Acne vulgaris is one of the most common chronic inflammatory skin conditions affecting young adults worldwide. It is characterized by the involvement of pilosebaceous units, leading to the formation of comedones, papules, pustules, and in severe cases, nodules and cysts. The condition has multifactorial pathogenesis, including increased sebum production, follicular hyperkeratinization, microbial colonization, and inflammation (1,2).

In recent years, increasing attention has been given to the role of dietary factors in the development and severity of acne. Traditionally, diet was considered to have minimal influence on acne; however, emerging evidence suggests a significant association between dietary habits and acne progression (1,3). Several studies have highlighted that modern dietary patterns, particularly those rich in high glycemic index foods, may exacerbate acne by increasing insulin levels and promoting androgen-mediated sebum production (4,7).

Dairy consumption has also been implicated as a potential aggravating factor in acne. Epidemiological studies have demonstrated a positive association between milk intake and acne prevalence among adolescents and young adults (5,6). The proposed mechanism involves the stimulation of insulin-like growth factor-1 (IGF-1), which contributes to increased sebaceous gland activity and keratinocyte proliferation (9).

Furthermore, clinical trials have shown that dietary modification, particularly the adoption of a low glycemic 

Study Design and Setting

This cross-sectional study was conducted to assess the association between dietary habits and acne severity among young adults.  The study population consisted of young adults aged 18–30 years. Participants were recruited from [medical colleges/universities/community settings/outpatient departments]. Both male and female participants were included. A total of 300 participants were included in the study. The sample size was determined based on previous similar studies and feasibility. A non-probability convenience sampling technique was used to recruit participants who met the inclusion criteria.

Inclusion Criteria

Young adults aged 18–30 years , Individuals with clinically diagnosed acne or willing to undergo acne assessment Participants who provided informed consent

Exclusion Criteria

Individuals with chronic dermatological diseases other than acne .Patients on systemic retinoids, hormonal therapy, or long-term antibiotics .Individuals with endocrine disorders (e.g., PCOS, Cushing syndrome)  Pregnant or lactating females .Data were collected using a structured and pre-tested questionnaire. The questionnaire consisted of two main sections: Age, gender, educational status, and lifestyle factors. Dietary habits were assessed based on frequency of consumption of:  High glycemic index foods (e.g., sweets, sugary drinks)  Dairy products (milk, cheese, yogurt)  Fast food and fried items .Fruits and vegetables .Participants were asked to report their dietary intake on a frequency scale (daily, weekly, occasionally, rarely).

Assessment of Acne Severity

Acne severity was evaluated using the Global Acne Grading System (GAGS). This system considers the distribution and severity of lesions across different anatomical regions (forehead, cheeks, nose, chin, chest, and back). Based on the calculated score, acne was categorized as: Mild ,Moderate ,Severe Very severe Ethical approval for this study was formally obtained from Review Board of Mirpur Medical College. Participants were confidentially assured that all responses would remain anonymous. Participation was voluntarily maintained, and students were freely allowed to withdraw at any stage without any disadvantage.

Socio demographic Characteristics of Participants

A total of 300 participants were included in the study. The mean age of participants was 23.4 ± 3.2 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the age group 21–25 years (48%), followed by 18–20 years (32%) and 26–30 years (20%).

Based on the Global Acne Grading System (GAGS), acne severity among participants was categorized as follows:

Mild acne: 102 (34.0%) ,Moderate acne: 118 (39.3%) ,Severe acne: 60 (20.0%) ,Very severe acne: 20 (6.7%) Moderate acne was the most prevalent form observed in the study population. A total of 156 (52.0%) participants reported frequent consumption of high glycemic index foods. Among them, a higher proportion had moderate to severe acne.Frequent dairy consumption was reported by 140 (46.7%) participants. Increased acne severity was observed among participants with higher dairy intake compared to those with low intake.Approximately 168 (56.0%) participants reported consuming fast food more than twice per week. A significant proportion of these individuals had moderate and severe acne.

Only 110 (36.7%) participants reported regular consumption of fruits and vegetables. Participants with lower intake showed relatively higher acne severity.Participants with frequent consumption of high glycemic foods, dairy products, and fast food were more likely to have moderate to severe acne, whereas regular intake of fruits and vegetables was associated with milder forms of acne. Overall, the study demonstrated a significant positive association between unhealthy dietary habits and increased acne severity, while healthy dietary patterns appeared to have a protective effect.

Table 1: Sociodemographic Characteristics (n=300)

Table 2: Acne Severity Distribution

Table 3: Dietary Habits

Table 4: Association with Acne Severity

The present study evaluated the association between dietary habits and acne severity among young adults and found a significant relationship between unhealthy dietary patterns and increased acne severity. The findings of this study are consistent with a growing body of evidence suggesting that diet plays an important role in the pathogenesis and progression of acne. In this study, a significant association was observed between high glycemic index food consumption and acne severity. Participants with frequent intake of sugary foods and refined carbohydrates were more likely to have moderate to severe acne. This finding is in agreement with previous studies, which have reported that high glycemic diets increase insulin levels and androgen activity, thereby promoting sebum production and acne formation (17,20). Similarly, a review by Spencer et al. highlighted that dietary factors, particularly high glycemic load diets, contribute to acne exacerbation (11).

Dairy consumption was also found to be significantly associated with acne severity in the present study. Participants with higher intake of milk and dairy products exhibited more severe forms of acne. This observation aligns with earlier research suggesting that dairy products may influence acne through hormonal mechanisms, including increased levels of insulin-like growth factor-1 (IGF-1) (20). Large cohort studies have also demonstrated a positive correlation between dairy intake and acne prevalence (16).

Fast food consumption showed a strong association with acne severity in this study. Frequent consumption of fast food, which is typically rich in fats and refined carbohydrates, was linked with moderate to severe acne. These findings are supported by studies conducted in different populations, including Korean and Jordanian cohorts, where unhealthy dietary habits were associated with increased acne severity (14,15).

On the other hand, regular intake of fruits and vegetables was associated with milder forms of acne, suggesting a protective role of a balanced diet. Diets rich in antioxidants, vitamins, and fiber may help reduce inflammation and improve skin health. This is consistent with the concept of the “exposome” in acne, where environmental and dietary factors collectively influence disease outcomes (19).

The results of this study are also in line with the Western diet hypothesis proposed by Cordain et al., which suggests that modernization and dietary changes, particularly increased consumption of processed and high glycemic foods, have contributed to the rising prevalence of acne (12). Furthermore, randomized controlled trials have demonstrated that dietary modification, particularly reducing glycemic load, can significantly improve acne severity (13).

Despite these findings, some variability exists across studies due to differences in study design, population characteristics, and dietary assessment methods. However, the overall evidence supports a meaningful association between diet and acne (18).

The present study concludes that there is a significant association between dietary habits and acne severity among young adults. High consumption of high glycemic index foods, dairy products, and fast food is associated with increased severity of acne, whereas regular intake of fruits and vegetables appears to have a protective effect.

These findings highlight the importance of dietary modification as a potential adjunct in acne management. Promoting healthy eating habits may help reduce the burden of acne and improve overall skin health

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