The True Link between Food and Acne

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ACNE and food cookies

I’ve heard many many links between specific foods causing acne in dermatology clinic (dermatologist approved acne treatment algorithm here). Patients have suggested yogurt, beer, cheese, cereal, chocolate, cinnamon, you name it! My own father swears that when he eats oily Mickey D’s, he gets acne breakouts on his nose. So I was actually pretty excited that we were assigned a journal article earlier in the year looking at the scientific evidence linking certain foods to pimples. Though there’s a lot in the literature, few links are actually solidly based in scientific evidence. Here are the main takeaways:

Glycemic Index / Glycemic Load

cupcakes sugar carbs

Carbs are sugars that are an important source of energy for our body when broken down in glucose. Carb-heavy foods are found in processed foods like pasta, bread, sweets like cookies and candy, table sugar, etc. The glycemic index is basically a measure of rise in blood sugar caused by eating a carbohydrate, and the glycemic load is a measure of carbohydrate content based on what you’re eating. Studies have found that eating a HIGH glycemic index or glycemic load results in MORE acne.

The link between the two is actually well-studied. When you eat high-carb foods, your body releases a hormone called insulin and insulin-like growth factor (IGF-1), which normally helps you process the carbs and turn it into energy storage for the future. Too much IGF-1 however, and a decrease in the proteins that usually bind and deactivate them, causes acne. How? IGF-1 increases skin cell turnover and oil gland and fat production. In addition, insulin and IGF-1 also increase androgens, male hormones that increase oil/sebum production. All this adds to a recipe for MORE acne.

cookies sweets desserts

Researchers have assigned groups of study subjects to either low glycemic index diet or normal diet in the gold standard of scientific research, randomized controlled trials. They found that people eating the low carb diets had less number of pimples, and when they looked at this group of people’s skin under the microscope, they found smaller oil glands as well. (One caveat: this study was confounded by weight loss; as the study subjects all lost weight on low carb diets, it is hard to attribute the improvement in acne completely to carbs without considering weight loss as a factor).

What this means for you is that if you struggle with acne, try cutting down on high carb foods, meaning go easy on the sugars and sweeteners, bread, candies, cookies, jams, potatoes, and more. This is definitely not easy (I would have trouble cutting down on carbs! I LOVE noodles more than anything), so I would recommend trying to eat carbs in moderation to help your acne, in addition to the other treatments prescribed by your friendly dermatologist.

Milk

milk carbs

 

Surprising? Well, not really. Milk causes acne the same way that high carbohydrate loads cause acne; they both increase insulin and insulin growth-like factor and production of male hormones (androgens). The surprising thing to me was actually that higher acne was associated with those who drank skim milk and also WHEY protein (found in supplements). Whey protein causes a big spike in insulin production, hence the acne. These patients found that their acne went away after stopping their supplementation.

Miscellaneous

Other reviews (here and here, just to name two) have looked at the link between acne and various other foods. Unfortunately, we need more modern studies to examine the relationship between these other foods and pimples because the evidence currently isn’t there. Some other foods researchers have looked at include:

  • Omega-3 fatty acids – a small study of 5 people (very small!) found that taking Omega-3 fatty acid supplements seemed to have an improvement in inflammatory acne
  • Topical and oral antioxidants (vitamins A and E, a catechin found in green tea, flavonoids found in flowers, and resveratrol found in grape skin and red wine, among others) may have beneficial effects on making oil glands smaller in hamsters and have bacteriocidal activity against P. acnes grown in petri dishes. Nothing has been tested on humans.
  • Zinc supplementation has been controversial – sometimes it seems to help patients and in other studies, it did not improve acne at all
  • Fiber, Iodine, Vitamin A (oral): Inconclusive studies with no clear recommendations
  • Chocolate seems to make acne flare in acne-prone teenage boys in a very small study done in 2014, but not reproduced in other studies. No clear conclusion can be drawn.

Overall, the only two things we know for sure so far are that milk and foods high in carbohydrates can trigger and worsen breakouts. What I suggest is if you notice certain foods being linked to bad acne flares for you, try cutting down on those and seeing if you find an improvement in your pimples. I personally feel like I get more acne if I eat oily foods and don’t sleep, so I try to stay well rested and eat healthier (I try!).

Which foods do you find trigger your acne?

6 Comments on The True Link between Food and Acne

  1. jennventures
    February 1, 2016 at 3:47 pm (2 years ago)

    This is such a timely post for me… but so hard to cut down on sugar!!

    Reply
    • Joyce
      February 1, 2016 at 6:24 pm (2 years ago)

      Agreed…it is definitely very hard. Setting small goals helps me like saying dessert only on weekends or something ridiculous like that 😛

      Reply
  2. Dave H
    February 2, 2016 at 2:31 am (2 years ago)

    Great article! I’ve been coaching people to cut down on sugar and dairy to reduce acne for a few years now. I read a similar article by Mark Hyman, MD, that made me give it a try. Some patients have amazing results! Others have either struggled to stay consistent with the restriction or there are other factors in play. Overall it’s always worth a shot so I always mention it.

    Reply
    • Joyce
      February 3, 2016 at 5:29 pm (2 years ago)

      Thank you for your comment Dr. Dave! After we read this review article in journal club, I was shadowing the chair of our department in his peds derm private practice, and he recommended these strategies to his teenage patients who were struggling with recalcitrant acne. I thought that if our chair is passing this information along to his patients, I definitely should be too. Glad to hear that you have had some success with diet alteration for some of your patients!

      Reply
  3. jessica
    July 7, 2017 at 12:48 pm (3 months ago)

    I love this article and your blog so much! I actually dramatically reduced my dairy intake. It is very rare for me to have dairy and If I do I try to head for like goat cheese. Regular cheese, ice cream, milk, etc (aka my weakness) constantly caused gross whitehead breakout. I did an informal test on my skin and switched to almond milk and vegan cheeses and the whiteheads have completely disappeared! I notice that if I slip up and binge on dairy it goes nuts.

    I haven’t reduced my sugar or carb intake but I feel like I really should. I always go bare faced (except date night) and I need my skin to continue to glow!

    Reply
    • Joyce
      July 7, 2017 at 5:41 pm (3 months ago)

      Hi Jessica, that’s awesome to hear! Thanks for sharing your experience and keep up the great work :)

      Reply

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