As if being a teen wasn’t hard enough, up to 80-90% of teens suffer from acne. Acne occurs when oil and dead skin plug the pores and result in outbreaks of lesions (aka pimples or zits). The severity ranges from mild to severe and finding an effective treatment is vitally important because acne can significantly affect your teens quality of life because in some cases it may lead to distressing symptoms like social withdrawal, anxiety or even depression.

There are quite a few factors that impact acne including genetics as well as hormonal, inflammatory and environmental influences. The discussion around how diet impacts skin health and acne has been raging on for decades¹ and the current consensus is that diet does not cause acne, but nutritional adjustments in conjunction with dermatology therapy may be beneficial².

WHAT KIND OF DIET AGGRAVATES ACNE?

Young adults with moderate to severe acne have reported that they often eat a diet that contains a significant amount of high glycemic index (GI) foods and cow’s milk.

HIGHT GLYCEMIC INDEX (GI)

High GI foods are generally quite processed, meaning that they have been stripped of some of their healthy nutrients and they raise our blood sugar levels quickly. On the other hand, low GI foods are generally unprocessed or minimally processed. They usually contain more nutrients and provide us with slow and sustained energy.

The effect that high GI foods can have on your teen’s skin is two fold 1) including more unprocessed or minimally processed foods in your diet may increase your micronutrient intake, which may help improve general skin health and reduce inflammation and 2) blood sugar level spikes also increase inflammation in the body and the excess sugar acts as a fuel source to the sebaceous glands causing them to excrete more sebum³-⁵ and high sebum production plays a role in acne. Low GI diets may also lead to less androgen hormone release (testosterone and androsterone), which may also reduce sebum levels. Unfortunately the evidence to support this is weak as most of the studies conducted to test this theory are small in size and also contain more males than females⁶. So we can’t really generalise this to entire populations (like all teens). However, from an overall health perspective, low GI foods are generally a good choice.

To move towards a lower GI diet, incorporate the following swaps⁷:

2. Cow’s milk

Some studies have suggested that drinking this cow’s milk may be linked to an increase in acne breakouts. In general all types of cow’s milk (whole, low fat and skim) are linked to acne⁸-¹º, but some of the research specifically highlights low fat/ skim milk (specifically in boys⁹.

Although the reason behind why this seems to happen is not entirely clear, one theory is that a specific hormone naturally present in milk (insulin-like growth factor-1 or IGF-1) may increase androgen secretion. IGF-1 is an important contributor to sebaceous gland growth and increases the amount of sebum produced¹¹. Interestingly, low fat/ skim milk has more IGF-1 than full cream milk and so this may be the reason why some studies show an increase in acne when low fat milk is consumed. While milk has been implicated in these studies, none have found that milk-products like yoghurt or cheese, lead to more breakouts. More research needs to be conducted to understand why, but the silver lining is that not all dairy products need to be removed, making meeting nutrient goals a little easier.

Milk is a great source of a variety of nutrients (macro and micro) and is specifically encouraged for it’s bone health benefits. If your teen does decide to give milk a break, it’s important to make sure that they eat enough bone health micronutrients, like calcium. 1 cup of milk contains about 420mg calcium⁷. Here are a few non-milk calcium sources:

ANTI-INFLAMMATORY DIET

As we can see, besides the hormonal component, inflammation plays a pivotal role in the development of acne. In addition to this, inflammation is known to be the basis of most diseases, so eating an anti-inflammatory diet may help with more than just skin health⁷.

The premise of an antiinflammatory diet is to increase the amount of variety you eat regularly and focus mainly on whole, unprocessed foods that are chock a block filled with nutrients (and specifically phytonutrients and antioxidants).

THIS MEANS FOCUSING ON A VARIETY OF:⁷

• Colourful fresh fruits and vegetables
• Unrefined and whole grain starches (low GI)
• Lean proteins
  • Vegetarian: Beans, lentils, chickpeas, tofu
  • Non-vegetarian: Fish, poultry and meat
• Healthy fats and oils like olive oil, avo, nuts and seeds
• Anti-inflammatory spices like ginger, curry, turmeric and rosemary

CONCLUSION

All in all, creating well balanced meals made up of a variety of unprocessed or minimally processed foods is the way to go. This way of eating is beneficial, not just for your teens skin health, but for the entire family’s long-term well-being. Improving the appearance of acne can be an important driver for your teen to start making healthful changes to their diet, but giving them all the right facts is important to prevent extreme (and often unnecessary or even dangerous) dietary restrictions. Tackling this as a family can also help your teen to feel more supported and is likely to result in long term, sustainable habits and dietary changes. Start small and be consistent.

REFERENCES

1. Baldwin , Tan J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol. 2021.
2. Burris J, Rietkerk W, Woolf K. Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults. J Acad Nutr Diet. 2014;: p. 384-492.
3. ​​Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007;86(1):107-15. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/17616769
4. Reynolds RC, Lee S, Choi JY, Atkinson FS, Stockmann KS, et al. Effect of the glycemic index of carbohydrates on Acne vulgaris. Nutrients. 2010;2(10):1060-72. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/22253996
5. Smith R, Mann N, Mäkeläinen H, Roper J, Braue A, et al. A pilot study to determine the short-term effects of a low glycemic load diet on hormonal markers of acne: a nonrandomized, parallel, controlled feeding trial. Mol Nutr Food Res. 2008;52(6):718-26. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/18496812
6. Cao H, Yang G, Wang Y, Liu JP, Smith CA, Luo H, Liu Y. Complementary therapies for acne vulgaris. Cochrane Database Syst Rev. 2015 Jan 19;1:CD009436. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/25597924
7. Mahan LK, Escott-Stump S, Raymond J. Krause’s Food and the Nutrition Care Process. 13th ed.: Elsevier; 2012.
8. Adebamowo CA, Spiegelman D, et al. “Milk consumption and acne in adolescent girls.” Dermatol Online J. 2006;12(4):1.
9. Adebamowo CA, Spiegelman D, et al. “Milk consumption and acne in teenaged boys.” J Am Acad Dermatol. 2008;58(5):787-93.
10. Di Landro A, Cazzaniga S, et al. “Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults.” J Am Acad Dermatol. 2012 ;67(6):1129-35.
11. Clatici V. Milk and Insulin Growth Factor 1 (IGF1) – Implication in Acne and General Health. Romanian Biotechnological Letters. 2015;20(1):10013-10025.