The acne diet or more accurately, the acne-free diet, is simply a way of eating claims to improves or eliminates acne. There is some debate in the medical community about the impact of diet on acne; however, there is a body of evidence to support the idea that what is eaten may affect the skin.
By reviewing research from over 40 years, doctors such as dermatologist, Dean Goodless have developed a set of recommendations regarding foods that may prevent acne. In his book The Acne-Free Diet Plan, Dr. Goodless presents his recommendations. He suggests eating a diet low in fat and high in fiber along with avoiding peanut product, fried foods, excessive salt, dairy products, foods that are high in refined sugars, and high carbohydrate foods.
As long as people have had pimples, there have been attempts to clear them up quickly or prevent them all together. Most cultures have folk remedies to help clear the skin. It wasn’t until the last 50 years that serious scientific research has been conducted to confirm or disprove these folk tales and myths. One of the earliest studies about food and acne focused on chocolate. This study found that chocolate did not increase acne breakouts. Other studies since have confirmed this finding.
For the most part, acne treatment has been the emphasis of research; however, there have been isolated studies that explored the effect of specific vitamin and mineral supplements on acne. Other studies have investigated ethnic groups and communities from the
Possible causes of acne
- The hormone increase in teenage years (this can cause the oil glands to plug up more often)
- Hormone changes during pregnancy
- Starting or stopping birth control pills
- Some types of medicine
- Greasy makeup
source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, U.S. Department of Health and Human Services.
(Illustration by GGS Information Services/Thomson Gale.).
Pacific Islands to Africa where there is little or no incidence of acne, even during puberty. When the diets of these people are compared to the typical Western diet, there are nutritionally significant differences. The ethnic groups with very low incidence of acne ate predominately plant-based diets that were low in fat and virtually sugar-free. The typical Western diet is heavy in meats, saturated fat, refined sugar, and highly processed foods. By studying these differences, doctors and researchers have developed suggestions for dietary changes to improve or eliminate acne.
Integrating the results of many studies, dermatologists and nutritionists have developed a list of foods to avoid and beneficial vitamins and minerals to consume. The following acne diet has been proposed to help prevent acne breakouts:
- Eat 20 to 30 grams of fiber every day–Fiber helps keep the colon clean and may remove toxins from the body before they reach the skin.
- Eat a low fat diet–The cultures whose natural diet was low in fat, had less acne, and high fat consumption may elevate hormone levels in the body that cause blemishes on the skin.
- Avoid peanut products–Peanut products were found to cause acne flare ups in a study of 500 adolescents.
- Avoid fried foods—Fried foods were found to caused break outs.
- Limit salt intake especially table salt or iodized salt– Many people with acne have elevated levels of iodine, found in table salt, in their blood stream during acne flare ups.
- Avoid highly salty sacks such as chips, lunch meats, canned foods, and salted popcorn–These foods are high in salt and, in some cases, fat.
Acne Vulgaris— An inflammatory disease of the skin characterized by pimples and cysts that may cause scarring in severe cases.
Carbohydrate— An organic compound that supplies energy to the body.
Dermatologist— A doctor who specializes in the treatment of the skin.
Glycemic index— A scale for rating how quickly foods are converted to glucose or sugar by the body. It describes the impact on insulin levels of foods as they are digested.
Hormone— Substances in the body that regulate a process such as metabolism or growth.
Insulin— A hormone that regulates the conversion of food into glucose or sugar so it can be used by the body for energy.
Metabolism— The process by which food is converted into energy.
Nutritionist— A specialist in the field of diet and nutrition.
PreMenstrual— The days prior to menstruation in a woman.
Sebaceous glands— Small glands in the skin, usually part of hair follicles, that produce a fatty substance called sebum.
Sebum— The fatty substance secreted by sebaceous glands. It helps moisturize and protect skin and hair.
- Avoid dairy products such as milk, cheese and ice cream
- Avoid highly processed carbohydrates such as sodas, candy, and baked goods–High carbohydrate foods raise the level of insulin in the blood and elevated insulevel may raise the levels of acne–causing hormones in the body.
In addition to following the acne diet suggestions, taking the following supplements are proposed to also help prevent acne:
- Vitamin A (may be toxic consult your doctor first)
- Vitamin E
- Vitamin B6
- Omega-3 Fatty Acid
Opinions vary in the medical community as to whether or not diet plays a significant role in acne. Some common misconceptions about the connection between food and acne breakouts have been disproved. For example, according to several studies, chocolate does not cause acne.. Acne is caused when glands in the skin called sebaceous glands begin to form sticky oil called sebum. These glands are stimulated by hormones that become active at puberty which is why acne occurs most often in adolescence when these hormones are produced in abundance. The oils formed by the sebaceous glands hold dead skin cells preventing them form being sloughed off. As these cells die, they create the perfect environment for bacteria to grow. When these bacteria called Acne Vulgaris become too plentiful, they will attempt to erupt from the skin causing a pimple. Sometimes, when the bacteria grow, the body sends white blood cells to fight the infection. This natural reaction can cause painful, large cysts to form in the deeper layers of skin. Chocolate may not cause acne, but the fat and sugar that usually accompanies chocolate may.
Eliminating certain foods from the diet and increasing the amount of specific vitamins and minerals may help reduce the amount of sebum produced and prevent acne breakouts. However, the interaction between diet and acne is not a simple cause and effect relationship. If an oily food is eaten, the oil does not travel to the skin or cause it to be oily, but high levels of fat in the blood may effect the production of hormones such as testosterone. Higher levels of hormones may cause acne to worsen.
Many high carbohydrate foods are believed to worsen acne. Researchers have discovered that high carbohydrate foods increase the levels of insulin in the blood. High levels of insulin can raise hormone levels in the blood.
Researchers recognize that not all carbohydrates are bad. Some carbohydrates digest more slowly than others, causing a gradual rise in blood sugar after eating. Researchers have developed a glycemic index to rank carbohydrates and other foods according to the effect they have on blood sugar.
The glycemic index is a scale of 0–100. Foods with higher glycemic index ratings break down quickly and cause a sharp spike in blood sugar. When blood sugar rises quickly, the body produces a surge of insulin to lower the amount of glucose in the blood. Insulin is a hormone that helps the body take sugar (glucose) out of the bloodstream and put it into cells, where it can be used for energy or stored in fat. Foods with lower glycemic index ratings break down more slowly. They cause a more gradual rise in blood sugar, which means less insulin will be needed.
Foods that have a high glycemic index rating include: white bread, white rice, white potatoes depending on how they are cooked, beer, corn products and some products containing refined sugars. Foods with moderate glycemic index ratings include: whole grain breads and pastas, brown rice, sweet potatoes, green peas, many fruits (especially when eaten alone) and yogurt. Many of these foods are on the list of foods to avoid in the acne diet.
Low glycemic index or no GI foods include: rye grain, nuts, legumes such as black beans and lentils, green vegetables, apricots, and cherries. These foods may be enjoyed an may not worsen acne.
Foods that are high in fiber tend to have lower glycemic index numbers, because fiber takes longer to digest. Studies have shown that the presence of other foods such as fats like olive oil, can also slow digestion and keep blood sugar from rising too quickly. The glycemic index can be used along with the acne diet, to help choose which carbohydrates can be eaten with the least effect on blood sugar.
Even if many dermatologists do not believe dietary changes will improve acne, they see little harm in adopting a diet that encourages eating fruits and vegetables and limits processed and high sugar foods.
Eating foods low on the glycemic index may help prevent other medical conditions such as diabetes, heart disease, and obesity.
Limiting the amount of dairy products in the diet may limit the amount of calcium consumed, for that reason, a calcium supplement may be needed to insure daily dietary calcium requirements are met. Poor intakes of calcium can be very damaging to one’s health.
Zinc supplements can cause stomach upset. Authors of acne diet plans recommend no more than 30mg of zinc per day to avoid this.
Vitamin A is a fat soluble vitamin. That means that excess vitamin A is stored in your body rather than eliminated in your urine. Too much vitamin A can be harmful. Consult a doctor before taking vitamin A supplements.
QUESTIONS TO ASK THE DOCTOR
- What type of acne do I have?
- Will this diet improve my acne?
- Can this diet hurt me?
- Will this diet make my acne worse?
- How long do I need to follow this diet?
Pregnant women or those who may become pregnant should not take vitamin A supplements. Excessive amounts of vitamin A may cause birth defects in the unborn children of women who consume too much vitamin A.
There are few risks associated with an acne diet. Most relate to taking zinc, vitamin A, and calcium. Zinc may prevent the body from absorbing enough copper. To avoid this, take a supplement that specifically states that it does not prevent copper absorption.
High doses of vitamin A can be toxic. Many acne prescriptions contain concentrated forms of vitamin A. Consult a doctor before taking vitamin A supplements.
Limiting intake of calcium can cause deficiency and significant health problems. Supplementation may be necessary.
High doses of vitamin A can cause birth defects if taken during pregnancy. Pregnant women should, under no circumstances take vitamin A supplements or medications containing vitamin A.
While most dermatologists will not confirm that altering diet may prevent acne, it is standard practice for many doctors to advice patients to avoid foods that seem to cause more severe breakouts.
It is widely accepted that supplements such as zinc and vitamin A help reduce the number and severity of acne breakouts. In fact, Acutane and Retin A, popular prescription medications used to treat acne are both made from forms of vitamin A.
Early studies about diet and acne focused on specific foods believed to trigger acne breakouts. Most of these studies found no evidence that individual foods cause acne.
Studies of the diets of ethnic groups that have a low incidence of acne form the basis of most of the acne diets. Studies of the diets of tribes in New Guinea, Paraguay, and the Bantu of South Africa, all of whom have little or no acne, show that they eat a primarily plant-based diet. Similarly, in other countries where the diet is plant-based such as Japan, there is a relatively low occurrence of acne.
Studies have shown that half of acne patients tested had abnormal glucose levels, and in another study, 80%of premenstrual women with acne had abnormal glucose metabolism These data and others that show a high carbohydrate diet increases the levels of testosterone in the blood of both men and women, have lead to the recommendation of reducing the amount high carbohydrate foods or foods containing high levels of refined sugar to treat acne.
Researchers have developed a method for measuring how quickly carbohydrates are converted into glucose. The more rapidly a food is converted to glucose, the higher the level of insulin is secreted into the blood. The scale is called the glycemic index. Eating lower glycemic index foods may help reduce the number and severity of acne breakouts.
A large study of over 45,000 nurses found a link between the amount of dairy products these women consumed and the severity of acne they experienced. Women who reported consuming higher amounts of dairy products reported more severe acne. Similarly, the two ethnic groups with little or no acne also consumed no dairy products.
Several studies have compared the results of zinc supplementation with oral antibiotic therapy to resolved acne and found zinc to be almost as effective as the antibiotic tetracycline.
Goodless, Dean R. MD. The Acne-Free Diet Celebration, FL: New Paradigm Dermatology, 2005.
Perricone, Nicholas MD. The Acne Prescription: The Perri-cone Program for Clear and Healthy Skin at Every Age New, NY: HarperCollins, 2003.
Adebamowo, C. A., D. Spiegelman, F. W. Danby, A. L. Frazier, W. C. Willett, and M. D. Holmes. “High School Dietary Intake and Teenage Acne.” JAm Acad Dermatol 52 (2005): 207–14.
Ayres, S. and R. Mihan. “Acne Vulgaris: Therapy Directed at Pathophysiologic Defects.” Cutis 28 (1981): 41–42.
Cordain, L., S. Lindeberg, M. Hurtado, K. Hill, S. B. Eaton, and J. Brand-Miller. “Acne Vulgaris: A Disease of Western Civilization.” Arch Dermatol 139 (2002): 1584–90.
Deplewski, D. and R. L. Rosenfield. “Growth Hormone and Insulin-like Growth Factors Have Different Effects on Sebaceous Cell Growth and Differentiation.” Endocrinology 140, no. 9 (Sept 1999): 408–994.
Gaul, L. E. “Salt Restriction in Acne Vulgaris.” Indiana State Med Assoc 58 (1965): 839–42.
Levin, O. L. and M. Kahn. “Biochemical Studies in Diseases of the Skin: II Acne Vulgaris.” Am J M Sc 164 (1922): 379–85.
Leung, L. H. “Pantothenic Acid Deficiency as the Pathogenesis of Acne Vulgaris.” Medical Hypotheses 44 (1995): 490–92.
Michaelsson, G., L. Luhlin, and K. Ljunghall. “A Double-Blind Study of the Effect of Zinc and Oxytetracycline in Acne Vulgaris.” Br JDermatol97 (1977): 561–66.
Yeh, H.P. “Acne in Taiwan.” J Formosan Med Assoc 74 (1975): 212–19.
Deborah L. Nurmi, MS