"Could what I am eating be causing or worsening my acne?" Many patients come in to clinic pondering this thought and ask me this question. The old adage claims that "We are what we eat;" but does this apply to those suffering with acne? For years, the role of diet and nutrition in acne has been debated in the scientific community. Personal anecdotes from individuals abound as to what is the cause of their acne. While assumptions and hypotheses about the impact of high-fat diets and dairy were speculated, it had been difficult to reach clear consensus on the associations between acne and specific diet trends. The most critical review of the literature in the last decade has revealed the surprising finds below.
The associations between acne and diet?
1. Dairy ingestion appears to be weakly associated with acne: this was specifically found to be true with skim milk and low-fat milk intake in teenage boys. However, consuming whole milk did not seem associated with acne.
2. Dairy fat itself did not show an association with acne.
3. High sugar (glycemic load) diets, with foods such as chips, cookies, bread may exacerbate acne.
4. High fat diets did not show an association with acne burden.
5. No associations have been shown with increased ingestion of the following with acne: omega-3 fatty acids, antioxidants, zinc, vitamin A, and dietary fiber.
Where do we go from here?
More research is needed to explain these findings and their role in acne. Is the hormones in milk causing acne? Is it a metabolic response from the body when it does not ingest whole milk vs skim milk? We know very well that restricting diet in certain individuals does not magically make acne go away. While many people personally claim that refraining from dairy, sweets, or fats seems to improve their acne, the improvement most often is modest. An Australian research study did show that low glycemic load diets can significantly improve acne in young men, in addition to reducing their weight, body mass index (BMI), blood hormone levels with improved insulin sensitivity.
Please don't expect your inflammatory or comedonal acne to disappear by avoiding skim milk alone or avoiding all sugary foods, but it might slightly improve it. A low glycemic diet with less refined sugar consumption is a good start not only to help your acne but also to promote overall positive health and wellness. Acne likely is multifactorial with genetics, hormones, and other environmental factors beyond diet playing a role that still have yet to be identified. Adult female acne and teenage acne during puberty have a clear hormonal link that is supported by the literature. Talk to your skin care provider or me if you desire an evidence-based approach to treating your acne.
Bowe WP, et al. Diet and acne. J Am Acad Dermatol. 2010 Jul;63(1):124-41.
Williams HC, et al. Acne vulgaris. Lancet. 2012 Jan 28;379(9813):361-72.