Metabolic parameters in acne vulgaris: a case control study investigating fasting blood glucose and insulin levels in acne vulgaris


  • Saranya Palaniswami Department of Dermatology, S. P. Skin & Hair Clinic Laser and Cosmetology Centre, Tirupur, Tamil Nadu, India
  • Bhanu Prakash Department of Dermatology, Venereology, Leprosy, Vydehi Institute of Medical Sciences and Research Centre, Nallurahalli, Bengaluru, Karnataka, India
  • Praveen Vasanthi Saminathan Department of Dermatology, S. P. Skin & Hair Clinic Laser and Cosmetology Centre, Tirupur, Tamil Nadu, India



Acne vulgaris, Fasting blood sugar, Serum insulin, Insulin resistance


Background: Influence of diet and lifestyle on acne among Indian population. Objectives were to identify the clinico-epidemiological profile of patients with Acne vulgaris and to assess the fasting plasma glucose and serum insulin levels in Acne vulgaris patients and the controls and correlate them.

Methods: This was a hospital-based case-control study conducted in the Department of Dermatology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Study included 60 cases of acne and 60 controls (age and sex matched), attending the outpatient department. After complete history, general physical, systemic and cutaneous examination, all cases were subjected to following investigation: fasting blood sugar and serum insulin levels.

Results: Acne was common in the age group 18-24 yrs (70%). In almost half the patients the age of onset was between 12-18 yrs. Commonly observed site for acne was cheeks (83.3%), forehead (66.7%), nose (55%) and chin (41.7%). The risk of developing acne was 3.5 times more among smokers than non-smokers. The mean fasting blood sugar values of cases and controls when compared showed a statistically significant difference (p<0.05). Our study did not find any statistically significant difference in fasting insulin levels between cases and controls.

Conclusions: There was only significant difference in the Mean fasting blood glucose in cases as compared to controls. Mean fasting serum insulin level though found to be raised in cases compared to controls, does not prove statistical significance. Fasting plasma glucose was significantly raised in grade III acne as compared to other grades.


Geller L, Rosen J, Frankel A, Goldenberg G. Perimenstrual flare of adult acne. J Clin Aesthet Dermatol. 2014;7(8):30-4.

Tahir CM. Pathogenesis of acne vulgaris: simplified. J Pak Assoc Dermatol. 2010;20(2):93-7.

Layton MA, Eady EA, Zouboulis CC. Acne. In: Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D, eds. Rook’s textbook of dermatology. 19th ed. West Sussex, UK: Wiley Blackwell; 2016:3;1-65.

Davidovici BB, Wolf R. Myths and beliefs of acne pathogenesis: Diet, Smoking, hygiene. In: Zouboulis CC, Katsambas AD, Kligman AD eds. Pathogenesis and Treatment of Acne and Rosacea. 1st ed. Berlin, Heidelberg: Springer; 2014:195-205.

Adityan B, Thappa DM. Profile of acne vulgaris-A hospital-based study from south India. Indian J Dermatol Venereol Leprol. 2009;75:272-8.

Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002;138:1584-90.

Cerman AA, Aktaş E, Altunay İK, Arıcı JE, Tulunay A, Ozturk FY. Dietary glycemic factors, insulin resistance, and adiponectin levels in acne vulgaris. J Am Acad Dermatol. 2016;75(1):155-62.

Reynolds R, Lee S, Choi J, Atkinson F, Stockmann K, Petocz P, et al. Effect of the Glycemic Index of Carbohydrates on Acne vulgaris. Nutrients. 2010; 2(10):1060-72.

Kaymak Y, Adisen E, Ilter N, Bideci A, Gurler D, Celik B. Dietary glycemic index and glucose, insulin-like growth factor-1, insulinlike growth factor binding protein 3, and leptin levels in patients with acne. J Am Acad Dermatol. 2007;57:819-23.

Kumari R, Thappa DM. Role of insulin resistance and diet in acne. Indian J Dermatol Venereol Leprol. 2013;79:291‐9.

Verma A, Agarwal S, Manisha N, Shivi N, Rakesh J, Manmohan B, et al. Role of Insulin Resistance in Acne Vulgaris: A Hospital Based Observational Study. IOSRJ. 2019;18(2):63-8.

Yeung CK, Teo LH, Xiang LH, Chan HH. A community-based epidemiological study of acne vulgaris in Hong Kong adolescents. Acta Derm Venereol. 2002;82(2):104-7.

White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol. 1998;39(3):S34-7.

Dreno B, Poli F. Epidemiology of acne. Dermatology. 2003;206:7-10.

Hosthota A, Bondade S, Renu K, Braroo S. The association of acne vulgaris with smoking in men: a hospital based study. Int J Res Dermatol. 2017;3:196-201.

Seité S, Caixeta C, Towersey L. Large-scale survey to describe acne management in Brazilian clinical practice. Clin Cosmet Investig Dermatol. 2015;8:571-7.

Munichandrappa P, Manjunath KG, Kiran C, Variyar A. A comparative study of insulin resistance in acne vulgaris. Int J Res Dermatol. 2017;3:403-6.

Nagpal M, De D, Handa S, Pal A, Sachdeva N. Insulin Resistance and Metabolic Syndrome in Young Men with Acne. JAMA Dermatol. 2016;152(4):399-404.

Del Prete M, Mauriello MC, Faggiano A, Di Somma C, Monfrecola G, Fabbrocini G, et al. Insulin resistance and acne: a new risk factor for men? Endocrine. 2012;42(3):555-60.

Balta I, Ekiz O, Ozuguz P, Ustun I, Karaca S, Dogruk KS, et al. Insulin resistance in patients with post-adolescent acne. Int J Dermatol. 2015;54:662-6.






Original Research Articles