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  • Denise Scott

Can Diet Help or Worsen Acne?

Many of you may have heard that sugar and dairy are bad for acne. There is actually science behind this. Acne is an inflammatory process; it makes sense that inflammatory foods (those high in sugar) may trigger more acne development. 

Face of teenage male with acne - the hormonally charged affliction of adolescence.

The primary factors in acne development include sebum (oil) production, bacteria, hormones, and overgrowth of follicular cells (cells in the epidermis and dermis).

Researchers report that foods with a high glycemic index (foods that rapidly raise blood sugar) are associated with acne. These foods increase insulin levels, increasing androgen (male hormone) concentrations and sebum production. 

Low glycemic foods can have the opposite effect, reducing androgen levels. 

There is actually a physiologic reason for this. Sugar stimulates insulin and insulin-like growth factor 1 (IGF-1) production, which act on androgen receptors all over the body, including the skin. Androgens trigger more sebum development, fat breakdown, and skin keratinization (when keratin cells move from beneath the skin to the surface). These can all contribute to acne development. 

Sugar, refined grains, and simple carbohydrates such as 

  • Breads, crackers, pastas, and pastries made with white flour

  • White rice

  • Sugar-sweetened beverages

  • Sweeteners from honey, syrup, jams, jellies, sugar, agave, etc. 

are all inflammatory foods that raise blood sugar quickly. This is followed by an increase in insulin and IGF-1, which increase androgen levels, which in turn increases sebum production and causes skin cells to grow more rapidly.

Photo of a variety of simple carbs made from refined grains including white bread, white flour pasta, crackers, candies, cookies, jam, ice cream, sugar, and white rice. These quickly raise the blood sugar.

Diets low in refined carbohydrates and sugars can aid in reducing acne by keeping blood sugar and insulin levels stable. In other words, a diet rich in fresh produce and whole grains. 

Milk and other dairy products can also increase IGF-1 levels; whether milk directly causes acne development is uncertain. The thought is that it is actually the whey protein in milk that increases acne. When fat is removed from milk to make 2%, 1%, or skim milk, manufacturers often increase the whey protein so that the lower the fat content, the higher the whey content. Some dermatologists think skim milk is the worst for acne, but it is unclear whether milk actually causes acne. 

Whey protein powder, a popular supplement in protein powders and shakes, is also thought to possibly trigger acne. Whey is rich in the amino acids leucine and glutamine, which can trigger insulin and IGF-1 production and make skin cells grow and divide more quickly, leading to acne development. There aren’t many studies on this. Best to check the source of protein in supplements your teen may be taking and limit the frequency of these. 

Thus, there are reasons that nutrition can influence acne.

A diet high in fat and fried foods such as burgers, fried chicken, sausage, hot dogs, French fries, and other fried foods has reportedly been associated with an increased risk of acne, but whether these cause acne is unclear.

So what foods or diet can contribute to keeping the skin clear?

A diet rich in healthy fats, vitamins, and antioxidants helps to promote healthy skin. Retinoids, which are used to treat acne, are derived from vitamin A.

  • Vitamin A plays an essential role in skin health. Vitamin A-rich foods include citrus, leafy greens, yellow and orange vegetables, eggs, dairy, fish, and liver.

  • Vitamin D helps to regulate keratin-producing cells. Get this from dairy products, fatty fish, eggs, and vitamin D-fortified foods.

  • Omega-3 fatty acids are anti-inflammatory and can help lower rates of inflammatory disease, one of which is acne. Fatty fish and seafood are some of the best options, but also walnuts, olives, avocados, and flaxseed.

  • Probiotics promote a healthy gut and balanced microbiome. These are linked to reduced inflammation and a lower risk of acne development. Probiotics can be obtained in the diet with fermented foods such as Greek yogurt, sauerkraut, kimchi, kombucha, sourdough bread, and tempeh. 

  • High-fiber foods help to control blood sugar and insulin levels to avoid spikes. Add fiber with fresh vegetables, fruit, legumes, nuts, and whole grains.

  • Green tea, full of polyphenols, is anti-inflammatory and can lower sebum production.

Photo of anti-inflammatory foods that are part of a healthy diet, such as fruit, vegetables, nuts, and yogurt which have micronutrients that are healthy for the skin.

Rather than eating particular foods, one’s overall diet is more important. Limiting processed, fried, fatty, and high-sugar foods is healthy for the skin and body.

The Mediterranean diet, rich in fruits, vegetables, whole grains, legumes, fish, olive oil, and low in dairy and saturated fats, promotes healthy skin and protects against heart disease, obesity, and type 2 diabetes. What a great way to convince your adolescent to eat more veggies!

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