Causes of Acne: The Real Role of Milk, Chocolate and Fish

Craig Kraffert, MD

For years people have speculated on possible acne triggers. Medical dogma and old wives’ tales abound. Yet the real scientific question has, for the most part, been relatively unaddressed by scientific study: are there lifestyle elements that make acne better or worse? Historically, there has been little population-based data relating to which environmental factors protect against or increase the risk of acne. This year, however, an Italian study of more than 200 acne sufferers has shed light on the relationship of acne to several lifestyle and situational factors.

Non-dietary Factors and Acne

There are a few non-dietary factors directly associated with an increased risk of developing moderate to severe acne. Those with brothers, sisters or parents with a history of moderate to severe acne have almost a 3.5 times greater risk of developing this condition. Those with a body mass index greater than 18.5 (18.5 BMI is quite thin by US standards) have almost double the risk of developing acne. This BMI link may help explain the high prevalence of acne in the well-fed USA compared with less fortunate parts of the world where societal food stress remains problematic. The study also showed that Italian males are approximately 14 percent more likely to develop moderate to severe acne than females.

Dairy and Acne

Milk appears to be the biggest dietary contributor to acne risk. Consumption of skim milk more than doubles this risk, while whole milk increases risk by more than 60 percent. Cheese and other fatty foods do not appear to affect acne risk.

Positive Effects of a Fish-rich Diet

The one surprising positive dietary finding in this study was the protective value of a diet rich in fish. Those who consumed at least one daily fished-based meal per week had approximately two-thirds the risk of developing moderate to severe acne compared with those who abstained from fish.

Myth vs. Reality

The Italian study analyzed several medical dogma concepts related to acne risk in a noble attempt to help separate myth from reality. For example, despite all the old wives’ tales, chocolate had zero effect on acne. Also, a recent medical study suggesting that an increased glycemic index is linked to acne risk was refuted by the study, as those with diets rich in cakes and sweets had no increased acne risk. Another medical myth relating to the belief by some dermatologists that cigarette smoking has a protective effect on acne has been shot down by the data; cigarette smoking had no effect on acne risk. In addition, menstrual history was found to have no significant effect on acne risk.

Overall, this study is interesting for two reasons. First, it sheds new and valuable light on some of the factors that play a real role in the risk of developing moderate to severe acne. Second, it reminds us that some of the things we have been told or believe to be true may actually be wrong. This indirectly affirms the important role of scientific research in the betterment of human health and welfare. Acne can certainly be a troublesome and challenging disease with the potential for great physical and psychological morbidity. As such, dermatologic consultation for assistance with disease management remains ever appropriate. We can help with acne. Click here to schedule an evaluation.


1 responses to "Causes of Acne: The Real Role of Milk, Chocolate and Fish"

    Kelli Graves | Commented on

    For years I have been telling my acne clients to eliminate dairy from their diets, to reduce the severity of their acne. Asian clients especially seem to have trouble with dairy, and an almost immediate favorable result from cutting back or eliminating. Interesting that cheese isn't a factor. very nice website, btw.

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