DIET AND ACNE
THE ACNE DETOX: IS IT WORTH TRYING TO CHANGE MY DIET TO HELP MY ACNE?
This is the question I heard from almost every single acne patient that I treated over the years. Does my diet have anything to do with my acne?
When I was in dermatology training 20 years ago, my professors all answered this question the same way. "The research studies that have been done have never found a link between diet and acne."
When I was in practice, I repeated this same answer to my patients (with the caveat that if you found a particular food that you thought was a trigger, you should avoid that food.)
It turns out we were wrong. Research has now shown that certain foods may act as an acne trigger in some persons.
Research has now shown that certain foods, in some people, may trigger acne
Researchers went back and looked at the original studies. In one of the largest studies, performed in the 1960s, researchers studied 65 individuals. Half the group was given chocolate bars, while the other half received bars without chocolate. After 4 weeks, they compared the two groups to see if there was a difference in acne. There wasn't. The researchers concluded the chocolate did not have any effect on acne, and this and other studies then permeated our recommendations for the next several decades.
What did they get wrong? The comparison group didn't have chocolate in their bars, but they did have sugar and trans fats.
Research now points to sugar as a major potential culprit. Multiple studies have now found that diets with a high glycemic load can trigger acne in certain persons.
Is this the case for everybody? Definitely not. Some people have a genetic tendency towards acne, and teenagers are especially susceptible because of hormonal changes
However, diet may play a role in some people. In one study, acne patients were put on a low glycemic load diet and compared to a control group that ate a high glycemic load diet. (A high glycemic load diet is one that leads to spikes in blood sugar.) After 12 weeks, the acne patients on a low glycemic load diet showed significant improvement in their acne. Other studies have biopsied the skin of acne patients after a low glycemic diet. They've found less inflammation and shrunken oil glands.
What about dairy? The evidence is less strong for milk and dairy products serving as an acne trigger, but in some individuals, they may be a trigger. Even milk that comes from cows never treated with growth hormone can be a trigger. The theory is that since milk is used to help baby cows grow, it naturally contains many hormones, and these may contribute to the development of acne.
There was also a recent report of 5 teenagers who developed moderate to severe acne after starting whey protein supplements. None had responded to acne treatment with antibiotics by mouth and topical medications. What finally cleared their skin? In 4 of these patients, their acne completely cleared after stopping the whey protein. [Link to study]
What about foods that fight inflammation? There's been a suggestion that foods that fight inflammation may be helpful in improving acne, such as antioxidants in fruits and vegetables, and omega-3 fatty acids in fish. There's less evidence for this, but given all the health benefits of these anti-inflammatory foods, I recommend them.
How does this translate into an acne detox diet?
1. There's strong evidence that foods that spike blood sugar may promote acne in some people.
2. It's worth a try to eat less sugar over the next 8 weeks. Less soda and fewer cookies, cupcakes, and candy bars. Also be careful about less obvious sources of sugar, like your breakfast cereal.
3. Also cut down on other foods that can spike your blood sugar. This means refined carbohydrates like white bread, white pasta, and crackers. The carbohydrates in these foods are broken down quickly in your system, which translates to blood sugar spikes.
4. If you're taking whey protein powder as a nutritional supplement, it's worth a try to stop for 8 weeks.
5. Milk and dairy products may be an acne trigger in some people, but may have no effect in others. If you're going to drink milk, I recommend organic milk and dairy products that haven't been treated with bovine growth hormone.
6. As you can see just by looking at skin with acne, there's a lot of inflammation involved. Will anti-inflammatory foods help? We don't know for sure, but preliminary research is promising. Most fruits and vegetables in their natural form are anti-inflammatory. While they're high in vitamins and minerals, they also contain fiber and many phytonutrients, substances in plants that are being studied for their disease fighting power. So go ahead and eat more clementines. And apples and grapes and frozen cherries. Have a salad with your dinner and double up on your veggies.
Will this acne detox work? There's no way to know for sure, since every case is different, but while you're taking your acne medications, it's definitely worth a try to change your diet at the same time.