Eating your way to acne-free skin: What the latest research shows

Can food you eat make your acne worse? Yes, according to recent studies, what we eat can make us more or less likely to have acne.

At the same time, do not blame your diet habits for having acne. Many people can eat junk food and not get pimples. They are blessed with the right genetics. Less fortunate of us are more prone to acne genetically. In these cases, the food we eat might contribute to having breakouts.

Based on the evidence we have at the moment, you are unlikely to be able to cure your acne with "food therapy". If you already have acne, a treatment regimen with skincare and/or oral drugs (prescribed by a doctor) is the most effective way to get clear skin. But: paying attention to what you eat can help you make the treatment more effective. Also, if you stick with a balanced "anti-acne" nutrition long term, you can decrease the chance of future breakouts.

Unfortunately though, even if your nutrition is perfect, you still can get acne. The good news is that the "anti-acne" nutrition is in line with the general advice for healthy eating. So there are few downsides (if any) to trying it out.

Scientists researched the link between food and acne for quite a long time. However, until recently, the quality of the studies was not high. The results were contradictory and the study methodologies were questionable. It led most experts to conclude that the link between acne and nutrition is too uncertain to take it seriously.

In 2020, a big new nutrition study came out of France. It included over 24000 of participants observed over the course of 8 months. Researchers could take into account the participants' eating habits, medical history, socioeconomic status, gender and more. In short, this is the most high-quality data on the link between food and acne we've got so far.

The big conclusion is: yes, food we eat can make people more or less likely to have acne.

Another big conclusion: your weight or body-mass index is not related to acne. How much calories you eat is not important. What is important:

1. Getting enough nutrients. "Junk food" can fill you up, but not provide all the nutrition your body (and skin) needs. (Disclaimer: this conclusion is not directly based on the study statistical findings, but seems to be the most likely explanation of the patterns the researchers did discover).

2. Eating a lot of some foods - mostly milk and sugar - makes people more likely to get acne.

Let's see what the study found in more detail.

Participants who ate / drank more milk were more likely to have acne at the moment of the study than the people without acne. (We'll talk about milk in detail later in this article). The same is true for participants who drank more sugary beverages and ate more "fatty and sugary" products (sweets).

The link between higher consumption of other specific sweet or sweet & fatty products like chocolate, refined cereals and fast food wasn't certain.

Eating more carbohydrates (carbs-rich foods include sugar, white bread, rice) and saturated fatty acids (frying oils, butter and many fats added to sweets and fast foods) in general made the study participants more acne-prone.

What this can mean in practical terms is: eating a chocolate bar occasionally is unlikely to give you acne. But eating a lot of sweets and "easy carbs" in general can make you more acne-prone.

Interestingly, the participants who ate more meat (but not processed meat like sausages) were less likely to have acne. The way how more meat consumption impacts acne is not very clear. The most plausible explanation is that meat (and other types of whole food protein-rich food like beans) is both filling and nutritious. Meaty meals keep you full for longer, and make you less likely to crave sweets and less healthy snacks. The study did not investigate this, but there is no reason why the effect won't be the same for not-processed plant-based sources of protein.

The participants who ate more fiber-rich foods (this includes vegetables, whole grain, seeds and nuts) also had less acne.

The study did not focus on vitamins and microelements, but still found that participants who got more Vitamin D had less acne.

Other studies found that consuming more fish and fish oil (rich in Omega-3 fatty acids) is linked to less acne.

In summary, it looks like eating more whole foods proteins (meat), Omega-3 fatty acids (fatty fish, fish oil and other Omega-3 supplements), fiber (vegetables, whole grain) and foods rich in vitamin D (fish, egg yolk and supplements) can make you less acne-prone. On the contrary, consuming milk, "easy carbs" (white bread, sweets) and sugary drinks can make you more prone to acne.

There is pretty strong evidence that consuming cow milk can contribute to acne. In rare cases, milk-based products (protein powders) can even be the main trigger for acne. (In a small study with female participants with acne who were consuming diary-based protein powders, acne cleared once they stopped the powders. For one of the participants, the acne came back with re-introduction of the protein powders).

Earlier studies found that only skim milk consumption was linked to acne. New research suggests that any kind of milk (raw or pasteurised, regardless of the fat content) can make people more acne-prone. Most likely, it has to do with bioactive compounds and/or proteins that are naturally present in cow milk. In other words, both organic and non-organic milk can contribute to acne. Because of how it is modified during the production, skim milk is more "acne-triggering" than full fat milk, but both types can contribute to acne.

There is no good research on whether fermented milk products (cheese, yoghurt) has an effect on acne. The same goes for non-cow animal milk: no research has been done on the link between goat milk consumption and acne, for example.

It's simple: eat whole, non-processed food as much as possible, eat enough protein, vegetables and whole grain. Take care to get enough Omega-3 fatty acids and vitamin D (from food or supplements). Limit your cow milk consumption, regardless of the type (skim, full fat, organic or conventional). Do not take dairy-based protein supplements.

• Effects of Diet on Acne and Its Response to Treatment https://link.springer.com/article/10.1007/s40257-020-00542-y

• Acne and diet: a review https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.15862

• Effects of Diet on Acne and Its Response to Treatment https://link.springer.com/article/10.1007/s40257-020-00542-y

• A systematic review of the evidence for ‘myths and misconceptions’ in acne management: diet, face-washing and sunlight https://academic.oup.com/fampra/article-abstract/22/1/62/440463

• Acne and diet: truth or myth? https://www.scielo.br/j/abd/a/Z3dZJSC3bd3V6CvSR3n5V4h/abstract/?lang=en