Can diet affect skin and trigger blemishes? A summary of scientific thinking

Can your diet cause acne?
The food we eat may trigger or exacerbate acne-prone skin

The food we eat has long been associated with skin health and research has proven the link between diet and skin. *1 Despite this, the relationship between diet and acne remains controversial and often inconclusive. *2,3

This article explores the latest thinking on this subject, looks at those foods most commonly associated with acne and explains the reasons for the link. To find out more about the changes you might want to consider making to your diet to help keep your acne under control read What changes can I make to what I eat to help my skin?

What types of foods are most commonly linked to blemishes and acne?

There have been numerous research reports that conclude that rural and non-industrialised societies have fewer instances of acne than Western populations.*4 A 30-year study conducted on the Inuit population of Northern Canada in the early 1970’s showed that there were no cases of acne when the population lived and ate in their traditional way. It was only when Western foods were added to their diet that cases of acne occurred. *5, 6 Related reports or studies on rural Irish immigrants in the United States *7, communities in Papua New Guinea and Paraguay *8, and the rural areas of Kenya, *9 Zambia, *10 South Africa *11 and Brazil *12 have also been used to support the point that the typical components of a Western diet can trigger acne.

The main components of a Western diet are hyperglycemic carbohydrates, (cow’s) milk and saturated fats and there is compelling evidence to suggest that foods with a high Glycemic Index and milk might well trigger acne.*3 Both are known to stimulate androgens (male hormones) which play an important and proven role in the development of blemishes. You can find out more in acne and hormones.

 

Science is less clear on the role a deficiency of certain foods may play in acne but the debate is largely around: the balance of Omega-3 versus Omega-6 fatty acids, dietary fibre, antioxidants and zinc.

Sugary foods have been known to trigger acne

Acne and foods with a high Glycemic Index

The Glycemic Index (G.I.) is a rating system for foods containing carbohydrates. It shows the impact they have on blood sugar. High G.I. carbohydrates are broken down quickly and cause a rapid increase in blood sugar. Lower G.I. carbohydrates are broken down more slowly so that blood sugar rises gradually.

Foods with a high G.I. rapidly increase blood sugar which causes our body to produce more insulin (insulin is a hormone produced in the Pancreas which makes it possible for human cells to use and store the sugar from carbohydrates). Insulin stimulates androgens (male hormones) which, in turn, stimulate excess sebum production (seborrhea) and hyperkeritanisation (the over production of cells that leads to a hardening of skin which blocks the sebaceous glands). Seborrhea and hyperkeritanisation are key stages in the development of blemishes. Find out more in acne and hormones and in the development of acne.

A Western diet, with a high Glycemic Index, may cause acne

Foods with a high G.I. include: refined foods such as white sugar and white bread, sugary foods (soft drinks and chocolate, often cited as triggers of acne, fall into this bracket), potatoes and white rice. You can find out more about the possible impact they have on your skin, and alternatives that you may want to consider, in What changes can I make to my diet to help my acne-prone skin?

Sugar indirectly triggers the hormones that exacerbate acne

Acne versus milk and other dairy products

Milk has a relatively low G.I but is the food type most commonly implicated for acne flare-ups. In fact, a recent study that analysed the volume of research on nutrition and acne between 2004 and 2014 found that milk and milk products were the most studied area.*3 That said, the data is often anecdotal and some scientists believe the comedogenic effect of dairy is yet to be proven.

 

 

Milk is the food type most commonly implicated in acne flare-ups

For those people who do experience flare-ups after drinking milk or consuming dairy products, the hormone content is probably the most likely cause. Like humans, cows produce hormones during pregnancy, and these hormones have an insulin-like effect on the human system, stimulating androgens.

 

Again, there is no conclusive evidence on the effects of other dairy products (curd, cheese, yoghurt etc.) on acne but, being milk derivatives, they are likely to contain similar hormones. 

 

You can find out more about changes you might want to consider making to your diet in What changes can I make to what I eat to help my skin?

Sources

1 Nutrition and skin. A. Pappas, A. Liakov, C.C. Zouboulis. Rev Endocr Metab Disord. 2016 Sept 17 (3) 443-448
2 Significance of diet in treated and untreated acne vulgaris. A Kucharska, A. Szmurli, B. Sińska. Postepy Dematol Alergol, 2016 April, 33(2): 81-6
3 Acne and nutrition: a systemic review. F. Fiedler, G. Stangl, E. Fielder, K-M. Taube, 26 April 2016. Acta Derm Venerol 2017, 97: 7-9
4 Acne and diet. R. Wolf R, H. Matz, E. Orion. Clin Dermatol. 2004 Sep-Oct; 22(5):387-93
5 Schaefer O. When the Eskimo comes to town. Nutr Today. 1971;6:8–16
6 Bendiner E. Disastrous trade-off: Eskimo health for white “civilization” Hosp Pract. 1974;9:156–89
7 Diet and acne revisited. Thiboutot DM, Strauss JS Arch Dermatol. 2002 Dec; 138(12):1591-2.
8 Acne vulgaris: a disease of Western civilization. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J Arch Dermatol. 2002 Dec; 138(12):1584-90.
9 Skin diseases in Kenya. A clinical and histopathological study of 3,168 patients. Verhagen AR, Koten JW, Chaddah VK, Patel RI Arch Dermatol. 1968 Dec; 98(6):577-86.
10 Skin diseases in Zambia. Ratnam AV, Jayaraju K, Br J Dermatol. 1979 Oct; 101(4):449-53.
11 The age distribution of common skin disorders in the Bantu of Pretoria, Transvaal. Park RG Br J Dermatol. 1968 Nov; 80(11):758-61.
12 Epidemiological survey of skin diseases in schoolchildren living in the Purus Valley (Acre State, Amazonia, Brazil). Bechelli LM, Haddad N, Pimenta WP, Pagnano PM, Melchior E Jr, Fregnan RC, Zanin LC, Arenas A Dermatologica. 1981; 163(1):78-93.
13 Milk consumption: aggravating factor of acne and promoter of chronic disease of Western societies. B. Melnik, J Dtsch Dermatol Ges. 2009, 7: 364-70

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