The acne diet—or, more accurately, the acne-free diet—is a way of eating that claims to improve or eliminate acne. There is, in fact, no official acne diet.
Doctors, nutritionists, and acne sufferers have experimented with various dietary modifications, some of which are claimed to be effective. The internet and bookstores are full of resources claiming to know how to cure acne with diet. The medical community has engaged in debate about the impact of diet on acne, and for years, many doctors claimed that acne was not affected by diet. A growing body of evidence, however, supports the idea that certain foods affect the skin and that nutrient deficiencies affect skin health and appearance.
Most cultures had folk remedies to help clear the skin, and until the 1960s most Americans believed that diets high in sugar caused acne. In the later part of the twentieth century, serious scientific research attempted to confirm or disprove these folk tales and myths. This early research failed to find a connection between food and acne. One of the first studies on food and acne focused on chocolate, based on the belief that chocolate contributed to acne. The study found that chocolate did not increase acne breakouts. Most other studies have since confirmed this finding, though recent research is again implicating chocolate. Based on these early findings, dermatologists insisted that diet made no difference to acne.
Adding to the hypothesis that ethnic groups that maintain traditional diets do not get acne, a 2016 paper studied adolescent boys of the Dogon tribe in Mali and found a connection between their new acne outbreaks and their recently modernized diet; it suggested that acne should be considered one of the “diseases of civilization” that is promoted by the inflammatory properties of modern diets. The same result was seen in another 2016 study of adolescents in Nigeria.
In the 2000s and 2010s, several studies have found a relationship between high-glycemic index foods and acne. Widespread internet reports of skin miraculously clearing after dietary changes expanded the conversation on the topic; individuals have discovered diets that they believe actually do help them and have been sharing their findings online.
Acne is caused when glands in the skin called sebaceous glands begin to form a sticky oil called sebum. These glands are stimulated by hormones that become active at puberty, which is why acne occurs most often in adolescence, when these hormones are produced in abundance. The oils formed by the sebaceous glands hold dead skin cells, preventing them from being sloughed off. As these cells die, they create the perfect environment for bacteria to grow. When these bacteria, called acne vulgaris, become too plentiful, they will attempt to erupt from the skin, causing a pimple. Sometimes, when the bacteria grow, the body sends white blood cells to fight the infection. This natural reaction can cause large, painful cysts to form in the deeper layers of skin.
Some dietary changes have been proposed to help prevent acne breakouts. The advice can be contradictory, and much of it has little scientific evidence to back it up:
Other vitamins and minerals proposed to improve acne include vitamins A, D, E, and B; selenium; zinc; omega-3 fatty acids; iodine; and chromium. Vitamin D is of particular interest now; in 2016 Korean researchers found that patients who took vitamin D supplements experienced significant improvement in their acne. Omega 3 fatty acids, found in fish, also seem to work to reduce acne. A 2014 study, also from Korea, found that patients who took fish oil supplements saw a significant reduction in inflammatory lesions.
Research in the 2010s found an association between a food's glycemic index and the likelihood it would lead to acne breakouts. The glycemic index is a measure of the effect that food has on blood sugar. The glycemic index ranks foods based on a scale of 0–100. Foods with higher glycemic index ratings break down quickly and cause a sharp spike in blood sugar. When blood sugar rises quickly, the body produces a surge of insulin to lower the amount of glucose (sugar) in the blood. Insulin is a hormone that helps the body take glucose out of the bloodstream and put it into cells, where it can be used for energy or stored in fat. Foods with lower glycemic index ratings break down more slowly and cause a more gradual rise in blood sugar, meaning that less insulin will be needed to restore blood sugar to normal levels.
Foods with a high glycemic index rating include:
Foods with moderate glycemic index ratings include:
Low glycemic index foods include:
Foods that are high in fiber tend to have lower glycemic index numbers because fiber takes longer to digest. Studies have shown that the presence of fats, such as olive oil or butter, can also slow digestion and keep blood sugar from rising too quickly. It can be difficult to determine the GI of meals, which is influenced by ripeness, cooking method, and other factors
Some experts recommend eliminating most carbohydrates from the diet. Practitioners of low-carb high-fat (LCHF) diets report that people who adopt a low-carb or ketogenic diet often see improved skin quality. Research from 2015 suggests a relationship between insulin resistance and acne. Some experts believe that insulin resistance is the result of a lifetime overconsumption of refined carbohydrates, and low-carb diets are one approach to combating this problem. Acne is common in people who are overweight and obese, who are also often insulin resistant.
Eliminating certain foods from the diet and increasing the amount of specific vitamins and minerals, if lacking from the diet, may help reduce the amount of sebum produced and prevent acne breakouts. The interaction between diet and acne, however, is not a simple cause-and-effect relationship—if an oily food is eaten, the oil does not travel to the skin or cause it to be oily.
Habits such as limiting sodium and processed foods and increasing intake of whole grains, vegetables, and fiber are in line with federal dietary recommendations and support overall health. Eliminating entire food groups could potentially lead to vitamin or mineral deficiencies. People interested in the acne diet should consult with a physician or registered dietitian before starting the diet.
An acne diet, like all acne treatments, can take time to work. Some people who adopt a low-glycemic-index diet report improvement after 10 to 12 weeks. If the diet is, in fact, responsible for the improvement, relapsing and eating sugars or starchy foods could result in acne coming back.
Some acne diets suggest zinc or vitamin A supplementation. People should always consult with their physicians before taking any supplements or other drugs. Zinc supplements can cause stomach upset, and authors of acne diet plans recommend no more than 30 mg of zinc per day to avoid this.
Dietary supplements could potentially interact with medications prescribed for acne. Some acne medications contain retinol, a form of vitamin A. Taking a vitamin A supplement with these prescriptions can cause a dangerous buildup of vitamin A in the body.
Women who are pregnant or those who may become pregnant should not take vitamin A supplements or any medications containing vitamin A, as excessive amounts of vitamin A may cause birth defects. Women should never take the acne medication Accutane during pregnancy because it does cause birth defects; women who take this medication should be very careful not to become pregnant.
There are few risks associated with an acne diet. Most relate to taking dietary supplements. Zinc may prevent the body from absorbing enough copper. To avoid this, consumers should avoid taking high doses.
Vitamin A is a fat-soluble vitamin. That means that excess vitamin A is stored in the body rather than eliminated in the urine. Many acne prescriptions contain concentrated forms of vitamin A, but too much vitamin A can be toxic. Consult a doctor before taking vitamin A supplements.
No consensus has been reached on whether or not diet plays a role in causing or preventing acne. Many dermatologists do not believe that diet has a significant effect on acne. Early studies about diet and acne focused on specific foods believed to trigger acne breakouts. Most of these studies found no evidence that individual foods cause acne. The most recent research is, however, finding links between diet and acne, especially between acne and high glycemic-index foods.
The theory with the strongest support is that foods high on the glycemic index contribute to acne, making existing acne worse. Studies have shown that half of acne patients tested had abnormal glucose levels, and in another study, 80% of premenstrual women with acne had abnormal glucose metabolism. This data, and others that show a high-carbohydrate diet increases the levels of testosterone in the blood, have led to the recommendation of limiting consumption of refined carbohydrates as a means of treating acne.
A US study in 2016 found the same relationship between milk and high glycemic foods and teenage acne, as did a 2017 paper from Norway. Another 2016 study found a link between acne and low-fat milk, but not full-fat milk. A 2017 study found a link between high carbohydrate consumption and acne in adults in New York City.
Chocolate's role in causing acne has been revisited in recent years. A study published in 2016 found that adolescent boys who ate chocolate daily for four weeks had significantly worse acne at the end of the period, though the authors hesitated to conclude that the dietary change caused the acne. A Polish study from 2016 linked milk and chocolate to acne, and concluded that evidence for an association between diet and acne is compelling.
See also Dietary supplements ; Fiber ; Glycemic index diets ; Vitamins ; Zinc .
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American Academy of Dermatology, 9500 W. Bryn Mawr Ave., Ste. 500, Rosemont, IL, 60018-5216, (888) 462-3376, www.aad.org .
Deborah L. Nurmi, MS
Revised by Amy Hackney Blackwell, PhD