The Best and Worst Foods for Acne

The Best and Worst Foods to Eat for Resolving Acne

In a recent article we went into all the nitty gritties about the connection between the gut microbiome and acne, which you can check out here! Since we’ve established the very real effect of the gut-skin axis on skin diseases, we can start to look at the ways in which we are influencing this axis and in turn, our acne presentation.

It’s probably not a surprise to learn that one of the main influences on the gut-skin axis is what we eat.

While acne has many factors involved and requires working one-on-one with a health practitioner, there is a lot we can start to do ourselves each day, just by what we choose at the grocery store and prepare in our own kitchen. So let’s take a look at which foods are the best when we have acne, and which ones could be making your acne worse

What are the Best Foods to Improve Acne and the Gut Microbiome?

Low glycemic

A food’s glycemic index represents how much it raises the blood sugar a couple hours after eating, when compared to pure glucose. Diets that are low glycemic index are generally lower in carbohydrates and sugars and are more balanced with protein and fat. Low Glycemic index diets reduce IGF-1 and free androgens and are associated with fewer and less severe acne lesions and smaller sebaceous glands. 

Foods that are Low Glycemic:

• Most vegetables (except high carb, such as potatoes), especially dark leafy greens, broccoli, cauliflower, eggplant, peppers, brussel sprouts and raw carrots. 
• Legumes, kidney beans, chickpeas, lentils (which have fiber and resistant starch)
• Some fruits, especially berries, citrus, apples, cherries, and grapefruit
• Meat, poultry, fish and eggs
• Nuts and seeds 
• Full fat, grass-fed milk, yogurt, and cottage cheese
• Avocado and olives
• Minimally processed grains 
• Olive oil, butter, lard

Hot tip: Rather than thinking of single foods as low or high glycemic, you can also look at the meal as a whole. If you do want to eat potatoes or higher glycemic fruit, pair it with a balance of foods high in protein, fat, and fiber, to slow the glycemic response. Going for a short, brisk walk after meals can also help in lowering the blood sugar spike. 

Rich in probiotics

Studies show that probiotic rich foods may improve insulin levels and glucose metabolism, are anti-inflammatory, inhibit bacteria and benefit the overall presentation of acne . Probiotics can improve the microbiota of both the skin and gut, which is also associated with better acne treatment outcomes. 

Foods that are high in probiotics:

• Kimchi, sauerkraut and pickled vegetables. 
• Low-sugar kombucha and Kefir
• Greek yogurt and other fermented dairy
• Natto and miso
• Probiotic supplements. While not a food, there are many probiotic supplements on the market with varying quantities and strains. Not all are appropriate for everyone’s gut profile so gut-testing with a practitioner is important. 

Rich in fermentable fiber

Incorporating fiber into the diet has been discussed in our articles on the gut microbiome and is key in populating the gut with helpful bacteria. Many forms of fiber are fermented in the gut to form short-chain-fatty-acids (SCFAs), such as butyrate, which are metabolites that are important contributors to the gut microbiome and directly affect the skin microbiome. SCFAs also support the immune system and reduce inflammation, both of which are involved in the production and resolution of acne. 

High Fiber Foods:

• Vegetables like dark leafy greens, asparagus, chicory root, garlic and onions
• Beans, peas and lentils
• Nuts, especially almonds, hazelnuts, and pistachios.
• Flax, chia, and sunflower seeds.
• Fruit like apples, less ripe bananas, and berries (especially raspberries)
• Whole grains like oat, barley, and rye. 

Hot Tip: If you are significantly increasing the fiber content in your diet, make sure to start slow and increase your water intake while you’re tapering up. Fiber can increase gut motility and improve stools, but if you go too fast or get dehydrated, it can have the opposite effect!

Rich in Omega 3s 

Dietary Omega-3 decreases inflammation and IGF-1 and reduces acne lesions and sebum production. Higher Omega 3 to Omega 6 ratio is also associated with less inflammation. Overall, there may be a reduction in how much acne is present and the severity of it, improving both the discomfort and the appearance. Omega-3s may also contribute to skin hydration and elasticity as well as wound healing, which is an added benefit while your acne lesions start diminishing and the skin starts to repair. 

High Omega-3 Foods:

• Fatty fish like wild-caught Salmon and Mackerel, Tuna, Sardines, Herring
• Oysters
• Extra virgin olive oil, cod liver oil
• Grass-fed red meat and dairy
• Flax seeds, chia seeds, walnuts
• Pastured eggs

Rich in antioxidants

Oxidative stress plays a critical role in our immune system, wound healing, and in resolving inflammation, all of which contribute to the prevention and repair of acne. Following antioxidant rich diets may improve both the appearance and severity of acne as well as the overall skin health and vitality. “Antioxidants” is a broad category that has some overlap with other categories already mentioned, but it’s helpful to understand it as its own set of properties. Many of the foods listed in this article are wonderful because they fit into multiple beneficial categories!

Antioxidant Rich Foods:

• Broccoli, red cabbage, kale, artichokes, most leafy greens, beets and sweet potatoes
• Green tea, especially matcha
• Fruits like blackberries, strawberries, raspberries, cranberries, cherries, blueberries, apples and grapes
• Turmeric/Curcumin
• High quality Cacao/ Dark Chocolate
• Nuts like pecans and Brazil nuts

Rich in Vitamin A and E; Zinc and Selenium

Vitamin A is the main vitamin involved in skin regeneration and cell turnover which is why it is used in synthetic form in popular acne products such as retinoids, like isotretinoin. It also has a beneficial effect on collagen and hyaluronic acid production which can help improve skin integrity and appearance.  Consuming synthetic vitamin A can be tricky because of unreliable dosages and absorption in supplements, but consuming it in its natural form in whole foods can be very beneficial for acne. 

Vitamin E is an important part of the skin’s lipid mantle and contributes heavily to skin hydration as well as having anti-inflammatory, anti-seborrhoeic and antioxidant effects. 

Zinc is important for its anti-inflammatory and antioxidant properties but also has a bacteriostatic effect on the primary bacteria involved in acne, Cutibacterium acnes. 

Selenium is also anti-inflammatory, but more specifically to acne it can regulate sebum production. When combined with Zinc it enhances the antioxidant effect of both.

Food high in Vitamin A and E, Zinc & Selenium:

• Vitamin A: Butter, fish, beef liver. 
• Vitamin E: Eggs, green leafy veggies, tomatoes, walnuts, sunflower seeds
• Zinc: Pumpkin seeds, sunflower seeds, oysters, beef, lamb and poultry
• Selenium: Brazil nuts can provide the entire daily requirements for Selenium. Red meat, organ meats and fish and also good sources. 

Overall best diet for Acne 

Considering all of the categories and foods we’ve just learned about for improving acne, is there any one diet that has it all?

While we all have slightly different needs depending on where we live, what we do, and our medical history, there is one diet that ticks the most boxes!

The Mediterranean Diet

This diet is rich in protein, healthy fats, carbs and fiber. It has lots of fruits and vegetables, nuts and seeds, and good quality animal foods. It is also rich in fatty acids from high quality fish and olive oil. There is tons of research on the benefits of the Mediterranean diet for the gut microbiome (and the resulting skin benefits), but also for many other aspects of health such as metabolic and cognitive function. If you need one diet to give you some guidelines for improving acne, the Mediterranean is a great place to start. 

What are the WORST FOODS to eat when you have Acne?

Now that we have some idea about which foods are good to eat when we have acne, it’s helpful to consider which foods are not doing us any favors. Any balanced diet is going to include some foods that aren’t perfect, and this is probably okay if you are giving your body the right macro and micronutrients the majority of the time. But certain ingredients may be in your daily diet that could be making your acne significantly worse. Let’s take a look at which foods are the worst to eat when you have acne. 

Sugar/high glycemic foods

In the first section on best foods for acne there is an explanation about foods that are low on the glycemic index and why they are beneficial for keeping acne in check. So what about the foods that are high glycemic? Unsurprisingly, these foods will have a nearly opposite effect to their low G.I. counterparts by raising our blood sugar rapidly, triggering the release of insulin. The effect of high glycemic food is eventual damage to our metabolic health which can increase our risk of cancers, cardiovascular disease and diabetes. This also has an effect on our gut health, our immune system, and in turn, our skin health. High glycemic foods can eventually lead to overproduction of sebum, worsened infection with Cutibacterium Acnes, and increased inflammation. 

We mentioned this as a hot tip above, but if you missed it, It’s important to note that some of the foods that are high on the glycemic index will have the worst effect when eaten on their own. However, it’s possible to combine foods in such a way that will reduce the effect on blood sugar. For instance, white rice on its own will likely spike blood sugar, but combining it with protein, fiber, and fat will reduce the blood sugar response. Try it with some stir-fry steak and veggies!  Another idea is having something like high glycemic fruit as a dessert after a balanced meal of protein, fat and fiber, rather than on its own. If you are having it as a snack, you might combine it with certain nuts or a protein rich source of food such as beef jerky or some turkey slices.

Foods that are high glycemic when eaten on their own:

• Soda, sugary beverages, juices etc. 
• Refined grains such as bread products, white rice, pastries, donuts etc. 
• Potatoes 
• Crackers, rice cakes and most packaged snacks and breakfast cereals
• Watermelon, raisins, mango, dried cranberries, pineapple, date palm, and overly ripe bananas

Dairy (certain types!)

In dairy products, it is primarily the whey protein content that raises IGF-1 and insulin and is associated with increased number of acne lesions. However, it is impossible to make a blanket statement about dairy and acne as many of the studies do not specify the quality of dairy used. For instance, unpasteurized whole milk from no-pesticide, pasture-raised cows will have more available fat soluble vitamins that fight acne (like A, D, E and K),  a better Omega 3 to 6 ratio, much higher concentration of conjugated linoleic acid (CLA) and more available digestive enzymes present, all of which could benefit the gut microbiome and could be potentially beneficial for acne, depending on the total insulin enhancing effect of one’s diet and if you have any allergies to milk or lactose. Most milk produced in America and many developed countries is ultra-pasteurized, low fat, and taken from cows that are grain fed and on antibiotics and have metabolic disorders themselves. In these instances, diary can be highly inflammatory and aggravate an acne condition. 

Dairy foods that might worsen acne:

• Whey protein supplements from low-quality, conventional dairy. 
• Low fat dairy has a higher Glycemic Index, more effect on blood sugar, and may be worse than full fat dairy for acne sufferers. 
• Conventional dairy has a higher omega 6 to omega 3 ratio and less CLA, which is more inflammatory and could exacerbate acne lesions. 
• Dairy in general can be inflammatory depending on the source and an individual’s existing gut microbiome and ability to digest it. In this case milk, cheese, ice cream, and even fermented dairy such as yogurt and kefir may be problematic. 

Growth Factor supplements

Many people who have used insulin-like growth factor (IGF-1) developed acne during supplementation, while it tends to resolve afterwards. This is popular amongst many athletes, such as bodybuilders, in attempts to build more muscle. On the other hand, teens who have a disorder that reduces IGF-1, called Laron syndrome, don’t develop acne at all. The caveat here is that pure HGH supplements are prescription only and may be prescribed by your doctor for a reason that is congruent with a medical diagnosis and may be beneficial for your condition.

The supplements listed below are those that claim to raise levels of growth factor and so may have variable effects depending on the ingredients. It’s important to note that including them in the “worst” list does not make them inherently unhealthy. In the context of acne alone, without considering the overall picture of an individual patient, supplements that boost HGH are likely to exacerbate the condition. But this is why it’s so important to work with a practitioner to treat your acne.

Supplements that raise Growth Factor:

• Hgh injections (prescription only)
• Examples of popular supplements for bodybuilders: GenF20 Plus, HyperGH 14x, CrazyBulk HGH-X2, Provacyl, Brutal Force HBULK, GenFX, VigRX Tongkat Ali, LJ100
• Some popular ingredients in ‘HGH’ supplements, in various ratios and combinations:: Amino Acids, Gaba, Colostrum, L-Arginine, L-Ornithin, Deer Antler Velvet, Astragalus Root Extract, Tribulus Terrestris Extract, Hawthorn Berry, Mucuna Purines, Maca root, DHEA, Ginseng, Tongkat Ali, B Vitamins.

Overall worst diet

Considering everything we have just learned about what may aggravate, cause, or prevent healing from acne, the overall worst diet would be the Standard American Diet (SAD). The SAD is  high in refined foods, poor quality dairy, high glycemic index foods, sugar, industrial seed oils, and  inflammatory foods in general. It is also relatively low in quality animal protein, fiber, polyphenols and many micronutrients that benefit acne healing. There have been examples of several populations, such as the Okinawans, the Canadian Inuits, the Zulus and others, who historically had no acne until they were introduced to refined sugars, conventional dairy, and highly processed foods. While everyone has different needs when it comes to diet and acne treatment, these foods we have deemed “the worst foods for acne” seem to have a universally negative effect on health and acne presentation. 

To wrap things up on best and worst foods for acne:

This article provides some informative and practical food guidelines for anyone currently suffering from acne. But they are just that, guidelines!

The only way to know precisely which diet is going to work for you is to work one-on-one with a health practitioner. For treating acne, your practitioner should understand the gut-skin axis and your individual health profile, likely through detailed and professional consultation as well as testing on your gut, your micronutrients and other factors that become relevant during your intake.

A functional medicine practitioner or Chinese Medicine practitioner is a great direction to go in. That said, before your first appointment you can use this article to start making healthy choices that are going to support your efforts in improving your acne, all the way down to the gut. 

Dr. Jenny Bisset
Founder of The Bisset Method
JB Wellness
Chinese + Functional Medicine

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