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Acne and Nutrition: Do's & Don'ts

by Constantia Zioga, BSc, MSc Nutritionist-Dietician

01 Apr 2025 • 0 min read

'Acne' is a topic that troubles many! If you have acne you are not alone! Acne is a skin condition that affects 80% of the population, it is estimated that at some point in life someone between the ages of 11-30 years may develop a form of acne. Let's get to know together what acne is and how we can treat it nutritionally and with over-the-counter products.

Acne: What it is and what types of acne there are

Acne is a skin condition that occurs when hair follicles become clogged with sebum and dead skin cells. This clogging is the cause of the formation and appearance of pimples. Pimples or open and closed freckles are divided into different types and based on these, an appropriate diagnosis can be given by dermatologists.

Acne is therefore distinguished in the following types:

Mild acne with:
  • Blackheads are light blemishes appear on the nose, chin and forehead. It is a type of grade 1 acne that forms when sebum and dead skin cells clog the pores of the skin. Blackheads are non-inflammatory as they do not cause swelling.
  • Whiteheads are the closed pores below the surface of the skin. They appear as white or flesh-coloured spots on the skin and are grade 1 acne. They appear mainly on the neck, back, chest, nose, forehead and chin.
Moderate acne with:
  • Papules are inflammatory acne grade 2 that look like red or pink bumps on the skin. They appear on the face, neck, chest, buttocks, shoulders and back and may be sensitive to touch. They may leave behind signs of hyperpigmentation on the skin.
  • Pustules are small pus-filled bumps with a white to yellowish appearance and a red halo. They are moderate to severe acne and can appear on the face, neck, back, shoulders and arms.
Severe acne with:
  • Nodules are grade 3 to 4 acne, characterized by large, inflamed lesions under the surface of the skin. They have no visible head. Nodular acne occurs on the face, neck, back, chest and shoulders and can result in black spots or scars.
  • Cysts: Cystic acne is one of the most severe 4-5 degrees of acne. It appears as a large, pus-filled and painful inflammation. When left untreated or not treated properly, it can lead to scarring. The most prominent area affected by cystic acne is the face, especially the cheeks, chin and jawline. Cysts can also appear on other areas of the body, such as the arms, back and torso.
  • Neonatal acne: Red rashes appear in the first month on the face of the newborn.
  • Infantile acne: Similar to neonatal acne, infantile acne may occur more often in boys during 6 to 16 months.
  • Hormonal acne: Hormonal acne is associated with hormonal fluctuations that usually occur during puberty, the menstrual cycle, pregnancy and menopause. It tends to appear along the jawline, chin and lower face. While this type of acne is more common in women, it can affect men with fluctuating testosterone levels.
Rosacea acne: Rosacea mainly affects adults with fair skin. Unlike common acne, rosacea does not involve clogged pores, but the symptoms are caused by inflammation. Common symptoms of rosacea include:
  • Persistent redness on the central part of the face, including the cheeks.
  • Pimples: Small, red and painful bumps.
  • Red, red, red, red pimples: Damaged small blood vessels appear as red lines on the skin.
Fungal acne: Fungal acne, also known as Malassezia folliculitis, is caused by yeast overgrowth in the hair follicles rather than bacteria, leading to infection. It grows in hot and humid environments and can be aggravated by excessive sweating, tight clothing and a weakened immune system. Certain medications, particularly antibiotics and contraceptives, also play a role in its development.The main symptoms of fungal acne include:
  • Homogeneous appearance: Fungal acne usually appears as small, uniform clusters of bumps that are about the same size and shape.
  • Itching: Fungal acne often causes itching or burning sensation in the affected areas.
  • The skin may be very hot or hot and hot to the touch: Fungal acne develops quickly, sometimes appearing overnight, especially in tropical environments.
Contact acne:
  • Mechanical acne: The formation of freckles due to long-term friction or contact with objects e.g. belt, helmet, collar, musical instrument.
  • Acne from cosmetics and professional acne: The formation of freckles caused after exposure to substances, which cause the pores of sebaceous follicles to become blocked, contained in cosmetics or found in the workplace e.g. oils and chemicals.

Acne and treatments

Initially, the acne should be examined by a dermatologist so that the appropriate treatment can be given depending on the type of acne. The doctor will decide if medication is required. Caution (!) do not take medication by yourself because you heard it worked well for a friend. Medications have side effects and we should be extra careful.

Medication treatment against acne includes the following:

Oral intake:
  • antibiotics
  • oral contraceptives
  • isotretinoin
  • corticosteroids
External use products and treatments with:
  • antibiotic cream
  • cream with benzoyl peroxide >10% (benzoyl peroxide)
  • adapalene ~ retinoid
  • cream with azelaic acid >10% (azelaic acid)
  • laser treatments
  • chemical peeling
  • surgical procedures for the correction of scars

Acne and nutrition

Diet also plays an important role in the treatment of acne. As many who are suffering with acne, have found that where everything was going well, suddenly a severe acne flare-up occurred and the cause of the trigger was simply something they ate. In the systematic review by James Meixiong and colleagues, the results showed that insulin resistance is one of the number one causes of both the onset and severity of acne. Acne, stemming from insulin resistance, affects both sexes equally, regardless of ethnicity. Also, the consumption of dairy products seems to be responsible for the occurrence of acne in both sexes, but it seems to be limited to ethnicity as it is mainly observed in people who follow a western-style diet, i.e. a diet poor in nutrients and high in over-processed foods.

Let's now look at which nutrients actually help to treat acne and which do not.

If you want to improve acne through diet, you can focus on the following nutrients:

Antioxidants and vitamins

  • Antioxidants help fight inflammation and oxidative stress associated with acne.
  • Vitamin A: It is particularly important for skin health, as it helps regenerate skin cells and reduce sebum production.
  • Vitamin C: Prevents inflammation and supports the production of collagen, which is essential for skin elasticity and glow.
  • Vitamin E: Has powerful antioxidant properties and protects the skin from inflammation and premature aging.
  • Vitamin D: Low levels of vitamin D have been linked to increased severity of acne. Sources: Sunlight, oily fish (e.g. salmon, mackerel), mushrooms, fortified cereals.
  • Omega-3 fatty acids: Omega-3 fatty acids are powerful anti-inflammatories and help reduce the inflammation associated with acne.
  • Zinc: Zinc is a trace mineral that has been shown to help fight acne, as it has anti-inflammatory and antibacterial properties. It may also help regulate sebum production.
  • Fibers: A high intake of fiber helps stabilize blood sugar levels, which can help prevent sudden spikes in insulin,. As mentioned earlier, insulin resistance is linked to worsening acne, so fiber is on our side!
  • Avoid foods with a high glycemic index (GI): High GI foods (such as white bread, white flour pasta, sweets and soft drinks) sharply increase blood sugar and insulin levels, which can worsen acne. By regulating the consumption of these foods, we help improve the hormonal profile and insulin resistance dramatically.
  • Hydration: Good hydration is important for skin health. Drinking enough water helps maintain skin moisture and reduce inflammation. TIP: Try to drink at least 8 glasses of water a day and add sugar-free beverages. Check your urine color! The lighter the color of your urine, the more hydrated you are!
However, some nutrients and foods negatively affect acne. Pay attention below to avoid possible flare-ups and discomfort.

  • Foods that may aggravate the condition. Some of them are:
  • Foods with a high glycemic index (GI): such as white bread, white flour pasta, processed cereals, potatoes and sweets. Long-term consumption of these foods can lead to the development of insulin resistance which in turn can increase inflammation and sebum secretion, exacerbating acne.
  • Dairy products: Some research suggests that dairy consumption, particularly milk and low-fat products, may be linked to acne, possibly due to its effect on insulin and hormones. Alternative options: Opt for plant-based beverages (e.g., almond or soy milk).
  • Chocolate: Milk chocolate is likely to negatively affect some people who have acne because of the whey it contains. Alternatively, a small amount of high cocoa dark chocolate would be a good choice as it does not contain whey and high added sugar.
  • Foods high in saturated fat and trans fats: These are found in processed foods, fried foods, fast foods and sweets and packaged foods in general. They can increase inflammation and worsen acne.
  • Sugar and sweets: Consuming large amounts of sugar and sweets can cause a sharp rise in blood sugar and insulin, which can cause inflammation and increase sebum production, leading to clogged pores and the appearance of acne. Warning. Focus on the long term! No single food in isolation can exacerbate or cure acne. Our habits as a whole, however, can stand - or not - on our side.
  • Processed meats: Like sausages, bacon and deli meats, which can contain extra sugar, preservatives and saturated fat, intensifying inflammation.
  • Alcohol: Alcohol overconsumption can worsen acne as it can affect the balance of hormones and cause dehydration of the skin.
  • Stress: stress alone does not seem to be a cause of acne. However, if you already have acne, stress can unfortunately worsen the severity of the acne form with flare-ups on the face and body.
So by reading this information you can do a self-assessment and identify the changes you need to make to your diet to help you improve your acne. It is important to remember that each case is unique and that progress can vary from person to person.
If your diet is not nutrient-rich, keep in mind that supplements can work alongside dietary changes to help you manage acne and give your body a boost. However, keep nutritional notes that will support reducing acne inflammation "from the inside out."

Do's

dos

Don'ts

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If you have mild to moderate acne, over-the-counter products may help. Always seek the advice of a dermatologist first. Over-the-counter (OTC) acne products contain ingredients that help fight acne by reducing inflammation, controlling sebum production and preventing clogged pores.

  • Benzoyl peroxide : kills acne-causing bacteria, while helping to remove excess oil from the skin and removing dead skin cells that can clog pores. Benzoyl peroxide products that you can buy without a prescription are available in contents ranging from 2.5% to 10%. Studies show that lower strength products are just as effective as higher strength formulations to reduce the risk of side effects.
  • Adapalene: is a retinoid that helps to block the pores and prevent new breakouts. Adapalene gel is available over-the-counter at 0.1%. Do not apply this product to skin that has a cut, sunburn or eczema rash. You may feel a slight tingling sensation when the gel is applied, but it soon subsides. Other possible side effects include dry skin, flaking and skin inflammation. Use a non-greasy (non-fasting) moisturizer to help alleviate these symptoms.
  • Salicylic acid: this ingredient can help to unclog pores and prevent new breakouts.Salicylic acid products that you can buy without a prescription are available in contents from 0.5% to 2%.
  • Azelaic acid: this ingredient helps prevent the build-up of sebum in the pores and is mildly antibacterial. Non-prescription azelaic acid products are available at 10%. Azelaic acid also helps correct black spots that may remain after acne is removed (post-inflammatory hyperpigmentation).
  • Alpha-hydroxy acids (AHAs). Alpha-hydroxy acids are synthetic versions of acids derived from fruit (citric acid), sugar cane (glycolic acid) or milk (lactic acid) containing sugar. Two types of alpha hydroxy acids used in non-prescription acne products are glycolic acid and lactic acid. They treat acne by removing dead skin cells and calming inflamed skin. The alpha hydroxy acids also stimulate the growth of new, smoother skin. This helps improve the appearance of acne scars and pores.
  • Tea tree oil: Tea tree essential oil has antibacterial and anti-inflammatory properties. It can help fight acne-causing bacteria. It may help to prevent bacterial infections and can help against bacterial acne. However, it should not be used undiluted as it will cause irritation. Usually, in acne products it is already dissolved and ready to use. However, if you find it as an essential oil you should mix it with an oil such as jojoba or argan oil.
  • Niacinamide: Niacinamide is vitamin B3, also known as nicotinamide, and can be used as an acne treatment available without a prescription. Niacinamide can be found in topical treatments applied directly to the skin. Oral niacinamide supplements may also prove useful in the treatment of acne. Niacinamide is an anti-inflammatory ingredient that works in favor of reducing the swelling and redness associated with acne. It also regulates the amount of oil that causes acne. In addition, it regulates skin tone and can help reduce red, purple and brown marks that acne can leave on the skin.
  • Centella asiatica: Centella is a perennial plant that grows in swampy areas of tropical and subtropical Asia. Several in vitro and in vivo studies have shown the therapeutic potential of Centella asiatica in the treatment of acne, burns, atopic dermatitis and wounds. Centella is non-toxic and is considered mild enough for daily use. The only potential danger is that it contains a high concentration of palmitic fatty acids which can be a cause of clogged pores. This means that sensitive skin types prone to severe acne or rosacea may not react well to this ingredient.
  • Honey (especially Manuka honey): honey has antibacterial and moisturising properties. Manuka honey in particular is very effective in fighting acne-related bacteria. A small amount can be used as a mask, applying a thin layer of honey on the acne area for 10-15 minutes, then removing it with lukewarm water.

5 steps for daily care of acne skin

  1. Facial/body cleansing: acne cleansing gels help remove dirt, excess sebum and impurities without irritating the skin.
  2. Toner: Acne toners help to restore the skin's balance and prepare it for the next skin care products.
  3. Serum: Acne serums are usually lighter and contain powerful ingredients to address specific problems such as acne.
  4. Acne creams: Acne creams contain ingredients to help fight acne and prevent its recurrence.
  5. Sunscreen for acne (non-comedogenic = does not clog pores): sun protection is essential, let alone for acne skin, as the sun can cause burns, purulent subcutaneous acne, irritation and scarring.
TIP: Follow these steps morning and night (without the sunscreen) with the appropriate products that you will find in one of Holland & Barrett's natural stores with the help of the qualified staff.
 

Do's

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Dont's

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Scientific sources
 
Journal Articles
Meixiong, J., et al. (2022). Diet and acne: A systematic review. *JAAD International, 7*, 95-112. https://doi.org/[DOI] 
 
Park, K. S. (2021). Pharmacological effects of *Centella asiatica* on skin diseases: Evidence and possible mechanisms. *Evidence-Based Complementary and Alternative Medicine, 2021*, 5462633. https://doi.org/10.1155/2021/5462633 
 
Books
Bolognia, J. L., Schaffer, J. V., Duncan, K. O., & Ko, C. J. (Eds.). (2016). *Basic dermatology* (L. Tsampas, Ed., S. Georgiou, A. Monastiri, & E. Pasiatzi, Trans.). Broken Hill Publishers. 
 
Websites and Health Organization Articles
Acne Support. (n.d.). Niacinamide for acne. *Acne Support*. Retrieved March 31, 2025, from https://www.acnesupport.org.uk/treatment/niacinamid/ 
 
Medical News Today. (n.d.). Best acne body wash. *Medical News Today*. Retrieved March 28, 2025, from https://www.medicalnewstoday.com/articles/best-acne-body-wash#for-sensitive-skin 
 
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). (n.d.). Acne: Diagnosis, treatment, and steps to take. *NIAMS*. Retrieved March 27, 2025, from https://www.niams.nih.gov/health-topics/acne/diagnosis-treatment-and-steps-to-take 
 
Oliva Clinic. (n.d.). Types of acne. *Oliva Clinic*. Retrieved March 26, 2025, from https://www.olivaclinic.com/blog/types-of-acne/ 
 
Schweiger Dermatology. (n.d.). The most common types of acne. *Schweiger Dermatology Group*. Retrieved March 25, 2025, from https://www.schweigerderm.com/skin-care-articles/acne/the-most-common-types-of-acne/
*Text editing: Maria Kirmanidou

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