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Myth or Fact: Eating Chocolate Causes Acne

If you’ve ever eaten a piece of chocolate and then studied your face for signs of an acne breakout, you’re not alone. Generations of teenagers have been cautioned that chocolate causes acne, but is there any truth behind the warning? Duke dermatologist Diana McShane, MD, says the connection between chocolate and acne is, in chocolate terms, only semi-sweet. “Chocolate has been implicated in the role of acne for decades without any convincing data to support or refute this theory,” McShane said.
  The Food-Skin Connection

It’s unclear where the link between chocolate and acne first came from, but well-intentioned adults have been passing it on for at least 100 years. One reason for this long life may be that there has only been one controlled medical study on the idea. To the delight of chocolate lovers, the trial, performed in 1969, found no relationship between chocolate and acne. However, it wasn’t conclusive enough to close the book on the matter. “Studies that specifically address the association of diet and acne are difficult to design with enough power to determine true cause and effect,” McShane said. This makes it difficult to determine not only what foods might be bad for your skin, but also what foods promote skin health. There is some evidence that foods high in anti-oxidants, such as green tea, blueberries, and pomegranate, may contribute to skin health; other studies have indicated that diets high in dairy or carbohydrates may promote acne, but none of them have been proven definitively. “I wish we knew more about which foods were best for skin health, but until we do, I suggest a balanced diet with a full complement of the recommended vitamins and minerals as the best way to promote skin health and overall body health,” McShane said.

   Good Skin Through Good Choices  Knowing how your skin reacts to foods or products is important because each person’s skin is unique and will have varying reactions to different triggers. McShane recommends paying attention to what foods or products cause breakouts and make good choices about what you use and eat. If you notice your skin reacts badly to a food or product, stop using it for a while and see if there is improvement. If satisfying your sweet tooth with chocolate doesn’t cause any reaction, it’s probably okay to indulge every so often. Keep in mind that how your skin behaves may change from season to season. In winter, dry air can make skin more sensitive; spending more time in the sun during warm months can encourage acne flare-ups. Certain foods may also interact badly with the sun and cause a rash. “In particular, limes are a common culprit,” said McShane. “Other foods that can cause this include fig, parsnip, parsley, and celery.”

  Simple Daily Skin Care Clean skin is also important in preventing outbreaks, and while there are hundreds of products available that claim to do just that, McShane recommends adopting a simple routine. “I find that many of my patients try to fight acne with aggressive cleansing routines, which can actually irritate the skin and make acne more noticeable,” McShane said. Instead, McShane suggests washing once or twice a day with a moisturizing cleansing bar or facial cleanser containing benzoyl peroxide or salicylic acid, which helps keep mild acne under control. In cases of moderate to severe acne, or acne that causes scarring, a dermatologist may be able to help find a treatment to restore healthy, blemish-free skin.

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What is acne?

What is acne?

Acne (acne vulgaris, common acne) is a disease of the hair follicles of the face, chest, and back that affects almost all males and females during puberty; the only exception being teenage members of a few primitive isolated tribes living in Neolithic societies. It is not caused by bacteria, although bacteria play a role in its development. It is not unusual for some women to develop acne in their mid- to late-20s. Acne appears on the skin as... congested pores ("comedones"), also known as blackheads or whiteheads, tender red bumps also known as pimples or zits, pustules, and occasionally as cysts (deep pimples, boils). You can do a lot to treat your acne using products available at a drugstore or cosmetic counter that do not require a prescription. However, for tougher cases of acne, you should consult a physician for treatment options. What causes acne? No one factor causes acne. Acne happens when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty by elevated levels of male hormones. Sebum (oil) is a natural substance which lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature so that they are predisposed to clog the follicular openings or pores. The clogged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); deeper still and it's a cyst. If the oil breaks though to the surface, the result is a "whitehead." If the oil accumulates melanin pigment or becomes oxidized, the oil changes from white to black, and the result is a "blackhead." Blackheads are therefore not dirt and do not reflect poor hygiene. Here are some factors that don't usually play a role in acne: Heredity: With the exception of very severe acne, most people do not have the problem exactly as their parents did. Almost everyone has some acne at some point in their life. Food: Parents often tell teens to avoid pizza, chocolate, greasy and fried foods, and junk food. While these foods may not be good for overall health, they don't cause acne or make it worse. Although some recent studies have implicated milk and pure chocolate in aggravating acne, these findings are very far from established. Dirt: As mentioned above, "blackheads" are oxidized oil, not dirt. Sweat does not cause acne, therefore, it is not necessary to shower instantly after exercise for fear that sweat will clog pores. On the other hand, excessive washing can dry and irritate the skin. Stress: Some people get so upset by their pimples that they pick at them and make them last longer. Stress, however, does not play much of a direct role in causing acne. In occasional patients, the following may be contributing factors: Pressure: In some patients, pressure from helmets, chin straps, collars, suspenders, and the like can aggravate acne. Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid), which is used to treat bipolar disorder. Most cases of acne, however, are not drug related. Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne. Cosmetics: Some cosmetics and skin-care products are pore clogging ("comedogenic"). Of the many available brands of skin-care products, it is important to read the list of ingredients and choose those which have water listed first or second if you are concerned about acne. These "water-based" products are usually safe.

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WHAT CAUSES ACNE AND HOW TO TREAT IT

All acne is a disorder of the pilosebaceous unit, which is made up of a hair follicle, sebaceous gland, and a hair. These units are found everywhere on the body except on the palms, soles, top of the feet, and the lower lip. The number of pilosebaceous units is greatest on the face, upper neck, and chest. Sebaceous glands produce a substance called sebum, which is responsible for keeping the skin and hair moisturized. During adolescence sebaceous glands enlarge and produce more sebum under the influence of hormones, also called androgens. After about age 20, sebum production begins to decrease. Acne & Bacteria A bacteria, known as Propionibacterium acnes, is a normal inhabitant of the skin. It uses sebum as a nutrient for growth, therefore increases in follicles during puberty. People with acne have more Propionibacterium acnes in their follicles than people without acne. The presence of bacteria attracts white blood cells to the follicle. These white blood cells produce an enzyme that damages the wall of the follicle, allowing the contents of the follicle to enter the dermis. This process causes an inflammatory response seen as papules (red bumps), pustules, and nodules. The bacteria also cause the formation of free fatty acids, which are irritants, increasing the inflammatory process in the follicle. Normal Follicles Sebum produced by the sebaceous gland combines with cells being sloughed off within the hair follicle and "fills up" the hair follicle. When the follicle is "full", the sebum spreads over the skin surface giving the skin an oily appearance. When this process works correctly, the skin is moisturized and remains healthy. Obstructed Follicles Problems arise when the sebum is trapped in the hair follicle. For reasons that are still unclear, some hair follicles become obstructed. The sebum is produced but gets trapped on the way out, and the cells that are normally sloughed off become "sticky", plugging up the follicle. The process of obstructing follicles is called comedogenesis. It causes some follicles to form a type of acne called comedones, also known as blackheads and whiteheads.

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