As a dermatologist, my acne patients ask me if there are foods they should avoid - or eat - to help their skin. While this may seem like a simple question, the relationship between diet and acne is surprisingly controversial. Since the early 1900s, the medical community has gone back and forth on the role of diet in acne. However, today there is enough evidence to suggest that foods may indeed play a role in acne.
In multiple studies, acne has been associated with a high glycemic diet. Glycemic index (GI) is a ranking of how quickly carbohydrates are digested into blood glucose. Heavily processed or refined carbs like white bread are rapidly digested and cause a sharp rise in blood glucose. Low glycemic carbs like whole grains and vegetables are digested more slowly and cause lower sugar spikes.
Rapid rises in blood sugar cause the body to produce insulin, which stimulates the production of androgens (“male hormones”). Androgens can cause acne by causing clogged pores and increasing your skin’s oil production.
Not only has acne been associated with a high glycemic diet, but the severity of acne can also correlate with the glycemic load (quality and quantity of carbs) of your diet. People with severe acne were found to have higher glycemic diets compared to those with milder acne.
🥛 Dairy Products: Low fat or skim milk has also been associated with acne, but not whole or reduced-fat milk. Despite having a low glycemic index, milk has been shown to cause insulin spikes similar to high glycemic foods like white bread. Additionally, milk contains hormones from cows that may also play a role in acne. There is limited data on other dairy products, but ice cream has been associated with acne.
🍩 Sugary Foods: Acne has been associated with sugary beverages and high-fat/high-sugar foods. Think foods like soda, cinnamon rolls, and cupcakes.
🍫 Chocolate: Chocolate also appears to worsen acne, regardless of the amount of milk or sugar added. 100% pure chocolate (cocoa) was found to cause acne. A high-fat, high-sugar diet (including chocolate) was linked with acne.
🥦 Low Glycemic Load Diet: Amazingly, switching to a low glycemic load diet (LGLD) has been shown to measurably decrease acne. With no other acne treatment, switching to a LGLD improved acne and resulted in weight loss after 12 weeks. Another study echoed these results, even without weight loss. Acne was reduced by 70% in the group that changed their diet, compared to no change in the control group.
🥣 High Fiber Foods: Daily consumption of 30 grams of fiber from high fiber breakfast cereal has been shown to improve acne. 80% of people who followed the popular South Beach Diet (a low glycemic load diet) reported a reduction in acne.
🌱 Soy-based Foods: Soy also appears to be beneficial for acne. Two studies show that 160 mg of soy isoflavone improved acne, with no benefit from lower doses. Soy isoflavone acts as an anti-androgen, which may explain this effect. However, many soy-based food and drinks contain added sugar, which could negate their benefit.
So what would a “non-comedogenic diet” look like for someone who has acne?
It’s best to avoid refined sugar, flour, and processed carbohydrates like white bread, white rice, and chips/crackers. Sugary beverages, chocolate, and other sweets should also be avoided.
Instead, opt for minimally processed carbs like whole-grain bread, pasta, and brown rice. Eating more fruits, vegetables, and lean proteins like fish, poultry, and beans is also beneficial.
A good ratio to aim for is 25% of your diet from protein, 45% from low glycemic index carbs (including fruits and vegetables), and 30% from fats. It may be best to avoid milk and other dairy products, but you may want to take a calcium supplement if you decide to eliminate dairy.
Overall, while genetics and hormones are the primary causes of acne, diet also appears to play an important role too!
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