Can you cure acne with diet?
Have you tried cutting out or adding certain ingredients to your diet in the hope it will improve your complexion? When it comes to diet and acne, there are lots of myths about what you ‘should’ do. But do the foods you eat really contribute to a break-out? We asked an expert… A quick search of any social media platform brings up plenty of suggestions, advice and anecdotes about how certain diets and ingredients can transform an individual’s complexion. But is all as it seems? “This is an issue I encounter daily in my clinics”, says Dr Anjali Mahto, a consultant dermatologist and author of The Skincare Bible. “Many people have tried to manipulate their diet to control their skin disease. Sometimes patients do this on the advice of well-meaning friends and family, other times because of poor information found on social media or the internet”, she continues. The impact of following an influencer’s dietary advice rather than heading to a doctor is a problem Dr Mahto regularly comes across. “The way people are accessing their healthcare information is changing and, rather than seek professional medical advice, people will often turn to social media, the internet and online magazines. Misinformation is rife, conflicts of interest are not declared and the personal care market is there to sell. Many people are doing a real disservice to their skin by taking advice from celebrity bloggers, ‘clean’ eaters and the booming industry of ‘wellness’. Consultant dermatologist, Dr Anjali Mahto. The difference between being spotty and having acne “Acne is the medical word for ‘spots’ – there is no real difference between the terms, but acne is a label that dermatologists use to describe a skin condition”, explains Dr Mahto. However, there are different types of acne lesion, including comedones, papules, pustules, nodules and cysts. “Comedones consist of a widened hair follicle, which can become filled with keratin, oil and bacteria. They may be open (blackheads) or closed (whiteheads). They often appear as small bumps on the skin surface and are commonly found on the forehead or chin. “Papules are small red bumps, usually less than half a centimetre in size. When papules have a yellow or white centre containing pus, they are then describes as pustules. “Nodules and cysts are more severe types of acne. They tend to be deep and painful and often measure more than one centimetre. They usually last for weeks rather than a few days and may result in scarring of the skin. Cystic acne, unlike nodular acne, tends to be softer to the touch as it contains pus; nodules feel hard underneath the skin surface. “Comedones are the primary acne lesion, from which the other types may develop. One person may have different types of acne, for instance a combination of comedones, papules and nodules, particularly as acne progresses or becomes more severe.” Consultant dermatologist, Dr Anjali Mahto. Can greasy food cause acne? “There is a common misconception that greasy foods can be the cause or trigger for acne. That said, foods with a high glycemic index, or diets consistently high in refined sugar, may cause acne, according to emerging scientific evidence. These foods can still be part of a well-rounded healthy diet, but should be consumed in moderation.” Can dairy cause acne? “For a small, select group of individuals, removing dairy can be of benefit for acne. Clinical studies suggest low-fat dairy seems to be more of a problem than full-fat, but the reasons are unclear. Anecdotally, I have also had a small number of people who have cut out whey-based protein supplements and their acne has improved. “So dairy may have a role to play in this small, select group. The difficulty we have is identifying who they are and recognising that ‘dairy’ is a large food group – milk may not have the same effect as yoghurt or cheese, for example. There is still much that remains unclear.” Are there ‘bad foods’ that cause spots and acne? “This causes me two concerns. We know acne is often down to hormones and genetics – factors largely outside of our control. Telling someone they are eating ‘bad food’, which is causing their acne, shifts the blame onto the individual and creates a sense of shame around their dietary choices. Often the food consumption has little to do with the acne. “Secondly, it results in many people cutting out foods from their diet, and in resultant disordered eating patterns, for fear of aggravating their skin disease. I have seen patients refuse to eat cake on their birthday, decline dinner with friends, and develop health anxiety around food, for fear of triggering acne. “There are inherently no ‘good’ or ‘bad’ foods. Diet is more about eating in a sustained, healthy manner across the course of one’s lifetime. Moderation is key. “In my practice, I have seen more negative outcomes than success stories – this is probably because those who this works for do not end up seeking dermatological advice. “However, for the vast majority of people with acne, manipulating diet is likely to have a fairly negligible effect. Acne is largely down to an individual’s hormones and genetics. I have seen many cases of people, particularly young women, who have cut out a large number of food groups including dairy, sugar and gluten to improve their acne and have developed resultant orthorexia or disordered eating around food, which is very worrying. If treating acne was as simple as cutting out dairy, I would not have so many vegan patients." Food and nutrients said to help reduce acne Probiotics, antioxidants, omega-3 fatty acids, zinc and vitamins A and E have been linked to helping acne-prone/spotty skin. But does science support the claims? “The data for all these is limited and comes from small observational studies with relatively few participants, often with poor methodology or trial design and statistical analysis”, explains Dr Mahto. She adds, “it is therefore definitively difficult to say if supplementation of any of the above will have a true benefit for acne. The doses of the supplements suggested may be difficult to tolerate. An example is that zinc sulphate can cause gastrointestinal side-effects (if consumed in excess). “Vitamin A in high doses – higher than one would find in an over-the-counter supplement – is already used in prescription acne treatment in the form of isotretinoin (Roaccutane). My advice would be to exercise caution with over-the-counter supplements as the evidence is limited, resulting in unnecessary expense and potential side-effects. It is better to have a discussion with your GP or consultant dermatologist about the tried, tested and validated treatments on offer with known safety-profiles. If you are planning a pregnancy, are pregnant, breastfeeding or taking other prescribed medications, then speak to a doctor first.” If you’re worried about acne “Nobody should have to feel miserable or self-conscious because of their acne. Being concerned about your skin is not vanity – and acne is not a beauty or cosmetic problem, it is a medical one with medical treatments. Please do not suffer in silence and do not get conned into spending a fortune on beauty products or supplements. “Seek professional help from your GP or a consultant dermatologist, who will diagnose the type and severity of acne you have and tailor a plan individual to you. We know that acne is related to anxiety, depression, low self-esteem and poor body image, and in an ideal scenario we would like to treat you before you develop physical or mental scarring because of it.” Originally published July 2020