The role of food in the aggravation of acne has been a
controversial topic since a long time. Although there have been several
case reports, surprisingly, very few systematic studies have been done on
Fulton et al (JAMA,1969) in a short-duration study of 65
patients, showed that there was no association between the consumption of
chocolate bars and acne, sebum production and composition, and
comedogenicity. Interestingly, the chocolate bars used in their study had
very low milk component, in contrast to a typical chocolate bar of that
period. The perceived association with commercial chocolate products may,
therefore, be a result of the presence of milk in them. The above study
has also been refuted by Bruce and Laila Mackie (Australian Journal of
Dermatology,1974) for not making adequate allowances for the dietary
properties of chocolate. They hypothesized that fats with higher melting
points may reduce sebum flow, and thus cause the plugs to become comedones,
the primary lesions of acne.
In another study, patients were fed large amounts of food
that they believed exacerbated their acne, but no noticeable effect was
found after one week.(Anderson PC, American Family Physician, 1971).
In contrast, as early as in 1949, Robinson had reported in
South Medical Journal that 1925 patients who kept food diaries had noted
that milk was the most common food associated with their acne flares.
The incidence of acne in young black populations (eating a
traditional diet) in both Zambia and Kenya is much less than that of young
blacks in the U.S. Observational studies indicate that a low fat, high
fiber and low refined carbohydrate diet may be beneficial for acne (Frank,
1971; Kaufman, 1983; Ringsdorf et al, 1976).
A study by nutritionists at
RMT University in
Melbourne found significant improvement in the acne lesions of 25
adolescent boys when they were put on low glycemic index(GI) carbohydrate
food like wholegrain bread, pasta and legumes along with lean meat and
seafood. High glycemic index carbohydrates stimulate increased insulin
release into the blood stream.
Recent research has indicated that this hyperinsulinaemia,
through a hormonal cascade action, promotes unregulated tissue growth and
enhanced androgen production. Note that the two main pathological events
that take place in acne(hair follicular epithelial growth and androgen
mediated sebum secretion) can be induced by hyperinsulinaemia!
To determine whether milk or other dairy products is
associated with acne outbreaks, Adebamowo from Harvard University and his
team analyzed survey responses from 47,335 women involved in the National
Nurses Health Study( Journal of American Academy of Dermatology,
2005).They found a positive association with acne for intake of total milk
and skim milk.