Patients with acne vulgaris are more likely to have irritable bowel syndrome (IBS) than the general population, but the mechanisms driving the link between the 2 disorders have yet to be fully established, according to study research published in the Journal of Cosmetic Dermatology.
Patients with acne vulgaris (n=300) and age- and sex-matched healthy control participants (n=300) were recruited to the prospective study. Although there was no significant difference between the 2 groups in terms of mean age at baseline (20.22 vs 20.49 years; P =.215), patients with acne had a significantly lower body mass index (23.37 vs 23.95 kg/m2; P =.001).
The global acne grading system (GAGS) was used to calculate the clinical severity of acne, and all patients were assessed for the presence of IBS. The IBS diagnosis was based on the ROME IV diagnostic criteria. Patients with acne and IBS were asked if they experienced an increase in acne symptoms during IBS episodes.
In patients with acne, the mean duration of the disease was 3.52±2.12 years (range, 1-12 years). A statistically significant higher proportion of patients with acne had IBS according to the Rome IV diagnostic criteria compared with control participants (61.0% vs 28.0%, respectively; P =.001). No difference was observed between patients with acne and healthy control participants in regard to familial history of IBS (P =.220).
Relative to the patient group, control participants had a higher frequency of mucus in stool (P =.001). The investigators found a significant association between higher mean GAGS scores and IBS diagnosis (P =.001), abnormal stool form (P =.001), abdominal distention (P =.001), and feeling of incomplete evacuation (P =.001).
A limitation of this study included the relatively small sample size.
Although the study did not examine the factors that fueled IBS in patients with acne, the researchers suggest there may be a link between acne vulgaris and impaired intestinal permeability and that other studies “indicate that endotoxins produced by the intestinal microbiota may trigger acne formation.”
Demirbaş A, Elmas ÖF. The relationship between acne vulgaris and irritable bowel syndrome: A preliminary study [published online May 28, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13481