Throughout my years of cystic acne, my diet was a major stressor.
I love food, I love to cook — and while I largely try to stick to a healthy diet, I’m still partial to the occasional processed treat and junk-food-fuelled Friday night.
But the link between is diet and acne is continuously debated, with research on the connection appearing vast, varied and sometimes downright confusing.
Plus, if you struggle with acne, handling the never-ending barrage of “dairy/sugar/gluten/soy/nuts/fruit can cause acne” headlines can lead to anxiety, shame and blame.
So today, I’ll be discussing the link between diet and acne from a scientific perspective, whilst also sharing my own experiences and tips on navigating acne and diet in a safe, healthy and manageable way.
Does diet affect acne?
According to the British Association of Dermatologists (BAD), there has not yet been enough research to prove a direct link between diet and acne.
There is, however, some anecdotal evidence. This basically means that some links have been observed. But there just hasn’t been enough rigorous scientific studies or trials to confirm that any specific foods or food groups can be labelled as acne triggers for certain.’
Personally, I think the simplest way of explaining it is this: Your diet alone is unlikely to be the sole cause of cystic, persistent acne, but what you choose to eat can influence your skin and, in some cases, trigger breakouts.
Foods that may cause acne
Although studies and research on acne and diet are kinda weak right now, that doesn’t mean we should ignore the observations altogether. I personally think it’s all about balance (more on that later), so I’d advise against suddenly restricting yourself or cutting out all of these foods at once.
The most commonly observed and reported links between foods (or food groups) and acne are:
The glycemic index measures the effect a certain food has on your body’s blood sugar levels — the higher ‘GI’ the food is, the higher the effect it has on your blood sugar. These foods tend to be sugary and starchy, though some of them may come as a shock — take a look at the chart below:
So what’s the link between high-GI and acne? Well, extreme spikes in blood sugar lead to increased insulin production, which then leads to increased inflammation, androgen-activity and oil production — which (you guessed it) can trigger breakouts.
Here are a couple of studies I found on high or low-GI diets and how they affect acne:
- A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial: Concluded that total acne count decreased more in a group of males following a low-GI diet, in comparison to a group of males following a high-GI diet.
- Effect of the Glycemic Index of Carbohydrates on Acne vulgaris: Suggested that a low GI diet does not significantly improve facial acne, but that there was a trend for the low GI diet to improve acne to a greater extent than the high GI diet.
“Don’t eat all those sweets, you’ll get spots!” — it’s an age-old stereotype, but can sweet treats actually cause acne?
Turns out a day filled with sweets, cakes, cookies and doughnuts (aka a dream) could potentially trigger a breakout or two down the line. And it’s all down to the glycemic index I spoke about above — sugary treats, it appears, are often sky-high on that GI scale.
Again, this means that binging on sugar-filled snacks can increase blood sugar (and therefore insulin), leading to inflammation, the production of clogging skin oils and then, maybe, a bit of a pesky breakout.
But, gals and guys, don’t go denying yourself of sweet treats altogether — let’s not deny it, brownies are life. As I said, it’s all about getting the balance right.
The internet is rife with articles along the lines of ‘I quit dairy and my acne cleared up for good’ and ‘I gave up acne and now have flawless skin’ — but clickbait aside, how strong is the link between acne and dairy in reality?
Well, it does seem that the link between dairy and acne is among the strongest, in terms of research and anecdotal evidence, of all food groups. Research generally suggests that dairy can contribute to breakouts, largely because of the hormones found in milk. As well as artificial hormones, cow’s milk contains whey and casein, which stimulates growth and hormones in their calves.
When we drink this milk (which, remember, was essentially meant for their calf), these factors can impact our own endocrine system and throw our hormones off balance. Hormones play a huge role in the way skin behaves, so there’s no surprise that this hormonal disruption could then trigger breakouts.
And it turns out that quite a few studies have been carried out on the link between acne and dairy (though probably not enough, still) — take a little look here:
- Dairy consumption and acne: a case-control study: Concluded that there is an association between high intakes of dairy products and acne in adolescence.
- Consumption of dairy in teenagers with and without acne: Concluded that the consumption of low-fat/skim milk, but not full-fat milk, was positively associated with acne.
- High school dietary dairy intake and teenage acne: Suggests there is a link between acne and the intake of whole milk and skim milk because of the presence of hormones and bio-active molecules in milk.
Another commonly-touted dietary acne trigger is food intolerances, sensitivities or allergies.
The link here is actually pretty easy to understand. Research suggests that acne, at its core, is an inflammatory disease. This is supported by the fact that acne sufferers normally have elevated inflammatory molecules in their system.
Food intolerances and sensitivities cause the immune system to confuse food as a threat and then launch an immune ‘attack’ against the proposed threat. This causes a surge in inflammation and — as acne in itself is inflammatory — increased breakouts.
Obviously, food intolerances will be different for everyone, but some of the most commonly reported are:
Acne and diet: My thoughts + experience
Before I jump into my own acne diet story, I wanted to quickly share my thoughts on the information above. As someone who’s experienced acne myself, I know that discovering all the possible food triggers and reading studies can cause a hell of a lot of anxiety.
I don’t deny that — sometimes — what we eat may influence our skin and trigger a few breakouts. But I personally think it’s rare for severe, cystic acne to be caused by diet alone.
Sure, there may be somewhat of a link — but if the links were strong, wouldn’t that mean anyone and everyone who eats an unhealthy diet, would have acne? I’m sure you know someone who seemingly eats all the ‘bad’ foods and rarely experiences breakouts in their life. Likewise, I’m sure you know someone who’s super healthy, eats all the ‘good’ foods and, unfortunately, has struggled with their skin.
The truth is, some people seem to be affected by acne and others just don’t — regardless of how they live or what they do and don’t eat. Acne can be caused by hormones, stress, genetics, underlying medical problems and countless other factors. That’s why, in my opinion, it’s hard to put a hard and fast link between diet and acne.
Still, I don’t deny that exploring the relationship between skin and food can be worthwhile in some instances. It’s just not always the be-all-and-end-all and rarely a miracle cure — unless someone did happen to have a severe food intolerance.
Diet and acne: My personal story
I’ve had acne throughout my teens and early twenties and have only managed to clear it recently, through a course of spironolactone and, later, Roaccutane.
After university, I lived, worked and travelled across Vietnam for a year with my boyfriend — and it was then that my acne peaked. I hadn’t left our flat in weeks and was too scared to go to work. All I wanted was clear skin. My mental health was suffering.
It prompted a desperate “how to get rid of acne” and “does diet affect acne?” stream of Google searches, which inevitably led me down a rabbit hole of health articles and lifestyle coaches claiming that overhauling diet was the cure for acne.
Dreaming of the prospect of clear skin, I suddenly cut out anything and everything that any old internet article suggested could cause acne. This included anything even the slightest bit processed, as well as dairy, gluten, soy, nuts and sugar. I was veggie by this point anyway, so meat was out of the question, and in rural Vietnam, I also couldn’t get hold of gluten-free or dairy-free alternatives.
This basically led me to living on fruits, veg and 4 litres of water per day. I was also mixing 4 teaspoons of turmeric with a glass of water 3 times a day and downing it — eugh. I thought it would clear up my skin, but instead, it actually just made me overly obsessed and critical of what I was eating.
I think this is the only time in my life where I’ve personally been on the verge of disordered eating. All I could think of was what I was eating — and if I caved into some fries or a chocolate bar, I’d send myself on a guilt trip for hours afterwards. In my eyes, eating one ‘wrong’ food meant my spots were my fault.
This lasted a few weeks, but thankfully, my parents and sister came to visit me shortly after. One thing I remember vividly is being in a restaurant in Mai Chau — one of the most beautiful places I’d ever been to — which had pizza on the menu. I hadn’t had cheese or gluten in months… but I wanted it so badly. I was winding myself up about it. My sister turned to me and, bluntly, said “just get the fucking pizza!”.
She also pointed out that the stress and anxiety I was causing myself by not eating — well, basically anything — was probably making my skin much worse. Stress is a proven acne trigger, so I do believe she was spot on.
The funny bit is, after letting go a little whilst I was with them — and not cutting out entire food groups — my skin actually started to calm down. I think my low mood, obsessive thoughts and the stress I was experiencing, was having more of an effect on my skin that I’d ever thought possible.
By feeling happy and treating my body with more respect by eating a balanced diet, the inflammation eased significantly. Sure, my skin still wasn’t clear, but it was healing faster and was far less angry than it had been in months.
My tips for approaching diet and acne
Aim for a balanced diet
If you’ve been suffering with acne for some time and are set on changing up your diet in a bid to calm your skin, by all means, go for it. But my single tip would be to aim for a balanced diet, rather than following anything strict or overly limiting.
If you’re switching up your eating habits in order to calm your skin, it’s a long-term game. That means any changes you make need to be achievable, manageable and healthy — both physically and mentally — for the long haul.
To me, balance means aiming to eat regular meals with plenty of healthy whole foods, but not restricting your calories and allowing yourself to eat a variety of food without guilt.
Don’t develop the bad habits that I did and end up beating yourself up over eating a portion of fries or a packet of crisps. Remember that you’re entitled to a treat without feeling bad. You deserve to feel satisfied and nourished, so try your best to keep that inner diet critic silenced.
Try a gradual elimination diet
As we’ve discussed, there is some (keyword: some) research and evidence to suggest that certain food groups — such as dairy and sugary foods — can trigger breakouts. If you’re at your wits end with acne, you might be tempted to cut them out and see what happens.
But my advice here would be not to cut everything out at once. It’s too easy to fall into the trap that I did, end up lacking in nutrition and, frankly, becoming obsessed over every single ingredient.
Instead, I’d suggest making one move at a time. As well as being a mentally healthier approach, eliminating one food group at a time makes it much easier to see which foods are triggering for you personally.
For example, you might decide to cut out dairy for two months and notice no changes — but for the three months after, you might go gluten-free and then see a significant difference in your skin. By eliminating them separately, you’d know that dairy doesn’t affect your skin, but reducing your gluten intake might be helpful.
If you try an elimination diet, remember to give each food group a fair chance and to keep a record of your skin — buy yourself a pretty journal and make a quick record of your skin progress everyday.
Don’t rely on diet alone as an acne cure
There may be the occasional success story of acne sufferers ridding themselves of their spots by adjusting their diet. But I personally feel that’s pretty damn rare — and can often take a very, very long time to get right.
We know that acne can have a detrimental impact on mental health, so please don’t rely on diet alone to cure your acne and end up delaying professional help. If you’re in the UK and going through the NHS, it can take a long time to first get referred to a dermatologist — and then you’ve got the added wait for an appointment to come through.
So, if you feel your acne is denting your confidence or making you feel low, book an appointment as soon as you can and get started on finding a treatment that’s right for you!
Diet and acne: It’s all about balance
I’ve been through acne and understand the desperation you may feel to clear your breakouts.
But please remember that skin problems can be caused by a multitude of factors and, in the majority of cases, are unlikely to be down to your diet alone.
In my opinion, adjusting your diet for acne should be about achieving sustained, healthy and balanced eating patterns over time — not restricting yourself or feeling guilty about eating a brownie.