From plate to pores: How the Mediterranean diet’s transformative power fights stubborn skin disorders—discover the science-backed strategies behind clearer skin and better health.
Review: Plant-Based Foods for Chronic Skin Diseases: A Focus on the Mediterranean Diet. Image Credit: luigi giordano / Shutterstock
In a recent review article in the journal Current Nutrition Reports, researchers discussed how following a Mediterranean diet (MD) can complement conventional treatments for hidradenitis suppurativa (HS), psoriasis, and acne by reducing inflammation and improving overall patient outcomes.
They highlighted that the diet’s antioxidant and anti-inflammatory properties help lessen disease severity, mitigate metabolic and cardiovascular risks, and support weight control, making it a valuable non-pharmacological treatment option.
Background
Chronic inflammatory skin conditions like HS, psoriasis, and acne can significantly affect physical and mental health. While these disorders share common inflammatory pathways (e.g., TNF-α and IL-17 signaling), they have distinct characteristics.
Psoriasis and HS involve immune system overactivation (mediated by Th17 cells and IL-23), while acne is linked to excessive oil production, bacterial growth (Propionibacterium acnes), and follicular hyperkeratinization. Since these conditions are chronic, long-term management is necessary, but conventional treatments often have side effects and varying effectiveness. Therefore, an integrated approach that includes dietary modifications can help improve symptoms.
MD is a well-researched eating pattern known for its antioxidant and anti-inflammatory properties. It emphasizes whole foods like vegetables, fruits, whole grains, legumes, nuts, fish, and extra virgin olive oil while limiting red meat and processed foods.
Key compounds in the MD, such as monounsaturated and polyunsaturated fats, polyphenols, and omega-3 fatty acids, help reduce inflammation and oxidative stress (e.g., by inhibiting NF-κB signaling). These nutrients also support gut health and immune regulation, making MD a valuable dietary strategy for managing inflammatory skin diseases.
Due to its overall health benefits, including positive effects on obesity, metabolic syndrome, and cardiovascular health, the MD is a promising non-drug therapy for chronic skin conditions. Its ability to lower systemic inflammation makes it a beneficial addition to traditional treatments.
Evidence for HS Treatment
MD is crucial in managing HS due to its antioxidant and anti-inflammatory properties. HS is a chronic inflammatory skin disease influenced by metabolic and endocrine factors (including thyroid dysfunction and vitamin D deficiency). Research suggests that patients with HS often have poor adherence to the MD, which is associated with more severe symptoms.
One study found that lower adherence to the MD correlated with higher disease severity, with a PREDIMED score of ≤5 specifically linked to worse HS outcomes. Further studies confirmed this, showing that a preference for extra virgin olive oil and poultry over red meat was a major determinant of reduced HS severity.
The MD helps regulate inflammation by balancing gut microbiota, reducing oxidative stress, and influencing key pathways like IGF-1, FOXO1, and mTORC1 (as well as defects in Notch signaling). Nutrients such as omega-3 fatty acids, polyphenols, and monounsaturated fats play a vital role in reducing inflammation.
Evidence for Psoriasis Treatment
MD may help manage psoriasis due to its anti-inflammatory and antioxidant properties. Studies show that lower adherence to the MD is linked to more severe psoriasis, as measured by the Psoriasis Area and Severity Index (PASI).
Key components of the MD, such as extra virgin olive oil and fish, are associated with reduced inflammation and lower psoriasis severity. EVOO and omega-3 fatty acids were identified as independent predictors of both PASI scores and C-reactive protein (CRP) levels, reinforcing their role in mitigating systemic inflammation. The MD also provides essential vitamins and minerals, including vitamin D, which supports keratinocyte function. Its ability to counteract oxidative stress may improve psoriasis severity.
Given its benefits, the MD is considered a form of medical nutrition therapy for psoriasis. While diet alone is not a cure, incorporating the MD alongside conventional treatments, such as biologics (whose efficacy may be reduced in obese patients), may enhance disease management and overall health. Further research is needed to optimize dietary interventions for psoriasis patients.
Evidence for Acne Treatment
Acne is a common inflammatory skin condition influenced by genetic, hormonal, and lifestyle factors. Diet, particularly MD, has been increasingly recognized for its potential role in acne management.
Studies suggest that high adherence to the MD is linked to lower acne severity, likely due to reduced insulin-like growth factor-1 (IGF-1) levels, which influence sebum production and inflammation. In contrast, diets high in refined carbohydrates, dairy, and unhealthy fats can exacerbate acne by promoting hyperinsulinemia, androgen stimulation, and inflammation.
While some research supports the protective effects of the MD, findings are not entirely consistent (due to variability in dietary assessment tools like MEDAS scores). More studies are needed to establish clear dietary guidelines for acne prevention and treatment. However, incorporating MD principles may benefit overall skin health and reduce acne severity.
Conclusions
MD is a valuable approach for managing chronic inflammatory skin conditions, but its effectiveness depends on personalization. Rather than simply listing foods to include or avoid, healthcare professionals should tailor dietary plans to fit individual habits and preferences, promoting better adherence.
A well-balanced MD-based nutritional plan should align with metabolic needs, and calorie deficits should be recommended for weight loss when necessary. Essential nutrients for skin health should be obtained through whole foods or supplementation if needed.
A structured meal schedule, dividing daily intake into multiple meals, can help regulate glycemic response and reduce emotional eating. While avoiding excessive consumption of red meat, dairy, alcohol, and irritants is recommended, strict restrictions are unnecessary.
The MD can enhance treatment outcomes and support long-term skin health by incorporating personalized dietary education and recommendations.
Journal reference:
- Plant-Based Foods for Chronic Skin Diseases: A Focus on the Mediterranean Diet. Annunziata, G., Verde, L., Zink, A., Muscogiuri, G., Albanesi, C., Paganelli, A., Barrea, L., Scala, E. Current Nutrition Reports (2025). DOI: 10.1007/s13668-025-00632-5, https://link.springer.com/article/10.1007/s13668-025-00632-5