Can Food Cause Acne? What We Actually Know About Diet and Breakouts
If you’ve ever had acne, there’s a good chance somebody has suggested that something you’re eating is responsible for it.
Chocolate seems to have spent decades being blamed, while more recently I’ve seen dairy, sugar, gluten, soya and various other foods accused of causing breakouts. Spend long enough looking online and you can end up with a rather depressing list of things you’re apparently supposed to stop eating if you want clear skin.
I originally wrote this article much more confidently about foods that “cause acne”, but having revisited the research, I don’t think that’s a particularly accurate way to describe the relationship between food and our skin.
Acne is complicated. Hormones play an important role, as do genetics and the way the hair follicles and oil-producing glands in our skin behave. Diet is being studied as another possible influence, and there are some interesting findings, particularly around the overall glycaemic load of our diets and possibly dairy, but we haven’t discovered a simple list of foods that give everybody spots.
That means I wouldn’t start eliminating half your diet because you’ve developed acne.
There are, however, some things worth knowing.
Is there really a connection between food and acne?
For a long time, the idea that diet affected acne was often dismissed, but research over recent years has made the picture rather more interesting.
The strongest evidence seems to relate to diets with a high glycaemic load. In very simple terms, this means eating patterns containing lots of foods that cause blood glucose to rise relatively quickly.
Researchers have found associations between higher glycaemic diets and acne, and some controlled trials have found improvements when people followed a lower-glycaemic-load diet. The effect isn’t enormous, though, and that doesn’t mean eating a slice of white bread tonight will give you a spot tomorrow morning.
That’s the problem I have with a lot of “foods that cause acne” articles.
They take evidence about an overall dietary pattern and turn it into a list of individual foods we’re supposed to fear.
If you’re interested in whether your diet could be influencing your acne, I’d look at how you’re eating overall rather than trying to identify one guilty biscuit.
What about sugar and refined carbohydrates?
Foods such as sugary drinks, sweets, cakes and some highly refined carbohydrates can contribute to a higher glycaemic load, particularly when they make up a large part of someone’s diet.
That may influence insulin and other signalling pathways involved in oil production and skin-cell behaviour, which is one reason researchers have become interested in the connection with acne.
What I wouldn’t do is turn that into “carbohydrates are bad for your skin”.
Fruit contains carbohydrate. So do oats, potatoes, beans, wholegrain bread, pasta and countless other perfectly nutritious foods. Even higher-GI foods don’t need banning because we’re talking about the pattern of an entire diet rather than a single ingredient.
If your diet currently contains lots of sugary drinks, sweets and heavily refined foods, eating more fruit, vegetables, pulses and higher-fibre carbohydrates is sensible for all sorts of health reasons. If your acne happens to improve as well, lovely.
You don’t need to become frightened of eating a potato.
Does dairy cause acne?
Dairy is probably the most complicated part of the discussion because some research suggests an association, particularly with milk, but the evidence isn’t consistent enough to say dairy causes acne in everyone.
Some studies have found that people consuming more dairy, particularly milk, report more acne, while others haven’t found the same relationship. Researchers are still trying to understand whether there is a genuine causal effect, whether particular dairy products matter more than others and why the association seems to vary between different groups of people.
What I definitely wouldn’t say is what the old version of this article claimed: that hormones fed to dairy cows enter milk, disrupt your own hormones and therefore cause acne. That’s an enormous oversimplification.
I also wouldn’t automatically stop eating all dairy because you have spots.
Milk, yoghurt and cheese can provide useful nutrients including protein and calcium, so removing an entire food group deserves a little more thought than simply swapping everything for a plant-based alternative.
If you’ve noticed a very consistent relationship between a particular food and your skin, you could discuss it with your GP, dermatologist or a registered dietitian, particularly if you’re considering a significant dietary restriction.
Chocolate probably deserves a word too
Poor chocolate has been accused of causing teenage spots for generations. The evidence isn’t clear enough for me to tell you that chocolate either definitely causes acne or definitely has nothing to do with it.
Part of the difficulty is that chocolate isn’t one ingredient. A milk chocolate bar contains cocoa alongside sugar, milk and fat, making it difficult to separate any potential effect of cocoa from the rest of the product or from somebody’s wider diet.
There have been studies looking specifically at chocolate and acne, but they’re generally small and aren’t strong enough to justify telling everybody with acne that chocolate has to go.
If you personally notice that your skin consistently seems worse after eating lots of a particular food, that’s useful information about you. It isn’t necessarily a universal rule for everyone else’s face.
Does fast food cause spots?
Research sometimes finds associations between acne and dietary patterns containing more fast food or highly processed foods, but people don’t eat individual foods in laboratory isolation.
Someone who frequently eats fast food may have a very different overall diet from someone who rarely does. There can also be differences in lifestyle, sleep, stress and plenty of other factors that make it difficult to say the burger itself caused the acne.
There are plenty of reasons not to build your entire diet around takeaway burgers, chips and fizzy drinks, but promising clearer skin if you stop eating them isn’t one I’d rely on.
What about soya?
Sometimes it is claimed that phytoestrogens in soya disrupt hormone balance and cause acne, before suggesting people replace soya with beans, lentils or nuts.
I haven’t found convincing evidence to justify advising people with acne to avoid soya.
Soya foods such as tofu, edamame and fortified soya milk can be useful sources of protein and other nutrients, particularly for vegetarians and vegans. Removing them because of a vague claim about phytoestrogens doesn’t make much sense.
This is a good example of why I’m much more cautious now about articles that give us long lists of foods supposedly responsible for particular health problems. Something can sound scientifically plausible while being considerably less certain when you actually look for good evidence behind it.
Should you try an acne diet?
I wouldn’t follow a restrictive “acne diet”, particularly one that tells you to remove several major food groups at once.
If you eliminate dairy, gluten, sugar, soya, chocolate and anything remotely processed and your skin changes, you’ve got no idea which change mattered anyway. You’ve also made eating considerably more difficult and potentially removed useful nutrients from your diet.
A much more sensible starting point is simply a balanced diet.
That might mean eating plenty of fruit and vegetables, choosing higher-fibre carbohydrates regularly, including suitable sources of protein and healthy fats and making foods high in added sugar a smaller part of what you eat overall.
Interestingly, that’s fairly ordinary healthy-eating advice rather than a special skin-clearing diet.
If you suspect one particular food affects you, keeping a simple food and symptom diary for a while may be more useful than randomly banning things. Acne naturally gets better and worse too, so I’d look for a repeated pattern rather than deciding that one breakout after eating pizza proves mozzarella is your enemy.
There have been reviews on diet and acne, and generally they are quite mixed in their findings!
Food isn’t the only reason you have acne
This is probably the most important part of the whole article.
Acne isn’t evidence that you’ve eaten badly or failed to look after yourself.
During puberty, changes in hormone levels can affect the glands next to hair follicles and increase the amount of oil they produce, which is one reason acne is so common during the teenage years. Hormonal changes at other stages of life can influence acne too, which is why some women notice changes around their periods, pregnancy or later hormonal changes.
Genetics matter as well. If your parents had acne, you’re more likely to develop it yourself.
Certain medicines can also cause or aggravate acne, and some cosmetic or hair products may contribute to spots in particular areas.
Stress is another area where the relationship is more complicated than simply saying “stress causes acne”. Some people notice their acne gets worse during stressful periods, but that doesn’t mean you can meditate your spots away or that developing acne means you’re not managing stress properly.
Your skin is an organ, not a report card on how healthy your lifestyle has been.
Washing your face more isn’t necessarily the answer either
When acne appears, it’s tempting to assume the skin must be dirty and start scrubbing it more aggressively.
Acne isn’t caused by poor hygiene.
In fact, repeatedly washing or scrubbing acne-prone skin can irritate it and make things feel worse. Gentle cleansing is generally much kinder than attacking your face with exfoliators because you’re trying to scrub spots away.
I think this matters particularly for teenagers. Acne can already have a huge effect on confidence without adding the idea that they’ve somehow caused it by being dirty or eating the wrong foods.
When should you see your GP about acne?
If your acne is mild, a pharmacist can advise on treatments available without a prescription, and there are effective acne treatments with much stronger evidence behind them than giving up chocolate.
If your acne is moderate or severe, you’re developing painful nodules or cysts, treatments you’ve tried aren’t working or you’re starting to develop scarring, I’d speak to your GP rather than continuing to experiment with your diet.
I’d also ask for help if acne is having a significant effect on how you feel about yourself.
Skin conditions can affect confidence far more than people sometimes realise, particularly during the teenage years, and you don’t have to wait until acne is physically severe before acknowledging that it’s affecting you emotionally.
There are prescription treatments available, and a GP can refer you to dermatology when appropriate.
So, can changing your diet improve acne?
Possibly, for some people, but I wouldn’t promise it.
The research around lower-glycaemic eating is interesting enough that looking at the overall quality of your diet is reasonable, and there may be a relationship between dairy and acne for some people. We still don’t understand those relationships well enough to create a definitive acne diet, though.
That’s very different from saying that milk, bread, chocolate or a takeaway gave you acne.
If you’re eating a reasonably balanced diet already, I wouldn’t keep removing foods in pursuit of perfect skin. Acne is a medical skin condition with established treatments, and sometimes the most useful thing you can do is stop blaming your dinner and ask someone for help treating your skin.
I wish more health advice online was comfortable saying that. Sometimes the answer genuinely isn’t hiding in the fridge.
