Nutrition, Obesity, and Anxiety Can Impact the Severity of Seborrheic Dermatitis

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Researchers analyzed the relationship between nutrition habits, BMI, psychoemotional status, and seborrheic dermatitis (SD).¹ There was a positive correlation observed between SD severity and all of these categories, specifically in patients with moderate to severe disease status.

Although research identifying the relationship between nutrition and other sebaceous gland diseases like acne, rosacea, and androgenetic alopecia currently exists, this study is one of the first to recognize the correlation between SD and nutrition.²

The single-center prospective study included 100 patients with SD and 110 healthy controls. All were between the ages of 18 and 65. The mean age was 30.1 in SD patients and 31 in the healthy control group (p = 0.06). In the SD group, 53% of participants were male and 47% were female. In the control group, 46.4% were male while 53.6% were female.

The trial took place at the Dermatology Outpatient Medical Clinic of Eskişehir Osmangazi University between December 30, 2019, and December 30, 2020. BMI was calculated and questionnaires including the Adolescents Food Habits Checklist (AFHC), and the 4-point Depression Anxiety Stress Scale-21 (DASS-21) were given to participants. More specifically, patients noted their consumption of fat, salt, spice, tea, coffee, sugar, bread, vegetables, fruit, red meat, and milk. A high AFHC score indicates a healthier pattern of eating habits.

SD was clinically diagnosed by a physician in which characteristic erythema and oily scales in sebaceous gland–rich areas were assessed. Disease severity was measured using the Seborrheic Dermatitis Area Severity Index (SDASI). Patients with a ≤ 3 SDASI score were considered to have mild SD while those with a ≥ 4 SDASI score were categorized as having moderate to severe disease. With this indication, 79% of patients had mild SD and 21% had moderate to severe SD.

Investigators found a positive correlation between SD severity and BMI (p = 0.018). Overall, the average BMI in the SD group was 25 ± 4.28 and 24.1 ± 3.78 in the control group (p = 0.22). Moreover, the mean BMI of 27.39 ± 4.76 was significantly higher in patients with moderate to severe disease compared to 24.50 ± 4.15 in the mild group (p = 0.01). A significant relationship was observed between high SDASI and high BMI (p = 0.018).

Participants with SD had an average AFHC score of 8.92 ± 3.75 while healthy participants had a significantly higher score of 10.3 ± 3.97. Fat, salt, spice, tea, coffee, and milk consumption was relatively similar in both groups, but bread consumption was more frequent in patients with SD (p = 0.001).

These patients also consumed less fruits and vegetables (p = 0.006). However, one’s dietary preferences, such as whether they are vegetarian or not, did not have a large impact. Additionally, bread, margarine, animal fat, and sugar consumption rates were higher in patients with moderate to severe SD versus those with only mild disease severity (p = 0.008, p = 0.050).

Furthermore, DASS-21 total scores, along with its anxiety, depression, and stress subscale scores, were higher in the SD group. More specifically, these scales were overall significantly higher in the moderate to severe disease group than in the mild disease group (p = 0.035, p = 0.049).

Some limitations such as the study design and small sample size were noted. Additionally, the trial only includes the Turkish population, but these can be addressed in further research. Genetics, weakened barrier function, and increased sebum secretion can all contribute to the pathogenesis of SD.³

“Dietary lipids (fatty acids), glucose, and acetate intake, which are important substrate sources for sebum synthesis, affect sebaceous gland activity,” the authors wrote. “Consuming carbohydrates with high glycemic index may also contribute to the development or exacerbation of SD by stimulating sebum secretion.”

Because of this, healthier nutrition habits and stronger psychoemotional status could reduce the occurrence and severity of AD, as these factors may play a role in its etiopathogenesis.

References

1. Batan T, Acer E, Kaya Erdoğan H, Ağaoğlu E, Bilgin M, Saraçoğlu ZN. The Relationship Between Nutrition Habits, BMI, Anxiety, and Seborrheic Dermatitis. J Cosmet Dermatol. 2025;24(1):e16737. doi:10.1111/jocd.16737

2. Aksu AE, Metintas S, Saracoglu ZN, et al. Acne: prevalence and relationship with dietary habits in Eskisehir, Turkey. J Eur Acad Dermatol Venereol. 2012;26(12):1503-1509. doi:10.1111/j.1468-3083.2011.04329.x

3.De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021;9(2):353. Published 2021 Feb 11. doi:10.3390/microorganisms9020353