Wellness

Do Milk and Sugar Cause Acne?

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Hiya Smarties!

Check out this super informative guest article by Mark Hyman, MD from my blog archives. If you or someone you know struggles with acne, the information and tips in this post could change your life.

Take it away, Dr. Hyman…

As our sugar and dairy consumption has increased over the last 100 years, so has the number of people with acne.

We now have over 17 million acne sufferers, costing our health care system $1 billion a year. Eighty to 90 percent of teenagers suffer acne to varying degrees. The pimply millions rely on infomercial products hawked by celebrities, or over-the-counter lotions, cleansers and topical remedies.

Recent research suggests that it’s not what we slather on our skin that matters most, but what we put in our mouth.

Many have suggested a diet-acne link, but until recently, it has not been proven in large clinical studies.

Instead, dermatologists prescribe long-term antibiotics and Accutane, both of which may cause long-term harmful effects. In 2009, a systematic review of 21 observational studies and six clinical trials found clear links. Two large controlled trials found that cow’s milk increased both the number of people who got acne and its severity. Other large randomized prospective controlled trials (the gold standard of medical research) found that people who had higher sugar intake and a high glycemic load diet (more bread, rice, cereal, pasta, sugar and flour products of all kinds) had significantly more acne.

The good news is that chocolate (dark chocolate, that is) didn’t seem to cause acne.

The dietary pimple-producing culprits—dairy and sugar (in all its blood-sugar-raising forms)—cause spikes in certain pimple producing hormones.

Dairy boosts male sex hormones (various forms of testosterone or androgens) and increases insulin levels, just as foods that quickly raise blood sugar (sugar and starchy carbs) spike insulin.

Androgens and insulin both stimulate your skin to make those nasty, embarrassing pimples. One patient recently told me he would give a million dollars for a pill to cure acne. He doesn’t need to. It seems that, for many, the cure to acne is at the end of their fork, not in a prescription pad.

While pimples are not as simple as too much milk or sugar in your diet, both have a significant impact.

Nutritional deficiencies, as well as excesses, can worsen acne.

Correcting common deficiencies, including low levels of healthy omega-3 anti-inflammatory fats, low levels of antioxidants such as vitamin E, zinc and vitamin A, and including an important anti-inflammatory omega-6 fat called evening primrose oil all may be helpful in preventing and treating unwanted pimples.

I will explain how you can correct and incorporate all of these nutritional elements of your diet and outline some supplements that will help you fight acne in a moment.

First it is worth taking a deeper look at milk and sugar.

Stay Away from Dairy and Avoid Acne

One scientist referred to milk as a “complex aqueous, suspended fat, liposomal, suspended protein emulsion.” What we know that milk is designed to grow things—namely, babies—and in the case of cow’s milk, calves. It is naturally full of what we call anabolic hormones (the same ones that bodybuilders and A Rod use to grow big muscles, and that cause bad acne). These are mostly androgens (like testosterone) and growth hormones, including insulin-like growth factor-1 (IGF-1).

There is no such thing as hormone-free milk.

Here’s a short list of the 60-some hormones in your average glass of milk—even the organic, raw, and bovine-growth-hormone-free milk:

  • 20 α-dihydropregnenolone
  • progesterone (from pregnenolone)
  • 5 α-pregnanedione
  • 5 α-pregnan-3 β-ol-20-one, 20 α- and 20 β-dihydroprogesterone (from progesterone)
  • 5 α-androstene-3 β17 β-diol
  • 5 α-androstanedione
  • 5 α-androstan-3 β-ol-17-one
  • androstenedione
  • testosterone
  • dehydroepiandrosterone sulphate acyl ester
  • insulin like growth factors 1 and 2 (IGF-1 and IGF-2)
  • insulin

This is what our government suggests we drink in high doses—at least three glasses a day for me, a healthy adult male, according to the choosemyplate.gov website. Those guidelines have been strongly criticized by many, including leading nutrition scientists from Harvard such as Walter Willett and David Ludwig.

The famous Nurses’ Health Study examining health habits of 47,000 nurses found that those who drank more milk as teenagers had much higher rates of severe acne than those who had little or no milk as teenagers. If you think it is the fat in milk, think again. It was actually the skim milk that had the strongest risk for acne. In other studies of over 10,000 boys and girls from 9 to 15 years old, there was a direct link between the amount of milk consumed and the severity of acne.

It appears that it is not just the anabolic or sex hormones in milk that cause problems, but milk’s ability to stimulate insulin production. It actually may be the lactose or milk sugar in milk that acts more like a soft drink than an egg.

Drinking a glass of milk can spike insulin levels 300 percent. Not only does that cause pimples, but it also may contribute to prediabetes. This is true despite studies funded by the dairy council showing that milk helps with weight loss. The question is compared to WHAT diet—a diet of bagels and Coke, or a healthy, phytonutrient- and antioxidant-rich, plant-based diet with lean animal protein?

Stay Away from Sugar, Refined Carbs and Pimples

If a glass of milk causes pimples, that may drive you back to your Pepsi. But not so fast. Recent studies also show that sugar and refined carbs (a high-glycemic diet) cause acne. More importantly, taking kids off sugar and putting them on a healthy, whole foods, low-glycemic load diet resulted in significant improvements in acne compared to a control group eating a regular, high-sugar American diet.

In addition to having fewer pimples, the participants lost weight and became more sensitive to the effects of insulin (resulting in less pimple-producing insulin circulating around the blood). They also had fewer sex hormones floating around their blood that drive pimples. We know that women who have too much sugar and insulin resistance get acne, hair growth on their face, hair loss on the head and infertility. This is caused by high levels of circulating male hormones and is called polycystic ovarian syndrome, but is a nutritional, not gynecologic, disease.

But the dietary influences don’t stop there. It is not just sugar, but the bad fats we eat that may also contribute to acne.

Get an Oil Change

Our typical Western diet is full of inflammatory fats—saturated fats, trans fats, too many omega-6, inflammatory, processed vegetable oils like soy and corn oils. These increase IGF-1 and stimulate pimple follicles.

Inflammation has been linked to acne, and anti-inflammatory omega-3 fats (from fish oil or a vegan source) may help improve acne and help with many skin disorders.

Balance the Hormones that Cause Skin Problems

The link is clear—hormonal imbalances caused by our diet trigger acne. Our diet influences sex hormones like testosterone, IGF-1 and insulin, which promote acne. The biggest factors affecting your hormones are the glycemic load of your diet (determined by how quickly the food you eat increases your blood sugar and insulin levels), and the amount of dairy products you eat.

The good news is that eating a healthy diet and taking a few supplements can balance those hormones. Exercise also helps improve insulin function.

How To Prevent and Treat Acne

Nine simple steps will help most overcome their acne problems.

1. Stay away from milk. It is nature’s perfect food—but only if you are a calf.

2. Eat a low glycemic load, low sugar diet. Sugar, liquid calories, and flour products all drive up insulin and cause pimples.

3. Eat more fruits and vegetables. People who eat more veggies (containing more antioxidants and anti-inflammatory compounds) have less acne. Make sure you get your 5 to 9 servings of colorful fruits and vegetables every day.

4. Get more healthy anti-inflammatory fats. Make sure to get omega-3 fats (fish oil, or a vegan source of omega-3).

5. And anti-inflammatory omega-6 fats (evening primrose oil). You will need supplements to get adequate amounts (more on that in a moment).

6. Include foods that correct acne problems. Certain foods have been linked to improvements in many of the underlying causes of acne and can help correct it. These include fish oil, turmeric, ginger, green tea, nuts, dark purple and red foods such as berries, green foods like dark green leafy vegetables, and omega 3-eggs.

7. Take acne-fighting supplements. Some supplements are critical for skin health. Antioxidant levels have been shown to be low in acne sufferers. And healthy fats can make a big difference. Here are the supplements I recommend:

  • Evening primrose oil: Take 1,000 to 1,500mg twice a day.
  • Zinc citrate: Take 30 mg a day.
  • Vitamin A: Take 25,000 IU a day. Only do this for three months. Do not do this if you are pregnant.
  • Vitamin E (mixed tocopherols, not alpha tocopherol): Take 400 IU a day.

8. Try probiotics. Probiotics (lactobacillus, etc.) also help reduce inflammation in the gut that may be linked to acne.

9. Avoid foods you are sensitive to. Delayed food allergies are among the most common causes of acne—foods like gluten, dairy, yeast and eggs are common culprits and can be a problem if you have a leaky gut.

Following these simple tips will help you eliminate acne and have that glowing skin you have always dreamed of. It’s much cheaper (and safer) than expensive medications and dermatologist visits. Improve your diet and take acne-fighting supplements, and you will watch your pimples disappear.

Thank you so much for sharing your expertise with us today, Dr. Hyman!

Now I’d like to hear from you: Have you struggled with an acne or skin problem? Have you noticed any link between your skin? What seems to be a problem for you? Let’s share our collective wisdom in the comments below.

To Clearer, Healthy Skin

 

 

Sources:

F. William Danby, MD, Nutrition and acne, Clinics in Dermatology (2010) 28, 598–604.

White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol 39(2 Pt 3):S34-7 (1998 Aug).

Lello J, Pearl A, Arroll B, et al. Prevalence of acne vulgaris in Auckland senior high school students. N Z Med J 108(1004):287-9 (1995 Jul 28).

Venereol 21(6):806-10 (2007 Jul).

Wolf R, Matz H, Orion E. Acne and diet. Clin Dermatol 22(5):387-93 (2004 Sep-Oct).

Magin P, Pond D, Smith W, et al. A systematic review of the evidence for myths and misconceptions’ in acne management: diet, face-washing and sunlight. Fam Pract 22(1):62-70 (2005 Feb).

Spencer EH, Ferdowsian HR, Barnard ND. Diet and acne: a review of the evidence. Int J Dermatol 48(4):339-47 (2009 Apr).

Bendiner E. Disastrous trade-off: Eskimo health for white civilization, Hosp Pract 9:156-89 (1974).

Adebamowo CA, Spiegelman D, Danby FW, et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol 52(2):207-14 (2005 Feb).

Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in adolescent girls. Dermatol Online J 12(4):1 (2006).

Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol 58(5):787-93 (2008 May).

Hoyt G, Hickey MS, Cordain L. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. Br J Nutr 93(2):175-7 (2005 Feb).

Kaymak Y, Adisen E, Ilter N, et al. Dietary glycemic index and glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels in patients with acne. J Am Acad atol 57(5):819-23 (2007 Nov).

Cordain L, Lindeberg S, Hurtado M, et al. Acne vulgaris: a disease of Western civilization. Arch Dermatol 138(12):1584-90 (2002 Dec).

Smith RN, Mann NJ, Braue A, et al. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr 86(1):107-15 (2007 Jul).

Smith RN, Mann NJ, Braue A, et al. The effect of a high- protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol 57(2):247-56 (2007 Aug).

Smith RN, Braue A, Varigos GA, et al. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci 50(1):41-52 (2008 Apr).

Zouboulis CC. Is acne vulgaris a genuine inflammatory disease? Dermatology 203(4):277-9 (2001).

James MJ, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr 71(1 Suppl):343S-8S (2000 Jan).

Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr 70(3 Suppl):560S-9S (1999 Sep). 26. Kaaks R, Bellati C, Venturelli E, et al. Effects of dietary intervention on IGF-I and IGF-binding proteins, and related alterations in sex steroid metabolism: the Diet and Androgens (DIANA) Randomised Trial. Eur J Clin Nutr 57(9):1079-88 (2003 Sep).

Fulton JE, Jr., Plewig G, Kligman AM. Effect of chocolate on acne vulgaris. Jama 210(11):2071-4 (1969 Dec 15).

Anderson PC. Foods as the cause of acne. Am Fam Physician 3(3):102-3 (1971 Mar).

Add a comment
  1. Jessica Cohen says:

    I have been struggling with adult acne for the past 7 years (since I was 23). I have researched every angle of it, and it was nice to see all the research bundled into a tight and concise package. I need a reminder every now and then to fix my diet, so thanks for that. I do have a quick question though – what are your thoughts on a clean whey protein (to add to green shakes in the morning)?

    And anything to take it to the next level? I went on a anti-candida diet for about year and still had acne at the end – my diet could not have been cleaner. Is it possible that too much lean meat could be causing issues? Or other ways to balance my hormones (most of my acne is on my chin, neck, chest and forehead)?

    Thanks for this great article and for your help!

    ~Jessica

  2. Elsa cavazos says:

    I too saw a tremendous improvement in my skin when I followed a low glycemic diet, low gluten foods, low sugar, no processed foods, no dairy, only 8oz. Kefir, which I make at home with whole fat organic milk and kefir grains. Heavy on the leafy greens and citrus. My skin has never looked better!

  3. Jo. says:

    I eat no soy/dairy/legumes/grains…. meat fruit veg nuts seeds cofffee. Ive even given up chocolate for 30 days. And I still have acne….. flax/chicpeas (phytoestrogens) give me acne also

    What food allergy test do you reccommend? my dr wont give me it bc she says it’s “innaccurate” but Ive tried everything. Also do you reccommend saliva hormone testing? Ive heard its the best.

    I need to try magnesium for my consptaion and probiotics. THeyre the only things I havent tried.

  4. Elizabeth says:

    THANK YOU for this information! My 20 yr old daughter never had to deal with acne until this past summer. I took her to a natural facial esthetic Ian who suggested stopping sugar and dairy in diet. Unfortunately my daughter hasn’t and I feel diet/acne/stress has contributed to her feeling depressed. She went this week to a dermatologist who prescribed 3 medicines to take and said will take 2-3 months to clear up”. I have offered to take her to naturopath and natural supplement store for items you’ve suggested but with no luck. She has tweeted about her acne and feels she scars people for life at the sight of her acne. As a parent it is tough to see your child suffer. I will print this article and pray your wise information will offer facts for her to see there is truth to what she’s been told.

  5. Mireille Kortz says:

    Acne may be treated with a combination of remedies including over-the-counter skin care, acne medications, and chemical or laser procedures. Learn safe ways to banish blackheads, whiteheads, and cystic acne, and get the clear skin you want.

  6. Acne Light Therapy Boots says:

    We can try a variety of exercises, it is not always to
    visit the gym, you can try jogging, swimming, skipping, dancing, rowing, cycling, aerobics; infact they are endless.

    At this point, rinse out your facial area to eliminate sebum and apply organic cotton
    wool to soak up the juice. Aloe Vera, turmeric and papaya are highly recommended to cure
    acne due to their cosmetic effectiveness.

  7. jimmy jack says:

    interesting. thanks for sharing this article. do post up update.

  8. Amy says:

    Interesting article. I’m 35 and I’ve suffered from acne for the past 3 years or so. I’ve definitly noticed a change in my skin, it’s more more oily than ever before. I attributed it to age but now I’m wondering if it’s my diet. I don’t eat a lot of dairy because I used to be lactose intolerant. I’ve been seeing a dermatologist and the medication she has me on is expensive and doesn’t really work in fact my skin looks worse after I use it (drying, peeling). I was going to go back and try something different but now I think I will take a closer look at what I’m eating and add some of those supplements to my diet.

  9. Michelle S. says:

    I definitely had acne (normally have clear skin) when i went vegan and detoxed. it took some time to clear up, even though i was already gluten free and dairy free. it as quite traumatic for a few months. now it is great. for people having a hard time giving up cheese, learn how to make delicious plant based meals, and use transition products like Daiya in place of cheese, almond milk instead of cow’s milk… you can live without these harmful foods, and i think it is better to cut them out completely than “treat yourself”.

  10. Andrea says:

    I have absolutely found a link between my acne and dairy, especially cheese. When I first started the CSD, I jumped in with both feet and my skin cleared immediately, in addition to all the other amazing health benefits. I backtracked a little and had some cheese and greek yogurt recently for about a week, and BAM: tons of tiny little whiteheads all over my face, neck and chest that won’t go away with any over-the-counter topical medication. The only thing that works is JUICING, lots of green juice and fresh smoothies. My acne wasn’t this bad before the CSD, but I guess it was just so happy with the change it doesn’t want me to go back! I had bad cystic acne when I was a teenager and had to get injections from a dermatologist, but from my mid twenties to now I had much better control over it. The CSD makes my skin like silk, as long as I don’t eat cheese! =]

  11. Ryan G says:

    I know this site is mostly applicable to individuals looking to cut mass and proteins from their lives, but what about people who work out and who are trying to gain? Sex hormones are the things that drive growth, why would I want less of them in my life? I’ve seen more acne as a result of working out and sweating than from anything else related to my changing diet.

  12. Thanks Dr. Hyman-I am a big fan of your work ever since the lecture you gave at IIN 🙂 I had mild acne from middle school until my early twenties. Cutting out diary helped, but it wasn’t until I removed gluten AND lowered my sugar intake that I saw a real difference. Now I can tell when i need to cut back on sugar when my face breaks out. Thanks again 🙂

  13. Monica says:

    I’ve had various degrees of acne since my teen years and I am now in my mid-thirties. It was under control while using proactiv but eventually I decided that a product that bleaches everything it comes in contact with can’t be good for my skin and I stopped using it, trying to deal with the acne in a healthier way.
    I went from vegetarian to a mostly strict vegan diet about 3 years ago with a goal of eating a high-raw diet (more or less successful). Despite the fact that I ate healthier than anyone else I knew, my skin got worse and worse with bouts of cystic acne. Finally a few weeks I discovered the culprit – soy. I had noticed when I stayed away from soy lattes for a few days my skin got better so I tested soy in various forms and realized I am sensitive to all soy products and have been trying to eliminate them from my diet since. Not an easy task for a vegan…
    I do realize though that it wasn’t the only cause. On top of abstaining from soy, I notice that the cleaner and less processed I eat and the more I juice, the clearer my skin gets. I am in the process of exploring if my skin reacts to other foods (gluten, fruit, etc.) but haven’t gotten that far yet as I am currently eating as raw as I can so I my skin can fully clear up and heal first. I am also hoping the scars will eventually fade (suggestions are welcome)…
    My 2 cents and advice for acne sufferers is to take a close look at how your body responds to soy (if you eat any) and try googling “soy” and “cystic acne” – there are quite a lot of people with the same problem and sensitivity out there.

  14. Babs says:

    I’ve been battling acne since getting off of the pill three years ago. Over the last few years, my acne has gotten worst. I’ve visited the dermatologist each year for the past two years and been prescribed face washes, Retin-A and long-term doses and antibiotics. Although these things have helped, I have not found a permanent solution to my acne problem, which seems to flare up when the weather gets warm. I’ve tried acupuncture, which helped me tremendously in so many ways, but has not helped my acne much. I also decided to see a doctor specializing in Celiac Disease. I tested negative for Celiac, but my doctor has not ruled out the possibility along with gluten intolerance. I do not drink milk, but often eat cheese, eggs and yogurt. Likewise, I’ve always had a bad sweet tooth. Although my craving for sugar has improved with age, I still indulge in many sweeter treats. This article comes at a wonderful time as I’m still experiencing acne despite being on antibiotics for two months, washing my face with benzoyl peroxide wash and Retin-A. My hope is to be able to use natural products without worrying about acne. I may try cutting out dairy and gluten completely to see how it affects my diet and will try the suggestions above as well. Thank you!

  15. Dustin says:

    I really appreciated your article Dr. Hyman. Dairy is definitely bad news. I’m a pharmacist and have seen several patients get prescriptions filled for Accutane (the heavy duty medicine used for last line therapy in treating acne). Accutane works well for acne but it also put several of these patients into a severe depression and some became suicidal. Bad, bad news. All this while they continued to put the cause of their acne into their mouth three times a day by consuming low nutrient food with lots of animal-based and processed sugars/carbs.

    I’ve been trying my best to spread the word about the benefits of a plant-based diet in treating both acne and many of the other chronic diseases for patients out there. Thanks to articles like yours it is becoming easier to do this.

  16. sarah says:

    WOW!! I have been suffering from constant acne problems since I was a teen. Almost 40 now I have tried everything imaginable and get so frustrated. So happy to have read this. THANK YOU!!

  17. Rosie says:

    This article is awesome! I wish I had known this long ago… I have never liked milk, but I do like cheese. I know I eat too much sugar still. It helped my acne a lot when I cut out caffeine and drank more water. I will continue to try eat more veggies and antioxidants! Thanks for the article.

  18. Teresa says:

    Jumping on the band wagon with CRYSTAL PALMER BULL and her 2 cents! Having been brought up on a farm, drinking raw milk straight from the cow, and have eaten sugar in some form or another on a daily basis for the past 50 years – I do not have acne, nor any other health issue. I weigh 120 lbs (same as in High School, btw) and have 2 grown children and 3 grandchildren. I do know that the pasturized milk that is sold in plastic jugs tastes nothing like the raw milk that we always kept in glass containers. So, the statement that dairy products and sugar cause acne can not be true. There simply has to be more to the equation. I can believe, however, that all of the unfortunate processing that store bought milk goes through probably does have negative effects on the body, along with all other processed dairy products – ice cream, yogurt, cheese, etc. Then, to toss in the ‘plastic’ factor – yuck. But, even then, other factors must play a part as well – stress, inactivity, chemicals in products of all sorts including facial (make-up and cleansers), household cleaners, environmental, etc., etc., etc. To do a study on raw milk vs pasturized milk (and include the ramifications of glass vs plastic) — in my opinion — would be the interesting one.

  19. Rachel says:

    Another cause of acne once dietary and hormonal issues have been ruled out is bacterial infection (typically staphlycoccus and streptacoccus strains). After 4.5 have years of painfully embarresing adult acne and sticking to all dietary and supplemental regimes for years without success, I was finally diagnosed with a staph infection from the last time I was in hospital 5 years ago! A combination of antibiotics and herbal/nutritional/immune boosting support cured it in 2 weeks.

    I wish I had discovered the cause sooner and saved myself years of low self esteem and now the expensive costs of scar treatment.

  20. Ruthie says:

    I laughed out loud when I saw this article because it described everything I have been going through the last little while. About two weeks ago I had a little bit of a break down because my acne (which had suddenly become very bad) was getting worse and nothing seemed to help. I soon realized that I had been eating a lot more dairy products. I had gone a while without them because I don’t really like milk and in general just didn’t consume any for a couple of months. I would get the odd pimple here and there but nothing bad. Then I started working full time in the summer and packing my lunch with little cottage cheese to go packs and yogurt. After a few months of eating this way I began to break out. Thinking it was a topical issue I started trying every acne medication out there. Eventually (two weeks ago), I realized the amount of dairy I had suddenly been consuming and the fact that I only started getting bad acne when I started eating it! I have stayed away from dairy for the past little while and my acne is slowly getting better. This article was a huge help and made me realize that I was right all along! Thanks for posting it!!! 🙂

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