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Chocolate and acne: A long-standing myth?
For decades, chocolate has been blamed for causing acne, but scientific evidence suggests this reputation may be unfounded. While diet does play a role in skin health, recent research points to broader factors beyond just sweet treats.
The 1960s study that started it all
Early research in the 1960s, including a study with just 65 participants, initially found no connection between chocolate consumption and acne. However, critics later highlighted significant flaws in the study's design, leaving the question unresolved for years.
The Western diet's impact on skin
Modern studies suggest that acne is influenced by the Western diet, which is high in saturated fats, sugars, and dairy. Acne occurs when hair follicles become clogged with oil and dead skin cells, a process largely determined by genetics, according to Beibei Du-Harpur, a dermatologist and clinical lecturer at King's College London.
Genetics dictate the size of sebaceous glands, which produce oil, making some individuals more prone to acne. However, environmental factors, including diet, may exacerbate the condition.
Rising cases of adult acne
Adult acne, particularly among women, has been increasing in recent years. While there is no single cause, lifestyle factors such as stress, infections, and hormonal fluctuations-like those during PMS-are believed to contribute, says Zainab Laftah, a consultant dermatologist at Guy's and St Thomas' Hospital in London.
"Generally, our lifestyles aren't good for the human body, and perhaps acne is a manifestation of that."
Beibei Du-Harpur, Dermatologist
The role of diet in acne
Researchers argue that modern lifestyles, including diets high in sugar and fat, may aggravate acne. However, the interplay between health, immune function, diet, inflammation, stress, and environmental exposures requires further study.
Laftah notes that while genetics are the primary factor, certain foods may provoke inflammation in some individuals. Dairy, for example, can trigger reactions in rare cases, potentially linked to intolerance.
Chocolate's complex relationship with skin
Studies examining chocolate's impact on acne have yielded mixed results. A 2011 study on 100% dark chocolate-testing chocolate without sugar-found a link to worsened acne, but the study was small and lacked a placebo control group.
The glycaemic index (GI), which measures how quickly food raises blood sugar, has been linked to acne. High-GI foods like bread, pasta, and fruit can spike insulin levels, increasing inflammation and sebum production, which clogs pores. However, chocolate has a low to medium GI, complicating its role in acne.
The Western diet and acne: A broader look
Population studies have shown an association between acne and high-fat, high-sugar diets. A 2020 study of over 24,000 people found that the Western diet likely plays a role in acne development. Conversely, the Kitavan islanders of Papua New Guinea, who consume a low-GI diet, show no instances of acne.
Bodo Melnik, a professor of dermatology at the University of Osnabrück, describes acne as a "metabolic syndrome of the skin," linked to other Western diseases like diabetes and obesity. He argues that refined carbohydrates, milk, and saturated fats promote acne by triggering a "danger response" in sebaceous follicles, increasing sebum production.
Potential benefits of dark chocolate
While chocolate contains saturated fat and sugar, its effects depend on the type consumed. High-percentage dark chocolate, which is lower in sugar, may offer dermatological benefits. Studies suggest it reduces oxidative stress in the skin, which contributes to inflammation, though this may primarily benefit skin aging rather than acne.
"There are some benefits to the skin from eating dark chocolate because of its flavonoid content, particularly flavanols, which are powerful antioxidants."
Zainab Laftah, Consultant Dermatologist
Flavanols help combat free radicals linked to skin aging, offering a potential upside to dark chocolate consumption.
Genetics and diet: A combined effect
While diet can influence inflammation, its impact on acne may only manifest in individuals genetically predisposed to the condition. Du-Harpur emphasizes that a diet rich in fruits, vegetables, and antioxidant-rich foods benefits overall skin health.
"The body works in coordination, so things that are good for the heart and gut and brain are good for the skin, too."
Beibei Du-Harpur, Dermatologist
