One of the more controversial issues surrounding the causes of acne is the role diet plays in triggering acne. Experts’ opinions on the subject vary tremendously and are also very polarizing. For example in her book Rx for Brown Skin Dr. Susan Taylor writes: “Although many women believe that certain foods contribute to their acne outbreaks, there’s no evidence that food contributes to acne. So the good news is that fried foods, greasy foods, chocolate, soda, and candy do not cause acne!” (p. 173). Furthermore, Dr. Taylor writes that if you notice breakouts after you eat certain foods you shouldn’t jump to the conclusion that the foods triggered the acne. Instead she points out: “the foods you may tend to eat when you’re stressed – sugary or greasy comfort foods – are probably just coincidental.” (p. 174) The acne that you see after eating sugary or greasy foods is related to hormonal changes brought on by stress and not by the foods, Dr. Taylor concludes.
Dr. Doris J. Day takes a similar approach to Dr. Taylor in regards to foods as an acne trigger. While Dr. Day writes in her book 100 Questions and Answers about Acne that “there is no scientific evidence available to show that high-carbohydrate and/or fat intake has any effect on sebum production or acne” (p.45) she does point out that there might be an explanation to the long held idea that diary can make acne worse. Dr. Day explains that the hormones that are naturally found in the milk of cows, particularly pregnant cows which produce between 75% to 90% of the milk sold in stores, could play a role in acne formation (p.45). Further, Dr. Day does suggest that eliminating certain foods from your diet that you deem are acne triggers is ok as long as those foods do not affect your overall health. Dr. Day will concede that there is one ingredient that, if consumed in large enough quantities, can trigger acne. That ingredient is iodine.
At the complete opposite spectrum is the advice of dermatologist Dr. Nicholas Perricone. As outlined in his best-selling book The Clear Skin Prescription and on his website perriconemd.com Dr. Perricone promises a flawless complexion, in only four weeks, if one is to follow his anti-inflammation diet, take the supplements he recommends (which he conveniently sells for a very high price on his website), and use the topical treatments he recommends. Why is Dr. Perricone so convinced that food does make a significant difference in the appearance of one’s skin and in the formation of acne? Because Dr. Perricone believes that all acne is inflammatory acne and that a diet that combats inflammation will positively affect acne, i.e. stop acne from occurring in the first place.
How exactly does the inflammation trigger acne? Acne begins to form when pores become clogged with dead cells that have not been properly removed. In his book Dr. Perricone writes that an increase in blood sugar causes retention hyperkeratosis or the retention of and sticking together of dead cells in the pores. This same increase in blood sugar causes inflammation on a cellular level and can even increase sebum production in the sebaceous glands. The inflammation continues working on a molecular level in the cells, and causes the sebaceous cells to secrete proinflammatory fatty acids. The crux of Dr. Perricone’s reasoning for following his anti-inflammatory diet is that by reducing the inflammation on a cellular level through the foods we eat will radically affect existing acne and prevent future breakouts.
Dr. Perricone writes that the foods one eats as well as the foods one avoids are equally important. Dr. Perricone explains that one needs to carefully regulate their blood sugar level in order to have clear, healthy skin. A rapid rise in blood sugar levels makes the body create insulin which then causes the body to have an inflammatory response. More insulin equals more inflammation equals more acne, according to Dr. Perricone. Sweets are certainly rapidly converted to sugars in the body but so are simple starches such as bananas, potatoes, corn, and peas – to name a few. When you eat these foods your body experiences a rapid rise in blood sugar, which triggers an increase in insulin, and then inflammation on a cellular level (p.57). In addition to avoiding foods that trigger that above mentioned responses it is important, according to Dr. Perricone, to integrate anti-inflammatory foods into one’s diet. These foods are usually high in essential fatty acids. He particularly advocates eating a lot of wild Alaskan salmon, fresh berries and melon, and drinking lots of water ( p.59).
Dr. Perricone is only one of a few experts who see a direct connection between food and acne. Certainly his argument does make some sense and the before and after photos in his book are dramatic and intriguing, but if Dr. Perricone is so right about the role diet plays in the formation of acne why do more experts not agree with him? In my opinion, Dr. Perricone’s advice is certainly another acne solution to consider especially if one is inclined to seek more natural solutions for health issues as opposed to prescription solutions or if one has tried numerous options and has yet to experience relief from acne breakouts. Yet for Dr. Perricone’s advise to be taken more seriously more studies have to be done that are independent of his own research. It will be interesting to see what research about the connection between acne and diet reveals in the future.
UPDATE: Since I wrote this post I’ve reconsidered the idea of how diet impacts acne. See my post Book Review: The Clear Skin Diet for more information.