Most teenagers and many adults have acne and will go to great lengths to avoid breakouts.
For decades, doctors have told patients that what you eat does not have an impact, but as Dr. Linda Stein Gold explains, that's just not the case.
Stein Gold, a dermatologist at Henry Ford Hospital in Detroit, literally helped write the book on acne.
"I was fortunate enough to actually be involved in the writing of the guidelines," she explains.
Those would be the New American Academy of Dermatology's guidelines on managing acne. Stein Gold says that, for years, doctors were misled by some earlier research on foods and acne. More current research has put a new light on this age-old problem
"This is such a hot topic because every patient that comes in, they want to know, 'Is something that I'm eating contributing to my acne?' Today, we say it might be true," she explains.
Here is one of the most convincing associations. "They're the sugary foods, the white bread, the donuts and the muffins," Stein Gold says. These foods have what is known as a high glycemic index.
"The sugar in the blood goes up quickly, and that triggers a cascade of events that increases hormones and increases sebum, and all this together actually causes acne to flare up," she explains.
What about dairy products?
"We do see some association between milk products and acne," she admits, adding, "It appears that skim milk actually has a higher association of the development of acne than whole fat milk."
And what about chocolate?
"They found a slight association with bingeing on chocolate and a subsequent acne breakout," Stein Gold says.
Greasy foods are often blamed for acne, but when you look at the science, oily foods do not cause oily skin. "There hasn't been an exact association between the greasy foods and acne," Stein Gold explains.
So what's her best advice for eating with acne in mind?
"Eat a low glycemic load diet," she says. "The whole grains, the brown foods, the more healthy fruits and vegetables, that's never a bad thing."
As far as beneficial foods, there's currently research into the potential benefits of antioxidants, zinc, probiotics, and fish oil, but none of it is conclusive enough to make a clear recommendation yet.