Dietary Intake and Acne: What is the Link?
If you are struggling with unwanted breakouts, you are far from alone. The prevalence of acne is estimated to affect 9.4% of people worldwide. The incidence rate is highest in adolescents and young adults but typically decreases with age beyond 30 years. Because this can be difficult condition to manage, many people who struggle with acne often want to know what factors can contribute to or prevent breakouts. While typical areas examined will include skin hygiene, stress, and personal care products, interest has increased in recent years regarding the connection between dietary intake and acne.
There are so many foods we eat daily, many of which are beneficial to our skin, and others that are not. So, which are affecting the condition of our skin the most? Read on to learn which foods may affect skin health and which do not.
Sugar and High-glycemic Index Foods
Consumption of sweets and other carbohydrate-rich foods have been attributed to the majority of skin breakouts. (1) When the body breaks down carbohydrates, it releases insulin. This is normally an okay, and much needed, reaction from the body. Trouble begins when we are regularly consuming “high-glycemic” foods, which cause large spikes in blood sugar and lead to high blood sugar. When the body is in this consistent state of high blood sugar, it leads to multiple reactions:
- Increased Insulin-like growth factor-1
- Increased Insulin-like growth factor binding protein-3
- Elevated Androgen Hormones
All these reactions can lead to cellular, follicular growth and/or androgen-driven sebum production, which can affect oil production in pores.
- Low glycemic load diet led to participants improving their acne and weight loss. (2)
- Low glycemic load diet led to participants improving acne, no weight loss. (3)
These two studies show connections between the improvement of acne and skin lesions and a low glycemic index diet.
The first offers a strong study using a randomized controlled study but limited from having only 43 participants.
- The control group was asked to remain on their diet consisting of, generally, high-glycemic index carbohydrates/foods.
- The experimental group was provided a diet consisting of 25% energy from protein, 45% from low-glycemic index carbohydrates, and 30% energy from fats.
- Both groups received a topical cleanser to use in place of typical soap and water.
The experimental group began with an average of 40.6 skin lesions and the control group began with 34.9. At the end of a 12-week assessment, skin lesion count had gone down by an average of 21.9 and 13.8, respectively. Additionally, the experimental group had a loss in BMI.
The second study also has limitations of 32 participants and self-reported diets from the participants. They had a low glycemic load diet group of 17 participants and a control group of 15.
- The low glycemic load diet group ate a diet that consisted of 25% energy from protein, 45% from low-GI carbohydrates, and 30% energy from fats.
- The control group ate carbohydrate-rich foods daily.
The mean non-inflammatory lesion counts for the LGLD group and the control group were significantly decreased, by 27.6% and 14.2%, respectively.
Aside from the small group size, each study is completed with strong methods and results. Strengths are especially seen in the studies being randomized controlled trials and researchers and dermatologists not knowing which participants are part of which group until the end of the study. In conclusion, it is suggested that following a low-glycemic load and low-glycemic index food intake may benefit skin health based on these two studies.
Milk and Dairy Products
The effects of dairy products on skin health are closely related to the effects of sugar on skin. Milk has carbohydrates in it, which can produce a spike in blood sugar, as we mentioned for high-glycemic index foods. The difference between milk and carbohydrate-rich foods is that milk is considered low on the glycemic index compared to food like a slice of bread, which is considered high on the glycemic index.
Milk consumed in excess can lead to high blood sugar levels. In addition to the effects of high blood sugar, dairy intake increases insulin-like growth factor-1. This may lead to the same effects that high blood sugar produces in relation to acne production.
- 6,094 girls, ages 9–15 years, yielded a positive association between acne prevalence and consumption of whole, skimmed, and low-fat milk; there was no association with non-milk dairy foods, chocolate, and pizza. (4)
- 4,273 boys, ages 9–15 years, discovered a weak association between acne and skimmed milk; there were no associations with milks of a higher fat content. (5)
These two large studies mentioned above report some relevance of milk consumption and acne. They were limited because the children were self-reporting their dairy intake and, if they had acne, its condition. It is difficult to know whether any certain component within dairy is contributing to acne.
There is little possibility the fat content of milk would affect the condition of acne. Some researchers are attempting loosely to consider any connection to whey. There are no randomized controlled trials investigating the relationship between frequent dairy or milk consumption and acne. Overall, there is minimal evidence suggesting dairy would have an impact on acne outside of containing carbohydrates; but milk is also considered a low on the glycemic index, making that assumption difficult to conclude.
Another food item thought to affect acne is chocolate. It has been difficult to find a strong connection between acne and any specific component of chocolate. The major component that has been hypothesized to have an effect on skin health is cocoa. Other than the cocoa content, sugar in regular chocolate products could be what is contributing to potential acne breakouts.
- Thirteen men consumed 100% cocoa, hydrolyzed gelatin powder, or a mix. The study found a statistically significant increase in acne lesions after cocoa consumption (6)
The researchers discovered that the thirteen men in this study had an increase in acne. The limitations of the study are that they only had 13 participants and the men were “acne-prone.” While the study used a randomized controlled trial, the evidence is considered weak due to the low number of participants and being the only study of its kind. More research is needed to conclude significant evidence.
Omega-3 Fatty Acids
Omega-3 fatty acids provide a unique perspective on the impact of food on acne. Unlike the rest of the food items mentioned here, omega-3 fatty acids offer a protective result from acne due to reducing inflammatory responses.
- A 10-week, randomized, controlled parallel study had 45 participants, ages 18 – 33 (36 men, 9 women), split into groups that received omega-3 fatty acid supplementation, γ-linoleic acid (an anti-inflammatory omega-6 fatty acid) supplementation, or were in a control group. The omega-3 fatty acid and γ-linoleic acid groups both show improvement from supplementation. (7)
This study shows a small connection for improved acne conditions while taking γ-linoleic acid or omega-3 fatty acid. This study does not provide strong enough evidence of omega-3 fatty acid due to the small size of the group. More studies could greatly benefit this research. However, omega-3 fatty acid supplements have many health benefits outside of skin health. Considering its great availability and health benefits, supplementation could be a considerable option to improve acne conditions.
- High-glycemic index/load foods are likely to aggravate acne when consumed regularly.
- Milk and dairy products could affect acne conditions if consumed heavily for extended periods of time.
- Chocolate has loose connections to aggravation of acne unless considering its high glycemic index like any other sugary candy.
- Omega-3 fatty acid supplementation has loose connections to benefiting the condition of a person’s acne.
In closing, there are many studies to be considered when researching what dietary effects have on the condition of skin and acne aggravation. While research on this topic started decades ago, it was not until recently, in the 2000s, that more research has come out. If your acne is at a stage where it is just beginning, some of these dietary tips may be of benefit to you.
- Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Postepy Dermatol Alergol. 2016;33(2):81–86.
2. Smith RN et al. The effect of a high-protein, low glycemic–load diet versus a conventional, high glycemic–load diet on biochemical parameters associated with acne vulgaris: A randomized, investigator-masked, controlled trial. J Am Acad Derm. 2007;57(2):247-56.
3. Kwon HH et al. Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in korean patients: a randomized, controlled trial. Acta Derm Venereol. 2012;92: 241–246.
4. Adebamowo et al. Milk consumption and acne in adolescent girls. Dermatol Online J. Retrieved from https://escholarship.org/uc/item/77b9s0z8.
5. Adebamowo et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58(5): 787–793.
6. Caperton C et al. Double-blind, Placebo-controlled Study Assessing the Effect of Chocolate Consumption in Subjects with a History of Acne Vulgaris. J Clin Aesthet Dermatol. 2014 May; 7(5): 19–23.
7. Jung JY et al. Effect of Dietary Supplementation with Omega-3 Fatty Acid and Gamma-linolenic Acid on Acne Vulgaris: A Randomised, Doubleblind, Controlled Trial. Acta Derm Venereol 2014; 94: 521–525.
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