Acne occurs when the pores in your skin become blocked with bacteria, dead skin cells, or both.
Your pores can also become clogged when your body produces too much oil or sebum.
Clogged pores lead to pimples, blackheads, and other forms of acne.
You're at a higher risk of developing acne during puberty because, at this time of your life, your body ramps up production of a hormone known as insulin-like growth factor. (IGF-1)
A 2014 study published in the Journal of Clinical Aesthetic Dermatology indicates that high levels of IGF-1 can increase sebum production and thereby exacerbate acne symptoms. (Katta et al., 2014)
Avoiding foods that raise IGF-1 can help reduce acne breakouts. So can limiting other foods that we list below. A high glycemic load or excessive caloric intake also contribute to acne development. An individual's diet is important when considering what changes can be made to improve acne.
We also recommend a few supplements — at the bottom of this page — that can help address your symptoms.
Foods That Can Worsen Acne
If you suffer from acne, you may want to avoid these foods as they can trigger a flare-up or worsen a current breakout.
Not everyone tolerates dairy products well. This is either due to the lactose content, which results in digestive upset for some, or the proteins such as casein and whey, which usually have more systemic effects in susceptible individuals.
Another key factor is the naturally occurring (and sometimes added) hormones found in dairy and the stimulation of growth hormones in an individual from dairy consumption.
It is these proteins and hormones that are the culprits when dairy causes acne.
A meta-analysis from 2018 showed that people between the ages of 7 and 30 were more likely to suffer from acne if they had dairy vs. those who did not. (Juhl et al., 2018)
The casein protein in dairy can be inflammatory for some individuals, especially those with a leaky gut. Additionally, both casein and whey stimulate the release of IGF-1, which increases sebum production (a key factor in acne development).
Fatty foods, such as fast food, potato chips, and deep-fried food, is one of the main types of food that cause acne. A 2012 study of Turkish men published in The European Academy of Dermatology and Venerology revealed a positive correlation between eating fast food and acne outbreaks. (Aksu et al., 2012)
Medical experts are not exactly sure how eating fatty foods causes acne, but some suggest fast food may affect hormone levels and gene expression. (Agamia, 2016)
It may be that the cheap oils found in these foods are pro-inflammatory due to Omega 6. In may also be that fried foods are high in calories, contributing to insulin resistance, which can affect the proper regulation of skin health.
There is mixed and somewhat weak evidence that soy causes acne, but there are many anecdotal reports from individuals who reported skin improvement after removing soy from their diet.
Soy products include tofu, soy burgers, tempeh, miso, soy sauce, and soy lecithin (an emulsifier found in processed foods such as chocolate).
The only way to know if soy is causing acne is to remove it for some time, usually two months. This is usually best done as part of an elimination diet where other suspected culprits can also be removed and then challenged.
Sugar and Sweetened Foods
Sugar, along with high-glycemic foods such as donuts, cookies, and many processed foods, can cause your blood sugar and insulin levels to spike, putting your glycemic index out of kilter.
This, in turn, results in inflammation throughout the body, which can worsen acne. Sugar also causes an increase in a hormone known as insulin-like growth factor (IGF-1), which can trigger your sebaceous glands to produce more oil and increase the risk of acne. (Cappel et al., 2005)
Omega-6 Fatty Acids
Omega-6s comprise a group of polyunsaturated fatty acids found in foods such as seeds, nuts, and vegetable oils.
The typical Western diet contains excessive amounts of omega-6 fatty acids. This can be problematic if you suffer from acne. A diet with an imbalance of omega-6 and omega-3 fatty acids results in an inflammatory state throughout the body, which can exacerbate or trigger acne. (Tanghetti, 2013)
Refined grains, such as those in white bread, contain gluten. Gluten is a group of proteins present in wheat, barley, rye, and triticale.
While gluten can be dangerous for people who have Celiac disease, many other people have a sensitivity to gluten that can lead to numerous uncomfortable symptoms such as abdominal pain, bloating, gas, diarrhea, and constipation.
Your gut produces a substance known as zonulin, which regulates the permeability of your intestines. Gluten can affect zonulin levels, making your gut excessively permeable. (Fasano, 2011)
When this happens, bacteria and endotoxin (LPS or lipopolysaccharide) have easy access to your bloodstream, which may result in breakouts of acne and other skin disorders.
Research has suggested a higher rate of sensitivity to endotoxin in those with acne than those without acne. (Bowe and Logan, 2011)
Too Much Meat
Eating too much red meat can worsen acne, so if you’re following a Paleo diet and you’re prone to acne, watch out.
Red meat is rich in vitamin B12 — the vitamin vital to the functioning of the brain and the nervous system.
A recent study by researchers at UCLA's David Geffen School of Medicine revealed that vitamin B12 alters the behavior of genes in facial bacteria.
This change in activity can trigger inflammation and result in acne, even in people who normally have clear skin. (Li, 2015)
This research involved a small sample and was focused on external B12 supplementation rather than dietary intake. Research is ongoing and will ideally look at dietary B12 intake more closely.
There has, for some time, been conflicting debate over whether chocolate can cause acne.
However, there is a possible like between acne and chocolate. In a 2014 study published in the Journal of Clinical and Aesthetic Dermatology, a group of 14 males, between the ages of 18 and 35, were given capsules filled with either unsweetened 100-percent cocoa or alternatives.
After seven days, the subjects who had eaten the capsules filled with cocoa showed an increased number of acne lesions. (Caperton et al., 2014)
More research is needed. In some cases, the acne may not be from the cacao itself but added ingredients such as dairy or soy lecithin. Dairy-free dark chocolate without any soy lecithin added is often well tolerated.
Soda and Energy Drinks
Soda drinks are typically so high in sugar that they can contribute to insulin resistance. This upsets the body's delicate hormonal balance.
Even sugar-free sodas can upset your gut because they contain artificial sweeteners that can disrupt the balance of the gut's beneficial microbacteria. (Wang et al., 2018)
There is a strong link between the gut and the skin. Anything that upsets your digestive system can have a negative effect on your skin, particularly if you are prone to acne breakouts.
Not only are energy drinks often loaded with sugar, but many are also fortified with B vitamins — such as B12 — which can trigger an acne response in some people.
Alcohol may trigger or worsen acne in three different ways.
First, alcohol can cause inflammation by triggering excess production of microflora-derived lipopolysaccharide (LPS) in the gut. (Wang et al., 2010)
When LPS gets out of control, it impairs gut function, which can also affect the immune system. If you suffer from acne, this can worsen its effects.
Second, drinking alcohol can cause dehydration. When your skin becomes dehydrated, it becomes dry. Although most people associate oily skin with acne, dry skin can also make this condition worse. (NCBI, 2013)
Third, heavy alcohol consumption can prevent the absorption of certain nutrients, such as zinc. (Barve et al., 2017)
Zinc helps to protect the skin and reduces the risk of inflammatory responses. Too much alcohol can worsen acne and prevent it from healing quickly.
If you suffer from a skin condition such as intermittent or severe acne, take a look at your diet to see where improvements can be made.
If you are not sure if or how your diet is affecting your acne, keep a food journal so you can see if your acne breakouts coincide with consuming specific foods and beverages.