Can Your Diet Make Your Acne Worse?
Lets briefly talk about the relationship between diet and acne. There are a lot of myths circulating about how certain foods can cause or worsen acne, and I wanted to take a few minutes to talk about the evidence currently available and to dispel some of those myths.
Here is a short list of things we know that play a significant role in causing acne:
Causes of Acne: https://www.youtube.com/watch?v=Wa5D1PY2vsM
- Hormones, especially testosterone and other androgens
- Infectious bacteria that live in the pores on our face
- Inflammation caused by clogged pores
- Poor exfoliation, or the buildup of dead skin on our face
And here is what we do know about food…
High glycemic index foods can worsen acne.
Glycemic Index Explained: https://www.youtube.com/watch?v=F1YDR2S7SPU
The glycemic index is an advanced metric to quantify the degree to which a certain food product will affect your blood sugar. Check out the video to learn more specifically about the glycemic index. However, it essentially describes how much a given food increases your blood sugar after ingestion. For example, a baked potato has a glycemic index of 85 (and 33 net carbs) while an equivalent serving of spaghetti has a glycemic index of 42 (and 38 net carbs). So even though there are more carbohydrates in spaghetti, it does not drive your blood sugar up as high, and the significance of that is explained in the glycemic index video.
There are three studies referenced by the American Academy of Dermatology that look at glycemic index and acne symptoms. The best study out of Australia shows that young adult males who followed a strict, low glycemic load (glycemic load is a modified version of the glycemic index) had significant improvement in their acne severity. There is also evidence in women with polycystic ovarian disease, who often suffer from acne, that eating a low carb diet can improve your acne symptoms. There is also a third survey study which I wont dive into.
So the best “food and acne” evidence is in it’s relationship to high glycemic load foods and worsening acne severity. Expert advice from the AAD is that eating low glycemic index foods may improve acne.
Dairy Products Show a Weak Association With Acne.
Physicians have theorized for decades that there was a relationship between dairy consumption and acne, however there has been a lack of data to support the idea. Nonetheless, the idea has persisted and there are several studies that find a weakly positive association.
Unfortunately, all three are survey studies. They all ask a group or population of people to recall their dietary intake, including dairy, and look for positive associations with acne severity. These types of studies are certainly suggestive of a relationship, but are limited by their design and far from conclusive.
It’s not clear how dairy products like milk may worsen acne, but it’s possible that growth hormones and other growth factors may play a role. Expert advice is that if an individual does notice that milk and dairy are worsening their symptoms, it’s reasonable to limit their intake. It should be noted that these foods are high in calcium and vitamin D, and if you choose to limit intake you should be supplementing calcium and vitamin D.
Western Diet Versus non Western Diet.
Interestingly, there appears to be a relationship between the incidence of acne and whether or not you eat a Western diet (e.g. American) when compared to individuals eating a non-Western diet. A 2010 review of the evidence sought to identify some trends in acne and diet and reviewed 70 papers on the subject. The link to the study is in the discussion section.
Non-western diets tend to have little or no processed foods, refined sugars and oils or excessive dairy. Instead, they are high in fresh fruit and vegetables, lean meats and seafoods. It also appears that you can switch from a non-western to a western diet and your acne will worsen. Unfortunately, these questions are very complicated and there needs to be some large scale, randomized clinical trials to evaluate this multifactorial nutritional question.
Another study published in 2010 also sought to review the evidence linking acne and diet. In addition to what we have previously discussed, they also note that other food content may play a role in acne including:
- omega-3 fatty acids
- vitamin A
- dietary fiber
Again, more research is needed. There is a lack of randomized clinical trials.
- Acne Treatment Options: http://amzn.to/2qgScQ1
- Causes of Acne: https://www.youtube.com/watch?v=Wa5D1PY2vsM
- Diet & Acne: https://youtu.be/582FyCUB1IE