Which foods can indirectly cause acne?

Which foods do you need to steer away from if you suffer from acne? Although controversial, this question is very often posed when it comes to those suffering from numerous inflammatory dermatoses, and with good reason. Contemporary research carried out in the fields of dermatology and endocrinology (since junk food is a source or at the least a contributing factor to numerous metabolic diseases) increasingly explicitly acknowledge that there indeed is a connection between unhealthy food and problems in the proper functioning of the human organism. No food causes acne directly, but there are certain foods which have been proven to contribute to the creation of “ideal” conditions for the development of acne. Specifically, when we are talking about inflammatory skin diseases (which include acne), there are two large food groups that need to be avoided. The first is food with a high glycaemic index.

There is a very clear and well-researched connection between food with a high glycaemic index and acne vulgaris. Namely, intake of foods that are rich in sugar and as a rule have a high glycaemic index brings the organism into a state of hyperinsulinemia. Increased insulin levels result in an increased secretion of androgen hormones which in turn leads to increased sebum production. Although increased sebum production in itself is not the cause of acne it can certainly contribute to the possibility of developing clogged pores which are the perfect microclimate for the development of acne.

The state of hyperinsulinemia brings about an increase in the level of circulating hormone IGF-1 (insulin-like growth factor) and a decrease in the level of IGFBP-3 (insulin-growth factor binding protein) whose misbalance has been proven to directly affect the proliferation and apoptosis (programmed death) of skin cells – keratinocytes. This process contributes to irregular functioning of the skin, or to be more precise, it has a negative impact on the normal desquamation function which is a crucial precondition for clear skin.

The process of increased sebum production and hyperkeratinisation creates a never-ending cycle in which one mechanism prompts the other towards creating ideal conditions for bacterial proliferation of naturally present P. acnes bacteria, very easily leading to inflammation. Even the smallest hormonal fluctuation in favour of androgen hormones (such as during PMS) may lead to a substantial inflammation which is cyclically repeated from one month to the next. Standard western diet rich in saturated fats, sugar-filled carbohydrates and processed foods (salty snacks, sweets, bread, etc.) certainly plays a part in the pathogenesis of inflammatory disorders of the skin. A change in diet by itself most probably won’t cure acne completely but attempting to treat acne without changing dietary habits will prove to be equally unproductive.

A second large food group which has been proven to have a negative effect on the appearance of acne (especially those of hormonal nature) are dairy products. Milk, whether organic or not, is rich in hormones which lead to increase of IGF-1 hormone levels, just as refined carbohydrates do. Receptors for this hormone are located in keratinocytes. In persons suffering from acne a very clear and very definite link has been found between the amount of IGF-1 hormone, dihydrotestosterone or DHT (testosterone metabolite), amount of sebum and the intensity of acne lesions since IGF-1 has been proven to stimulate the enzyme 5α-reductase responsible for metabolising testosterone in DHT. The number of acne lesions or the intensity of proliferation of sebocytes has a positive correlation to IGF-1 levels which in turn have a positive correlation to the consumption of dairy products.

Not only does IGF-1 take action in a way that it increases the level of androgen hormones but it also decreases the levels of SHBG (sex hormone binding globulin) which enables the bioavailability of those androgen hormones. Milk is rich in progesterone but also in DHT precursors (such as 5α-pregnanedione and 5α-androstanedione) which through enzymatic pathways are easily converted into DHT. This is very unfortunate for people already suffering from oily skin, since DHT has a direct effect on the intensity of sebum production. Therefore, for people who are already suffering from hormonal acne adding endogenous hormones from food may have catastrophic consequences on the entire hormonal functioning of the organism, and even on the health of the skin.

A food which is frequently called out for causing acne is chocolate. Classic milk chocolate unfortunately contains the “winning” combination of milk and large amounts of sugar so it’s not at all unusual that it causes skin problems. However, don’t despair – chocolate without milk, a high percentage of cocoa and a low percentage of sugar will not present a problem for most people, consumed as a dessert in moderate quantities. Each dietary change needs at least three months to show real results, so you mustn’t give up too early and too easily. Even if the change in diet does not have a significant impact on your acne, cutting out the above-described foods from your diet will most certainly have a positive effect on your health.

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