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Fact or Fiction: Does Sugar Cause Acne?

Sugar – a word that has been demonised in the wellness community for years. And if you’re anyone who’s experienced acne, I’m sure you’ve been told to “eat less sugar” when frantically searching for ways to heal your skin. But what does this really mean? Is it just eating less dessert, not having Cocopops for breakfast and opting for a coffee with no sugar? And now, with an ever growing market of ‘sugar free’ or ‘natural sugar’ alternatives, people are getting more confused than ever.

But is one type of sugar better than another? Does it make a difference to acne? It’s time to finally put an end to the question: does sugar really cause acne?

What is sugar?

From a chemistry perspective, sugar is essentially a molecular compound, a simple carbohydrate, that the body converts into glucose that can then be used to make energy. That’s all it is!

Refined Sugar is sugar that has been processed and is typically added to packaged foods and beverages. It’s the white table sugar you put in your coffee, the brown sugar in your baking or the high fructose corn syrup in your store-bought muffins and sushi.

Natural sugars on the other hand are sugars that are in their natural state and are found in fruits (as fructose), dairy (as lactose), starchy vegetables, wholegrains and in things like honey and maple syrup.

But here’s the thing, the body can’t tell whether you’re getting your sugar from a brownie or a banana – it’s essentially just a molecular structure that is broken down the same in the body.

So does that mean it doesn’t matter whether you’re eating a piece of fruit or a soft drink because your body can’t tell the difference? Definitely not.

The reason why natural sugars are superior is because of their “packaging”. Natural sugars found in fruits, vegetables and grains contain fibre which increases the feeling of being full and helps slow the rate of absorption into the blood stream. This means you’re not getting those rapid blood sugar spikes and drops that you get from eating a sugary dessert packed with added refined sugars. Similar to fibre, products like dairy contain a combination of sugar and protein which slows the absorption into our bloodstream. Natural sugars also contain vitamins and minerals that refined sugars have been completely stripped of, giving them an added health benefit.

Can sugar Cause acne?

Short answer: Yes. Sugar can be a big contributing factor in the formation of acne. And not just “sugar” as we know it. High glycemic index foods (or high GI foods) are foods that are rapidly absorbed into the blood stream causing a spike in blood sugar. These can include white bread, crackers, cereals, desserts made on white flour, white rice, rice noodles, white pasta, sugars and sweeteners, soft drinks etc.

When we consume these high GI foods it triggers an increase in insulin production and a subsequent production of insulin-like growth factor 1 (IGF-1) from the liver. Research has demonstrated an increase in in IGF-1 is correlated with an increase in acne severity of female patients.

How does it work? Okay now we get a bit sciencey, but bare with me: IGF-1 triggers the overproduction of skin cells (keratinocytes), as well as increasing the production of androgens(male hormones) and growth hormone. When there’s an increase in the levels of growth hormone and androgens, it can cause an excessive production of sebum – our skin’s natural oil.

What you’re left with is an excess of sebum getting mixed with an overproduction of skin cells creating a sticky, congested plug in the pore. This can trap acne causing bacteria and dirt deep into the pores resulting in inflammation and acne. IGF-1 has also been shown to cause further inflammation of the skin cells which can exacerbate small pimples into the deeper, cystic red ones.

Not only in your skin cells, but inflammatory biomarkers are increased throughout your body by the excess consumption of added sugar. Inflammation in the body = increased inflammation in the skin.

Sugar causes a cascade of events that cause increased sebum, skin cells and inflammation resulting in the perfect environment for acne to form

Consuming a diet high in sugars can also trigger acne if you have a compromised gut. If there are any gut issues present such as an imbalance of bad bacteria or pathogens, simple sugars will feed these “bad guys” causing a release of toxins and inflammation into the body. This is then detoxed out through our largest detox organ, the skin, and shows up as acne

Studies have also shown that diets high in added sugars from processed foods can increase intestinal permeability (e.g leaky gut) which also can lead to acne.

When I was dealing with the warzone happening in my gut, ANY form of sugar broke me out: I’m talking fruits, a little bit of honey, certain carbohydrate vegetables like sweet potato (the devastation of having no sweet potato fries). It wasn’t until I healed my gut, eliminated the bad bacteria and repopulated it with a thriving little micro-ecosystem, was I able to reintroduce sugars back into my diet.

If you are getting symptoms on top of breakouts like: bloating, gas, bowel issues (diarrhoea, constipation) and fatigue, it could be signs of a gut imbalance. It’s worth working with a trusted medical practitioner and getting specific gut tests done to see what’s actually going on inside. Always test it, don’t guess it.

So in regards to acne, sugar is sugar. But the type of sugar – whether from processed or wholefoods – and how it’s consumed makes a big impact around whether acne will form. Does that mean you can’t have a smoothie in the morning or never have dessert again? No, you still can! But there are specific things you can do to control these high sugar spikes and prevent the arrival of some unwelcome friends on your face.

What can you do?

  • Focus on eating a wholefood, unprocessed, low GI diet. Studies have shown that an emphasis on a low glycemic diet has resulted in an improvement in acne.
  • Avoiding eating a sugary breakfast first thing in the morning – Yes those acai bowls are just a mountain of sugar with minimal protein to slow the absorption.
  • Always read the labels – Even if things are marketed as “sugar free” or “healthy” they’re generally still full of natural sugars and sometimes multiple different types in a single product. For example a “healthy” granola might have dates, honey, rice malt syrup AND coconut sugar making the total sugar content very high.
  • Balance your meals – When consuming sugars or simple carbohydrates, make sure you include a source of protein and fats to stabilise blood sugars and slow the release into the blood stream.
  • Avoid things with artificial sweetners – These are things like splenda, equal and sweet’n low. They’re essentially just chemicals and are far worse than normal sugars (don’t even get me started on these ones).
  • Consume the whole fruit not fruit juices – Fruit juices have no fibre involvement which means it will just cause a pretty rapid blood sugar spike.
  • Avoid doubling up on other acnetriggers – If you’re going to have a dessert (because I mean you’ve got to enjoy life, right?) maybe don’t opt-for the chocolate cheesecake or the donut filled with custard. Try to avoid doubling up on acne-triggers such as gluten AND dairy AND sugar. Stick to that gluten free brownie girl.
  • Minimise sugars, even that natural ones – If you are particularly sensitive to sugars like I am, try to minimise the amount of natural sugars and syrups like maple syrup, honey, agave etc. They will still cause spikes in our blood sugar even though they are “natural”.

So though sugar can trigger acne, every person is individual. My tolerance to the amount of sugar I can consume before I breakout is different from yours. It’s about finding your individual tolerance level and listening to your body – or skin for that matter.

We want to find that balance between enjoying life, not depriving ourselves, and managing our breakouts. And it’s completely achievable – you’ve got this!

Let me know in the comments below or send me a email: what did you find helpful? Is there anything else you’ve tried to manage those not-so-fun sugar breakouts?

Sending love,

References

Aeberli, I., Gerber, P. A., Hochuli, M., Kohler, S., Haile, S. R., Gouni-Berthold, I., Berthold, H. K., Spinas, G. A., & Berneis, K. (2011). Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. The American journal of clinical nutrition94(2), 479–485. https://doi.org/10.3945/ajcn.111.013540

Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. 2005;141:333–338.

Kim, H., Moon, S. Y., Sohn, M. Y., & Lee, W. J. (2017). Insulin-Like Growth Factor-1 Increases the Expression of Inflammatory Biomarkers and Sebum Production in Cultured Sebocytes. Annals of dermatology29(1), 20–25. https://doi.org/10.5021/ad.2017.29.1.20

Kucharska, A., Szmurło, A., & Sińska, B. (2016). Significance of diet in treated and untreated acne vulgaris. Postepy dermatologii i alergologii33(2), 81–86. https://doi.org/10.5114/ada.2016.59146

Makrantonaki, E., Ganceviciene, R., & Zouboulis, C. (2011). An update on the role of the sebaceous gland in the pathogenesis of acne. Dermato-endocrinology3(1), 41–49. https://doi.org/10.4161/derm.3.1.13900 – showing how growth hormone can increase sebum

Pereira MT, Malik M, Nostro JA, Mahler GJ, Musselman LP. Effect of dietary additives on intestinal permeability in both Drosophila and a human cell co-culture. Dis Model Mech. 2018 Nov 28;11(12):dmm034520. doi: 10.1242/dmm.034520. PMID: 30504122; PMCID: PMC6307910.

Reynolds, R. C., Lee, S., Choi, J. Y., Atkinson, F. S., Stockmann, K. S., Petocz, P., & Brand-Miller, J. C. (2010). Effect of the glycemic index of carbohydrates on Acne vulgaris. Nutrients2(10), 1060–1072. https://doi.org/10.3390/nu2101060

Saleh B. O. (2012). Role of growth hormone and insulin-like growth factor-I in hyperandrogenism and the severity of acne vulgaris in young males. Saudi medical journal33(11), 1196–1200.

Smith R.N., Mann N.J., Braue A., Mäkeläinen H., Varigos G.A. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J. Am. Acad. Dermatol. 2007;57:247–256. [PubMed] [Google Scholar]

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