Nutrition, Dieting, and the Skin

People made connections between diet and skin symptoms long before physicians knew very much about this subject. A good example is the well-known story of how British sailors noticed that when they failed to eat citrus fruit on their long voyages they developed bleeding gums and spiny skin rashes. The disease these sailors suffered, which was the result of the absence of vitamin C in their diet, came to be called scurvy.

It is a skin and mucous membrane disease that begins with bleeding gums and rashes and can be fatal. To combat the problem, these seafarers would load up on lemons and limes and suck on them during the course of their journeys. (In fact, that’s why British sailors are called “limeys.”) Their discovery about the importance of eating citrus fruit took place, however, long before vitamin C had been isolated or named. Eventually, medicine became more aware of the role nutrition plays in skin health and disease. Besides the connection made between vitamin C and scurvy, the inadequacy of, the total lack of, and even too much of certain nutrients-like vitamin A, niacin, riboflavin, pyridoxine (vitamin B6)’ and vitamin B12-have been recognized as playing a role in skin problems including causing wrinkles.

Improper dietary intake is not the only reason for nutritional and caloric deficiencies and excesses. However, most frequently, it is the culprit. The word malnutrition is often thought to refer to an insufficient quantity and variety of food, mostly due to poverty and economic and social underdevelopment, and sometimes to eating disorders. However, malnutrition really refers to more than insufficient nutritional or caloric intake, and includes, for example, overeating.

Among the poor in this country, who exist in far greater numbers than many of us are aware, hunger-related malnutrition is still a problem. However, in the United States in the twentieth century, malnutrition is often related to other phenomena as well. Among these are alcoholism, dieting, obesity, and conditions like anorexia nervosa and bulimia. Some of these problems are more prevalent among the middle and upper classes, although some occur in conjunction with poverty.

Lack of vitamin A produces dry eyes and skin. An overdose of vitamin A causes peeling of the skin, headaches, arthritic pains, and even liver problems. Niacin, a vitamin recently made popular for its beneficial effects upon cholesterol, can be deficient in cases of severely inadequate nutrition. This deficiency leads to pellagra, which is characterized by dermatitis, diarrhea, and dementia.

The dermatitis takes the form of a sun-sensitive rash on the arms and face, accompanied by a V -shaped, upper chest rash referred to as “Casal’s necklace.” Riboflavin deficiency produces cracked lips and a groin rash. Insufficient amounts of pyridoxine (vitamin B6) will cause a seborrheic dermatitis on the face, while a deficiency in vitamin B12 results in only a mild rash of the hands.