Diet and acne

For many years it was thought that diet had no relation with acne. However, the scientific research of the last decades has shown that certain dietary habits can influence its appearance or worsen its evolution in some people.

It is important to highlight that diet is usually not the only cause of acne. Genetic predisposition, hormones, inflammation and sebum production play a much more important role.

Nevertheless, a balanced diet can be part of an integral approach to the patient with acne.

Acne develops through the combination of several factors:

• Increased sebum production.
• Obstruction of the pores.
• Proliferation of Cutibacterium acnes.
• Inflammation.
• Hormonal influence.
• Genetic predisposition.

Diet can act as a modulating factor in some people, but it rarely explains the disease on its own.

Not all people react the same way, but some foods have been associated with a greater risk of worsening.

High glycaemic index foods. Foods that produce rapid rises in glucose and insulin can stimulate mechanisms related to the development of acne. Among them are:

• Sugary drinks.
• Industrial pastries.
• Sweets.
• Candies.
• White bread.
• Refined cereals.
• Some ultra-processed products.

Excess of added sugars. A diet rich in sugars favours a metabolic environment that can increase the activity of certain hormonal pathways involved in acne.

Some dairy products. Various studies suggest that, in some people, especially skimmed milk, could be associated with a worsening of acne. It does not mean that all people with acne should eliminate dairy products. The decision must be individualised.

Diets very rich in ultra-processed foods. Diets with abundant industrial foods are usually associated with greater general inflammation of the organism and can contribute to the worsening of the skin.

Although no food «cures» acne, a balanced diet can favour healthier skin.

It is recommended to prioritise:

• Vegetables.
• Fruits.
• Legumes.
• Natural nuts.
• Oily fish.
• Extra virgin olive oil.
• Whole grains.
• Quality proteins.

This dietary pattern is close to the Mediterranean diet, considered one of the healthiest nutritional models.

Omega-3 fatty acids have anti-inflammatory properties.

Some studies suggest that a diet rich in oily fish can contribute to decreasing skin inflammation in certain patients.

Nevertheless, the evidence is still limited and does not replace medical treatment.

One of the best-known myths.

Currently it cannot be affirmed that chocolate on its own produces acne.

The possible problem is usually related to products rich in sugar and added fats. Dark chocolate with a high percentage of cocoa probably has a different effect than very sugary milk chocolate.

No.

Only some patients seem to present a relation between certain dairy products and the worsening of acne.

It is not recommended to eliminate complete food groups without an adequate medical or nutritional assessment.

There is no vitamin capable of curing acne.

In addition, some inadequate supplementations can even favour its appearance.

Therefore, any supplement must be assessed individually.

Maintaining adequate hydration is important for general health and for the correct functioning of the skin.

However, drinking large amounts of water does not eliminate acne.

In some patients with overweight and metabolic alterations, improving lifestyle can favour hormonal balance and contribute indirectly to improving the skin.

It does not occur in all cases.

In general it is advised to:

• Maintain a varied and balanced diet.
• Reduce the consumption of sugary drinks.
• Limit ultra-processed foods.
• Prioritise fresh foods.
• Consume quality proteins.
• Choose whole carbohydrates when possible.
• Maintain a healthy weight.

No.

Diet constitutes a complement to the treatment, but does not replace medicines when they are indicated.

The best result is usually obtained by combining:

• Medical treatment.
• Adequate skin care.
• Healthy diet.
• Balanced lifestyle habits.

• Myth: Chocolate produces acne. Fact: There is not enough evidence to affirm that chocolate on its own causes acne. The global context of the diet is much more important.
• Myth: Eliminating all dairy products cures acne. Fact: Only some patients can benefit from reducing certain dairy products.
• Myth: Acne appears from eating fatty foods. Fact: The amount of fat in a food does not by itself determine the appearance of acne.
• Myth: Drinking a lot of water eliminates acne. Fact: Hydration is important, but it does not replace medical skin treatment.
• Myth: There is a specific diet that cures acne. Fact: Currently there is no diet capable of curing acne, although some dietary patterns can help to improve its evolution.

• Diet can influence acne, but it is usually not its main cause.
• High glycaemic index foods and some dairy products can worsen acne in predisposed people.
• The Mediterranean diet constitutes a healthy dietary pattern and potentially beneficial for the skin.
• There is no diet capable of curing acne on its own.
• Medical treatment remains the basis of acne management.
• An integral approach combining medical skin treatment, healthy diet and good habits offers the best results.