Acne isn’t just a nuisance that makes a brief appearance in your teenage years and then goes away. For many people, acne sticks around for much longer than we’d like, and can lead to confidence and self-esteem problems. In this article, we look at the how your diet can help, and suggest a few of the best foods for acne.June 22, 2021 3:18 pm June 22, 2021 3:18 pm
What is acne?
Acne is a condition which causes spots or pimples on the skin. The most common type is formally called acne vulgaris.
It occurs most frequently during your teenage years. Up to 85% of teenagers will experience it to some degree. However, it can continue beyond adolescence and some people do experience it later in life.(1)
For many years, acne didn’t get the attention it deserved from the medical community because people often thought of it as not being particularly serious. While it’s true that acne doesn’t cause serious physical illness and is largely a cosmetic issue, it can seriously affect your quality of life.
Embarrassment or feelings of shame caused by acne can contribute to damaged confidence, low self-esteem and can even lead to anxiety and depression.(1)
Astonishingly, for a disease that so rarely gets taken seriously, some scientists believe that the effect on one’s quality of life is comparable to diseases such as epilepsy, asthma and diabetes.(1) In the United States, scientists estimate that acne cost the country around $3 billion in 2016 thanks to healthcare costs and lost productivity.(2)
Fortunately, attitudes to acne are changing. Now, there are a range of treatments that can help manage the symptoms. If you suffer from acne, it’s important to speak to your doctor as soon as possible, as early treatment can help you avoid issues like scarring.
Alongside treatments recommended by your doctor, you may also want to make changes to your diet. Before we get into the best foods for acne, let’s take a look at what causes it in the first place.
How do spots form?
The exact causes of acne aren’t known, but we do understand the mechanisms behind how it produces spots.
It all starts in your sebaceous glands. These little glands are found in the dermis (the second layer of your skin) and produce sebum, or natural oil. Its job is to help moisturise and protect your skin.
Sebaceous glands are closely linked to your hair follicles; in fact, if you look at a diagram of a follicle, you will see that the sebaceous gland is almost a little offshoot to one side.
Sebum also helps to lubricate the hair shaft so that it can grow up and out of the skin.
Sometimes, a mixture of sebum and dead skin cells can clump together, creating a blockage.(1)
What is the difference between spots and acne?
The term ‘acne’ refers to a skin disorder, one of the symptoms of which is spots. However, even if you only experience the odd spot now and again, rather than the clusters commonly seen in people with acne, they’re still formed in exactly the same way.
The blockage of cells and sebum causes a ‘plug’ to form in the hair follicle. Sebum builds up behind it, pushing it up to the surface of the skin. You will see this as either a whitehead or a blackhead.
The difference between the two is that in a blackhead, the blockage is exposed to the surface. In a whitehead, it is still enclosed under a layer of skin.(1)
The ‘acne’ bacterium
Things can get trickier if a certain type of bacteria shows up.
Propionobacterium acnes is a particularly annoying species which gets into the blockage in our pores and starts to reproduce. It breaks down the sebum, turning it into triglycerides which irritate the skin.(1)
Next, your immune cells get word that there’s an invader in their midst, and head off to fight the infection. However, the sudden arrival of lots of bacteria, plus your own immune cells (such as lymphocytes and neutrophils) cause the follicular epithelium to burst, releasing the whole lot into your dermis.(1) (Sorry, you weren’t reading this on your lunch break, were you?)
As the tussle between the bacteria and your immune cells continues, the area becomes inflamed and pus forms.
This is all good stuff, in terms of your ability to fight infection. Inflammation, for instance, is the result of your blood vessels dilating. The purpose of it is to make sure more blood can reach the injured tissue, delivering vital nutrients, immune cells and oxygen.
Meanwhile, pus contains dead white blood cells and the bacteria they have successfully killed off.
Unfortunately, both can cause spots to swell, become red and inflamed, or fill with unsightly pus.
Topical treatments for acne
Now that we’ve covered the mechanics behind acne, let’s look at the available treatments.
Speak to a pharmacist or doctor about the options which are most appropriate for you.
If you have mild acne, your pharmacist will likely recommend that you try a topical treatment containing benzoyl peroxide. This works as an antiseptic, helping to remove some of the bacteria on your skin which may otherwise go on to cause spots. It takes a few weeks to show results.(3)
If that doesn’t work, or if you have more severe acne, your doctor may recommend prescription medication such as antibiotics or retinoids.(4) Antibiotics are a stronger method of killing off bacteria.
Meanwhile, retinoids help to stop ‘plugs’ of sebum and dead cells forming, and also act to reduce inflammation.(2)
Some doctors may also recommend the contraceptive pill for women. This is particularly common if flare-ups of acne seem to be related to your menstrual cycle or hormone-related health conditions.(4)
Changing your diet to help with acne
While many of the treatments available are very effective at managing the symptoms of acne, they do take some time to work. You may also want to support your treatment by taking some positive steps in terms of lifestyle alongside it. If so, making some changes to your diet can be really helpful.
Here are the best foods for acne, along with some recommendations of what to avoid.
Do eat: low GI foods
There is some evidence that eating a diet made up of low GI (glycemic index) foods can be beneficial for people with acne.
The glycemic index is a scoring system from 1 to 100 which measures how much a particular food elevates your blood sugar levels.
The reason it may be useful for acne sufferers is that scientists believe that high levels of insulin in the blood encourage your skin to make more sebum. Insulin is released into the blood when your blood sugar levels are raised, and helps to bring them back down to a normal level.(5)
There are a number of studies which seem to support this hypothesis.
A 2002 study looked at the prevalence of acne in two non-Western communities: the Kitavan islanders of Papua New Guinea and a group of Paraguayan hunter-gatherers called the Aché. There were no instances of acne in around 1300 participants, a fact that the researchers attributed to their diet of local whole foods.
This led scientists to wonder whether the difference was definitely down to diet, as opposed to some other unidentified reason.
An older study from 1971 shed some light on the matter. As it turns out, a community of Inuits living in Canada had no cases whatsoever of acne until Western foods were introduced. It was only once the community began to eat foods like beef, dairy, soda and processed foods that instances of acne began to occur.(5)
"A community of Inuits living in Canada had no cases whatsoever of acne until Western foods were introduced. It was only once the community began to eat foods like beef, dairy, soda and processed foods that instances of acne began to occur."(5)
How to follow a low GI diet
The glycemic index only applies to foods which contain carbohydrates. So if you’re aiming to eat lower GI foods, that’s where you should focus your efforts.
Refined grains tend to have a higher GI score because much of their dietary fibre is removed. Fibre helps stop you absorbing carbohydrates into your bloodstream as quickly, so swap out refined grains for wholegrain versions. For example, switch white bread for wholegrain or rye and choose brown rice over white.
Avoid processed breakfast cereals, snacks and cookies and replace them with fruit, vegetables and legumes. If you need to snack on the go, try one of our range of low GI crackers, made with activated nuts and seeds. Our Organic Cashew Cheese crackers hit the spot when you need something savoury, or try our Spicy Kimchi flavour for a hint of the exotic.
Not only could this benefit your skin health, but eating a varied diet of whole foods is good for your overall health as well!
Do eat: zinc
Zinc is an essential mineral that we all need for our bodies to function healthily. It plays a vital role in helping your immune system fight off bacteria and viruses, and even helps you make DNA.(6)
It seems that it can help with acne as well.
Zinc has a bacteriostatic effect on the ‘acne bacterium’ Propionobacterium acnes. This means it stops it from growing and reproducing.(4)
Studies have also found that people suffering from acne are often deficient in zinc.(5)
Getting enough zinc is especially important for vegans and vegetarians. This is because many non-vegetarians get their zinc from meat.
Another contributing factor is that many vegetarians and vegans eat a lot of legumes and whole grains. While generally speaking these are great for your health, they do also contain phytates, chemicals which can stop you absorbing zinc properly.(5)
Soaking or sprouting your beans and legumes helps to make their zinc more bioavailable.(5)
To get more zinc into your diet, aim to include foods like tofu, oatmeal, shiitake mushrooms, nuts and seeds.
Be careful with: chocolate
There are two main types of food which scientists have linked (controversially) with acne. The first is chocolate.
A study in 2011 found that participants who ate chocolate just once over the course of the study experienced worse acne symptoms. They reasoned that chocolate must exacerbate acne.(5)
There are other studies which have linked chocolate with acne, but the results were inconclusive or the methodology was later questioned by other scientists.
There is no conclusive proof that chocolate aggravates acne, nor do we fully understand what the mechanism behind the link might be.
For example, one study which looked at one group of students who ate a chocolate bar containing a large proportion of cocoa, and another which ate a candy bar containing no cocoa. Their results were pretty much identical.(5)
In short, we don’t really know if chocolate definitively worsens acne, but there have been studies which hint that it might. Our advice would be to approach it with caution; perhaps keep an eye out for a few days after you’ve eaten chocolate to see if you notice a difference in your symptoms.
Scientists also note that, since dark chocolate has more antioxidants and less milk that other types, its pore-blocking effects may be smaller. This brings us onto the second type of controversial food: milk.
Be careful with: dairy, particularly skimmed milk
Many people cite dairy as one of the worst foods you can eat for acne, but is there any truth to this claim?
Most concerns about dairy are related to the presence of hormones in cow’s milk. In particular, scientists have pinpointed one compound called ‘insulin-like growth factor’ or IGF-1. It’s thought to encourage the process which blocks your pores.
Research has found a link between high levels of IGF-1 (among other compounds) and the likelihood of experiencing acne.(5)
Hormones such as IGF-1 are soluble in fat, so you would assume that drinking skimmed milk would help avoid its effects, Curiously, though, skimmed milk actually seems to be worse for blocking pores. Scientists believe that this is because the production methods used to make skimmed milk change the bioactivity of certain compounds which can lead to ‘comedogenesis’, or blocked pores.(5)
However some researchers have called the link between milk and acne into question. For example, one of the studies asked participants to remember what they had eaten a year previously, which is obviously open to error. Nor did it take into account factors such as genetics.(7)
While there is clearly some debate over the science, it is worth noting that the American Academy of Dermatology Association lists cow’s milk as a food which may lead to an increase in acne breakouts.(8)
The best foods for acne
The strongest scientific evidence we’ve been able to find about the best foods for acne focuses on the importance of a low GI diet.
This means eating lots of healthy whole foods – which are good for you anyway – and avoiding processed, high-sugar foods.
Fortunately, it’s an easy change to make, and one that your skin (and your whole body) will thank you for.
You should also think about whether you are getting enough zinc from your diet, especially if you are vegetarian or vegan. Consider soaking and sprouting your legumes to get the best out of them.
When it comes to chocolate and dairy, the jury is out. The evidence suggests that there may be a link with worsened acne, but it’s not definitive.
We recommend keeping a food diary for a few weeks and noting down when you experience a flare-up. This will help you figure out which foods make acne worse for you. If you do eat chocolate and dairy as part of your diet, you should be able to see if there’s a link for you personally.
That way, you can make a much more informed decision about cutting those foods out of your diet.
However the main advice, as it so often is, is to focus on healthy whole foods. They’ll have you feeling and looking great, and are a great addition to a treatment plan from your doctor.
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