Dr. Patricia Farris: Nutraceuticals for Skin Health

At the recent AAD 2025 meeting, you gave a very insightful lecture on “Nutraceuticals for Skin Health and Appearance.” What initially sparked your interest in this field?

I became interested in nutrition when I started taking a more holistic approach to patient care. We know that nutrition is very important for skin health, and dietary changes can help reduce inflammation and improve many inflammatory skin disorders. I also became interested in the role of botanical ingredients in preventing skin aging as these are used widely in topical skincare products and can also be delivered through nutraceuticals. This growing interest ultimately led me to write a consumer book called “The Sugar Detox” which was designed to help readers understand how a diet high in sugars can accelerate skin aging and how certain nutritional components can help prevent it.

Nutraceuticals for Skin Health:

The gut–skin axis is becoming an important area of research. What are the main ways the gut microbiome influences skin health and function?

The gut microbiome affects skin in several ways. When it becomes imbalanced—what we refer to as dysbiosis—it can trigger systemic inflammation that ultimately affects the skin. Gut dysbiosis is found in patients with acne, eczema, psoriasis and other inflammatory skin disorders. It also affects the skin microbiome and plays a role in barrier function and sensitive skin. For example, certain metabolites produced by gut bacteria, most notably Clostridium difficile have been identified as biomarkers of gut disturbance. These metabolites (such as the products of aromatic amino acids) can access circulation, preferentially accumulate in the skin, and impair epidermal differentiation and skin barrier integrity (1)

With growing interest in prebiotics and essential fatty acids, how do you guide patients when it comes to choosing between supplementation and nutrition-based approaches ?

Both prebiotics and essential fatty acids play a role in skin barrier function.  Although studies are promising on these supplements, there is so much variability in the testing protocols that it is difficult for physicians to make specific recommendations.  As an alternative to supplements, eating food high in prebiotic fiber can help balance the gut microbiome.  In a similar manner, eating foods rich in omega 3 fatty acids can help keep the skin barrier healthy.

Acne is another condition where nutraceuticals are gaining attention. What does emerging evidence tell us about the role of nutraceuticals in improving acne outcomes?

Acne vulgaris is the number one skincare concern of women and is in the top 3 complaints dermatologists see in their office, with the prevalence increasing across the globe (2).  Acne is a condition that is influenced by many system factors or what we refer to as root causes.  Hormones, nutrition, metabolism, stress, microbiome, and aging have been identified as root causes that contribute to acne.  While traditional acne therapies target the pilosebaceous unit, dietary changes, stress- reducing techniques, and lifestyle modifications are becoming more mainstream recommendations for acne patients (3) – and nutraceuticals can provide solutions to address the root causes.

This more holistic approach is favored by many patients and in clinical practice can be used in conjunction with topical or oral medications. Well designed, clinical studies have confirmed the benefits of a recently marketed supplement using this approach for treating adult females with mild or moderate non-cystic acne. A 12-week randomized, double-blind, placebo-controlled trial demonstrated the potential of a novel oral nutraceutical for women with mild-to-moderate acne. This study showed significant improvements in acne severity, with more participants reaching clear/almost clear ratings, along with reductions in both inflammatory and non-inflammatory lesion counts when compared to placebo. These results highlight the potential of nutraceuticals as a safe and effective option to support skin health and improve acne in adult women (3)

What progress has been made in strengthening the scientific evidence behind nutraceuticals in dermatology?

Despite their widespread use, Nutraceuticals are generally not tested with the same scientific rigor that medications are tested.  For this reason, many physicians shy away from supplements.  There are, however, some supplement companies that conduct double-blind, placebo-controlled studies on their products, but they are few and far between.  Dermatologists have widely embraced supplements for hair growth because extensive clinical testing has confirmed their efficacy and safety.

Acne is another example where the conversation is evolving. Complementary and alternative medicine such as Nutraceuticals have long been explored for their use in improving skin health, but the paucity of scientific evidence and lack of clinical data on the safety and efficacy have limited their recommendation for use in the clinic.  Now, scientific literature is bridging the gap with clinical evidence that provides support for a systemic, multi-targeting approach. The approach does not reject the established, effective therapeutics that are available to us, rather it proposes an expanded consideration using evidence-based studies to provide a more comprehensive approach to Acne Vulgaris management (3).

Looking ahead, how do you see nutrition-based therapies shaping the future of dermatologic care?

There is more and more interest in nutritional therapies in dermatology, and I think in medicine in general.  Physicians can no longer ignore the obvious role that nutrition plays in health and many diseases. As Hippocrates said, let food be thy medicine and medicine by thy food. 

Bibliography:

1. Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol. 2018;9:1459. Published 2018 Jul 10. doi:10.3389/fmicb.2018.01459

2. Burgess C, Gold M, Farris PK, Hazan A, Raymond I. A Novel Systems-Wide Approach in Addressing Acne with a Multi-Targeting Nutraceutical. J Drugs Dermatol. 2024;23(3):160-167. doi:10.36849/jdd.8138

3. Draelos Z, Harper J, Farris PK, Hazan A, Raymond I. A 12-Week Randomized, Double-Blind, Placebo-Controlled Trial for the Efficacy and Safety of a Novel Nutraceutical for Mild-to-Moderate Acne. J Cosmet Dermatol. 2025;24(5):e70220. doi:10.1111/jocd.70220