Often I am asked if what we eat plays a role in acne, not only by my patients, but also by other dermatologists to whom I give lectures to at national dermatologist conferences.
It is a common question that dermatologist receive from patients.
It is important that dermatologists stay up to date on the latest research in regards to food and acne.
Acne is generally thought to be genetic and caused by (usually) normal male hormone fluctuations in the body (both men women have male hormones circulating in their bodies). Foods that go through the stomach and then are metabolized into the blood stream cannot directly influence your hormone levels.
For example, eating chocolate or greasy foods cannot make your pores immediately larger or cause a large red acne bump to appear on your face the next day.
Multiple real life clinical trials over the years have disproved this direct and immediate food affecting acne notion.
However, many studies have examined if certain food categories over time can trigger acne flares-albeit indirectly, not necessarily through a direct cause and effect action. One idea is that if people drink a lot of milk (which may contain male cow hormones), those male cow hormones will work with our human
male hormones and cause more acne to appear. Although it makes sense intuitively, this idea has not been proven when put to the test for verification.
Another concept is that people who eat a lot of complex carbohydrates (like pasta and rice) for the majority of their diet will have more acne. The theory here is that you need insulin to break down complex carbohydrates. Insulin also stimulates male hormones in the body. So, more complex carbs
leads to more insulin which leads to more male hormones and then more acne on your face.
Some research in impoverished areas where complex carbs are the diet staple, do indeed seem to corroborate acne being worsened with a complex carb diet. These studies were done in very poor third world countries, but not in the impoverished population in the United States.
Researchers over the years have looked into other possible factors influencing acne in the long term including eating a lot of greasy foods, chocolate, dairy, foods with a lot of gluten and having too much or too little of certain vitamins etc.
None have verified a relationship with acne.
Trying to be gluten free also has not been shown in research studies to help lessen acne, even in those individuals allergic to gluten.
Dermatologists are learning more and more about the complex interplay between our immune system, our hormones and the creation of acne. As I am often asked to update my dermatologist colleagues on this condition, I will also do my best to update both this blog and my patients!