UVB-induced
hyperpigmentation guinea pig skin  need further studies on human
 Source : safflower oil, sunflower oil, corn oil, olive oil, rapeseed oil
BIOTIN OR VITAMIN B7

 Biotin  enzym cofactor that regulate fatty acid metabolism

 Deficiency : hair loss, scaly erethematous dermatitis around mouth face
and scalp, dandruff
 Source : egg yolks, liver, swiss chard, romaine lettuce, almonds, walnuts
SULFUR

 Sulfur necessary for collagen synthesis  structure and strength of skin

 Sulfur and surlfur binding amino acids work in glutathione synthesis 
antioxidant work in cellular aging
 Source : egg yolks, meat, poultry, fish, garlic, onions, brussels sprouts,
asparagus, kale
 Sulfur bioavability ↑ on fermented food
ZINC

 The cutaneous manifestations of zinc deficiency are weeping dermatitis,

secondary infection, poor wound healing, excessively fragile hair and
sparse or no scalp and pubic hair.
 Dermatitis, alopecia, and nail defects are also associated with zinc
deficiency.Acrodermatitis enteropathica develops in a zinc-deficient
patient and a combined nutritional deficiency of zinc, EFAs, albumin and
amino acids may result in acrodermatitis enteropathica
ZINC

 Zinc take part in building protein & enzymes structure, gene expression
regulation, immune function, wound healing, DNA synthesis and cell
division
 In skin  assist protein & cell membrane structure, improve wound
healing, anti-inflammatory effects and protects against UV
 Acts as component of retinol-binding protein  positive effects on acne
 Source : organ meat e.g kidney, liver, red meat, shellfish, pumpkin seeds,
nuts  bound by phytates
ZINC

 Zinc plays a role as an antioxidant in protecting sulfhydryl groups from

oxidation and prevents superoxide and hydroxyl radical production by
pro-oxidant metals, copper, and iron.
 zinc deficiency may increase oxidative stress-induced tissue damage by
decreasing the antioxidant functions.
VITAMIN E

 Normal human epidermis contains 87% α-tocopherol, 9% γ-tocopherol,

3% γ-tocotrienol and 1% α-tocotrienol
 Vitamin E used in healing wounds, photoprotection as sunburn,
photocarcinogenesis, photoimmunoinhibition, changes in dermal matrix
ie wrinkles
 Source : vegetable oils, seeds, nuts, corn, soy, whole wheat flour,
margarine, meat, dairy products
SELENIUM

 Selenium is an antioxidant mineral responsible for tissue elasticity.,

prevent cell damage by free radicals.
 Reduced associated skin signs include hypopigmentation of the skin and
hair and whitening of the nails.
 it can protect the skin from damage from excessive ultraviolet light.
 Dietary sources of selenium include wheat germ, seafood such as tuna
and salmon, garlic, Brazil nuts, eggs, brown rice, and whole-wheat bread.
Β-CAROTENE

 Supplementation with β-carotene and other carotenoids, such as dietary

tomato paste containing lycopene protects against UV-light-induced
erythema
 β-carotene reported to exacerbate UV carcinogenesis under certain
dietary conditions, by acting as pro-oxidants, at high oxygen pressure and
under oxidative stress.
CURCUMIN

 Curcumin, a polyphenolic compound, isolated from the rhizome of the

plant Curcuma longa, has traditionally been used for pain and wound-
healing.
 The anti-inflammatory, antioxidant, chemopreventive, and
chemotherapeutic activities of curcumin are well-documented.
 Curcumin promotes faster wound healing in rats by increasing collagen
synthesis and cell proliferation, and by decreasing the ROS.
DIETARY CHANGES SHOWN TO BE BENEFICIAL IN SKIN DISEASES

Disease Diet
Low-calorie and protein diet, Balance ω-3 and ω-6 diet, Gluten-free
Psoriasis
diet
Elimination of refined sugar and arginine-rich diet,Vitamins, zinc, and
Herpes
iron supplementation
Scleroderma Vitamin E supplementation, Elimination of high-fiber diet
Acne Low-glycemic diet, Elimination of skim milk
Rosacea Elimination of hot beverages and hot meals
Pemphigus Elimination of thiol, isothiol, and tannin-rich food
Refsum’s disease Elimination of phytate-rich food
DIETS KNOWN TO PRECIPITATE VARIOUS SKIN DISEASES
IMMUNOLOGY LINKED TO NUTRITION

 skin involved in food hypersensitivity reactions, as in atopic dermatitis,

urticaria, and dermatitis herpetiformis.
 Dermatitis herpetiformis is a well-known gluten intolerance disease and
is controlled by a gluten-free diet.
 Symptoms of atopic dermatitis and urticaria have been provoked in
patients consuming foods such as, egg, milk, peanuts, tree nuts, soy, wheat,
fish, and shellfish.
DIETARY ANTIOXIDANT AND SUPPLEMENTS

 Antioxidant molecules in the skin, such as, glutathione, vitamin E, and

vitamin C, interact with the reactive oxygen species (ROS) or their by-
products to either eliminate them or to minimize their deleterious
effects.
 Vitamin C is a water-soluble antioxidant, whereas, vitamin E is
membrane-bound and capable of intercepting free radical-mediated chain
reactions.
 UV irradiation exposure has been previously seen to deplete vitamin E in
the skin,as a result of oxidation.
DIETARY ANTIOXIDANT AND SUPPLEMENTS

 Antioxidants are effective in reducing free radical damage of collagen and

elastin, the fibers that support the skin structure, and in preventing
wrinkles and other signs of premature aging.
 Example : vitamin E, ferukic acid, coenzym Q10/ubiquinone, lycopene,
curcumin, glutathione, green tea, silymarin, resveratrol, grape seeds exact,
α-lipoic acid, genistein, melatonin, extracts or pure compounds of coffee,
polypodium leucotomos, pomegranate, pycnogenol,
dehydroepiandrosterone, selenium, quercetin, rosemarinic acid.
ANTIOXIDANT

Ferulic acid
 Prevent UV induced damage to cells  combining with α-tocopherol
and/or ascorbic acid ↑ topical delivery  substantial UV
photoprotection
Coenzyme Q10/Ubiquinone
 Source : fish, shellfish
 Reduce wrinkles, reduce cell death and DNA oxidative stress, increase
ATP synthesis, suppress collagenase following UVA irradiation
ANTIOXIDANT

Lycopene
 Bright red carotene & carotenoid pigments : red fruit and vegetable
 Prevent carcinogenesis, cardiovascular and aging
Glutathione
 Prevents damage to important cellular components caused by reactive
species : free radicals and peroxides, implicate in skin lightening 
inactivation of melanogenic enzyme
ANTIOXIDANTS

Green tea
 Antioxidant flavanoid  catechins  inhibition of tyrosinase activity,
inhibition of melanin transfer, anti-inflammation, anti carcinogenesis
Silymarin
 Polyphenolic flavanoid coumpound derived from milk thistle plant seeds
 Prevent melanin production  decrease expression of tyrosinase
protein, burn-induced oxidative damage, morphological alteration in skin
on rats
ANTIOXIDANTS

Resveratrol
 polyphenolic phytoalexin compound in the skin of red grapes and is a
constituent of red wine.
 metabolism-regulating and pro-apoptotic/anti-cancer effects, suggested to
protect skin from (UV)-induced photodamage and photoaging
Grape seeds extract
 Polyphenolic proanthocyanidins and procyanidins,  facilitate skin
wound healing and protect collagen and elastin from degradation,
tyrosinaseinhibiting activity
 ANTIOXIDANTS

A-lipoic acid (ALA)

 organosulfur compound derived from octanoic acid, a universal lipid- and
watersoluble antioxidant and synthesized in bacteria, yeast, plants, and mammals
 enhances the biosynthesis of new collagen in normal human dermal fibroblasts.
Genistein
 Isoflavone soy derived phytoestrogen compounds  treat or prevent
inflammation, photoaging, and photocarcinogenesis, provides protective effects on
collagen biosynthesis, photoprotective efficacy on reconstituted skin induced by
acute UVB irradiation by preserve cutaneous proliferation and repair mechanisms
ANTIOXIDANTS

 Melatonin
 naturally compound found in animals, plants, and microbes  hormone
secreted by the pineal gland.
 Melatonin directly neutralize a number of ROS, stimulate several
antioxidant enzymes, reduce UV-induced erythema, modulate the
expression of apoptosis and alleviate sleep disturbances
 In skin, melatonin scavenges and inactivates free radicals arising from UV
irradiation, help wound healing
THANK YOU