Finally, dermatologists and medical researchers have acknowledged the fact that diet does affect acne and its course. How food influences acne is not very clear yet, though various hypotheses have been put forward by the researchers.
The recent reviews in a number of medical journals including the Journal of American Academy of Dermatology and Clinics in Dermatology have stated in no uncertain terms that evidence does exist for the effect of certain food items like high glycemic load foods (refined carbohydrates) and diary products in the causation, maintenance and exacerbation of acne eruptions.
How Does Acne Develop?
Though the basic reason for acne eruptions are the hormonal and sebaceous gland activities and bacteria induced inflammation, there are many other contributory factors influencing the natural course of acne.
Heredity, stress, climate, topical and systemic medications, and certain types of food are some of the factors that may have a positive influence on acne.
How Does Food Affect Acne?
The relationship between food and acne is not a myth anymore. Recent research has shown that diet does affect the course and severity of acne eruptions, especially in the teens.
The food items that have been studied for their effects on acne are milk and milk products, high glycemic index foods, meat and poultry, fats and fatty acids, chocolates, and, last but not the least, vitamins and minerals.
Does Milk Consumption Cause Acne?
A number of studies have shown a positive association between milk consumption and acne. Presence of hormones and other bioactive molecules in the milk is thought to be the reason for this aggravating effect of milk on acne.
Skimmed milk was found to cause more acne eruptions than whole milk, underlining the fact that the fat content of milk is not the real reason for the acne eruptions. Iodine content in diary products and an allergic inflammatory response to milk protein are also cited as acne triggers in some.
High Glycemic Index Foods as a Trigger for Acne
Refined carbohydrates increase the insulin secretion in the body and trigger a cascade of biochemical reactions resulting in increased sebum secretion and inflammatory responses within the hair follicle, the basic cause for acne eruptions. The main chemical mediator responsible for the pro-inflammatory response within the sebaceous gland is thought to be the IGF-1, the insulin like growth factor, the levels of which are elevated in response to high insulin content in the blood.
Studies have revealed that the rural and indigenous populations surviving on low fat, low refined carbohydrate foods, vegetables and fruits have very low incidence of acne. When they shift to a more Westernized food habits, the acne cases also increase proportionally. This observation was made during studies and surveys conducted among the indigenous populations of Papua New Guinea, Paraguay, Okinawan Japanese and the Canadian Inuit, to name a few.
Meat and Poultry Products and Acne
Like diary products, meat and poultry can also stimulate acne eruptions due to the presence of the hormones used to artificially increase the bulk of the meat. Saturated fats present in the red meats can also cause aggravation of acne eruptions.
In addition, use of saturated oils for frying, consumption of oily sauces, fizzy drinks and French fries along with the non-veg fast foods (all supplying high glycemic load) contributes to the induction of acne lesions.
Fats, Chocolates and Acne
Saturated oils high in Omega-6 fatty acids induce inflammatory reaction within the pilosebaceous units (which include the hair, sebaceous gland, hair duct and the surrounding tissue) resulting in aggravation of the pimples. On the other hand, food items containing Omega-3 fatty acids have anti-inflammatory properties, which help in keeping acne under control.
Though studies by Fulton et al and Anderson way back in the 1960s and 70s found no positive effects of chocolates on acne, these studies were later criticized for the small number of subjects studied and the short duration of follow-ups. As chocolates contain fat, refined sugars and milk, it is advisable for the acne sufferers to avoid these too, if they prefer a clear complexion.
Vitamins and Minerals: Do They Affect Acne?
Vitamin A in high doses does improve acne, but other side effects limit its common use as an acne medication. Vitamin A derivatives, the oral retinoids, are the mainstay in the treatment of cystic and nodulocystic acne. Utility of other vitamins like B5 are anecdotal and have not been studied in depth.
Minerals like zinc, chromium and selenium have been found to be effective in some studies and showed no effects in others, the exact mechanism of how these affect acne is not yet known.
Whatever be the mechanism, it is now clear that certain food items do affect acne and its natural course. Hence dermatologists and acne sufferers alike will do well to revise their misconception visa-vis the association of diet and acne as a myth. Dermatologists and physicians will have to make dietary advice a compulsory part of their acne treatment guidelines.
References on Food and Acne Connection
- Bowe PW, Joshi SS, Shalita AR. Diet and acne. J Am Acad Dermatol 2010;63:124-41
- Ferdowsian HR & Levin S. Does Diet Really Affect Acne? Skin Therapy Letter 2010;15:3:1-2
- Davidovici BB, Wolf R. The role of diet in acne: facts and controversies. Clinics in Dermatology. 2010;28:12-16
- Robinson HM. The acne problem. South Med J 1949;42:1050-60.
- Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton B, Brand-Miller B. Acne vulgaris-a disease of Western civilization. Arch Dermatol 2002;138:1584 -90.
- Adebamowo C, Spiegelman D, Danby F, Frazier A, Willett W, Holmes M. High school dietary dairy intake and teenage acne. J Am Acad Dermatol 2005;52:207-14.
- Smith RN, Mann NJ, Anna Braue, Henna Ma¨kela¨inen, and George A.Varigos. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr 2007;86:107-15.
- American Academy of Dermatology (2013): Growing Evidence Suggests possible Link between Diet and Acne
- Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2016;33(2):81-86.
The information given in this article is for educational purpose only so that patients are aware of the options available for diagnosis and treatment of common skin, hair and nail diseases. No diagnosis should be made or treatment undertaken without first consulting your dermatologist. If you do so, the author will not be responsible for any consequences. The images provided are for illustration purpose only and should not be reproduced without the consent of the author.
About the Author of Skin Care Tips from Dermatologist: Dr Hanish Babu, MD
Dr Hanish Babu, MD is a dermatologist with more than 3 decades of experience in treating skin and sexually transmitted diseases in UAE and India. He has been practicing in UAE since last 22 years. He is a respected speaker during the Continuing Medical education Programmes for doctors, medical students and paramedical staff and is also a Stress Management Trainer. He organises group therapy sessions for patients with psoriasis, eczema and vitiligo.
He is available for consultation at Cosmolaser Medical Centre in Samnan, Sharjah (06 5678 200) from 9 am – 1 pm and at City Medical Centre, Al Bustan, Ajman (06-7 441 882) from 4.30 pm – 9.30 pm.
Visit his personal website dr-hanishbabu.com for more details and for educational articles on Skin, hair, nail and sexually transmitted diseases. Click here to Book an Appointment with dermatologist Dr Hanish Babu, MD