More dermatologists are seeing a link between what people eat and what happens with their skin.
A recent report says cow's milk and high-glycemic foods such as white bread and sugary drinks may aggravate or influence acne. There is no evidence that such foods cause acne, experts say, but more study is needed.
Dr. Joel Schlessinger, an Omaha dermatologist, said he doesn't tell patients to stop drinking milk. “But we offer that as an idea for most people who come in who have issues with acne.”
Acne clearly can be influenced by diet and hormones, Schlessinger said. “The most common hormonal influence is that of milk,” he said.
Hormones are naturally present in milk. Some farmers also give their cows a hormone to increase milk production, “but science shows that there is no effect on levels in the milk itself,” according to the Midwest Dairy Council.
Hormones long have been known to play a major role in the development of acne, Schlessinger said. “We know that as children age and become pubescent, their acne worsens — that is because of our own natural hormones.” Often, he said, dermatologists will address acne by either starting female patients on birth-control pills or using other hormonal medications to control the acne.
Dr. James Shehan, a dermatologist with Alegent Creighton Clinic, said researchers think the link between acne and high-glycemic foods is that such foods stimulate the production of insulin and a protein that then stimulate the production of a hormone that clogs pores.
Shehan said he doesn't recommend “massive dietary modifications” to battle acne but said patients should consider changes, especially if they're drinking large amounts of milk every day.
“It's not like the acne disappears” after they change their diets, Shehan said. “They still need conventional treatments.”
A study published in the March edition of the Journal of the Academy of Nutrition and Dietetics reviewed 27 scholarly articles that looked for links between diet and acne. The authors said a growing body of evidence suggests a relationship.
One of the authors, dietitian and doctoral candidate Jennifer Burris, said researchers plan to conduct some randomized, controlled trials to look at how dairy and, separately, high-glycemic foods affect acne.
Stephanie Cundith, a registered dietitian with the Midwest Dairy Council, said it's important to note that teenagers, who are at the peak of their growth, need calcium for proper bone development. Milk, she said, contains both calcium and vitamin D, which helps with the absorption of calcium. “Dairy's role in a healthy diet has long been established by the nutrition and science community,” Cundith said.
Schlessinger said people have other ways to get calcium and vitamin D, such as fortified orange juice or almond milk. Shehan said people can take calcium and vitamin D supplements.
The American Academy of Dermatology, in a statement issued earlier this month, said the strongest evidence of a link between diet and acne comes from glycemic index studies, which show that low-glycemic diets may improve acne. A review of recent studies shows the link between dairy and acne appears weak, the statement reads, with the strongest association being to skim milk.
“Based on the studies we now have available, the evidence suggests that diet does play a role in acne,” the academy researcher said. “More studies are definitely needed in this area, but they are not easy studies to execute. Patients can be their own best detectives in determining possible food triggers for acne.”
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