Dietary beverages and cutaneous health: Mechanisms, clinical evidence, and practical implications for dermatologists.

Abstract

Beverage consumption is a common, modifiable lifestyle factor with potential relevance to cutaneous health. The aim of this study was to synthesize clinical and mechanistic evidence on commonly consumed beverages and dermatologic outcomes. A narrative review was conducted using targeted PubMed/MEDLINE searches and supplementary screening of dermatology and nutrition sources, prioritizing randomized trials, prospective cohorts, systematic reviews, meta-analyses, and Mendelian randomization studies. Alcohol has the most consistently reported adverse cutaneous associations, including rosacea triggering, psoriasis, urticaria, and skin cancer risk, although causal evidence is not uniform. Sugar-sweetened beverages and milk are associated with acne in observational studies, but current acne guidelines do not make formal dietary recommendations. Coffee shows mixed observational and Mendelian randomization findings for skin aging and melanoma. For green tea, randomized acne studies show benefit mainly with topical extract, whereas oral effects are limited; the effect of matcha remains supported mainly by mechanistic extrapolation. Spearmint tea lowers free testosterone in women with polycystic ovary syndrome, although objective clinical benefit remains unproven. Evidence for chamomile, rooibos, hibiscus, energy drinks, kombucha, and plant-based milk alternatives is limited or indirect. Citrus cocktails and St. John's wort may cause clinically relevant photosensitization. Beverage-skin associations vary substantially in evidence strength and causality. Beverage assessment can support individualized counseling as a low-risk adjunct to standard dermatologic therapy although avoiding overstatement of findings derived from observational studies, extracts, or nutraceuticals rather than beverages as consumed.