Relationship of Diet and Acne

Acne is a skin condition which affects many regardless of gender or age group. However, it predominantly affects adolescents as puberty is associated with an increase in the production of sex hormones called androgens which contribute to the development of acne. Therefore, much focus on acne is around acne in adolescents and how puberty plays a major role in the development of acne. However, acne is a multifactorial condition, hence there are other factors also need to be considered to provide a more holistic view in the management of acne. One factor that is emerging is diet.
Emerging studies have singled out certain food groups which may aggravate acne. One such group is high glycemic index foods such as white rice, white bread, potatoes and cornflakes. The glycemic index is a number assigned to foods reflecting how quickly or slowly they increase blood sugar levels. High glycemic index foods are those who release glucose (a type of sugar) rapidly, causing a quick spike in blood sugar levels.
So how do high glycemic index foods potentially lead to acne? High glycemic index foods cause an increase in blood sugar levels which lead to an increase in the secretion of a hormone called insulin. The increase in insulin levels cause an increase in the secretion of sex hormones called androgens which stimulate an increase in sebum production. Furthermore, elevated insulin levels cause an increase in a growth factor called Insulin like Growth Factor-1 (IGF-1) and a decrease in Insulin like Growth Factor Binding Protein-3 (IGFBP-3), a protein that binds to IGF-1 to prevent it from exerting effects. Therefore, the levels of IGF-1 eventually become elevated. IGF-1 is a major player in the development of acne as it activates various pathways leading to overproduction of sebum, an oily substance produced by the sebaceous glands to lubricate our skin and hair but when present in excessive amounts is a contributing factor towards acne. IGF-1 also stimulates the synthesis and activity of sex hormones called androgens which increase sebum production. Lastly, IGF-1 also induces the proliferation of cells that produce a protein called keratin eventually leading to the obstruction of sebaceous follicles. All these effects collectively contribute towards acne and draw potential links between high glycemic index foods and acne. This is supported by a study where participants on a low glycemic load diet had improvements in their acne condition, with greater reductions in the total number of acne lesions.
The link drawn between high glycemic index foods and acne is especially relevant in the context of Singapore as white rice which has a high glycemic index is a staple amongst most Singaporeans. White rice coupled with the intake of sugary drinks lead to a high glycemic index diet which may be the link to the high prevalence of acne in Singapore. As a change in diet is difficult, small steps can be taken to work towards a healthier and lower glycemic index diet. White rice can be slowly switched out for brown rice which has a lower glycemic index and is high in nutrients such as zinc and iron and healthier choices can be made by choosing the less sugar option or reducing intake of sugary drinks.
Another food group that has been identified are dairy products. The effect of consuming dairy products on acne is still highly debated but current research has drawn some links between the two. Cow’s milk contains IGF-1 that is a growth factor that is involved in the development of acne. Therefore, consuming cow’s milk can increase IGF-1 levels in the body and hence, may lead to acne. Furthermore, milk contains androgen precursors which can then be converted to androgens, stimulating the generation of sebum. Excessive sebum is then produced which may result in acne as well. Such claims are supported by a study done on 47,355 women who were asked on their high school diet and acne condition. The results of the study showed a positive relationship between acne and the consumption of milk.
However, not all types of milk are said to be related with acne. There are currently many types of milk in the market with different levels of fat content such as whole milk, reduced fat or skimmed milk. Skimmed milk is fat free milk and has lesser calories. In today’s world where dieting and tracking calories are the norm, it is no wonder that skimmed milk is rising in popularity among the health conscious who want to consume milk but without the fat and extra calories. However, research has shown that skimmed milk is the most highly associated with acne. Skimmed milk also contains less estrogen than whole milk, a female sex hormone that is said to decrease acne.
The links drawn between dairy products and acne may prompt you to immediately switch out dairy from your diet but before doing so, remember that dairy products are also rich in calcium and important vitamins that our bodies need. Current research has drawn potential links between consuming dairy and acne, but more research is required to provide conclusive evidence.

Besides diet, here are a few lifestyle tips to improve acne:

  1. Get sufficient sleep
  2. Exercise regularly
  3. Drink water
  4. Always use sunscreen out (good if it’s non-comedogenic)
  5. Clean makeup off thoroughly and cleanse twice a day
  6. Exfoliate your face
  7. Clean the surface of your phone

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What are the top foods that causes acne?

  1. Refined Grains and Sugars – get absorbed fast into the bloodstreams that spikes up the sugar and insulin levels in the blood and might contribute to the development of acne. Insulin increases the activeness of androgen hormones and makes skin cells grow faster by boosting the development of sebum. Examples of refined carbohydrates are products with white flour (desserts, pasta, white rice, bread, crackers, cereal), sodas, sugar-sweetened beverages and sweeteners (cane sugar, maple syrup and honey).
  2. Dairy Products – There is speculation on the relationship between milk and acne but there are some studies that have shown that milk increases insulin levels and hence worsen severity of acne.
  3. Foods rich in Omega-6 Fats – There are some studies that mentioned that omega-6 fats cause a rise in the level of inflammation and acne.

How diet can help with acne positively?

Apart from relooking your current diet, there are some school of thoughts that believe that some minerals and nutrients such as zinc and omega-3 fatty acids, incorporated in your diet can help with reducing acne.

  1. Zinc is a mineral which is said to be beneficial towards acne as it reduces inflammation and inhibits the growth of Propionibacterium acnes – a type of bacteria that plays an important role in the production of acne. This is supported by a study which showed that patients on oral zinc supplementation had a significant decrease in the number of acne lesions after four weeks. Hence, a diet that is naturally rich in zinc may improve acne and some examples of foods rich in zinc are oysters, beef, pumpkin seeds and cashews.
  2. Omega-3 fatty acids may also help with acne. Omega-3 fatty acids can be found in a variety of sources such as fish, fish oils, flax seeds and chia seeds. It can help to reduce inflammation, inhibit growth of Propionibacterium acnes and reduce stress, which are all contributing factors towards acne (Kern, 2018). The effect of omega-3 fatty acids on reducing stress is especially significant in today’s context as stress is now a major contributing factor to acne as people struggle to keep up in this modern fast paced society.

What are some skin-friendly food options?

  1. Tomatoes
  2. Yellow and orange fruits and vegetables such as sweet potatoes and carrots
  3. Dark green leafy vegetables such as spinach
  4. Blueberries
  5. Whole-wheat bread
  6. Quinoa
  7. Brown rice
  8. Pumpkin seeds and nuts
  9. Peas, lentils and beans
  10. Salmon and other kinds of fatty fish
  11. Turkey

Do take note that everyone’s body react differently. It takes time and patience to do some trial and learn more on what reacts positively to your body. Always consider any food allergies in your diet plan.