• PocketDerm is now Curology! Read the blog post from our CEO to learn more.

The conversation about diet and acne has been going on for years. Our friends tell us that chocolate and greasy foods can cause breakouts - and now there is scientific evidence telling us that (in some cases) they were right: Food can cause acne.

Big Offender #1 - Simple Carbs

Carbohydrates are fuels that our bodies use to make energy. But not all carbohydrates are created equal.

The glycemic index is a scale that classifies foods based on the effect they have on a person’s blood sugar (called glucose). You can think of carbohydrates as falling in two broad categories:

1. High glycemic index carbs, such as white bread, white rice, corn flakes, cake, cookies, pretzels, bagels, and most desserts.

2. Low glycemic index carbs, such as whole grain bread, veggies, seeds, legumes, hummus, and other high-fiber, unprocessed foods.

By definition, foods which rank high on the glycemic index increase blood glucose levels. To counteract this spike, our bodies produce more of a hormone called insulin, which helps our bodies to absorb the extra glucose from our blood. Studies show that insulin causes inflammation in the skin and may trigger breakouts.

So high glycemic index carbs can trigger acne, in addition to the other health risks they pose such as obesity, diabetes and heart disease.

Big Offender #2 - Dairy

Milk contains precursors to testosterone and other hormones, which can signal the receptors in our skin to produce more oil and thus produce more acne.

Skim milk is more likely to cause breakouts than whole milk, and this could be due to differences in hormone content or differences in hormone absorption. Those who consume at least three servings per week appear to be most affected. It is possible that cheese and yogurt may be associated with acne, but milk appears to be the worst offender.

If you are an athlete taking protein powder supplements, you may consider avoiding whey, casein, caseinates, and milk solids. These can have similar effects on the skin to as drinking too much milk.

Not everyone breaks out because of dairy. But if you think you might and you wish to cut back, you should make sure to get your calcium and vitamin D from elsewhere. Plain or unsweetened soy beverages may be substituted for milk. Non-dairy calcium-rich foods include:

• Tofu
• Soy beans;
• Some fish (like canned salmon with the bones, sardines, perch, and rainbow trout);
• Greens (such as spinach, kale, okra and collards);
• White beans; and
• Foods that are calcium-fortified, such as some orange juice, and oatmeal.

Remember: If you wish to remove dairy from your diet, be patient. It may take a full 6 months before you see improvement in your skin.

What about greasy foods and chocolate?

Many believe that greasy foods and chocolate can cause breakouts, and I’ve had some patients notice a correlation. But the scientific evidence isn’t as clear as for the offenders mentioned above.

The relationship between chocolate and acne is currently being studied again (we will keep you posted on the results). But my advice for now is to enjoy that chocolate! Just make sure it's dark chocolate, which boasts more antioxidants and a lower glycemic index.

Conclusion

Do your very best to avoid simple carbs - they can be bad for your skin, and for your waistline as well. For some great recipes that avoid simple carbs, check out here and here.

Dairy is the other part of our diet that seems to cause breakouts in many people. Evaluate for yourself what seems to affect your skin, and let me know if there is another food that makes you break out!

Photo credit: mindfrieze

Nancy Satur, MD, FAAD

Dr. Nancy Satur is a board-certified dermatologist and co-founder of PocketDerm, which enables patients to see a dermatologist online for comprehensive acne treatment. Dr. Satur received her medical degree from Jefferson Medical College, completed her residency at Case Western Reserve University, and is currently based in San Diego, CA. LinkedIn.