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  • Rajani Katta MD

Foods that make acne worse: more than just chocolate and fried greasy foods

Updated: Aug 16, 2020

Foods with refined carbohydrates and added sugars can lead to rapid rises in blood sugar, which may worsen acne in some people

Can certain foods cause acne? That's a straightforward question. And it's the exact question we asked our patients.

We surveyed these patients about their beliefs regarding the link between diet and acne. The overwhelming response was that yes, patients believed that certain foods could trigger acne (that's what 92% of respondents believed). What foods were believed to be potential culprits? In this study, 71% of patients identified fried, greasy foods as a trigger, while 53% identified chocolate as a trigger. Only 16% identified sugar as a trigger. And yet sugar, and other foods that cause a rapid rise in blood sugar, are the most likely potential triggers for acne. The field of dermatology is now working to get the word out about the link between diet and acne, and specifically the research linking a high-glycemic-load diet to acne. But if you had asked your dermatologist 20 years ago about this issue, you would have received a different answer. When I was in training, over 20 years ago, we were trained to respond to this question by saying no. " No, research has not been able to identify a link between diet and acne." How did we get it so wrong? In the 1960s a series of small studies impacted the beliefs of dermatologists for decades. One of the largest studies involved 65 patients. These patients were given either a chocolate bar or a placebo bar. At the end of 4 weeks, researchers counted acne lesions, and found that the two groups had the same degree of acne.

Based on studies such as this one, patients were told for decades that diet did not impact acne.

In the last 10-15 years, a number of research studies have shown us how wrong we were. First, researchers went back and looked at the original studies again. This time, they noted several major problems with study design.

To start with, 4 weeks just isn't a long enough time to measure treatment response in acne patients. (Many treatments can take up to 8 weeks before you see improvement.) Second, they were comparing a chocolate bar with a bar that was high in sugar and saturated fats. The researchers, in essence, were comparing 2 high-sugar bars.

There's now strong evidence that foods with a high glycemic load can make certain people more prone to acne. (Foods with a high glycemic load are those that trigger a rapid rise in blood sugar.)

Researchers in more recent years have approached this question from a different angle. In one well-done study, patients were asked to follow either a low-glycemic-load diet or a high-glycemic-load diet for 12 weeks. The patients who followed the low-glycemic diet, in which they ate food that limited a rise in blood sugar levels, had a significant improvement in their acne severity. These results have now been replicated by a number of researchers. It turns out it wasn't the chocolate in the chocolate bars – it was likely the sugar in the chocolate bars. And any other food that would lead to rapid elevations of blood sugar levels is equally suspect, such as sodas, cookies, and even white bread, white pasta, and white rice.

This is one of the reasons I emphasize the link between blood sugar and the skin.

When I talk about a healthy skin diet, one of the cornerstones is Rule #2: Stop Sugar Spikes. We know that the frequent spikes in blood sugar that result from a diet high in added sugar or refined carbohydrates can wreak havoc on our health.

Studies have found that these sugar spikes can also lead to collagen damage, which promotes wrinkling and aging of the skin.

These sugar spikes also appear to play a role in promoting acne in certain individuals. While the cause of acne is definitely multi-factorial (meaning that multiple factors, such as hormones and genetics, play a role), diet appears to play a role in some people. Therefore, if you're seeking treatment for acne, it's certainly worth changing your diet for 12 weeks also. Especially as these recommendations are good for overall health as well.

There are other potential acne triggers, such as dairy. Although the research isn't clear, I believe that in some individuals (certainly not all), dairy may act as a trigger. There's even research suggesting that the antioxidants found in certain foods may be helpful. For more information on further dietary recommendations for patients with acne, please see this link.

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Dr. Rajani Katta is the author of Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet. To receive future updates on preventive dermatology and the role of diet, sign up here.

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