April 2019

Before someone comes to see my in clinic, I ask them their 3 main goals they want to achieve from nutrition consultations with me. The three most common ones I see are: “Feel healthier” (nice and vague), “have a better relationship with food”, and “help fix my skin”.

Acne is something that affects a huge number of the population, and has some stigma attached to it. People assume that if you have ‘bad’ skin that it’s your fault, that you’re not eating well enough, that you’re not washing your face properly, and that you’re not healthy. One of the markers of health that we identify in people’s appearance is their skin: if it ‘glows’ then it’s a sign of health. Acne is in direct contrast to that.

There’s a pervasive myth that the most effective way to improve acne is to cut certain foods out of your diet. As someone who has suffered from acne for half my life, I understand that people are willing to do pretty much anything to try and improve their skin. Diet usually feels like a low-risk option because it’s ‘just food’. We forget or ignore (or perhaps are simply unaware) that there are side effects and consequences when we cut foods out of our diet.

But before we delve into that in more detail, I want to examine what the research says about the link between food and acne. In particular, dairy and sugar.

When it comes to dairy, there is a huge lack of evidence suggesting that dairy and acne are linked. There may be a very small subset of the population for whom it does make a difference, but these are rare. The issue here, though, is that we can experience what is known as the nocebo effect. This works the opposite way to a placebo effect, which means when we are so convinced that we will experience a negative reaction to a food that it actually physiologically happens. It really shows the power that our beliefs and perceptions can have, and reinforces the idea that the mind and body are so interlinked. What this also means is that you can potentially reduce the risk of any symptoms occurring by making sure you’re relaxed when you eat. Stress can play a significant role in acne and stressing about dairy is likely going to do more harm than dairy itself!

The idea that eating sugar causes acne is just as pervasive. There is some evidence that eating a lot of high-glycaemic index (GI) foods (things like ‘white’ carbs and sugary drinks) but the effect these foods have will vary depending on how much you eat them and what you eat with them. After all, you don’t often eat foods in isolation but generally as part of a meal, and it’s the overall meal that will dictate whether it’s low or high-GI, along with how much you eat and how quickly. Now this absolutely isn’t to say that to prevent or cure acne you have to remove all sugar and ‘refined’ carbs from your diet, because it’s more complex than that. However, if you’re eating a lot of these foods it can be helpful to reduce them – but this is true for your overall health, not just your skin.

As a nutritionist, I hear from people wanting to improve their skin regularly, because people think it’s a nutrition issue, when in fact they probably need to see a consultant dermatologist. I can attest to this through my own personal experience – going to a dermatologist has had a life-changing effect on my skin, something food was never able to do (and, believe me, I tried).

Cutting out foods is not a risk-free option. It can lead to potential vitamin deficiencies or mean your diet is less balanced than before, but in particular it can have consequences on your mental health. Overly worrying about your food means your body is in a stressful state, and food can end up preoccupying so much of your mind that it doesn’t leave enough room for you to be able to focus on all the incredible things you need to do in life. It can also have an impact on your social health, as cutting foods out can make it more difficult or more stressful to enjoy meals out. Social interactions are incredibly important, and one of the key things that helps us live long, happy lives.

Acne is not caused by lifestyle issues, we know it’s largely hormonal and genetic. But when we assume it’s caused by food, and that food is the solution, it leads us to blame others or ourselves for our choices, which is absolutely not helpful. All it does is add stress, guilt, and shame to acne sufferers, which can just make the situation worse.

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Pixie Turner
Registered Associate Nutritionist

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