Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 17;16(24):4354.
doi: 10.3390/nu16244354.

The Nutrient-Skin Connection: Diagnosing Eating Disorders Through Dermatologic Signs

Efstathios Rallis  1 , Kleomenis Lotsaris  2 , Vasiliki-Sofia Grech  1 , Niki Tertipi  1 , Eleni Sfyri  1 , Vassiliki Kefala  1
Affiliations

The Nutrient-Skin Connection: Diagnosing Eating Disorders Through Dermatologic Signs

Efstathios Rallis et al. Nutrients. .

Abstract

The interplay between nutrition and skin health provides a crucial lens for understanding, diagnosing, and managing eating disorders (EDs) such as anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED). This review explores the dermatological manifestations resulting from the nutritional deficiencies commonly associated with EDs, including conditions like hair loss, xerosis, and brittle nails. These changes in the skin and its appendages often reflect deeper systemic dysfunctions, such as deficiencies in essential micronutrients (zinc, iron, and vitamins A and C), hormonal imbalances, and electrolyte disturbances. Recognizing these dermatological signs as diagnostic tools is vital for the early identification and intervention of EDs. By integrating dermatological observations with psychiatric and nutritional care, a holistic, multidisciplinary approach can be developed to address both the physical and psychological complexities of EDs. This review highlights the critical role of these skin-related markers in promoting timely diagnosis and effective treatment. To examine the relationship between specific nutrients and dermatological manifestations in EDs, a systematic review of three electronic databases-PubMed, Google Scholar, and ResearchGate-was conducted. The findings underline the importance of early recognition of these skin symptoms for effective management. Collaborative care involving dermatologists, psychiatrists, and nutritionists is essential for diagnosing and treating EDs. Such integrated efforts ensure a comprehensive approach to these multifaceted conditions, ultimately improving patient outcomes and enhancing overall care.

Keywords: Russell’s sign; anorexia nervosa; bulimia nervosa; eating disorders; minerals; self-induced vomiting; starvation; vitamins.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The vicious cycle of feeding and eating disorders, malnutrition, and physical health deterioration.
Figure 2
Figure 2
Skin signs of mineral deficiencies.
Figure 3
Figure 3
Skin signs of vitamin deficiencies.
Figure 4
Figure 4
Behavioral patterns contributing to malnutrition.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. American Psychiatric Association . DSM-5-TR Classification. Volume xiv. American Psychiatric Association Publishing; Washington, DC, USA: 2022. 161p
    1. Hanachi M., Dicembre M., Rives-Lange C., Ropers J., Bemer P., Zazzo J.F., Poupon J., Dauvergne A., Melchior J.C. Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients. Nutrients. 2019;11:792. doi: 10.3390/nu11040792. - DOI - PMC - PubMed
    1. Setnick J. Micronutrient deficiencies and supplementation in anorexia and bulimia nervosa: A review of literature. Nutr. Clin. Pract. 2010;25:137–142. doi: 10.1177/0884533610361478. - DOI - PubMed
    1. Wong C.Y., Chu D.H. Cutaneous signs of nutritional disorders. Int. J. Womens Dermatol. 2021;7 Pt A:647–652. doi: 10.1016/j.ijwd.2021.09.003. - DOI - PMC - PubMed
    1. Crone C., Fochtmann L.J., Attia E., Boland R., Escobar J., Fornari V., Golden N., Guarda A., Jackson-Triche M., Manzo L., et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients with Eating Disorders. Am. J. Psychiatry. 2023;180:167–171. doi: 10.1176/appi.ajp.23180001. - DOI - PubMed

Publication types

LinkOut - more resources