Acne is a common inflammatory skin condition caused by inflamed sebaceous glands or hair follicles. Breakouts occur most commonly during puberty and adolescence, but many people continue to experience acne well into adulthood.
Many different factors can contribute to acne. However, it is clear that diet may have an influence, and nutrition often receives considerable attention when acne is studied and discussed.
In this article, we review some of the research conducted in this area to see where the evidence points. The focus is specifically on the impact of diet and nutrients on the development and treatment of acne. Other treatment methods, such as skincare routines, will therefore not be covered in this article.
What you will learn in this article:
- Which foods have been shown to potentially worsen acne
- Which foods, on the other hand, may help reduce acne
- Which supplements may have the potential to significantly reduce acne symptoms
Study 1
The first study is a review examining previous research on the relationship between acne and diet. It includes 53 articles—11 intervention studies and 42 observational studies—all published between 2009 and 2020.
The study found that foods with a high glycemic index (GI) or glycemic load (GL), dairy products, fatty foods and chocolate were associated with worsening acne, while fatty acids, fruit and vegetables were associated with reduced acne.
Study 2
Study 2 is a cross-sectional study examining the relationship between diet and acne severity among 2,467 Thai participants (681 men and 1,795 women) aged 18–44.
Participants completed an online questionnaire and self-assessed their acne using the revised Leeds acne grading system. Their dietary habits over the previous three months were assessed using a food frequency questionnaire. The results were adjusted for potential confounding factors such as age, acne among immediate family members, exercise habits and sleep.
Of the 2,467 participants, 51.66% reported having mild acne, while 18.34% reported having no acne at all.
Regarding the relationship between diet and acne, the study reached the following conclusions:
- Consuming at least 100 grams of chocolate per week was associated with a 29% higher likelihood of worsening acne.
- Eating fatty and fried foods at least three times per week was associated with an 84% higher likelihood of worsening acne.
- Eating white rice daily was associated with a 78–80% higher likelihood of worsening acne.
- Consuming at least three servings of tea per week was associated with a 26% lower likelihood of worsening acne.
- Drinking at least three glasses of tea without milk or sugar per week was associated with a 39% lower likelihood of worsening acne.
- Brown rice, dairy products, sweets and sweetened beverages were not associated with worsening acne.
An important limitation of this study is that participants were recruited online and consisted mainly of women seeking information about acne. This creates a risk of selection bias, and the prevalence of acne among participants was probably higher than in the general population.
Another point worth mentioning is that the lack of an association between dairy products and acne in this study could potentially be explained by participants' relatively low dairy consumption. The median intake was four glasses of milk per week.
Study 3
This case-control study investigated the relationship between vitamin D status, IL-17, and the presence and severity of acne.
IL-17 is a group of inflammatory cytokines that trigger various pro-inflammatory responses in the body.
The case group consisted of 50 acne patients aged 15–45, while the control group consisted of people without acne who were matched by age and sex. Levels of IL-17 and vitamin D, as well as the prevalence of vitamin D deficiency*, were measured and compared with participants' acne symptoms.
The study found that average vitamin D levels did not differ significantly between the acne group and the control group. However, vitamin D deficiency was more common among participants with acne.
The study also found that higher levels of the pro-inflammatory IL-17 and lower vitamin D levels were associated with greater acne severity and the presence of acne on the body, including the chest, back and shoulders.
A negative correlation between IL-17 and vitamin D was also identified. In other words, higher vitamin D levels correlated with lower IL-17 levels.
No adjustments were made for potential confounding factors, such as family history or sun exposure, which may somewhat reduce the strength of the study's conclusions.
Vitamin D deficiency was defined in the study as a Vitamin D 25-OH level below 10 ng/mL, equivalent to 25 nmol/L.
Study 4
The fourth study is a systematic review and meta-analysis of 24 studies involving a total of 2,445 participants. It investigated whether zinc—which has anti-inflammatory and antibacterial properties and may reduce oil production in the pores—could help reduce acne.
- 12 studies found that people with acne had lower zinc levels.
- 7 studies found that zinc, either taken orally or applied to the skin as an ointment or cream, reduced acne.
- 7 studies found that zinc supplementation improved participants' acne, while topical zinc did not make a difference.
- 4 studies produced varying results that, overall, suggested topical zinc may be more effective than oral zinc supplementation in reducing acne.
Overall, the review concluded that zinc, whether taken orally or applied to the skin, may help alleviate acne symptoms.
Practical Tips
Research is useful, but you are probably wondering what all of this actually means when deciding what to eat to help reduce or prevent acne.
Based on the findings of the studies above, here are our practical recommendations.
Foods you may want to limit if you suffer from acne
Foods with a high glycemic index (GI) or high glycemic load (GL). In simple terms, it may be beneficial to limit foods that cause rapid spikes and drops in blood sugar, including:
- Dairy products
- Fatty and fried foods
- Chocolate*
- White rice
Our observation is that it may be reasonable to assume that milk chocolate could have a greater impact than dark chocolate with a low sugar content. Dark chocolate generally has a lower GI and GL and also contains higher levels of potentially anti-inflammatory compounds.
Foods you may want to eat more of if you suffer from acne
Foods with a low glycemic index (GI) or glycemic load (GL)—in other words, foods that help maintain more stable blood sugar levels—including:
- Fruit
- Vegetables
- Healthy fatty acids
- Tea
- Foods rich in vitamin D, particularly fatty fish such as salmon, mackerel and herring, as well as eggs, meat, and dairy products or plant-based drinks fortified with vitamin D
- Foods rich in zinc, such as meat, organ meats, dairy products and wholegrain foods
Supplements that may help if you suffer from acne
The two nutrients that have shown associations with both the occurrence and severity of acne are:
- Vitamin D
- Zinc
