“Don’t eat chocolate, it’ll give you pimples.” Almost everyone has heard some version of that warning, usually from a well-meaning parent or friend. But is there any truth behind it?

Let’s take a look at the science behind how our diet and our skin interact and why, for some people, food choices seem to influence breakouts.

The Biology Behind Diet-Related Breakouts

Waking up to a new blemish can be incredibly frustrating, especially if you’re diligent about caring for your skin. The truth is that the skin is a complex organ, covered in follicles or pores, each made up of a hair, its roots, and the sebaceous, or oil, gland attached to it. Within that tiny space, several things can go wrong and increase your risk of a breakout:

  1. Hormones stimulate your sebaceous glands to make sebum, our skin’s natural, protective oil. Sometimes, our bodies increase the amount of oil they produce, causing the excess to collect inside the follicle.
  2. Usually, the dead skin cells lining the follicle shed from the surface. Once oil has pooled inside the follicle, those cells instead clump together, creating a plug that seals the follicle and traps the oils, skin cells, and any debris inside.
  3. The trapped oil creates an abundant food source for Cutibacterium acnes, bacteria that usually live harmlessly within our skin’s microbiome. The bacteria can then multiply very quickly within the blocked follicle.
  4. Your immune system recognizes the bacterial overgrowth as a threat. White blood cells rush in and release chemical messengers that trigger inflammation. The swelling creates pressure, pushing the plug sealing the follicle upward until it forms the raised, red bump we recognize as a blemish.

Because acne involves multiple body systems— the skin, the endocrine system, and the immune system— internal factors, including diet, can influence the frequency and severity of your breakouts.

Refined Carbohydrates

When you eat foods made with refined flour or added sugar, such as white bread, crackers, pasta, or soda, they break down rapidly in the digestive tract. This rapid digestion floods the bloodstream with glucose, prompting the body to release insulin to lower blood sugar levels.

That insulin surge increases levels of insulin-like growth factor 1 (IGF-1), a hormone that directly stimulates sebaceous glands. Overactive glands release more sebum into the follicle, raising the risk of a blockage. Elevated IGF-1 also encourages the cells lining the follicle to multiply more quickly, but without shedding at an appropriate rate to keep up with the increase.

Dairy Products

During puberty, rising levels of androgens— hormones such as testosterone— are one of the reasons acne becomes common. These hormones signal sebaceous glands to grow larger and release more oil. Dairy products contain small amounts of similar hormones and bioactive molecules that remain active even after processing. When they enter the bloodstream, they can add to the body’s own signals, pushing sebaceous glands to stay more active than they otherwise would.

There are also proteins in milk called whey and casein that stimulate insulin release, similarly to refined carbohydrates. They also increase IGF-1, only compounding the likelihood for some people to produce more pore-clogging serum. Interestingly, skim milk is more likely to cause a breakout than whole milk, likely because of its higher proportion of whey protein.

Highly Processed Foods

Not every clogged follicle turns into a painful pimple. What often makes the difference is inflammation, which highly processed foods can worsen.

Fried fast food and packaged snacks are usually cooked in refined oils that contain large amounts of omega-6 fatty acids. In small amounts, omega-6s are a necessary part of a balanced diet. On the other hand, eating too many omega-6-rich foods causes the body to produce more cytokines, chemical signals that instruct immune cells on how aggressively to respond to a threat. The more aggressive the response, the worse the inflammation.

Processed foods are also low in protective nutrients, such as antioxidants, which generally help keep inflammation under control.

Skin-Supporting Nutrients

Just as certain foods can set off the chain of events that lead to acne, others help keep that process in check. These nutrients don’t erase acne on their own, but they support the systems most involved in breakouts.

  • Low-glycemic foods like oats, beans, and leafy greens don’t cause insulin spikes like refined carbs do. Often, patients who switch from refined grains to whole, fiber-rich foods notice a difference in how frequently their pores become clogged.
  • Omega-3 fatty acids, found in fish such as salmon and sardines, as well as in walnuts and flaxseed, counterbalance the omega-6 fats commonly found in processed foods. Omega-3s help calm that immune response, so clogged follicles are less likely to turn into painful, inflamed blemishes.
  • Antioxidants, including vitamins A, C, and E, neutralize the free radicals that damage cells and worsen inflammation. You can get many of the most beneficial antioxidants by “eating the rainbow.”

When it comes to skin health, diet is only one of the many factors that might be the culprit behind your acne. Switching up your meals to include antioxidant-rich-rich foods low in refined carbs and omega-6s is a great place to start, but you will also benefit from working with a skincare expert. Set yourself on the right track for a radiant, blemish-free complexion by scheduling a consultation with Dr. Elizabeth Briden of Advanced Dermatology and Cosmetic Institute.