There is mixed evidence on the relationship between diet and acne. However, some people may find that it helps to eat foods with a low glycemic index (GI) or to avoid specific products, such as cow’s milk.
A hormonal acne diet may look different from person to person, depending on their individual triggers and dietary needs.
This article looks at what hormonal acne is, some foods that may trigger it, and some dietary changes that a person can try. It also explores some other ways to treat acne.
Acne develops due to clogged and inflamed pores. Pores are tiny holes in the skin that secrete sebum, which is an oily substance that seals in moisture. If a pore becomes blocked by sebum or other substances, a pimple can form.
Many factors can contribute to acne formation, including:
- having oily skin
- wearing pore-blocking (comedogenic) products
- taking certain medications
- sunlight exposure
Hormonal acne is an informal term that people use for acne that appears to be caused primarily by hormonal changes.
People with hormonal acne may notice that they are more prone to breakouts:
- before or during a period
- during or after pregnancy
- after starting or stopping birth control pills
- during perimenopause or menopause
It is not always possible to distinguish acne that is mainly due to hormones from other types of acne. However, for some people, the timing of their breakouts may be an indication.
Research into how different hormones affect acne is still ongoing. However, some researchers believe that androgens play a key role. Androgens are a group of hormones that can cause oil glands in the skin to produce more sebum.
A number of things can raise levels of androgen hormones in the body, including:
- certain medical conditions, such as polycystic ovary syndrome (PCOS)
- certain medications, such as progesterone-only birth control
However, diet can also impact androgen levels, as well as levels of other hormones that play a role in the development of acne.
The following sections will discuss some foods that could contribute to acne in more detail.
High GI foods
A number of studies suggest that modern Western diets may increase the likelihood of acne, potentially due to the amount of high GI foods they often contain.
GI is a way of measuring how quickly foods increase blood sugar levels in the body. Modern Western diets often contain high GI foods that have a significant effect on blood sugar levels. This may explain why acne is common in countries such as the United States but less common elsewhere.
For example, one 2016 review highlights several studies that investigated acne prevalence among Indigenous people in northern Canada, the Kitava Islands, and rural villages in Brazil, South Africa, and Kenya.
These studies found that acne prevalence was low in these locations, and they attributed it to the participants’ traditional low GI diets. The study in Canada found that when participants began eating Western foods such as soda, dairy, and processed foods, rates of acne increased.
Some high GI foods include:
- sweets and candy
- sugary baked goods
- refined carbohydrates, such as white bread
- sweetened cereals
There may also be a link between cow’s milk and acne. However, studies investigating this have produced mixed results.
A 2016 review cites a handful of studies supporting a weak link between dairy consumption and acne. Additionally, a 2018 review of nine studies — including 71,819 participants — found that people who drank milk were 16% more likely to have acne than those who did not drink milk.
According to the American Academy of Dermatology (AAD), although cow’s milk may be a trigger for some, there is currently no evidence to suggest that other dairy products, such as cheese or yogurt, cause acne.
People often believe that chocolate is an acne trigger. However, the 2016 review did not find much evidence for this. Several studies found a weak association between chocolate consumption and acne, but many of these had design flaws.
For example, some of the studies did not control for the type of chocolate product the participants ate, meaning that additional ingredients — such as sugar or milk — could have affected the results.
A 2018 study involving 33 males found that consuming 10 grams of dark chocolate per day for 4 weeks led to skin changes that could make acne more likely. This was especially true for younger males.
Because of this, some people may find that reducing their cocoa intake or excluding cocoa products from their diet altogether helps reduce acne breakouts.
Although there is no set diet for people with hormonal acne, some may find the following changes helpful.
Always discuss any major dietary changes with a doctor or dietitian beforehand to make sure that they are suitable.
Low GI foods
If a person’s diet contains a lot of high GI foods, reducing the intake of high GI foods and eating more low GI foods may have benefits for their skin. Eating lower GI foods also has other benefits, such as stabilizing blood sugar.
Some foods to focus on include:
- non-starchy vegetables
- whole grains and cereals
- beans and legumes
- nuts and seeds
- fruits such as apples, berries, and plums
Many protein and fat sources do not have a GI score because they have little to no effect on blood sugar. Incorporating foods such as olive oil, eggs, chicken, and fish into the diet can keep blood sugar levels stable and provide important nutrients for skin health.
Omega-3 fatty acids
Although research has not established a direct link between omega-3 intake and acne, omega-3 can lower insulin-like growth factor 1, which has an effect on androgen levels in the body.
People can get more omega-3 from:
- oily fish, such as wild salmon and mackerel
- fish oil supplements or algae oil
- nuts and seeds, such as flaxseeds and walnuts
However, because antioxidants have other important health benefits, it is a good idea to eat foods that contain them.
These foods include:
- Brazil nuts, fish, seafood, beef, turkey, and organ meats, which contain selenium
- red grapes, mulberries, and peanuts, which contain resveratrol
- other foods high in antioxidants, such as blueberries, leafy greens, red cabbage, and green tea
People who consume cow’s milk may want to try reducing their intake and opting for other types of milk, or milk substitutes, to see if this has a positive effect on their skin.
In addition to making dietary changes, a person may also wish to try other acne treatments.
For basic self-care, the AAD recommend:
- washing the face twice per day with a gentle, pH-balanced cleanser
- washing the face after sweating or wearing equipment that sits close to the face, such as a helmet or a mask
- switching to gentle, noncomedogenic skin care products that do not contain alcohol or abrasive material that scrub the skin
- using clean towels and face cloths and washing items that touch the face often
- avoiding touching the face to pick or squeeze pimples
After washing the face, a person may wish to try topical acne treatments. Some ingredients to look for include:
- salicylic acid, which reduces inflammation and unclogs pores
- retinoids, which unclog pores and reduce oiliness
- benzoyl peroxide, which kills bacteria that cause acne
A person can buy skin care products that contain these ingredients over the counter. Alternatively, a dermatologist can make recommendations or prescribe medical-strength versions.
Many acne treatments increase the skin’s sensitivity to sunlight, so it is important to also use a nonirritating sunscreen to protect the skin from UV damage during the day.
Keeping a diary and trying things one at a time may help people determine whether or not dietary changes and other strategies are helping their acne.
In some cases, people with acne can take medications that may improve their symptoms. These include:
- antibiotics such as clindamycin, which can help with painful inflammatory acne
- spironolactone, which is a hormonal treatment that can block the effect of androgens on the skin
- oral retinoids, such as Accutane
- birth control pills
These medications can cause side effects and are not suitable for everyone. It is always best to discuss the benefits and potential risks with a doctor.
Acne does not cause serious physical damage. However, it can have a significant effect on a person’s self-esteem.
It may be best to speak with a doctor or dermatologist if acne:
- is severe or very painful
- leaves scars or lesions on the skin
- does not respond to over-the-counter treatments
- affects a person’s mental health
Females with acne and accompanying symptoms — such as weight gain, irregular periods, hair loss, or excess body hair — should also speak with a doctor, as this may indicate the presence of PCOS.
Acne can develop due to a number of factors, including hormones. Specifically, androgen hormones can increase the skin’s oil production, which may increase the chance of acne.
There is mixed evidence about the impact of diet on acne. However, a person may wish to try eating lower GI foods, foods that contain antioxidants, and omega-3 to see if this helps.
If their acne persists, a person may wish to consult a dermatologist for safe and effective treatment options.