Acne is a common problem that many of us face at least at some point in our lifetime. Some of us are more likely to develop it because of genetics, which we can’t change. Other things can increase our risk of acne though, including our diet. Let’s talk more about what we can do to clear and prevent pimples!
ONE: We can avoid high sugar foods, or foods with high glycemic index.
Just briefly, to be high glycemic index means that when you eat the food, your body’s blood sugar level tends to rise more quickly, and you make more insulin, which is what helps your body pull the blood sugar into your cells. High glycemic foods include sugary sodas, chocolate (particularly milk, given it’s higher sugar content), processed carbohydrates like pretzels and French fries, cookies.
There are many studies looking at this, and the majority (> 70% in one meta-analysis, or a study looking at other studies out there) showed that eating high glycemic index foods correlated with worse acne.
Note that some of these studies were done in teenagers, more commonly males, so to some degree we may not be able to apply this conclusion to everyone.
Why would this be? If you’re interested, it looks like high GI foods tend to increase levels of a growth factor called IGF-1, which stimulates our bodies to make more sex hormones; with more hormones, our oil glands make more oil and the skin cells become sticker, more likely to result in plugged pores. High GI foods also stimulate a pro-inflammatory pathway that can result in pimples and pus bumps.
So what should we choose instead? And how quickly can we see results? In general, you want to pick foods that have a glycemic index <50. Good choices include:
- fruits like strawberries, blueberries, apples, and grapefruits
- Vegetables like cucumbers, tomatoes, bell peppers, greens
- Sprouted breads like Ezekial bread, steel cut oatmeal, brown rice
- Beans
- If you need something sweet, I’d choose dark chocolate, honey (over sugar)
- If you have a hankering for a fizzy sweet drink, kombucha would be a better choice; interestingly, there is at least one study that showed having kombucha compared to diet soda or sugary soda kept blood sugars lower than the latter.
You may start to see improvements as early as 2 weeks (polish study), though it may take up to 8-12 weeks.
Note that some fruits and veggies do tend to have higher glycemic indices compared to others, like bananas, watermelon, grapes, cooked carrots, corn. These are still better choices than something processed like milk chocolate, cookies, pretzels or chips, or a sugary soda.
TWO: Avoid dairy.
There are many studies that look at dairy intake and acne, and the majority (>70%) show increased risk of acne with dairy consumption. Skim milk is the classic thing that we’re taught in dermatology training, but it turns out that ALL forms of milk can make acne worse. Cheese and ice cream are also offenders! This is especially true in people that otherwise eat more of a Western diet — more processed and higher fat foods — versus people that live in Europe.
There are a few reasons for this. One, just like high GI foods, milk particularly the whey within it, stimulates production of the growth factor IGF-1. Again, this stimulates our bodies to make more sex hormones, which again in turn causes increased oil production, increased skin cell stickiness, plugging of our pores. This is a better environment for a bacteria on our skin, P acnes, to live. Finally, we have increased inflammation as a result of IGF-1 as well.
To make matters worse though, milk often times ALSO has bioactives within it, like hormones, IGF-1, and another molecule that can increase inflammation called TFG-B.
THREE: Avoid supplements that contain whey, high doses of vitamin B6/vitamin B12, and iodine like kelp
Many muscle building supplements contain whey because its protein content should theoretically help build muscle. As mentioned above, whey is a key component in milk, making up to 20% of milk), but it can increase growth factors, oil production, sex hormone production, and inflammation resulting in worse acne. There are studies that show that body builders that stopped their whey supplements had improvement in their acne.
Realize that avoiding whey doesn’t just mean the straight up supplement. Whey is sometimes a hidden, or not so hidden, ingredient in other things like Gatorade zero with protein, and even collagen supplements.
The increasingly popular AG1 supplement would theoretically also worsen acne, as it contains high levels of vitamin B6, B12, and kelp powder; there is some evidence that all three of these ingredients can worsen acne.
Choosing a plant-based protein powder may be a better option if you’re intent on using a protein supplement but want to lower your risk of acne.
FOUR: Consider starting a probiotic
The evidence is early, but there are studies that showed 80% improvement in acne after supplementation with oral probiotics containing lactobacillus for 12 weeks. These are thought to work by lowering inflammation and the oil in our skin and potentially even lower levels of the bacteria that contributes to acne, called C. acnes. Use of oral probiotics in combination with oral antibiotics, a commonly used treatment for acne vulgaris, actually allowed for even more improvement than with the oral antibiotic alone (Baquerizo et al).
Topical probiotics, like streptococcus thermophilus, may also help by helping restore skin barrier function.
The effect may depend on which probiotic you’re choosing, but unfortunately, there is not a lot of data to say which is best yet. One has to wonder if kombucha may also be beneficial; but careful, if you’re choosing one of these drinks, remember to check the sugar content and choose one with minimal added.
FIVE: Avoid saturated fats and omega-6 fatty acids.
(Omega-6 fatty acids are actually a precursor to many inflammatory molecules).
These include things like fast food, bacon, salami, chorizo, sausage, cakes and biscuits, margarine, ghee, butter, sunflower oil, corn oil, soybean oil. These foods tend to increase inflammation, making acne worse. Further, they may increase sex hormone production. More sex hormones means our skin will make more oil, which results in more plugged pores (Melnik et al).
Instead, you want to choose polyunsaturated like omega-3, in addition to essential unsaturated fatty acids, like linoleic and alpha-linolenic acid instead. Choose things like salmon, mackerel, sardines or anchovies, soybeans, chia seeds and flax seeds. These are thought to make the oil on our skin more liquid, for one, making it less likely to plug our pores. They are also thought to increase our body’s ability to tolerate bacteria on our skin and may even be anti-inflammatory (polish study — in that they block LKB expression).
If you’re going to choose a supplement to help your acne, an omega-3 fatty acid might be a useful one.
SIX: Make sure you have the right vitamins!
Vitamins A, C, D and E may be helpful for reducing inflammation, oil production, blackhead formation, and even bacteria growth that contributes to acne. Eat foods like carrots, avocados, pumpkins, papayas, and peppers, citrus and other fruits, fatty fish, eggs, green leafy vegetables, tomatoes, and walnuts.
Vitamin C interestingly may be even more useful applied topically than when eaten; this is at least in part because it tends to be more available to our skin cells when we apply it topically. You can find it over the counter in many serums. As noted in our vitamin C podcast, choosing a vitamin C serum that also contains vitamin E and ferrulic acid may enhance the benefits of the vitamin C.
As mentioned above, there is at least some evidence that high levels of Vitamin B6 and B12 may make acne worse.
Other B vitamins may be helpful though, including vitamins B1, B3, B5 and B7 in foods like nutritional yeast, nuts, oatmeal, fish, bran.
SEVEN: Minerals like zinc and selenium can also help acne. Whole grains, pumpkin and sunflower seeds are good sources of zinc. Brazil nuts are jam packed with selenium, but I would only eat these occasionally, because there is evidence that in high doses, selenium can actually cause skin cancer.
Well in sum, the key foods to avoid if you have acne include that are high in sugar/have a high glycemic index like sugary sodas and processed carbohydrates, dairy based products particularly milk (though kefir and yogurt may be helpful because of the probiotics), and saturated fats may help your acne if you’re struggling with it, as early as 2 weeks after changing your diet. Remember to avoid other key triggers too, like high dose vitamin B6, B12, and iodine like kelp supplements, and whey supplements.
In general, eating more of a Whole Foods diet that’s low in dairy, containing whole grains, fruits and vegetables, in addition to fish that contain omega-3 fatty acids like salmon, combined with vitamins A, B, C and D and zinc, may help improve your acne. Studies show that making these changes even on top of medical therapies you might be given can further enhance the results.
References
- Baquerizo K et al. Probiotics and probiotics in dermatology. JAAD 2014; 71: 814-21.
- Meixiong J et al. Diet and Acne: a systematic review. JAAD Int 2022; 7: 95-112.
- Melnick et al. Linking diet to acne metabolomics, inflammation and comedogenesis: an update. Clinical, Cosmetic and Investigational Dermatology 2015; 8: 371-388.
- Podgorska A et al. Acne vulgarism and intake of selected dietary nutrients - a summary of information. Healthcare 2021; 9: 668.
- Zamil DH et al. Acne related to dietary supplements. Dermatology Online J. 2020; 26 (8): 13030.
Additional notes:
Vitamin A can help reduce acne by helping our skin cells grow normally and be less sticky. It also has other benefits including protecting our skin from aging. Choose foods like fish, carrots, pumpkin, papayas, and even avocados.
Vitamin C is anti-inflammatory and can help block darkening of the skin in areas or prior pimples. This might be best used topically when dealing with acne, but making sure you have enough vitamin C in your diet is a good idea, as our skin otherwise needs it including for making collagen. Topically, you can find it OTC in serums ranging from 5-20%; you can otherwise choose foods like fruits and vegetables.
Vitamin D may help acne because it’s anti-inflammatory, lowers oil production, and lowers the number of blackheads we get. It also can block the growth of the bacteria that contributes to acne, called P acnes or C acnes.