If you struggle with acne, you may have been told that certain foods can make it worse. People commonly blame chocolate and greasy foods for triggering acne flare-ups, but is there any evidence to back this claim?
Read on to find out whether science can prove a link between diet and acne and what research says regarding specific foods that can cause or worsen this skin condition.
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Acne forms when your hair follicle or pore is blocked by dead skin cells, sebum (the oil that your body naturally produces to lubricate your skin and hair), and bacteria. When a whitehead or blackhead becomes inflamed, it can form a large, painful cyst or nodule.
The following factors can worsen or trigger acne flare-ups:
Excess sebum production
This is important because foods that influence these factors could potentially worsen acne.
Before we look at the evidence to prove a link between diet and acne, it’s necessary to understand the difference between an association and a causal link.
Many existing studies¹ that evaluate diet and acne are retrospective. They look back at existing data and derive conclusions from there. These studies may find that people who have worse acne commonly ate a certain food. This is called an association, and we can say that there is an association between that certain food and acne.
However, we cannot prove that the food caused acne.
While it’s far more difficult to prove a causal link than an association, an association can give us a good starting point for future studies designed to explore whether or not there is a causal link.
Here is the evidence we have so far.
Your mother might have been correct when she told you that your pizza and chocolates were causing your pimples, although not necessarily for the reason she thought. It may all have to do with how quickly a certain type of food causes your blood sugar levels to spike.
The glycemic index (GI) or glycemic load (GL) is a measure of how quickly food or a meal causes your blood sugar to rise after you eat it. The higher your blood sugar spike, the higher your subsequent insulin spike. Insulin is required to move glucose from your bloodstream and into cells where it is used.
Foods that have a high GI or GL include highly processed and refined foods such as white bread, fries, potato crisps, pastries, donuts, and sugary drinks. You can use the glycemic index chart² to see the GI of a certain food item.
Some studies³ have shown that eating a low-GI diet can improve acne; however, the link between a high-GI diet and acne is weak. Research has found an association⁴ between a high-GI diet and an increased prevalence of acne, but there is no conclusive evidence yet that a high-GI diet actually causes acne or worsens it.
One study³ looking at the relationship between chocolate and sugary beverage intake and acne found an association. People with high chocolate and sugary beverage intake were seen to have more acne.
The researchers, however, questioned whether it was the high-GI foods causing the acne or whether, for some reason, people with acne tended to eat more chocolate and drink more sugary beverages.
On the other hand, other studies³ have shown little to no evidence of a link between high-GI foods and acne.
Researchers hypothesized⁵ that the blood sugar spikes caused by a high-GI diet could lead to increased inflammation and hormonal changes, causing increased sebum production. These could both worsen acne or trigger acne flare-ups.
The American Academy of Dermatology Association has suggested that there may be a link⁵ between milk intake and more severe acne. Studies in the USA, Italy, and Malaysia, for example, all found an association⁵ between increased milk consumption and the incidence of acne.
The results were not always consistent, however. While consumption of full-fat and skimmed milk was associated with worse acne in teenage girls in one study, the same association was not found in teenage boys³.
In the cohort of boys, there was also no link between consumption of whole milk and acne in the boys and only a weak positive association between the consumption of skimmed milk and acne.
Interestingly, no studies³ have found an association between acne and the consumption of other dairy products, such as yogurt and cheese.
Researchers hypothesized that the hormones present in milk could trigger inflammation⁵ in your body, which would worsen acne.
Another theory is based on the insulin index of milk³, which is high (cheese, on the other hand, has a low insulin index). Because it has a high insulin index (i.e., it releases a high concentration of insulin into the blood), milk would affect the body in a similar way to foods with a high glycemic index.
The hypothesis is then that milk would worsen acne in the same way that high-GI foods trigger acne flare-ups.
All of this is simply an assumption, at present, and further research needs to be done to prove any causal link between milk consumption and acne.
There is good evidence³ that eating a low-GI diet that is high in fruit, vegetables, fish, and unprocessed foods may improve acne. If you are struggling with acne breakouts, it might be wise to consider a low-GI diet.
Until further research confirms or negates the other findings, the link between acne and other dietary components such as high-GI foods and milk is merely an association.
The American Academy of Dermatologists Association suggests that if you are wondering whether your acne could be caused by your diet, you should pay more attention to your breakouts and ask yourself these questions:
Does any specific food or drink seem to trigger a breakout or worsen my acne?
If something does appear to trigger a breakout, what happens when I don’t have that food or drink for a day, a week, or a month?
Keeping track of which foods or drinks aggravate your acne and cause acne breakouts and then avoiding those triggers may be the best way to manage this skin condition.
If you keep asking yourself, “Why am I getting pimples on my face?”, it may be time for you to look at your diet to manage your acne.
Until studies provide us with conclusive proof, dermatologists suggest monitoring your acne and diet and assessing whether any specific foods or beverages trigger your acne to flare up. That may be the best way to manage your acne at this time.
Acne: Diet and acnegenesis (2011)
Glycemic index chart: GI ratings for hundreds of foods | University Health News Daily
Can the right diet get rid of acne? | American Academy of Dermatology Association