Acne is a common skin condition that affects nearly 10% of the world’s population (1).
Many factors contribute to the development of acne, including sebum and keratin production, acne-causing bacteria, hormones, blocked pores and inflammation (2).
The link between diet and acne has been controversial, but recent research shows that diet can play a significant role in acne development (3).
This article will review 7 foods that can cause acne and discuss why the quality of your diet is important.
Foods rich in refined carbohydrates include:
- Bread, crackers, cereal or desserts made with white flour
- Pasta made with white flour
- White rice and rice noodles
- Sodas and other sugar-sweetened beverages
- Sweeteners like cane sugar, maple syrup, honey or agave
One study found that people who frequently consumed added sugars had a 30% greater risk of developing acne, while those who regularly ate pastries and cakes had a 20% greater risk (6).
This increased risk may be explained by the effects refined carbohydrates have on blood sugar and insulin levels.
Refined carbohydrates are absorbed quickly into the bloodstream, which rapidly raises blood sugar levels. When blood sugars rise, insulin levels also rise to help shuttle the blood sugars out of the bloodstream and into your cells.
However, high levels of insulin are not good for those with acne.
Insulin makes androgen hormones more active and increases insulin-like growth factor 1 (IGF-1). This contributes to acne development by making skin cells grow more quickly and by boosting sebum production (7, 8, 9).
While the research on this topic is promising, more is needed to further understand how refined carbohydrates contribute to acne.
Summary Eating lots of refined carbohydrates may increase blood sugar and insulin levels and contribute to the development of acne. However, more research is needed.
However, the studies conducted so far have not been high-quality.
The research to date has focused mainly on teenagers and young adults and has only shown a correlation between milk and acne, not a cause and effect relationship.
It is not yet clear how milk may contribute to the formation of acne, but there are several proposed theories.
Although there is speculation on why drinking milk may worsen acne, it is unclear whether dairy plays a direct role. More research is needed to determine if there is a specific amount or type of dairy that may aggravate acne.
Summary Frequently consuming dairy products is linked to increased acne severity, but it is uncertain whether there is a cause and effect relationship.
Fast food items, such as burgers, nuggets, hot dogs, french fries, sodas and milkshakes, are mainstays of a typical Western diet and may increase acne risk.
One study of over 5,000 Chinese teenagers and young adults found that high-fat diets were associated with a 43% increased risk of developing acne. Regularly eating fast food increased the risk by 17% (27).
A separate study of 2,300 Turkish men found that frequently eating burgers or sausages was linked to a 24% increased risk of developing acne (6).
It is unclear why eating fast food may increase the risk of developing acne, but some researchers propose that it may affect gene expression and alter hormone levels in a way that promotes acne development (28, 29, 30).
However, it is important to note that most of the research on fast food and acne has used self-reported data. This type of research only shows patterns of dietary habits and acne risk and does not prove that fast food causes acne. Thus, more research is needed.
Summary Regularly eating fast food has been correlated with an increased risk of developing acne, but it is not clear whether it causes acne.
While the links between omega-6 fatty acids and acne are promising, there have been no randomized controlled studies on this topic, and more research is needed.
Summary Diets rich in omega-6 fatty acids and low in omega-3s are pro-inflammatory and may worsen acne, though more research is needed.
Chocolate has been a suspected acne trigger since the 1920s, but so far, no consensus has been reached (37).
A more recent study found that acne-prone males who consumed 25 grams of 99% dark chocolate daily had an increased number of acne lesions after just two weeks (40).
Another study found that males who were given capsules of 100% cocoa powder daily had significantly more acne lesions after one week compared to those given a placebo (41).
Exactly why chocolate might increase acne is unclear, although one study found that eating chocolate increased the reactivity of the immune system to acne-causing bacteria, which may help explain these findings (42).
While recent research supports a link between chocolate consumption and acne, it remains unclear whether chocolate actually causes acne.
Summary Emerging research supports a link between eating chocolate and developing acne, but the reasons why and strength of the relationship remain unclear.
Another study found a direct correlation between acne severity and the number of days on whey protein supplements (53).
These studies support a link between whey protein and acne, but much more research is needed to determine whether whey protein causes acne.
Summary A small amount of data suggests a link between taking whey protein powder and developing acne, but more high-quality research is needed.
This is supported by the fact that anti-inflammatory drugs, like corticosteroids, are effective treatments for severe acne and that people with acne have elevated levels of inflammatory molecules in their blood (56, 57, 58).
One way that food may contribute to inflammation is through food sensitivities, also known as delayed hypersensitivity reactions (59).
Food sensitivities occur when your immune system mistakenly identifies food as a threat and launches an immune attack against it (60).
This results in high levels of pro-inflammatory molecules circulating throughout the body, which may aggravate acne (61).
Since there are countless foods that your immune system could react to, the best way to figure out your unique triggers is by completing an elimination diet under the supervision of a registered dietitian or nutrition specialist.
Elimination diets work by temporarily restricting the number of foods in your diet in order to eliminate triggers and achieve symptom relief, then systematically adding foods back while tracking your symptoms and looking for patterns.
Food sensitivity testing, such as Mediator Release Testing (MRT), can help determine which foods lead to immune-related inflammation and provide a clearer starting point for your elimination diet (62).
While there appears to be a link between inflammation and acne, no studies have directly investigated the specific role of food sensitivities in its development.
This remains a promising area of research to help better understand how food, the immune system and inflammation affect acne development (63).
Summary Food sensitivity reactions can increase the amount of inflammation in the body, which theoretically may worsen acne. However, no studies to date have been conducted on the topic.
While the foods discussed above may contribute to the development of acne, there are other foods and nutrients that may help keep your skin clear. These include:
- Omega-3 fatty acids: Omega-3s are anti-inflammatory, and regular consumption has been linked to a reduced risk of developing acne (64, 65, 66).
- Probiotics: Probiotics promote a healthy gut and balanced microbiome, which is linked to reduced inflammation and a lower risk of acne development (67, 68, 69, 70).
- Green tea: Green tea contains polyphenols that are associated with reduced inflammation and lowered sebum production. Green tea extracts have been found to reduce acne severity when applied to the skin (71, 72, 73, 74).
- Turmeric: Turmeric contains the anti-inflammatory polyphenol curcumin, which can help regulate blood sugar, improve insulin sensitivity and inhibit the growth of acne-causing bacteria, which may reduce acne (75, 76).
- Vitamins A, D, E and zinc: These nutrients play crucial roles in skin and immune health and may help prevent acne (77, 78, 79).
- Paleolithic-style diets: Paleo diets are rich in lean meats, fruits, vegetables and nuts and low in grains, dairy and legumes. They have been associated with lower blood sugar and insulin levels (80).
- Mediterranean-style diets: A Mediterranean diet is rich in fruits, vegetables, whole grain, legumes, fish and olive oil and low in dairy and saturated fats. It has also been linked to reduced acne severity (81).
Summary Consuming a diet rich in omega-3 fatty acids, probiotics, green tea, fruits and vegetables may be protective against the development of acne. Vitamins A, D and E, as well as zinc, may also help prevent acne.
While research has linked certain foods to an increased risk of developing acne, it is important to keep the bigger picture in mind.
Overall dietary patterns are likely to have a larger impact on skin health than eating — or not eating — any one particular food.
It is probably not necessary to completely avoid all the foods that have been linked to acne but rather consume them in balance with the other nutrient-dense foods discussed above.
The research on diet and acne is not strong enough to make specific dietary recommendations at this time, but future research is promising.
In the meantime, it may be beneficial to keep a food log to look for patterns between the foods you are eating and the health of your skin.
You can also work with a registered dietitian for more personalized advice.