Interested in Maintaining Healthy Skin?: The link between good nutrition and healthy skin

Importance of Skin Health:

The health of the skin is extremely important as the skin is the body's first line of defense against external influences such as bacteria, mechanical and chemical stressors as well as ultraviolet (UV) radiation.

Good nutrition is one of the major factors in attaining and maintaining healthy skin.  Both macronutrients and micronutrients are important to skin health (Lakdawala et al, 2013).  However, there are specific micronutrients (key vitamins and minerals) that play significant roles in maintaining the structural integrity of the skin barrier as well as important biological and physiological functions.

Functionality of the Skin:
 

The skin comprises of two major layers which are the epidermis and dermis.   The epidermis interacts directly with the external environment and may come into contact with toxic substances, pathogens and UV radiation.  Therefore, the epidermis primarily acts as a barrier.  As a barrier, the epidermis thus serves in the role of providing permeability, as an antimicrobial, as an antioxidant -protecting skin from oxidative stress and as a UV protectant- protecting the skin from UV light-mediated DNA damage. The dermis is important for maintaining structure and is involved in biological processes, and is equipped with blood vessels, nerves, hair follicles, connective tissues, and fibroblasts which enable functionality (Thangapazham et al, 2014). 

Nutrients with specific skin function:

Macronutrients:

The macronutrients-carbohydrates, protein and fats play important roles in the health of the skin and its function.  Control of glucose is important since high concentrations of glucose are implicated in decreased wound healing (Spravchikov et al, n.d).  Amino acids such as Proline and Glutamate help protect the skin from irradiation-induced skin aging as a result of exposure to UV.  Based on findings from Badiu et al (2010), amino acids such as Arginine and Ornithine are important for increased wound healing.  Lipids such as ceramide, cholesterol and fatty acids are key components of the epidermal membrane and are known to function in increasing epidermal permeability and barrier function (Uchida, 2014).

Micronutrients:

Micronutrients such as Vitamin A, Vitamin B3, Vitamin C, Vitamin D, Vitamin E, Zinc, Copper and Selenium play key roles in skin health and functionality.  Vitamin A and Vitamin C have been implicated in the prevention of UV irradiation-mediated skin damage.  Vitamin A is also used in the prevention and treatment of psoriasis and acne. Vitamin C promotes wound healing and suppresses production of free radicals thereby providing protection against oxidative stress. Vitamin B3 maintains the hydration of the skin by preventing water loss, increases keratin production-- a protein that maintains the health and strength of the skin, minimizes wrinkles and fine lines, and may reduce the risk of developing skin cancer in some people. Vitamin B3 has anti-inflammatory properties, which are useful in the treatment of acne, rosacea, and eczema. It also has skin brightening properties and can be used to address hyperpigmentation. Vitamin D modulates inflammation and is also implicated in wound healing. Vitamin E is an antioxidant and suppresses lipid peroxidation and plays an anti-inflammatory role. 

Selenium is an antioxidant and is implicated in protecting the skin from UV irradiation-induced oxidative stress. According to Pickart et al (2012), Copper also serves as an antioxidant. Zinc has antimicrobial activity and is also important in wound healing. 

Micronutrient Deficiencies & Associated Skin Disorders:

Both deficiencies in Vitamin A and Vitamin D are associated with atopic dermatitis ( Mihaly et al, 2011; Mesquita et al, 2013).  In addition, like Vitamin C deficiency, Vitamin A deficiency is also associated with delayed wound healing. Vitamin C deficiency has also been associated with subcutaneous bleeding. Vitamin B3 deficiency results in pellagra-- a condition that is characterized by four Ds: diarrhea, dermatitis, dementia, and death. The dermatitis associated with pellagra typically causes a rash on the lips, face, hands or feet. Additionally, the skin may appear red to brown, flaky, cracked, or scaly and have an itchy or burning sensation. Although pellagra is quite rare in the United States, it continues to be a problem in developing nations. Vitamin E deficiency has been associated with ulcerations of the skin while both zinc and selenium deficiencies are implicated in development of Epidermolysis bullosa ( a group of rare diseases in which the skin becomes fragile and tears, sores and blisters easily). Selenium deficiency is also implicated in Psoriasis and skin cancers. 

Eating to Lower Skin Cancer Risk:

Consume foods containing the following nutrients and non-nutritive food components to lower your risk of developing skin cancer:

• Beta-Carotene (activated to vitamin A which is an antioxidant vitamin and immune booster): found in foods such as citrus fruits, carrots, yams, squash, apricots, mangoes, peaches, and cantaloupes.
• Vitamin B3 is considered to have antioxidant and anti-inflammatory activity which may reduce the risk of some skin cancers: found in foods such as organ meats, poultry, seafood (such as salmon, tuna, and sardines), brown rice, avocados, mushrooms, and peanuts.
• Vitamin C which is an antioxidant and also contains anti cancer cell properties: found in foods such as citrus, bell peppers, broccoli, leafy green vegetables, strawberries and raspberries.
• Vitamin D is an immune booster: found in foods such as milk (get the low fat/fat free varieties or substitutes such as almond milk), cheese, vitamin D-fortified orange juice, and fatty fish such as salmon.
• Vitamin E is an antioxidant vitamin which acts as an anti-inflammatory and also helps protect cell membranes from free radical activity: found in foods such as sunflower seeds, almonds, peanuts, pumpkin, wheat germ, safflower and soybean oils, as well as beets and collard greens.
• Selenium is an antioxidant mineral which is implicated in reducing cancer risks: found in foods such as poultry, seafood, organ meats and richly in Brazil nuts.
• Zinc boosts immunity and is also implicated in the healing of the skin, and fighting cancer cells: found in foods such as poultry, shellfish, baked beans, chickpeas, cashew and almond nuts as well as meats (obtain lean cuts and cook by dry heat methods).
• Omega-3 Fatty Acids play an anti-inflammatory role and also inhibit the growth of skin cancers: found in foods such as fatty fish-salmon, tuna, and also found richly in flaxseed and walnuts.
• Phytonutrients such as Lycopene are protective against harmful rays from the sun: found in foods such as pink grapefruit, guavas, papaya, tomatoes and watermelon.
• Phytochemicals such as Polyphenols have anti-inflammatory and tumor-inhibition properties: found in green teas and black teas.

* Please note that many of the nutrient deficiency associated skin conditions mentioned earlier can also be prevented or managed by eating as suggested above.

References

Badiu, D. L., Luque, R., Dumitrescu, E., Craciun, A. and Dinca, D. (2010) Amino acids from Mytilus galloprovincialis (L.) and Rapana venosa molluscs accelerate skin wounds healing via enhancement of dermal and epidermal neoformation. Protein J. 29, 81-92.

Cleveland Clinic. (2022, December 19). Top 6 Benefits of Niacinamide. Cleveland Clinic. Retrieved March 30, 2023, from https://health.clevelandclinic.org/niacinamide/

Dix, M. (2018, September 18). Pellagra. Healthline. Retrieved March 30, 2023, from https://www.healthline.com/health/pellagra

Lakdawala, N., Babalola, O., 3rd, Fedeles, F., McCusker, M., Ricketts, J., Whitaker-Worth, D. and Grant-Kels, J. M. (2013) The role of nutrition in dermatologic diseases: facts and controversies. Clin. Dermatol. 31, 677-700

Mesquita Kde, C., Igreja, A. C. and Costa, I. M. (2013) Atopic dermatitis and vitamin D: facts and controversies. An. Bras. Dermatol. 88, 945-953.

Mihaly, J., Gamlieli, A., Worm, M. and Ruhl, R. (2011) Decreased retinoid concentration and retinoid signalling pathways in human atopic dermatitis. Exp. Dermatol. 20, 326-330.

Pickart, L., Vasquez-Soltero, J. M. and Margolina, A. (2012) The human tripeptide GHK-Cu in prevention of oxidative stress and degenerative conditions of aging: implications for cognitive health. Oxid. Med. Cell. Longev. 2012, 324832. 

Starr P. (2015). Oral Nicotinamide Prevents Common Skin Cancers in High-Risk Patients, Reduces Costs. American health & drug benefits, 8(Spec Issue), 13–14.

Thangapazham, R. L., Darling, T. N. and Meyerle, J. (2014) Alteration of skin properties with autologous dermal fibroblasts. Int. J. Mol. Sci. 15, 8407-8427.

Uchida, Y. (2014) Ceramide signaling in mammalian epidermis. Biochim. Biophys. Acta 1841, 453-462. 

Lorna C. Hylledig Ed.D., MSPH., R.D. L.D

&

Ashley J. Archer, B.S.

Medical Student