“I grew up with horrible skin. I had cystic acne ever since I can remember. I ended up finally listening to those people who say you are what you eat.”
-Yvonne Strahovsky
Acne affects approximately 14 percent of people in the United States.
There has been conjecture about the link between dairy consumption ever since the first formal descriptions of acne in the early 1800s, and the subject has been regularly discussed in both scientific papers and periodicals. While sugar was initially considered a more likely suspect, attention turned directly to dairy with the onset of randomized control trials of dietary influence in the early 2000s.
Research into the question “do dairy products cause acne?”, overwhelmingly indicates a relationship. The difference between correlation and causation requires the use of double-blind control studies, which are very difficult and expensive in dietary research.
The links are seen as likely and often cited as “potential”, especially in younger cohorts. The studies are often observational. Meta studies oversee a number of these results, serving to magnify the findings with correlation of studies that observe correlation.
One study exposes a correlation to skim milk, while others show no difference in the likely link. Other factors are discussed with and without research; some habitual, others genetic.
Looking deeper into these studies, the picture appears to be a lot less about causation, and more about a very loose correlation.
A 2016 observational study from the highly regarded Journal of the American Academy of Dermatology done in a hospital setting looked at 225 fourteen- to sixteen-year-olds with varying levels of acne, or none. The incidence of acne was higher among those with regular skim milk consumption. BMI, drinking full-fat milk and other dietary consumption was found to be statistically insignificant. This correlation needs to be confirmed with studies that eliminate skim milk from an observed population. And it should also be noted that while the subjects of the study were hospitalized teenagers randomized for acne, they were all hospitalized for the treatment for other ailments. None were healthy and there was no control for environmental factors (exercise, stress or sibling acne for example).
The 2019 Aghasi study, which was conducted in Afghanistan not only shows more than a simple correlation between acne and dairy, it also contradicts the 2016 study, inversely correlating skim milk consumption with acne. And it reinforces the correlation between acne and genetic disposition, a higher BMI, a greater consumption of chocolate, junk foods, and fried foods, and a lack of sleep. It also indicates a reduction in acne with exercise, a low GI, more chicken consumption, and better sleep.
This study, like its 2016 counterpart is, however, limited by the fact that the results were self-reported by the subjects. Do people with acne report more transparently to medical professionals who are there to help them with a condition linked to low self-esteem than a randomized control group?
In neither of these studies are any of the variables controlled. For example, there were no groups removing all dairy, controlling for sleep, broad dietary makeup, family history, exercise, BMI, junk food consumption, and more. Controlling for these variables is undoubtedly difficult and expensive. However, AI summaries did not effectively present these important limitations.
A 2024 literature review by Rygula et al titled “impact of Diet and Nutrition in Patients with Acne Vulgaris,” in published in Nutrients by the esteemed publisher of open-access scientific journals MDPI, found that dairy, along with a variety of other foods and conditions, plays a role in the presentation of acne. However, the authors caution, as we do here, that most of the studies were small and were not subject to rigorous single factor isolation and double-blind control samples.
This inconclusive link is supported by another 2024 literature review published in the Journal of the Egyptian Women’s Dermatologic Society, which found that links to causes of acne are cited widely, with Dairy and many other foods and variable, but that the link requires deeper and more rigorous investigation.
The 2022 literature review leans heavily on the study done in Afghanistan for its conclusions, while the 2021 Marinho & Portela meta analysis shows strong correlation between severe, but not mild, acne and dairy. Again these analyses take data from studies that lack rigorous control samples and depend on self-reporting. Every study mentions a limit to their confidence in the consideration of the degree to which other factors influence the results, and, as we have noted, almost all advise the consideration of multiple factors of influence.
All of the above findings are reinforced by the conclusion of the 2022 systematic review, Diet and acne: “High glycemic index, increased glycemic load, and carbohydrate intake have a modest yet significant proacnegenic effect. Increased dairy consumption may have been proacnegenic in select populations, such as those in which a Western diet is prevalent. The impact of diet on acnegenesis is likely dependent on sex and ethnicity. Further randomized trials are necessary to fully characterize the potential associations.”
Clearly, dairy should be considered a potentially causal link by those with acne and removed from their diet to see if their condition improves.
The good news is that we have a lot more information than a single study or a summary, and that there are many other possible causes to investigate. The most consistent finding is that individuals will benefit by isolating a range of possible factors for affect.
Source Material
Peer Reviewed Articles
Dairy Consumption and Acne: a Case Control Study in Kabul, Afghanistan. (Clinical, Cosmetic and Investigational Dermatology – Dec, 2019)
Dietary Intervention in Acne Management: Review of the Literature and Future Prospective. (Journal of the Egyptian Women’s Dermatologic Society – May-August 2024.)
The Effect of Milk Consumption on Acne: a Meta-Analysis of Observational Studies. (European Academy of Dermatology and Venereology.. – Dec 2018)
Consumption of Dairy in Teenagers With and Without Acne (Journal of the American Academy of Dermatology – August 2016)
Diet and Acne: A Systematic Review. (American Academy of Dermatology – March, 2022)
Impact of Diet and Nutrition in Patients with Acne Vulgaris. (Nutrients – 2024)
The History of Diet and Dcne: From Sugar and Dairy to the Western Diet (Journal of the American Academy of Dermatology. – September 2021)
Further Reading:
Diet and Acne
Can the Right Diet Get Rid of Acne? (American Academy of Dermatology Association)
Does Diet Really Matter when it Comes to Adult Acne? (Harvard Health Blog – August, 2020)
Effects of Diet on Acne and Its Response to Treatment (National Institutes of Health – August, 2020)
Is There an Anti-Acne Diet? (Healthline – August 9, 2024)
The Relationship of Diet and Acne ( Dermato Endocrinology – September-October 2009)
Eating for Acne. (Gold Coast Dermatology Clinic 2024)
Diet and acne: A Systematic Review (JAAD International – June 2022)
Can Dietary Changes Help Acne? (Medical News Today – July 2018)
Association Between Adult Acne and Dietary Behaviors Findings From the NutriNet-Santé Prospective Cohort Study (JAMA Dermitology – June 2020)
Best and Worst Foods for Acne (WebMD – August 2023)
Lifestyle and Acne
Acne Action: Lifestyle Action to Reduce Acne (Acne and Rosacea Society of Canada – 2025)
Lifestyle Changes to Tame Acne (WebMD – January 2019)
Acne: Tips For Managing (American Academy of Dermatology Association – November 2022)
Do These Lifestyle Choices Really Put You at Risk of Acne? (Skin Clinics UK – April 2021)
What Lifestyle Changes Improve Acne? (Southeast Dermatology Specialists)
Lifestyle Factors (All about Acne – Dec 2021)
Impact of Lifestyle Factors on the Development and Severity of Acne Vulgaris: a Cross Sectional Study (Research Square – November 2023)
The Association Between the Incidence of Acne Vulgaris and Lifestyle Factors Including Dietary Habits, Physical Activity, and Bathing Frequency (Journal of Skin and Stem Cell – March 2021)
Does Lifestyle Affect Isotretinoin Tolerance in Patients with Acne? A Retrospective Cohort Study (Dermatologic Therapy – 2024)
General Acne Advice
Acne (Mayo Clinic 2024)
The 10 Best Ways to Treat Acne (Nuffield Health – June 2015)
Acne (Yale Medicine)
Mayo Clinic Q and A: Facts about body acne (Mayo Clinic – October 2022)
Acne (NHS (National Health Service UK))
Adult acne: Understanding Underlying Causes and Banishing Breakouts (Harvard Health Publishing – September 2019)
Don’t Turn Your Back on Back Acne (Mayo Health – June 2022)
