Introduction
Acne is a commonly occurring skin condition that affects most people at some point in their lives. The disorder is mostly associated with puberty and is very common in teenagers. However, it can affect people of all ages. Acne can be defined as a skin condition resulting from hair follicles beneath the skin getting clogged.1
There are many factors affecting acne, with one of them being diet, which can impact skin health and therefore contribute to the development and management of acne. The typical Western diet, containing lots of dairy and high glycaemic index (GI) foods, can affect hormone levels – linked to acne formation. This article will describe what acne is, how it is caused, the connection between diet and acne and ways to manage acne.
Understanding acne
Acne is an often-occurring skin condition that is caused by clogged hair follicles beneath the skin. Sebum, the oil that helps keep skin hydrated, and dead skin cells can both contribute to the blocking of the pores – leading to acne pimples.
The role of sebaceous glands and hair follicles in acne
The sebaceous glands in the skin, connected to the hair follicle, contain fine hair. Sebaceous glands produce sebum that empties onto the skin’s surface from the pore (follicle opening), in healthy skin. Follicles are lined by keratinocyte skin cells, which normally rise to the surface of the skin as the body sheds skin cells. Keratinocytes, sebum and hair clump together in acne, which stops keratinocytes from shedding and sebum from rising to the skin’s surface. This mix of oil and cells causes bacteria on the skin’s surface to clog the follicles, resulting in inflammation. Once the wall of the clogged follicle is broken down, bacteria, cells and sebum go into the neighbouring skin, resulting in the formation of acne pimples.
Importance of managing acne for skin health
It is important to treat acne as early as possible to ensure good skin health and reduce the likelihood of acne becoming severe or worsening. Treating acne as soon as possible will also prevent potential acne scarring.
The connection between diet and acne
Constant research is being conducted on acne; therefore, the understanding of what causes acne is ever-evolving. Many factors impact acne formation, including genetics, hormones, and the environment, with diet impacting all of the aforementioned factors.1,2
Certain foods are known to exacerbate acne as they can impact hormone levels, resulting in the worsening of acne. These include foods with large sugar contents, which can cause a rise in insulin and change other hormones that can affect the skin.
Worst foods for acne
Some foods can exacerbate acne; these include
- Sugary foods and carbohydrates–These foods can increase the body’s insulin levels, leading to an overproduction of sebum and, hence, acne breakouts
- Dairy–There is limited research regarding the link between dairy and acne. However, some research suggests that dairy can increase insulin levels, resulting in acne.
- Fast foods–These foods are generally bad for health, as they are calorific, high in fat, sugars and carbohydrates, and therefore likely to lead to acne.
High glycaemic index (GI) foods
The glycaemic index (GI) is used to rate the carbohydrate food group, showing how they affect blood sugar when eaten in isolation. There is a link between high-GI foods and acne production.4.6
- Insulin–The body raises sugar levels when high-GI foods are consumed. The pancreas secretes insulin to regulate these levels. Insulin plays a role in cell growth, including skin cell growth and sebum (skin oil) production.
- Increased sebum–Increased insulin can stimulate sebaceous glands and sebum production, which can lead to clogged pores and, therefore, acne
- Inflammation–High GI foods also increase inflammation in the body, a known cause of acne. High blood sugar levels can release pro-inflammatory chemicals and further aggravate skin problems
- Hormone fluctuations–High GI diets can cause hormone fluctuations, which can play a part in acne development, stimulating sebaceous glands and oil production
Foods that are swiftly broken down in the body and cause an increase in blood sugar glucose have a large GI rating. Examples of these foods include:
- Sugary foods
- White rice
- White bread
- Soft drinks
The potential link between dairy and acne
Dairy products can lead to inflammation within the body leading to clogged pores. As previously mentioned, more research needs to be conducted on why dairy leads to acne. There’s lots of anecdotal evidence, but minimal clinical evidence supporting claims that dairy exacerbates acne.
The British Association of Dermatologists states there is “some evidence that consuming milk and dairy products may trigger acne in some people, but this hasn’t been studied in as much detail yet”. For this reason, it is s not recommended acne sufferers remove dairy from their diet.6
The role of sugar and sugary foods in acne development
High GI and sugary foods create inflammation in the body. These foods spike insulin levels, causing further inflammation. Large insulin spikes will increase skin oil production, leading to follicle clogging and, therefore, acne.
Examples of sugary foods and beverages to minimise in the diet and to improve skin quality include:
- Chocolate
- Ice cream
- Sugary drinks
The role of processed and fried foods in acne development
There are various reasons why processed and fried foods worsen acne. These foods are commonly high in trans fats and refined carbohydrates, which cause inflammation and increased sebum. These processed foods also have a high GI index and increase blood sugar levels and insulin production.
Examples of these foods include:
- Processed meats
- Processed cereals
- Chips
- Doughnuts
- Onion rings
Food allergens
The connection between food allergies and acne is still being researched, and the relationship can be complex and person-specific. Currently, there isn’t an established link to how food allergies cause acne, however, some people experience acne-like symptoms due to the inflammatory response caused by allergenic foods.7,8
Potential allergenic foods to watch out for:
- Dairy– Dairy allergies, whilst common in children, can affect people of any age and can cause skin reactions such as acne-like symptoms like pimples.
- Gluten–Those with gluten sensitivities can experience skin issues
- Iodine–Seafood, iodised salt and other iodine-rich foods can trigger acne-like symptoms in some people. Iodine can stimulate the skin’s oil glands and increase sebum production, causing clogged pores and acne.
The importance of nutrient-rich foods
A balanced diet containing nutrient-rich foods can be beneficial for acne-prone skin in various ways:5
- Reduced inflammation–Antioxidant and nutrient-rich foods can lower inflammation for clearer skin.
- Hormonal balance–Nutrient-rich diets can aid in maintaining a good hormonal balance, which is crucial for acne management.3 Zinc, vitamin A and omega-3 fatty acids regulate hormones, reducing acne outbreaks
- Healing–Highly nutritious foods provide the body with the necessary vitamins and minerals for efficient wound healing, ensuring acne lesions heal faster
Acne-friendly foods
- Fruits and Vegetables–These foods are rich in vitamins, minerals and antioxidants
- Oily fish–Salmon, mackerel and sardines are good sources of omega-3 fatty acids, with antioxidant properties and can aid skin health
- Nuts and seeds–Almonds, walnuts, flax seeds and chia seeds provide healthy fats, fibre and essential nutrients for the skin
- Lean protein–Skin-boosting proteins, such as lean meat, poultry, tofu and legumes. Protein supports skin tissue repair and collagen production
- Whole grains–Whole grains like quinoa, brown rice and oats are a better choice than refined grains. They provide fibre, have a low GI, and can help stabilise blood sugar levels
- Probiotic foods–Yogurt, kefir, sauerkraut, and kimchi are examples of probiotic-rich foods that support gut health
The role of hydration in skin health
Hydration is very important for people with acne:
- Moisture balance–Good hydration helps maintain skin moisture balance. Dry skin can cause discomfort and can aggravate acne
- Detoxification–Water helps flush toxins from the body, resulting in clear, healthy skin
- Wound Healing–Hydrated skin heals better, reducing acne and the likelihood of scarring
Summary
This review discusses some foods that exacerbate the risk of acne. Whilst hormones and genetics play a role in developing and managing acne, dietary decisions can also impact skin health. A well-balanced diet containing nutrient-dense foods can lead to healthier skin, reduction in inflammation, balancing hormones and overall better skin functionality.
Every individual’s skin is different, and therefore, what helps one person’s skin may not work for another’s. If you have acne concerns or believe dietary factors are creating skin concerns, a health professional or dermatologist should be consulted. These specialists can recommend dietary changes and suggest specific acne treatments.
Acne management requires a holistic approach that includes various factors, such as diet, genetics, and lifestyle. With a professional, a comprehensive plan to achieve and maintain healthier skin is specific to an individual’s circumstances.
References
- Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD International [Internet]. 2022 [cited 2024 Mar 12]; 7:95–112. Available from: https://www.sciencedirect.com/science/article/pii/S2666328722000281
- Pappas A. The relationship of diet and acne. Dermatoendocrinol [Internet]. 2009 [cited 2024 Mar 12]; 1(5):262–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/
- Podgórska A, Puścion-Jakubik A, Markiewicz-Żukowska R, Gromkowska-Kępka KJ, Socha K. Acne Vulgaris and Intake of Selected Dietary Nutrients—A Summary of Information. Healthcare (Basel) [Internet]. 2021 [cited 2024 Mar 13]; 9(6):668. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226785/.
- Penso L, Touvier M, Deschasaux M, Szabo de edelenyi F, Hercberg S, Ezzedine K, et al. Association Between Adult Acne and Dietary Behaviors: Findings From the NutriNet-Santé Prospective Cohort Study. JAMA Dermatology [Internet]. 2020 [cited 2024 Mar 13]; 156(8):854–62. Available from: https://doi.org/10.1001/jamadermatol.2020.1602.
- Baldwin H, Tan J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol [Internet]. 2021 [cited 2024 Mar 13]; 22(1):55–65. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847434/.
- Dall’Oglio F, Nasca MR, Fiorentini F, Micali G. Diet and acne: review of the evidence from 2009 to 2020. Int J Dermatology [Internet]. 2021 [cited 2024 Mar 13]; 60(6):672–85. Available from: https://onlinelibrary.wiley.com/doi/10.1111/ijd.15390.
- Barilo AA, Smirnova SV. [Food allergy as a risk factor for acne]. Vopr Pitan. 2022; 91(6):68–75.
- Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Postepy Dermatol Alergol [Internet]. 2016 [cited 2024 Mar 13]; 33(2):81–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884775/.