Calcium and acne: Unravelling the link between serum levels and disease severity

Abstract

Background

Acne vulgaris has a multifactorial pathogenesis; emerging evidence implicates micronutrients like calcium. This case-control study examined associations between serum calcium and acne, without assessing causality or ionized calcium.

Objectives

Compare serum calcium in acne patients vs. controls; correlate with severity and subtypes; adjust for dietary intake and hormones.

Methods

50 acne patients and 50 age-/sex-matched controls. Acne is graded by Global Acne Grading System (GAGS). Measured serum calcium, albumin, vitamin D, and parathyroid hormone (PTH). Dietary calcium via validated food frequency questionnaire (FFQ; dairy vs. plant sources). Analyses: t-tests, ANOVA, correlations, multivariate regression (adjusted for body mass index, smoking, and hormones).

Results

Acne patients had higher serum calcium (9.8 ± 0.6 mg/dL) than controls (9.2 ± 0.5 mg/dL; p < .001). Calcium correlated with severity (r = .42, p = .003); severe cases: 10.2 ± 0.7 mg/dL. Inflammatory subtypes showed higher levels (10.0 ± 0.6 mg/dL) versus non-inflammatory (9.5 ± 0.5 mg/dL; p = .002). Adjusted OR for acne presence: 2.1 (95% CI: 1.4–3.2); severity β = 0.38 (p = .004).

Conclusion

Elevated serum calcium associates with acne vulgaris, especially severe/inflammatory forms, suggesting a role in pathogenesis via metabolic alterations. Causality unestablished; calcium-modulating therapies warrant investigation.