Although the few studies conducted on this topic have yielded mixed results, “theoretically, people with acne may have hyperinsulinemia and foods that are low in the glycemic index (GI) may contribute to the hormonal control of acne,” says Alan R. Shalita, MD, thedistinguished teaching professor and chairman of the department of dermatology at SUNY Downstate Medical Center in New York.
Hyperinsulinemia is characterized by excess levels of the hormone insulin in the blood, and foods with a low glycemic index that are favored by low-carb eating plans can help control blood sugar (glucose) levels.
“I would encourage patients with acne to moderate the amount of carbs that they eat and not to overdo dairy,” he says. There is some suggestion that dairy products may contribute to acne, he says.
Shalita spoke on the relationship between diet and acne at the American Academy of Dermatology Summer meeting in New York.
Much of the information circulating about how certain foods cause or cure break-outs are myths, he says.
For example, there is no evidence that chocolate causes acne, he says. “One study that compared Hershey chocolate bars with carob bars found no difference in acne risk,” Shalita says. “There is sugar and fat in both, so for people that do react to chocolate, it has more to do with the sugar than the cocoa.”
Acne Treatment Update
The good news on the acne front has to do with treatments; Shalita says. Over-the-counter (OTC) products are the best place to start for mild-to-moderate acne. Shalita suggests a salicylic acid cleanser followed by a benzoyl peroxide leave-on product to help dry the skin for people with mild-to-moderate acne.
“If you don’t respond, see a dermatologist,” he says.
For severe, scarring acne, the gold standard is still isotretinoin, a form of vitamin A. This drug was formerly known by the brand name Accutane. It can cause severe birth defects and can have other side effects, including depression, hallucinations, and suicidal behavior.
So now people are looking for alternative acne treatments, says Amy Forman Taub, MD, the medical director of Advanced Dermatology and an assistant clinical professor of dermatology at Northwestern University Medical School both in Chicago.
Certain laser treatments can help with acne and acne scars, and for teenagers and people with severe acne, blue light Levulan photodynamic therapy can be an option, she says.
Levulan is a liquid that is applied to the skin and absorbed by the oil glands; blue light treatment activates the medicine in the glands and shrinks them. This treatment also kills acne-causing bacteria, she says.
Other acne treatment options include certain oral contraceptives and oral or topical antibiotics.
“If you have mild acne and can get away with using OTC salicylic acid cleansers and benzoyl peroxide, these are still very viable treatments,” Taub says. But “if your acne is severe, don’t mess with this as a first step as you may be flirting with acne scars."