I want to stress that diet ALONE does NOT cause acne. We cannot blame our acne solely on our diet. Acne has several factors at play simultaneously including genetic and hormonal factors. But the evidence does tell us that diet can have an influence on acne severity.

The most support today is seen with what’s called a diet’s glycemic index or glycemic load (GI/GL). A high GI diet is defined by a high intake of carbohydrates or sugar-dense foods that are quickly absorbed from the GI tract. These foods produce large spikes in blood sugar and insulin levels and can worsen acne. Additionally, switching to a low carb and high protein diet for 10-12 weeks decreases acne severity as well as oil glands in the skin.(3,4)  So starting with a low sugar diet is the first place to start.

The other dietary component that has a link with acne is milk, but it hasn’t been studied as extensively as GI/GL diets.(2) Specifically the whole fat, low fat and skim milks have been associated with worse acne but cheese and yogurt don’t seem to have this effect. Teasing out these details is going to take more investigation.

So is there good news? Yes! Despite early reports of a connection, chocolate (without any added sugar or milk) does NOT appear to worsen acne.  But the “superfoods,” including coconut oil, avocado, kiwis, etc., may bring other health benefits but do not appear to have any effect acne.

So if someone with mild-moderate acne is looking to improve his or her skin, seeing a nutritionist for advice on a low carb diet and limiting milk is an option. It may not resolve the acne completely but it can certainly help.

References:
1. Khanna, R., Shifrin, N., Nektalova, T. & Goldenberg, G. Diet and Dermatology: Google Search Results for Acne, Psoriasis and Eczema. Cutis 102, 44–48 (2018).
2. Matsui, M. Update on Diet and Acne. Cutis 140, (2019).
3. Smith, R. N., Mann, N. J., Braue, A., Mäkeläinen, H., et al. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: A randomized, investigator-masked, controlled trial. J. Am. Acad. Dermatol. 57, 247–256 (2007).
4. Kwon, H. H., Yoon, J. Y., Hong, J. S., Jung, J., et al. Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: A randomized, controlled trial. Acta Derm. Venereol. 92, 241–246 (2012).