Studies into How Isotretinoin Clears Acne Reveal Dietary Impact on Biological Pathways that Lead to Acne

In addition to the many ways diet and lifestyle affects your acne by affecting the function of the various organs involved in managing hormones and inflammation: liver, gut, adrenals, thyroid, brain, etc.  There are some pathways and systems involved.  Both of the below are recent studies looking into how isotretinoin tends to clear acne.  Because they've been prescribing it to children for a couple of decades without really know what it does.

mTORC1 Signaling:

Dietary intervention in acne: Attenuation of increased mTORC1 signaling promoted by Western diet -1

The purpose of this paper is to highlight the endocrine signaling of Western diet, a fundamental environmental factor involved in the pathogenesis of epidemic acne. Western nutrition is characterized by high calorie uptake, high glycemic load, high fat and meat intake, as well as increased consumption of insulin- and IGF-1-level elevating dairy proteins. Metabolic signals of Western diet are sensed by the nutrient-sensitive kinase, mammalian target of rapamycin complex 1 (mTORC1), which integrates signals of cellular energy, growth factors (insulin, IGF-1) and protein-derived signals, predominantly leucine, provided in high amounts by milk proteins and meat...

It is conceivable that isotretinoin may downregulate mTORC1 in sebocytes by upregulation of nuclear levels of FoxO1.

Fox01 Deficiency

The role of transcription factor FoxO1 in the pathogenesis of acne vulgaris and the mode of isotretinoin action. 2

QuoteNuclear FoxO1 deficiency is the result of increased growth factor signaling with activated phosphoinositol-3-kinase (PI3K) and Akt kinase during growth hormone signaling of puberty and increased insulin/IGF-1 signaling due to consumption of insulinotropic milk/dairy products as well as hyperglycemic carbohydrates of Western diet.

Sources:
1- http://www.landesbioscience.com/journals/dermatoendocrinology/article/19828/?show_full_text=true  The full text of this study is available here.

2 http://www.ncbi.nlm.nih.gov/pubmed/20930691