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    If you have acne, you're probably careful about what you put on your skin, but how careful are you about what you put in your mouth? A number of studies show that what you eat can trigger acne outbreaks and worsen their severity. If you've tried topical treatments to no avail, maybe diet changes will offer better results.

    Acne is caused by excess production of an oily substance called sebum, which is produced by sebaceous glands. The sebum mixes with dead skin cells and bacteria and clogs the opening of pores. The red pimples you see come from the inflammation associated with the blocked pore. If you can decrease sebum production, you reduce acne outbreaks, but that's sometimes easier said than done.

    What causes an increase in sebum? Hormonal fluctuations are one factor that increases sebum production. That's why adolescents and younger adults are more susceptible to acne, and women are more likely to experience an outbreak during certain phases of their menstrual cycle. However, certain foods may also cause the sebaceous glands to go into overdrive and produce too much sebum.

    What are some foods that can worsen the symptoms of acne?

    Dairy Products

    Dairy foods are a good source of calcium, but they may not be the best choice if you're prone to acne outbreaks. Not every dairy product is linked with acne. Based on science, the biggest culprit is dairy milk. The reason may be the IGF-1 in milk, a hormone that triggers cell growth and proliferation.

    Is there science to support the idea that milk triggers acne? One study looked at the dietary habits of almost 48,000 women. It showed that women who drank at least 2 glasses of skim milk daily were 44% more likely to develop acne. Other studies also show that skim milk is a bigger trigger of acne than whole milk. Skim milk also has higher levels of IGF-1 relative to whole milk.

    Fortunately, you have alternatives if you like to add milk to your coffee. Plant-based milk alternatives, like coconut and almond milk, don't contain IGF-1 and don't worsen acne in most people.

    High-Glycemic Carbohydrates

    High-glycemic carbohydrates are carbohydrates your body absorbs fast, so quickly that they cause a blood glucose spike. They're abundant in junk food and ultra-processed foods, like breakfast cereals, chips, crackers, pastries, and doughnuts. Plus, high-glycemic carbohydrates include foods made with white flour, like white bread, white rice, and pasta. These foods aren't good for your health, and if you eat too many of them, they may contribute to acne flairs. What distinguishes these foods from healthier foods is that they're highly processed and contain little fiber to reduce blood sugar spikes.

    A number of studies show high-glycemic carbohydrates can worsen acne. One study of 2,258 people found that those who ate a low-glycemic diet for weight loss experienced fewer acne flairs. In fact, 87% of the participants who eliminated high-glycemic carbohydrates said they had fewer acne flare-ups.

    How might high-glycemic carbohydrates bring on an acne outbreak? When blood glucose spikes, it triggers inflammation and hormonal fluctuations that can cause an acne outbreak. Avoiding ultra-processed carbohydrates and added sugar are two ways to keep your skin clearer, and it's better for your metabolic health too.

    Replace ultra-processed carbohydrates and starches with colorful fruits and vegetables. These foods contain antioxidants and compounds with natural anti-inflammatory activity that may reduce inflammation and keep your skin clearer.

    Chocolate

    You may have heard that chocolate worsens acne, and it's partially true. A study found that eating milk chocolate boosted the odds of an outbreak of acne by 28%, but eating dark chocolate lowered the risk by 10%. Why might this be? Dark chocolate contains less milk and sugar relative to milk chocolate. Since milk and sugar can trigger outbreaks in some people, this is consistent with science. If you eat chocolate, nibble on it in moderation and choose a dark chocolate bar that contains no more than 6 grams of sugar.

    Soft Drinks

    What about those fizzy drinks that so many people love? Soft drinks have little nutritional value, and they may worsen acne too. A study of over 8,000 people found that those who frequently drank soft drinks were more likely to experience moderate to severe acne. The risk was also proportional to how often and how many soft drinks they drank. The risk rose with 100 grams of soft drink daily or greater. Although not every study shows such a strong association, soft drinks are unhealthy for other reasons. Give them up for your health, and you might be surprised to find your skin is healthier too.

    What you eat matters for your health, but also for the clarity of your skin. If you're frustrated by frequent acne outbreaks, eliminate these foods one at a time for a few weeks and see how your skin responds. Keep a journal so you'll know if your skin improved. Hopefully, you'll be rewarded with clearer skin!

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