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For generations mothers, grandmothers, and nutrition experts have been telling teens who have acne to avoid chocolate, fried foods, and nuts, but teens keep getting acne anyway.

But Neither Acne Nor Obesity Is Caused By Eating Any Particular Food

For generations mothers, grandmothers, and nutrition experts have been telling teens who have acne to avoid chocolate, fried foods, and nuts—and teens keep getting acne anyway. Scientists have never been able to prove that any particular food always causes acne, but that could be because until recently scientists were not looking at the problem in the right way.

Sugar Does Not Cause Acne, If You Just Eat a Little

Scientists disproved the "candy bar theory" of the origins of acne beginning back in 1967 when Drs. Jill Morland, John Yudkin, and D. G. G. Bett showed that people who had acne don't eat any more sugar than people who do not. Sugar is not a toxin that can make your skin break out. But candy bars and similar sugary treats are not necessarily good for people who have acne, either.

A more modern understanding of the interrelationship between sugar and acne involves the concept of "glycemic load," the total amount of digestible carbohydrate people consume in their daily diets. The glycemic load consists of all the foods that the body readily converts into glucose. This includes sugar and candy, of course, but also bread, chips, potatoes, rice, and every kind of dessert. The glycemic load is a measurement not just of which foods a person eats, but how much of those foods a person eats. Someone who never eats candy bars but who loads up on bread and potatoes might have a higher glycemic load than someone who eats three or four or five chocolate bars every day of the week.

Glycemic Load and Acne in Women

The reason glycemic load makes a difference in the health of the skin in women is that all the extra glucose released into the bloodstream by the digestion of food has to go somewhere—and the place it goes is the ovaries.

The burning of sugar inside a cell releases free radicals that can damage DNA. Most of the cells in the body can protect themselves against a flood of sugar from the bloodstream by becoming insulin resistant. They switch off receptor sites that would be activated by insulin and bring sugar inside the cells.

The ovaries, however, do not have this protective mechanism. When some women overeat starchy and sugary foods, they ovaries absorb extra sugar and go into overdrive producing both estrogen and testosterone. Some of the testosterone circulates to the skin, where it can increase production of sebum, which clogs pores. (It can also trigger hair growth.)

Acne is not inevitable when the pores make more oil. It's just a lot more likely, if appropriate cleansing and skin treatment methods are not followed.

Glycemic Load and Acne in Men

Glycemic load has a different effect on the skin in men. In men, consuming a lot of carbohydrate forces the pancreas to release a lot of insulin. The additional insulin interferes with the action of a substance known as sex hormone binding globulin. More testosterone circulates unbound and ready to be converted into a form that stimulates the production of sebum in the skin.

As with women, excess oil production in the skin of men does not immediately lead to acne. The pores that produce excess oil are usually actually clogged by clumps of dead skin cells, and stress on the skin, not acne bacteria, is what causes blackheads and whiteheads to morph into pimples. In both males and females, however, eating less carbohydrate in general reduces acne.
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  • Smith R, Mann N, Mäkeläinen H, Roper J, Braue A, Varigos G. A pilot study to determine the short-term effects of a low glycemic load diet on hormonal markers of acne: a nonrandomized, parallel, controlled feeding trial. Mol Nutr Food Res. 2008 Jun, 52(6):718-26.