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SOUTHERN DERMATOLOGY & SKIN CANCER CENTER
An Affiliate of Anne Arundel Dermatology

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THE DERMATOLOGY & SKIN CANCER CENTER

Gregory J. Wilmoth, MD
Eric D. Challgren, MD
Margaret B. Boyse, MD
Laura D. Briley, MD
Tracey Cloninger, PA-C

Stephanie S. Pascale, FNP-C

4201 Lake Boone Trail, #200
Raleigh, NC 27607
Telephone: (919) 782-2152


THE SKIN RENEWAL CENTER AT SOUTHERN DERMATOLOGY

4201 Lake Boone Trail, #207

Raleigh, NC 27607
Telephone: (919) 863-0073

Healthy Diet Supports Healthy Skin

“What we eat affects our health, including our skin,” affirms Dr. Gregory Wilmoth of Southern Dermatology & Skin Cancer Center. “But, except in the cases of clear food allergies, our skin doesn’t react to specific foods; instead, it’s an unhealthy diet in general that leads to disease.

Dr. Wilmoth

“There are a lot of commonly held beliefs about acne being caused by chocolate or dairy products, for example. But it’s less likely that the individual foods are the culprits; rather, it’s the diet as a whole. A recent study associating acne with other diseases caused by high-glycemic diets bears this out,” he says.

“Such diets produce what’s known as ‘metabolic syndrome’—a group of risk factors that affects 23 percent of adults, and puts them at higher danger of cardiovascular disease, diabetes, stroke, and diseases related to fatty buildup in the arterial walls. The idea is that consuming lots of simple carbohydrates—sugar— creates inflammation in the body, eventually leading to cardiovascular disease and other serious health problems. This demands a lot of your body’s insulin cells, and some people secrete more insulin to take care of that demand. But that extra insulin can cause other health issues, such as stimulating some of the sebaceous cells that cause acne. Patients can improve their acne significantly with a low-glycemic diet.”

Obesity, Inflammation and Your Skin

“While I would not point to diet as causing or curing skin conditions,” notes Dr. Wilmoth, “it is true that the cumulative impact of poor diet—including obesity and systemic inflammation—plays an important role in skin health.

“For example, one of the risk factors for metabolic syndrome is obesity. People who are obese are more prone to inflammation, developing annoying skin conditions, such as intertrigo—an itchy rash that grows between the folds of their skin. Obesity can also lead to less physical activity, causing leg ulcers and sores. And the combination of inactivity and obesity results in poor circulatory function due to the fat in their legs. The veins don’t function well because the calf muscle pump isn’t working as it should, thus they have problems sending blood from their limbs back to the heart.

Gut Health and the Skin

“Beyond the general impact of a poor diet, there are a few interesting skin diseases with a direct correlation to the gut,” notes Dr. Wilmoth. “A classic one is dermatitis herpetiformis, which affects people who have a gluten sensitivity. They eat gluten, then their body doesn’t like it and creates IGA antibodies. These antibodies circulate out of the gut and go to the skin where they have the ability to react with the skin’s epidermal membrane, causing blistering and itching.

“I just saw a patient who has been itching for several months,” says Dr. Wilmoth. “He was covered in blistery, itchy rashes on his knees, elbows, and back. He’s been to two or three doctors and he’s no better. Steroids weren’t helping. Clinically we suspected what this was and the scan showed IGA antibodies binding in the biopsy. He eliminated gluten and within a week he wasn’t itching at all—after suffering for months. You can’t prevent this disease, but if you avoid gluten, you’ll do fine and can avoid all medicines. It’s the skin equivalent of celiac disease, with the gut getting inflamed and then the skin.”

Dr. Wilmoth notes that another extremely uncomfortable skin condition —hives—may be food related. “However, if a patient has hives, but they’re not having other gastrointestinal symptoms such as stomach distress or diarrhea, then it’s usually not food related. In fact,” he says, “most people with hives are idiopathic, meaning something triggered it, but you don’t know what it was. Sometimes it’s easy to figure out—they may have just started a new med or ate shrimp a few hours before. But I’ve had patients show up who have had hives for six weeks and nobody knows why. Then we focus more on treatment than prevention.”  

Dietary Support for Skin Health

Beyond adhering to a healthy—low-glycemic—diet, there may be foods and supplements, such as fish oil, that help support people with skin diseases, notes Dr. Wilmoth. “For example, the use of fish oil has shown marginal benefit in some psoriasis patients who also have an overall tendency towards metabolic syndrome. And upping their anti-inflammatory oil supplements may also benefit eczema patients.

“But, generally, there’s very little specific evidence that dietary changes improve eczema. Rather, it’s more about getting the skin barrier repaired and quickly turning off that inflammation. The main problem I see with eczema is that people, through fear of treatment or ignorance, don’t ever treat the inflammation. It just continues to get worse until they get some corticosteroid treatment to calm it down.”

Dr. Wilmoth notes that, while there aren’t any specific diet interventions for skin cancer, there’s an interesting study that looks at a high-dose supplementation of a medication called niacinamide or nicotinamide, a B-vitamin, which creates more antioxidant activity. “Data are just coming in, but it makes sense that an antioxidant rich diet would benefit sun damaged skin and its repair. The study suggests that, by supporting immune function, taking a niacinamide pill twice a day can decrease 20 percent of skin cancers.

“Another interesting development in dermatologic treatments has been the impact of the new biologic medications,” observes Dr. Wilmoth. “They have been transformational in treating many chronic skin conditions, such as psoriasis. And, it appears that they have secondary benefits, which may be helpful to those with metabolic syndrome. We’re noticing, for example, that some of these folks are seeing improvements in their cardiovascular health due to the anti-inflammatory qualities of the biologic meds they are using for their psoriasis.

“Similarly,” he notes, “I’ve been reading about how these biologics appear to help with COVID, which lowers people’s immune function. People are actually less likely to have problems with COVID if they were being treated concurrently with a biologic for psoriasis or rheumatoid arthritis. They still have the disease, but the anti-inflammatory qualities seem to benefit some of them.”