The onset of this inflammatory skin condition commonly occurs around puberty or during young adulthood—with approximately 85% of cases seen between the ages of 12 and 24 years. However, acne can occur at any stage of life and recent data indicates acne in adults is on the rise.
Genetic predispositions and environmental factors are considered to have pivotal roles in the development of acne. Environmental factors implicated in the development and severity of acne include: cosmetics, tobacco use, stress, exposure to pollution, bacteria and hormones imbalances and dietary behavior.
While inconsistencies exist in the published literature regarding the relationship between diet and acne, the findings from a large-scale 2020 study published in The Journal of the American Medical Association Dermatology suggest certain dietary patterns are associated with acne development. In this study, the consumption of milk, sugary beverages, and fatty and sugary food products appeared to be associated with acne in adults.
A 2018 meta-analysis investigating the role of dairy concluded that dairy consumption increased the odds ratio for acne in individuals aged 7-30 years. Additional studies evaluating dairy showed drinking cow's milk may increase or worsen acne, but no link between acne breakouts and eating yogurt and cheese was seen. More research is needed to elucidate if, how and the degree to which milk may trigger acne. The dairy-acne relationship, explained on the AAD website, purports the hormones in milk may cause inflammation, which in turn, can cause an increased production of pore-clogging sebum. Both inflammation and excess sebum set the stage for acne flare ups.
Other acne studies show increased intakes of sugar and refined carbohydrates with a high glycemic index may trigger or exacerbate acne in many individuals. High glycemic load (HGL) diets tend to produce elevated insulin levels, which leads to a cascade of endocrine system responses that may raise the risk of acne development. Glycemic load is a measure that accounts for both the amount of carbohydrate in a portion of food along with the speed at which it raises blood sugar levels. Examples of foods and beverages that raise blood sugar quickly include: white bread, bagels, corn flakes, chips, white potatoes or fries, doughnuts, pastries, sugary drinks such as sodas and milkshakes, and white rice. Various other small studies showed following a low-glycemic diet consisting mainly of vegetables, fresh whole fruits, beans and whole grains to reduce acne incidence and severity.
Glycemic load may also be an important factor in the prevention of acne. Such evidence comes from previous studies examining two distinct societies with a complete absence of acne. Researchers concluded the absence was most likely a direct consequence of their diets. Both populations subsisted on low glycemic load diets with no Western influences or refined foods such as cereals, chips, cookies and bread. Additionally, a 2012 Italian study that found following a traditional Mediterranean diet also offered protection in the pathogenesis of acne. Adherence to the traditional characteristics of the Mediterranean diet was assessed by a 10-point Mediterranean diet scale. A Mediterranean diet score of ≥ 6 demonstrated significant protective factors.
Although the impact of diet on the course of acne remains a controversial subject, mounting research suggests the effect of dietary habits can no longer be overlooked. For many individuals, modifying environmental and lifestyle factors certainly can have a positive effect. Named the best overall dietary pattern to follow—the low-glycemic, Mediterranean-style diet may also be one of the safest approaches, or adjunct treatments, in the prevention and management of acne and other inflammatory conditions.
Looking to follow the Mediterranean diet? Here are some basics…
Mediterranean Diet Characteristics
(Eaten a few times per week)
(Eaten a few times per month)
-Beans & Legumes
-Nuts & seeds
Fish and shellfish provide important omega-3 fats that are anti-inflammatory and boost heart and brain health.
Meats are eaten on average only five times per month. Serving sizes are 3-4 ounces---or the size of a deck or cards.
Burris, J., et al. (2017). 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, 117(9), 1375-1383. doi:10.1016/j.jand.2017.03.024
Emiroğlu, N., et al (2015). Insulin resistance in severe acne vulgaris. Advances in Dermatology and Allergology, 4, 281-285. doi:10.5114/pdia.2015.53047
Juhl, C., et al. (2018). Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients, 10(8), 1049. doi:10.3390/nu10081049
Kucharska, A., et al. (2016). Significance of diet in treated and untreated acne vulgaris. Advances in Dermatology and Allergology, 2, 81-86. doi:10.5114/ada.2016.59146
Penso, L., MSc., et al. (2020). Association Between Adult Acne and Dietary Behaviors. JAMA Dermatology. doi:10.1001/jamadermatol.2020.1602
Skroza, N., et al. (2012). Mediterranean diet and familial dysmetabolism as factors influencing the development of acne. Scandinavian Journal of Public Health, 40(5), 466-474. doi:10.1177/1403494812454235
These materials are provided to you by Blythedale Children’s Hospital and Kohl’s
Eat Well, Be Well Nutrition Outreach Program.
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