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Today we feature a question from our awesome reader Michelle, submitted via the FutureDerm.com Facebook page:
I’ve been following your blog for a while, and I was wondering about your thoughts on how diet could be connected to acne. I’m 30 yrs old and have suffered with acne since before puberty. Over the past few years it has been a little bit better, but still an always present struggle…
Recently, I tried my first cleanse. It was a pretty serious cleanse. One month long. The entire month no gluten, no wheat, no dairy, little meat, no added sugar, nothing processed, no caffeine. Over that month I of course felt better and lost a few lbs, but what really excited me was that my face completely transformed.
On the cleanse my skin looked less red and blotchy. Also, my skin is constantly oily. Post cleanse though, this oil disappeared. Even late at night, no oil. And finally, by the end of the month, I barely had any blemishes on my face.
Now I’m trying to figure out, what exactly is influencing this huge change. …Do you have any thoughts about the results I’m seeing? Is there anything in the research literature which discusses this?
Thanks so much!
Wow, thanks for your great question! That’s one of my favorite aspects of running this blog – sometimes I think I must have the most intelligent, well-informed beauty blog readers in the world!
Across different cultures, there are numerous examples of how diet affects acne:
- The Inuit (in Alaska). Amongst Eskimos who consume a traditional diet, there is almost no acne. Those who start to consume a more “American” diet, with lots of fried foods and unrefined carbohydrates, start to break out.
- The Zulu (in Africa). Like the Eskimos, the Zulu only started to get acne after adopting a western diet.
- Rural Brazil. Brazilians in cities get acne at rates typical to the rest of the world. Yet a study of nearly 10,000 preteens and teenagers found acne in rural Brazilian communities at less than 3 percent. The likely reason? A diet rich in fruits, vegetables, nuts, wild game, and other foraged foods – and a lack of access to flash-fried, packaged, and overly-processed foods.
The source I referenced here is dermatologist Dr. Jessica Wu’s book, Feed Your Face, which I highly recommend to any FutureDerm readers who are interested in learning more about how nutrition affects the skin.
What about actual studies?
Overall, the evidence says to eat a diet with:
- Limited or no milk or dairy products;
- A low glycemic index;
- A low content of iodine.
The reasons for #1 and #2 are explained in this diagram:
If you are looking for specific studies, you’ve also come to the right place. When it comes to linking milk consumption and acne, there is arguably no better source than F. William Danby at the Harvard School of Public Health. Danby and his team studied more than 47,000 women, asked to complete questionnaires relating to their diet as teenagers and to say whether they had ever been diagnosed with severe acne. The study found no link between food such as chocolate and chips and acne, but found one between women who had acne and those who had drunk a lot of milk. Danby proposes this is due to the DHT (androgens) in the milk, which increase oil production (Journal of the American Academy of Dermatology, 2008).
There are far more studies that demonstrate the effect of foods with a high glycemic index on acne. In one particularly poignant study, people placed on a low glycemic index for 12 weeks experienced dramatic clearing of the skin – and lost three pounds on average (American Journal of Clinical Nutrition, 2007). It seems the elevated blood sugar-insulin-androgen link to acne really is that profound.
What about iodine?
Iodine is found in milk, egg yolks, kelp (seaweed), and, of course, iodized salt. Not everyone will break out after iodine exposure. Amongst those that do, iodine-related acne is identifiable because it causes severe eruptions of cystic acne (Archives of Dermatology, 1961).
My best advice to those with cystic acne is to write down everything you eat for a week, as well as the condition of your skin. See if you can notice a link within 24-48 hours of an eruption to milk, egg yolks, kelp (seaweed), or excess sodium.
If yes, you may very well want to limit iodine within your diet. However, do not cut out iodine completely – iodine deficiency causes both goiter and hypothyroidism, which is why salt is enriched with it in the first place.
So what do I eat to avoid acne?
- Foods low on the glycemic index, such as whole grains, beans, lentils, nuts, and most vegetables (full lists are available, such as in the book The Glycemic Load Diet or online at Healthy Weight Forum.org);
- Limited amounts of milk and dairy products;
- Foods rich in zinc, such as red meat and lentils (zinc may decrease acne);
- Lots of food with anti-inflammatory omega-3’s, such as fresh fish;
- Avoid candy, sugary breakfast cereals, baked goods, cookies, pastries, and the like.
For complete recipes, the best books I have found with anti-acne recipes are Today show nutritionist Dr. Joy Bauer’s Food Cures, and Dr. Jessica Wu’s Feed Your Face. As the link between nutrition and skin care grows stronger, I’m sure there will be even more great resources!
Does science say your diet affects acne? ABSOLUTELY. Thus far, “opting out” milk and low-glycemic index foods seems to be more important than “opting in” zinc and omega-3’s. However, for your clearest skin, both are important.
Hope this helps,
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