could rosacea be caused by diet ?

If indeed acne, and perhaps other inflammatory skin conditions like rosacea are mediated by diet, then why are there no studies ? This is an important series of questions that are asked by this paper. If cited papers is a measure of how well the background research is, this paper shines with 106 references to date. It will be interesting to see if inflammatory pathways causing rosacea can be tied back to what we eat.

Implications for the Role of Diet in Acne, Seminars in Cutaneous Medicine and Surgery Volume 24, Issue 2, June 2005, Pages 84-91, Advances in Acne Research, Cordain L.

Within the dermatology community, a general consensus has emerged that diet is unrelated to the etiology of acne. Except for 2 poorly designed studies, now more than 30 years old, there are few objective data to support this notion. In contrast, a large body of evidence now exists showing how diet may directly or indirectly influence the following 5 proximate causes of acne:

1. increased proliferation of basal keratinocytes within the pilosebaceous duct
2. incomplete separation of ductal corneocytes from one another via impairment of apoptosis and subsequent obstruction of the pilosebaceous duct
3. androgen-mediated increases in sebum production
4. colonization of the comedo by Propionibacterium acnes
5. inflammation both within and adjacent to the comedo

This article will provide a review of the currently available literature on the association between diet and acne vulgaris as well as a discussion of the physiologic principles that may underlie this association.

Conclusion and Recommendations

The last diet-acne trial was published in 1971. In the ensuing 34 years, great strides have been made in understanding how diet influences long-term health and well being. Unfortunately, appreciation of this information has generally gone unnoticed in the dermatology community, as witnessed by the 34-year vacuum since the last dietary intervention in acne patients. A substantial body of literature now exists that directly implicates diet as the most likely environmental factor underlying the development of acne. Confirmation of the diet-acne hypothesis will require numerous well controlled dietary interventions examining multiple nutritional factors. As a starting point, future experiments testing the diet– acne hypothesis should employ diets that mimic the nutritional characteristics of diets found in nonwesternized populations known to be free of acne. Although there is no single nonwesternized diet, there are certain universal characteristics that have a theoretical basis for testing. These diets are free of processed foods, cereal grains, dairy products, refined sugars, and refined oils and almost entirely comprise unprocessed fresh, fruits, vegetables, and lean meats, fish, and seafood.

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