Acne is the most common skin condition in the United States, affecting up to 50 million people each year. While acne is often associated with hormonal changes during puberty, it can persist into adulthood and significantly impact self-esteem and quality of life. (44)
While diet alone may not cause or cure acne, emerging research suggests that making informed nutritional choices can help manage breakouts (7). The foods you eat can influence inflammation, oil production, and hormone levels in the body, all of which play a role in acne development. (40)
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The Connection Between Diet and Acne
Recent studies challenge the long-held belief that diet has little influence on acne development. The concept of the gut-skin axis has gained recognition in understanding various dermatologic conditions, underscoring the significant impact gut health can have on skin health. Given this connection, it is increasingly plausible that diet plays an important role in acne.
Acne develops when pores become clogged with excess sebum (oil), dead skin cells, and bacteria, often leading to inflammation. Diet influences many factors involved in acne physiology, such as hormonal imbalances, dysbiosis, and inflammation.
A well-balanced diet that provides adequate amounts of nutrients required for maintaining healthy skin, including:
- Essential fatty acids
- Selenium
- Vitamin A
- Vitamin C
- Vitamin D
- Vitamin E
- Zinc
Nutrient deficiencies have been linked to skin diseases due to their negative impact on skin barrier function. For example, people with acne tend to have lower levels of zinc, vitamin A, and vitamin E than those without (39).
Foods to Avoid for Acne-Prone Skin
Scientific evidence strongly supports that high-glycemic foods and dairy products are most likely to be dietary triggers of acne.
High-Glycemic Foods
High-glycemic foods cause a rapid increase in blood sugar levels after consumption. These foods typically contain simple carbohydrates and added sugars or are highly processed, such as:
- White bread
- Sugary breakfast cereals
- Pastries
- Sweetened beverages
Glycemic index (GI) is a numerical system that ranks foods based on how quickly they raise blood glucose levels. Foods are assigned a score from 0 to 100. High-GI foods (with scores above 70) cause rapid spikes in blood sugar, while low-GI foods (under 55) lead to slower, more gradual increases.
Glycemic load (GL) takes into account not only the GI of a food but also the portion size, offering a more accurate depiction of a food's real-life impact on blood sugar. A GL of 20 or higher is considered high, while 10 or lower is low.
When consumed, these foods cause rapid spikes in blood sugar, leading to increased insulin production. Elevated insulin levels stimulate the production of insulin-like growth factor 1 (IGF-1) and androgens, both of which promote excess sebum production. (19, 38)
Additionally, chronic hyperglycemia (high blood sugar) and insulin resistance, often associated with high-glycemic diets, trigger systemic inflammation, exacerbating acne severity by intensifying the inflammatory response in the skin.
Dairy Products
A meta-analysis of 14 observational studies that included nearly 80,000 participants showed the link between dairy products and increased risk of acne. Dairy products can stimulate sebaceous gland activity by increasing serum IGF-1 levels.
Dairy products include milk, yogurt, cheese, butter, and ice cream. Plant-based, non-dairy alternatives are made from almonds, soy, rice, peas, cashews, and oats.
Processed and Junk Foods
Acne has been linked to the Western diet, a pro-inflammatory diet characterized by a high intake of processed and refined foods, added sugars, unhealthy fats, and red meats, while low in fruits, vegetables, whole grains, and healthy fats. (35)
According to one study that included over 1,200 South Koreans, those who consumed a Westernized diet (characterized by a higher intake of processed "junk" foods) were more likely to have acne than those who ate more vegetables and fish.
Interestingly, the prevalence of acne is very low in populations consuming a Paleolithic diet, a type of anti-inflammatory diet that excludes sugar, grains, and seed oils (35).
Foods High in Iodine
High-iodine foods, such as seafood, dairy products, and iodized salt, contribute significantly to iodine intake in many populations. Some studies suggest that excessive iodine intake may exacerbate acne conditions. For instance, it has been documented that high levels of iodine can lead to thyroid dysfunction, which can increase the risk of severe acne (20, 37).
Nutrient-Rich Foods for Clearer Skin
Dietary modifications for acne should not only focus on eliminating common trigger foods but also emphasize incorporating foods that promote optimal skin health.
Low-Glycemic Foods
Multiple studies have shown that following a low-glycemic diet for 10-12 weeks can improve acne symptoms and reduce the need for acne medications.
Low-glycemic diets emphasize foods that cause slower rises in blood glucose and reduce insulin spikes. These foods include:
- Lean proteins
- Eggs
- Healthy fats
- Non-starchy vegetables
- Whole grains
- Legumes
- Nuts and seeds
Omega-3 Fatty Acids
Omega-3 fatty acids can inhibit the production of proinflammatory molecules and lower IGF-1 levels (31).
A study that included over 1,000 teenagers showed that those who consumed large amounts of fish and seafood (rich in omega-3s) had fewer blackheads, papules, and pustules and less oily skin (31).
Other foods rich in omega-3 fatty acids include:
- Flaxseeds
- Chia seeds
- Hemp seeds
- Walnuts
Antioxidant-Rich Foods
Antioxidants are substances that help combat oxidative stress by neutralizing free radicals. Free radicals are unstable molecules that can damage cells and contribute to inflammation and aging. This oxidative damage is particularly harmful to the skin, as it can lead to premature aging, inflammation, and various skin conditions.
Patients with acne have been found to have lower plasma concentrations of antioxidants compared to those without (18).
Antioxidant nutrients include:
- Vitamin C: found in citrus fruits, strawberries, and bell peppers
- Vitamin E: found in nuts, seeds, and green leafy vegetables
- Beta-carotene: a precursor to vitamin A found in carrots, sweet potatoes, and spinach
- Selenium: found in Brazil nuts, seafood, and whole grains
Hydration and Skin Health
Proper hydration helps the skin retain moisture and prevent dryness that can lead to increased oil production and clogged pores. When the skin is well-hydrated, it can effectively flush out toxins and bacteria, reducing the likelihood of breakouts.
Staying well hydrated improves skin physiology and function, supports gut health, and regulates blood sugar levels.
Drinks that contain high amounts of sugar, caffeine, or alcohol can dehydrate you because they act as diuretics and remove water from your body (26). Instead, focus on hydrating your body with water or unsweetened herbal teas, like green tea, which offers additional antioxidant benefits.
Supplements for Acne-Prone Skin
Consider incorporating the following supplements into your daily healthcare routine, as each offers unique benefits for optimizing skin health. However, it's important to consult your doctor before starting any new supplement. They can recommend specific formulas and doses based on lab results that indicate what your body may need most.
- A systematic review indicated that patients with acne often have lower serum zinc levels, and supplemental zinc could decrease the number of inflammatory acne lesions.
- Individuals with acne often have lower levels of vitamin D. Clinical trials show that supplementing vitamin D improves acne symptoms.
- Probiotics are beneficial bacteria that can positively influence gut and skin health through the gut-skin axis. Research indicates that an imbalance in gut microbiota may exacerbate acne and that probiotic supplementation can help restore this balance and reduce acne lesions.
Building a Balanced Meal Plan for Acne-Prone Skin
Making changes to your diet can feel overwhelming. A helpful first step is keeping a diet-symptom diary to identify foods that may contribute to breakouts. By tracking your dietary intake alongside acne flare-ups, you can better understand and manage individual triggers, making it easier to know which foods to limit.
Consistency is key when it comes to dietary changes for skin health. Gradual adjustments to your diet are more sustainable and effective over time. Be patient, as it can take several months to observe fewer acne breakouts.
Building a balanced meal plan involves focusing on whole, unprocessed foods while limiting known acne triggers. Here are some meal ideas that focus on nutrient-dense foods beneficial for acne-prone skin:
- Breakfast: Scrambled eggs and chia seed pudding topped with fresh berries and a handful of nuts
- Lunch: A quinoa salad with arugula, cherry tomatoes, cucumbers, avocado, and a drizzle of olive oil topped with grilled chicken breast
- Dinner: Baked salmon served with steamed vegetables and wild rice
Common Diet Myths About Acne
The belief that chocolate causes acne has persisted for years, but scientific evidence does not fully support this claim. While some studies suggest a correlation between chocolate consumption and acne flare-ups, others have found no such link. The results are likely influenced by other ingredients in chocolate, such as sugar and dairy, which have more substantial evidence connecting them to acne.
Another common myth is that avoiding all fats will improve acne. However, research does not support the idea that eating greasy foods causes acne. Oily skin is caused by overactive sebaceous glands, not dietary fats.
However, the Standard American Diet typically contains a higher ratio of omega-6 to omega-3 fatty acids, which can promote inflammation. To reduce inflammation, replace omega-6 fatty acids, commonly found in processed foods and vegetable oils, with omega-3s.
When to Consult a Healthcare Provider
It's time to schedule an appointment with your dermatologist for your acne if:
- Over-the-counter treatments and dietary changes fail to produce noticeable improvements in acne
- Your acne is severe, painful, or leading to scarring
- You feel emotionally distressed because of your acne
Not only is it helpful to have an integrative dermatologist on your side, but collaborating with a nutritionist can help tailor your diet to your specific needs. Together, a dermatologist and nutritionist can create a comprehensive plan that integrates dietary and skincare strategies, offering a more holistic approach to managing and improving acne.
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Key Takeaways
- Making dietary changes can play an important role in managing acne-prone skin.
- Reducing high-glycemic foods, dairy, and processed foods while increasing intake of omega-3-rich foods and antioxidant-packed fruits and vegetables can all contribute to healthier skin.
- Individual responses to foods vary, so what works for one person may not work for another.
- While diet is a valuable component of acne management, it is just one piece of the puzzle. A comprehensive approach should also include good skincare practices, regular exercise, stress management, and proper hydration.
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