Changing insights around the 1960s and 1970s
In the United States, dietary advice prior to 1960 was an important part of acne treatment. It was recommended not to use chocolate, fat, sweets, and carbonated drinks.
In 1969 and 1971, the results of two studies were published that showed that diet was not acne-related, which in turn changed treatment recommendations. However, there is a lot to be said about both studies.
The first study looked at the effect of chocolate. Half of the subjects ate a bar with chocolate every day, while the other half was given a bar without chocolate. The fact that in the end no difference was found in acne complaints between the groups may have been due to the fact that the bar without chocolate contained just as much sugar and fat as the bar with chocolate. The test period was also short: too short for the development of blackheads on the skin.
The second study looked at the influence of the use of chocolate, milk, roasted peanuts, or cola. Again, no relationship was found with acne. But because only a small group of subjects was followed, these results seem less reliable.
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There seems to be a relationship between drinking milk and pimples
Research into the influence of diet on pimples has often looked at the effect of dairy products. Indeed, it seems that there is a relationship between acne complaints and drinking milk.
In 2005, researchers asked 47,355 adult women what they ate and drank during their school days. The participants were also asked whether a doctor had ever diagnosed them with ‘severe acne’. These interviews revealed that the amount of milk drunk was related to the severity of skin complaints.
Interestingly, only skimmed milk was associated with acne, but not semi-skimmed or whole milk. One reason for this could be that skim milk contains less estrogen, a hormone that reduces acne.
But this study also has a number of shortcomings. Of course, it is difficult for the participants in the study to remember very precisely the amount of milk they drank during school. In addition, patients with acne were previously advised not to drink soft drinks. It was thought that this would make acne worse. If these women did indeed avoid soft drinks, then milk consumption was more likely among this group. These women would have drunk more milk as a result of acne.
This same group of researchers conducted a similar study of 6,094 girls aged 9 to 15 years. In this study, a relationship was found between all types of milk and acne. In the same study in 4,237 boys, a relationship was subsequently found between intake of skimmed milk and pimples.
It was therefore concluded that a relationship between milk and acne has been demonstrated within three different groups. Still, that relationship remains statistically weak. Follow-up research, with more evidence, will have to confirm the results.
What is the effect of carbohydrates on acne?
The role of sugars has also been extensively studied in acne. Is There a Link Between Carbs and Pimples? Yes, it certainly seems. Ultimately, the most compelling evidence for this has been provided by a study by Smith and his colleagues. They showed in a group of men aged 15-25 that skin complaints improved after a diet with a low glycemic load *. However, the diet also meant that the intake of fat and dietary fiber was reduced. This reduced the weight of the participants. This may of course have influenced the decrease in complaints. The diet also caused a decrease in androgen index (male sex hormone). The results therefore do not necessarily apply to (young) women.
The same researchers showed that a diet with a low glycemic load also had a positive effect on the composition of sebum and thus on acne. Only young men participated in this study.
Another important indication of the effect of diet on acne is provided by women suffering from polycystic ovary syndrome. These patients are treated with glucose-lowering drugs. As a ‘side effect,’ these medicines have a positive effect on the skin with acne complaints.
* The glycemic load says something about the extent to which the blood sugar level rises by eating certain foods. The faster that happens, the higher the burden.
Insufficient research on the effect of omega 3 fatty acids on acne
The intake of omega 3 fatty acids compared to the intake of omega 6 fatty acids may play a role in acne. A relatively high intake of omega-3 fatty acids suppresses the development of inflammatory reactions and therefore may have a positive effect on blemishes. However, more research should be done on this theory.
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Antioxidant treatment may be effective
Oxygen radicals also play a role in the aggravation and development of acne. Antioxidants or drugs that scavenge free radicals can therefore possibly be used as a treatment.
One study shows that patients with acne have less vitamin A and E (antioxidants) in the blood than subjects without blemishes. It has also been shown that certain flavonoids (derived from plants) and resveratrol have an antibacterial effect and can be used against the bacteria P. acnes, which plays an important role in the development of pimples.
The use of antioxidants seems promising. However, studies have yet to demonstrate that treatment leads to a significant result.
The advantages and disadvantages of zinc for acne complaints
Zinc is an important element in the development and functioning of the skin. Several studies have shown that the oral administration of zinc has a positive effect on acne, more than on a mild form of the condition. However, the doses used were relatively high, resulting in the following side effects in the study participants: nausea, vomiting, and diarrhea.
Vitamin A is effective for blemishes, but it also has side effects
Treatment of acne with (oral) vitamin A is effective. However, taking too much vitamin A can lead to serious side effects such as osteoporosis or birth defects with excessive use of vitamin A during pregnancy.
Does Dietary Fiber Help With Acne?
It is unclear what the effect is of dietary fiber intake. This relationship has not been sufficiently researched.
What do we know about iodine and acne?
The use of iodine can cause a blemish eruption, but it is not related to the development of blackheads.
Conclusion: there is a real relationship between acne and nutrition
The authors of this review conclude that a relationship has been shown between diet and acne. Although the relationship with products with a high glycemic load is stronger than that with dairy, it is good that the treatment also pays attention to the intake of dairy.