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offee, one of the most widely consumed beverages worldwide, can
trace its heritage back to the eighth century AD.1,2 Before it was com-
monly consumed on a daily basis, coffee had been used for medici-
nal purposes and regarded as a luxurious drink feasible only to upper-class.3
Coffee intake varies according to lifestyle and demographic factors.4Lastly
it has been reported that over 2.5 billion cups of coffee are consumed world-
31
Coffee and Skin:
What do We Know About it?
AABBSS TTRRAACCTT Coffee is one of the world's most popular drinks. It is only an inspirational morning re-
freshment for some, but for others it has become a lifestyle beverage with a global consumption of
billions cups per day. Because of its popularity, coffee has often been proposed to be able to prevent
health problems and has attracted a great deal of research over the years. Although there has been
limited research evaluating the effectiveness of coffee in ameliorating certain health conditions,
there is a compelling evidence that coffee consumption has potential benefits for a variety of chronic
diseases. Recent studies have confirmed that moderate amount of coffee consumption might have
a role in protection against type 2 diabetes, metabolic syndrome, Parkinson's disease, Alzheimer's
disease, depression, cognitive impairment, chronic liver disease, chronic kidney disease, prostate
cancer, endometrial cancer, liver cancer, leukemia and cardiovascular diseases, including hyper-
tension, coronary heart disease and venous thromboembolism. In dermatological point of view,
currently there is a growing body of evidence suggesting that caffeine and other nutrients con-
tained in coffee may protect against melanoma and non-melanoma skin cancer. Moreover, as the
new data on coffee and health continues to get emerged, it is getting clear that coffee is also effec-
tive in inflammatory disease prevention, including inflammatory skin diseases. In this review, we
focused on recent evidence about coffee and dermatological diseases and aimed to explore the link
between coffee and melanoma/ non-melanoma skin cancers, psoriasis and rosacea.
KKeeyywwoorrddss:: Coffee; melanoma; non-melanoma skin cancer; psoriasis; rosacea
ÖÖZZEETT Kahve dünyada en fazla tüketilen içecekler arasında yer alır. Kahve bazıları için sadece bir
sabah uyaranı olabilir, ancak bazıları içinse günlük global tüketimi milyarlarla ölçülen bir hayat
tarzı içeceğidir. Popularitesi nedeniyle, kahvenin sıklıkla sağlık problemlerini önlediği ileri sürül-
müş ve kahve yıllar içerisinde çok sayıda araştırmanın başlıca konularından biri olmuştur. Her ne
kadar, kahvenin bazı hastalıkları iyileştirmesindeki etkinliği ile ilgili ortaya konmuş yeterli veri
yoksa da, günümüzde kahvenin çok sayıda kronik hastalığın önlenmesinde faydalı olduğunu gös-
teren kayda değer veriler bulunmaktadır. Son yıllarda yapılan çalışmalar, makul düzeyde kahve tü-
ketiminin tip 2 diyabet, metabolik sendrom, Parkinson hastalığı, Alzheimer hastalığı, depresyon,
kognitif bozukluklar, kronik karaciğer hastalığı, kronik böbrek hastalığı, prostat kanseri, endomet-
rium kanseri, karaciğer kanseri, lösemi ve hipertansiyon, koroner arter hastalığı ve venöz trombo-
embolizmi de içeren kardiyovasküler hastalıklara karşı koruyucu rol oynayabileceğini göstermiştir.
Dermatolojik açıdansa, kahvede bulunan kafein ve diğer bileşenlerin melanoma ve melanom dışı
deri kanserlerine karşı koruyucu olduğunu gösteren veriler gün geçtikçe artmaktadır. Dahası, kahve
ve sağlıkla ilgili yeni veriler ortaya çıktıkça, kahvenin inflamatuar deri hastalıkları da dahil olmak
üzere, inflamatuar hastalıkların önlenmesinde etkili olduğu daha anlaşılır düzeye ulaşmış bulun-
maktadır. Bu derlemede, kahve ve deri hastalıkları ile ilgili güncel literatüre odaklandık ve kahve
ile melanom, melanom dışı deri kanseri, psöriazis ve rozaseanın ilişkisini irdelemeyi hedefledik.
AAnnaahh ttaarr KKee llii mmee lleerr::Kahve; melanom; melanom dışı deri kanseri; psöriazis; rozasea
Ahu YORULMAZa
aClinic of Dermatology,
Ankara Numune Training and
Research Hospital,
Ankara, TURKEY
Re ce i ved: 14.03.2019
Ac cep ted: 05.04.2019
Available online: 09.04.2019
Cor res pon den ce:
Ahu YORULMAZ
Ankara Numune Training and
Research Hospital,
Clinic of Dermatology, Ankara,
TURKEY/TÜRKİYE
ahuyor@gmail.com
Cop yright © 2019 by Tür ki ye Kli nik le ri
DERLEME DOI: 10.5336/dermato.2019-66044
wide each day.5Coffee literally has potential im-
plications on human health and some debates exist
regarding the association of coffee consumption
with certain health conditions. Recent studies have
shown that coffee decreases the risk of metabolic
syndrome, type 2 diabetes, Alzheimer’s disease,
Parkinson’s disease, gallstone disease, prostate can-
cer, endometrial cancer, liver cancer, leukemia,
cirrhosis, gout, renal stones and depression and re-
duces overall mortality (Table 1). On the other
hand, there are studies describing a possible asso-
ciation between coffee consumption and increased
risk of lung cancer, laryngeal cancer, gastric can-
cer, endometriosis, rheumatoid arthritis and frac-
ture in women (Table 2).1,2,5-10
Coffee contains a wide array of compounds,
including the major component, caffeine. Caffeine
is well-known to be associated with a range of
physiological effects, specifically on cardiovascular
system. Since caffeine has the ability to increase
blood pressure, coffee intake has been captured at-
tention with safety concerns about cardiovascular-
related risks. Nevertheless, contemporary studies
have revealed that caffeine intake lowers the ove-
rall mortality from all causes of cardiovascular di-
sease rather than increasing it. Beneficial or noxi-
ous associations of coffee intake seem to vary bet-
ween health outcomes of interest. Though, there is
a presumed evidence of coffee intake has favorable
effects for a variety of conditions.1,2,5-10 In this re-
view, we will outline contemporary evidence-
based knowledge in the context of association of
coffee with dermatological diseases, in particular,
melanoma/non-melanoma skin cancers, psoriasis
and rosacea.
THE MAJOR COMPOUND OF COFFEE:
CAFFEINE
Regarded as the most widely consumed psychoac-
tive drug in the world, caffeine, naturally found in
leaves or beans of coffee and tea, also in cocoa
beans. Caffeine can provide a boost in alertness/
mood and counteract feelings of “low-energy”. Caf-
feine is a methylxanthine, of which primary mec-
hanisms of action have been defined as antagonism
at the level of adenosine receptors and inhibition
of phosphodiesterases. Adenosine is an important
biological mediator and adenosine receptors are
expressed throughout the body. Via antagonizing
adenosine receptors, caffeine increases plasma con-
centration of circulating catecholamines, which
consequently results in increased peripheral resis-
tance and raised blood pressure.11-13
POTENTIAL ANTI-CARCINOGENIC
EFFECTS OF CAFFEINE
There is a growing literature indicating that caf-
feine may protect against melanoma and non-me-
lanoma skin cancers.14-26 In coffee, although there
are other potential anticancer ingredients other
than caffeine, caffeine is one of the mostly researc-
hed compounds in chemopreventive power of cof-
fee. Caffeine exerts its antiproliferative and
anti-carcinogenic action via regulating cell growth,
development and apoptosis. It has been shown that
caffeine has sunscreen effect, reduces sunburn le-
sions in the epidermis and inhibits ultraviolet
(UV)-induced carcinogenesis by suppressing for-
mation of thymine dimers. Caffeine increases eli-
mination of damaged precancerous cells and
Ahu YORULMAZ Turkiye Klinikleri J Dermatol. 2019;29(1):31-5
32
Lowers risk of type 2 diabetes/ metabolic syndrome
Reduces risk of Parkinson’s disease
Protects against cirrhosis/ chronic liver disease/ gallstones
Protects against chronic kidney disease/ renal stones
Decreases risk of liver cancer
Decreases risk of endometrial cancer
Lowers risk of leukemia
Reduces risk of prostate cancer
Decreases risk of depression
Reduces mortality
TABLE 1: Some beneficial health outcomes of
coffee consumption.
Increases risk of lung cancer
Increases risk of fracture in women
Increases rik of laryngeal cancer
Increases risk of rheumatoid arthritis
Increases risk of gastric cancer
Increases risk of endometriosis
TABLE 2: Some harmful associations of drinking coffee.
apoptosis in tumors. Caffeine modulates cell cycle
and increases UV-induced apoptosis through p53-
dependent and p53-independent biological path-
ways. Data from recent studies have revealed an
inhibitory effect of caffeine on the proliferation of
both melanoma and nonmelanoma cell lines.14-26
THE MIRACLE OF COFFEE POLYPHENOLS:
THE LINK BETWEEN POLYPHENOLS AND
SKIN CANCER
The anti-carcinogenic potential of coffee in skin
cancer is not only linked with caffeine. Dietary
polyphenols contained in coffee are known to in-
hibit carcinogenesis because they have antioxidant
and anti-inflammatory properties. Coffee is known
to contain a diverse kind of chemicals, including
carbohydrates, lipids, vitamins, minerals, nitroge-
nous and phenolic compounds. The main polyphe-
nols in coffee are phenolic acids (i.e., chlorogenic
acids) and flavonoids (i.e., catechins). A certain
amount of evidence exists regarding the consump-
tion of polyphenols has the potential to protect aga-
inst various oxidative-stress related diseases.
Polyphenols decrease oxidative stress by trapping
free radicals. Recent studies have shown that the
coffee bioactives enhance glutathione levels and
offer protection against DNA damage. Moreover,
beside their antioxidant activity, polyphenols are
known to inhibit carcinogenesis by inhibiting
cyclooxygenase-2 (COX-2). Polyphenols modulate
the activity of arachidonic acid metabolizing enzy-
mes including, COX. It has been demonstrated that
polyphenols suppresses UVB-induced COX-2 exp-
ression and prostaglandin E2 levels.6,14,18,19,26-29
CAFFEINE, POLYPHENOLS AND PSORIASIS
Other than protection against UV-induced carci-
nogenesis, the potential preventive effects of polyp-
henols against inflammatory skin diseases has also
raised great interest in recent years. A diet rich in
polyphenols is known to be associated with redu-
ced risk of developing chronic inflammatory disea-
ses. Psoriasis shares immunologic features with
other human autoimmune inflammatory conditi-
ons. Recent studies have offered support that
polyphenols may modulate inflammatory media-
tors and cell-mediated immunity responses in pso-
riatic patients, since they have anti-inflammatory,
antioxidant and immunomodulatory effects. Cof-
fee reduces the levels of interleukin (IL)-1β, IL-6,
tumor necrosis factor (TNF)-α and C-reactive pro-
tein (CRP) levels while increasing anti-inflamma-
tory markers, including adiponectin, IL-4 and
IL-10 levels. One of the most important polyphe-
nols, chlorogenic acid, exerts strong anti-inflam-
matory effects via inhibiting COX-2/ Nuclear
factor-kappaB pathway, consequently inhibiting
pro-inflammatory mediators synthesis and release,
especially TNF-α, IL-1β, IL-6 and interferon (IFN)-
γ). Moreover, another polyphenol, caffeic acid, also
known to inhibit inflammation by decreasing nit-
rite levels.30-32
The link between coffee and psoriasis is not
only based on the anti-inflammatory effects of
polyphenols. Caffeine is also known to have im-
munomodulatory and anti-inflammatory proper-
ties. The role of caffeine in immunosuppression has
been defined as the suppression of the release of
pro-inflammatory cytokines and Th1/Th2 cell pro-
liferation. Caffeine reduces the migration of mo-
nocytes and neutrophils. It has been shown that
higher caffeine consumption was associated with
reduced inflammasome activation. Caffeine in-
creases the release of anti-inflammatory cytokines
including IL-10 and decreases the release of pro-
inflammatory cytokines including TNF-α, IL-2 and
IFN-γ. Caffeine is an adenosine receptor antagonist
inhibiting phosphodiesterases. Caffeine adminis-
tration increases Cyclic Adenosine MonoPhosp-
hate (cAMP) levels, which also has immuno-
modulatory properties, since it is known to in-
crease the release of anti-inflammatory cytokines
and immune cells.32,33
COFFEE FOR ROSACEA:
THE GOOD OR THE BAD?
Other than caffeine and polyphenols, coffee also
contains numerous components that may also con-
tribute towards its antioxidant, immunomodula-
tory and anti-inflammatory effects.6However,
Ahu YORULMAZ Turkiye Klinikleri J Dermatol. 2019;29(1):31-5
33
there is not any solid data so far about the preven-
tive potential of other components of coffee aga-
inst further skin diseases. Rosacea represents a
dilemma among dermatological diseases in that it
tends to be aggravated with coffee consumption.
Until recent years, the aggravating potential of cof-
fee in rosacea has been linked with the thermal
heat of the beverages.34,35 On the other hand, there
has been a growing debate about whether the caf-
feine or the temperature of the coffee is the actual
culprit for exacerbation of rosacea.34-36 The fact that
increased risk of rosacea is also linked with caffeine
containing beverages that are lukewarm or cool in
temperature, has brought the idea of the associa-
tion of caffeine and rosacea is not only heat rela-
ted.36 Moreover, paradoxically, in a recent study it
has been shown that increased caffeine intake from
coffee is conversely associated with the risk of ro-
sacea in women.37
Caffeine is a methylxanthine, which increases
intracellular calcium stimulating the production of
nitric oxide (NO). NO is a mediator of vasodilation
in blood vessels. Caffeine is an adenosine receptor
antagonist, affects cAMP levels by inhibiting
phosphodiesterases. Administration of caffeine re-
sults in an accumulation of cAMP and vasodilation.
Caffeine plays a central role in activation of
sympathetic nerves and mediation of skin vasodi-
latation. Increased sympathetic excitability and va-
sodilatation are assumed to be implicated in the
development of flushing and subcutaneous telan-
giectasia in rosacea.34-36,39
The pathogenesis of rosacea still remains un-
clear. Abnormal neurovascular signaling is presu-
med to be one of the key constituents of the
pathogenesis. But other than neurovascular
dysfunction, neurogenic inflammation, a condition
induced by sensory nerves via antidromically re-
leased neuromediators, represents a prominent
etiological factor in rosacea development.39,40 The
conflicting results from large population-based stu-
dies have led to reconsideration of limiting of caf-
feine intake in rosacea.36,37 Components in coffee
are known to have potent antioxidant, anti-in-
flammatory and immunomodulatory effetcs. It is
still under consideration whether coffee has the
potential to ameliorate the symptoms of rosacea.36,37
CONCLUSION
There are evident effects of coffee on human
physiology in that it contains thousands of bioac-
tive components. Moreover, it is known that some
of these constituents have the potential to produce
unique health effects that could be different to ef-
fects of the same constituent from other sources.1
Over the years, conflicting findings and concerns
have arisen from the studies investigating associa-
tion of coffee intake with certain health conditi-
ons. Until now, studies oftenly focused on the
mostly well-known components of coffee. Some
components, for instance, caffeine and polyphe-
nols, both have antioxidant, immunomodulatory
and anti-inflammatory effects. Therefore, these bi-
ochemical ingredients display additive action in re-
gard to chemoprevention of diseases. However, due
to the myriad of compounds, coffee may have both
health promoting but, in some circumstances, un-
desirable effects to health.1,2,5-10 Not only large-scale
population based studies, but also biological and
molecular studies are needed to assess the poten-
tial benefits and impact of coffee intake on human
health.
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During this study, no financial or spiritual support was received
neither from any pharmaceutical company that has a direct
connection with the research subject, nor from a company that
provides or produces medical instruments and materials which
may negatively affect the evaluation process of this study.
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No conflicts of interest between the authors and / or family
members of the scientific and medical committee members or
members of the potential conflicts of interest, counseling, ex-
pertise, working conditions, share holding and similar situa-
tions in any firm.
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This study is entirely author's own work and no other author
contribution.
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