Tips for Discussing Nutrition with Patients

Hair, skin and nails provide a real-time snapshot of patient health. According to Zoe Diana Draelos, MD, FAAD, adjunct assistant professor of dermatology at Duke University School of Medicine in Durham, NC, and medical editor for Dermatology time®, dermatologists are uniquely qualified to observe the nutritional status of their patients.

Speaking at the 2022 Annual Meeting of the American Academy of Dermatology Association, held in Boston, Massachusetts, March 24-29, 2022, Draelos provided insight into the current understanding of nutrition and its impact on skin health and tips for dermatologists discussing the topic with their patients. and help them eat for optimal skin, hair and nail health1.

“The biggest challenge in helping patients understand the impact of nutrition on skin health is the misconception that vitamins and nutritional supplements can compensate for a poor diet. [except for vitamin D, which is a sex hormone and not a true vitamin]said Draelos Dermatology Times®, in a follow-up interview. “I tell people good nutrition is simple: eat something colorful every day.” It’s a simple way to prepare patients to get the vitamins and minerals they need, she added.

Draelos said Dermatology Times®that the most common deficiency she sees in her patients is vitamin D in postmenopausal women. She also said that since skin is made of pure protein, a good source of protein is especially essential for patients with skin diseases.

As noted below, Draelos prefers to offer its patients insight into the role of each vitamin and nutrient in skin health and in which foods to find them. She added that it is difficult to show vitamin deficiencies in lab work, with the exception of vitamin D. So “eating by color” is an important habit to help patients develop because levels Vitamin serum levels can vary between tests, making measurements difficult to obtain.

How to help patients “eat by color” for skin health

Draelos explained the links between vitamins and food colorings, their importance for skin health, and the foods she recommends to optimize her patients’ skin.

Yellow to Orange: Vitamin A

Vitamin E is required for vision and skin health activities of gene transcription and immune function, the retina is required for night vision, retinoic acid regulates skin gene transcription by se binding to DNA-bound retinoic acid nuclear receptors (RARs). Retinoic acid promotes the differentiation and proliferation of T cells.

  • Best source: 2/3 cup carrots (100 grams provides 93% of the RDA for an adult male).

Red to orange: vitamin C (ascorbic acid)

Vitamin C is needed for tissue repair (collagen), enzymatic production of neurotransmitters, the immune system and as an antioxidant.

  • Best source: a cup of tomatoes daily or a handful of cherry tomatoes to help patients achieve the RDA of 90 mg/day for men and 75 mg/day for women (tomatoes contain 14 mg per 100 grams ).

Green: Vitamin E and Folic Acid (Vitamin B9)

Vitamin E is a fat-soluble antioxidant that protects cell membranes from oxidative damage and contains alpha, beta, gamma, and delta tocopherols, of which alpha is the most biologically active and gamma the most common in the Western diet.

  • Best source: 1/4-1/2 raw avocado daily (to help achieve the RDA of 15mg daily for adults). Olive oil also helps improve absorption.

Folic acid is necessary for the reproduction of DNA, RNA and red blood cells and is therefore associated with healthy skin, hair and nails. It also converts homocysteine ​​to methionine, high levels of homocysteine ​​associated with heart disease.

  • Best Source: Avocado to help reach the recommended 400 mcg per day for adults.

Brown: trace elements and biotin

Trace elements are very important for metal-containing enzymes (matrix metalloproteinases [MMPs]) to function in the skin. Selenium is an important alternative antioxidant pathway. Electrolytes (potassium, chloride, phosphorus) and metals (copper, magnesium, molybdenum, manganese, iron, chromium) are also important.

  • Best source: A Brazil nut. Dermatologists may also consider a supplement.

Biotin deficiency is rare, but if present, an individual may experience poor nail and hair growth. There is no established RDA for biotin.

  • Best source: A handful of nuts per week. Almonds are an excellent source

Pink: Protein (Chicken and Fish)

Skin, hair and nails are pure proteins and individuals need a daily source of protein for the amino acids needed to repair the body. Many vegans struggle with hair loss as the first sign of nutritional issues.

  • Best sources: Chicken and fish are complete proteins. Patients can use egg or milk protein.

Blue/Purple: Antioxidants

The blue/purple skin of the blueberry contains the antioxidants, which are anthocyanins (flavonoids from the polyphenol family) malvidin and delphinidin. Blueberries also contain the antioxidant flavonols quercetin and myricetin.

  • Best source: blueberries.

Vitamin D supplementation

Vitamin D is a sex hormone, not a real vitamin. According to Draelos, it is impossible to orally consume adequate amounts in the diet, so this is a case where oral supplementation may be best. There are no age-adjusted supplementation guidelines, but the new recommendations are 800-1000 IU for adults and 2000 IU minimum for post-menopausal women.

How to optimize nutrition for healthy skin, hair and nails?

  • Yellow/orange (Vitamin A): 2/3 cup carrots
  • Red/orange (Vitamin C): one raw tomato per day
  • Green (Vitamin E, Folic Acid): 1/2 raw avocado
  • Brown (trace minerals, biotin): 1 Brazil nut, almonds
  • Rose (Protein): chicken, fish, collagen supplement
  • Blue/Purple (Antioxidants): 1 cup fresh blueberries
  • Vitamin D: 1,000 to 2,000 IU daily supplement


Draelos has received research grants/funding from Abbott Laboratories, Actavis, AGI Dermatics, Allergan, Inc., AmDerma Pharmaceuticals, LLC, Amgen, Amneal Pharmaceuticals, LLC, AstraZeneca, Avon Products, Inc., Bayer, Bayer Consumer Healthcare Pharmaceuticals, Beiersdorf, Inc., Boots, Celgene Corporation, Chattem, Inc., Colgate-Palmolive, Dermira, Dial Corporation, Eli Lilly and Company, Elizabeth Arden, Exeltis, Galderma Laboratories, LP, GlaxoSmithKline, Glenmark Generics Inc., Guthy-Renker, Helix BioMedix, Johnson & Johnson Consumer Products Company, Kao Brands, Kimberly Clark, Kythera, L’Oreal USA Inc., La Roche-Posay Pharmaceutical Laboratory, Lexington International LLC, Living Proof, Inc., Lumity, MakuCell, Inc., Maruho Co ., Ltd, Medicis Pharmaceutical Corporation, Merck & Co., Inc., Merz Pharmaceuticals, LLC, Mimetica Pty. Limited, Neocutis, Neutrogena Corporation, Niadyne, Novartis Pharmaceuticals Corp., Nuskin, Oculus, Onset Therapeutics, Otsuka Pharmaceutical Co., Ltd. , Paci fic Biosciences, Perrigo Company, Pfizer Inc., Procter & Gamble Company, Promius Pharma, LLC, Quinnova Pharmaceuticals, Inc., Ranbaxy Laboratories Limited, RECKITT BENCKISER (ESPAÑA), SL, Revance Therapeutics, Inc., Revision Skincare, Signum Biosciences, Inc., SkinMedica, Inc., Sun Products Corporation, Suneva Medical, Inc., Symrise, Syneron, Inc., Taro Pharm, Teva Pharmaceuticals USA, Tolmar, Valeant Pharmaceuticals International, Vichy Laboratoires – I (grants/funding from the research)


Draelos ZD. Optimize nutrition for skin health. Presented at the 2022 Annual Meeting of the American Academy of Dermatology; March 24-29, 2022; Boston, Massachusetts.

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