Thursday, June 13, 2024
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Zits and What You Eat: Does Diet Cause Severe Acne?

Particular foods have historically been implicated in the development of severe acne.  But is there a valid correlation between the type of diet and the development of acne in adults?

Acne is caused by an inflammation of the hair follicles and oil-producing glands, which are in greater distribution along the face, neck, and back areas. Numerous factors influence its development and severity, but what is most commonly implicated in acne development is an excess of oil or sebum production.  In the teenage years, this increase in sebum is attributed to the surges in the production of the sex hormone androgen.  What we have now found is that other mediators like insulin can also influence the production of sebum and that insulin resistance is significantly present in patients with severe acne.

Moderate to severe acne (termed acne vulgaris) usually resolves during and after the onset of puberty, but it can still appear and persist well into adulthood.  There has been a recent increase in the incidence of acne vulgaris among adults—and as hormonal levels usually normalize in adulthood, are there other factors that are causing this upsurge?

Eating particular foodstuffs have long been attached to acne; oily food and chocolate are notorious examples of this pervasive belief.  In truth, no specific food has been scientifically proven to directly cause acne formation. However, with the increase in the incidence of adult acne, along with the current prevalence of unhealthy dietary options, is there indeed a relationship between acne and diet? A recent study published in the Journal of the Academy of Nutrition and Dietetics sought to find the answer.

Researchers conducted a cross-sectional study in which 64 participants were evaluated for the presence and severity of adult acne. These same subjects completed a record of what they ate over a period of five days. Samples were drawn to determine corresponding blood levels of glucose, insulin, and other biological markers known to affect sebum production.  A questionnaire was also given to assess beliefs on food and acne development, and the effect of acne on quality of life.

They found that participants in the study who presented with moderate to severe acne consumed greater amounts of carbohydrates compared to those who presented with no acne. Similarly, their blood levels of glucose, insulin, and insulin-like growth factors were significantly higher than the low acne group. The answers to the questionnaire revealed that the majority of those in the study also believe in the influence of food on acne development and severity and that acne indeed negatively impacts the quality of life.

While there is a correlation between acne and amount of carbohydrates consumed, it still does not establish a direct causality between diet and acne. More studies must be undertaken to fully assess this possible relationship, as there are numerous other factors (genetics, existing disease conditions, etc.) that must also be taken into consideration.  Further investigations are required to determine if dietary modification or nutritional therapy have roles in acne treatment. But right now, what we can say is that in terms of diet, acne may not just be a function of quality (what we eat) but also of quantity (how much we eat). Literally, this is food for thought before reaching for that next chocolate bar.

Written by Jay Martin, M.D.


Burris, et al. “Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne”.  Journal of the Academy of Nutrition and Dietetics.  2017: 2212-2672.

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