Impact of Dairy Products and a High-Glycemic Diet on the Development and Clinical Course of Acne

Abstract

Objective. To assess the clinical and economic consequences of incorporating structured dietary modification into standard outpatient treatment for mild-to-moderate acne among individuals aged 18–35 years in Ukraine. Methods. A 12-week controlled modeling study was conducted using a synthetic cohort of 190 patients, with 95 individuals assigned to a group receiving standard pharmacotherapy supplemented with a structured nutritional program and 95 assigned to a group receiving standard pharmacotherapy without nutritional intervention. The program involved reducing daily glycemic load, separately assessing the consumption of milk, fermented dairy products, cheese, and whey protein, and individually modifying their intake. The primary clinical endpoint was the percentage change in acne lesion count. The effectiveness outcome for the cost-effectiveness analysis (CEA) was the proportion of participants whose acne lesion count decreased by at least 50%. Costs were calculated in UAH at January–February 2025 price levels from the societal, household, and payer perspectives. Economic uncertainty was assessed using 5,000 bootstrap replications. A one-year time horizon was applied only in the scenario analysis, without discounting. Results. At week 12, mean daily glycemic load was 78.2 units in the intervention group and 121.1 units in the comparison group, while mean milk consumption was 2.5 and 4.9 servings per week, respectively. A clinical response was observed in 56.8% of participants in the intervention group and 29.5% of those in the comparison group; the absolute difference was 27.4 percentage points (95% CI, 13.7–40.0). Total societal costs were 8,249 UAH per patient in the intervention group and 8,802 UAH in the comparison group, representing a reduction of 553 UAH (95% CI, –1,238 to 146 UAH). The incremental gain in quality-adjusted life years (QALYs) was 0.0048. Thus, in the base-case analysis from the societal perspective, the intervention was economically dominant because it combined lower costs with greater effectiveness. From the household perspective, savings amounted to 1,034 UAH per patient. From the payer perspective, additional costs were 481 UAH per patient, and the incremental cost per additional clinical responder was 1,758 UAH. In 93.1% of bootstrap replications, the intervention simultaneously reduced costs and improved the clinical outcome. Conclusions.Structured dietary counseling may be a cost-effective adjunct to standard pharmacotherapy for acne, provided that the program costs do not exceed approximately 1,600 UAH per patient and that dairy product consumption is assessed separately by category and modified on an individual basis. The scientific novelty of the study lies in integrating measures of dietary exposure, clinical response, productivity, and QALYs into a unified economic evaluation model adapted to the Ukrainian context. The practical significance of the findings lies in establishing a threshold cost for the nutritional program and quantitative effectiveness criteria suitable for evaluating this intervention in outpatient dermatology practice.