Abstract
Acne vulgaris, a chronic inflammatory skin condition, is influenced by multiple factors including sebum production, bacterial proliferation, and inflammation. Dietary interventions have garnered increasing attention as complementary management strategies. This study aimed to compare the effects of a Ketogenic Diet (KD) versus a Mediterranean Diet (MD) on sebum composition, Cutibacterium acnes (C. acnes) proliferation, and inflammatory lesion counts in individuals with moderate acne vulgaris. A randomized controlled trial was conducted over 12 weeks with 80 participants. Sebum excretion rates, fatty acid profiles, C. acnes bacterial load quantified by qPCR, and inflammatory lesion counts were assessed at baseline and post-intervention. Results indicated that both dietary interventions led to significant reductions in inflammatory lesion counts and C. acnes proliferation. The KD group demonstrated a more pronounced reduction in overall sebum excretion rate and a favorable shift in sebum fatty acid composition, including an increase in linoleic acid. The MD group showed significant improvements in inflammatory markers and a strong correlation between dietary adherence and reduction in lesion counts. While both diets offered benefits, KD appeared to exert a more direct impact on sebaceous gland activity, whereas MD’s benefits were likely mediated through its broad anti-inflammatory and antioxidant properties. These findings suggest that specific dietary modifications can serve as valuable adjunctive therapies for moderate acne vulgaris.
