Chocolate and Acne: The Evidence-Based Connection
Yes, chocolate consumption can exacerbate acne in acne-prone individuals, particularly in young men, as demonstrated by multiple recent clinical studies. 1, 2
The Scientific Evidence
Recent Research Findings
- A 2024 crossover study found that daily consumption of 50g of 85% dark chocolate significantly intensified acne lesions in participants, even when following an anti-inflammatory diet. Acne severity increased by approximately one point on the Investigator's Static Global Assessment scale in 65 participants, by two points in 13 participants, and by three points in one participant 1
- A 2016 study demonstrated that consuming 25g of 99% dark chocolate daily for 4 weeks caused statistically significant worsening of acne in male subjects with acne-prone skin 2
- A 2018 study found that dark chocolate consumption affects facial skin by enhancing corneocyte desquamation and promoting bacterial colonization, particularly in young men 3
- A 2014 double-blind, placebo-controlled study showed a statistically significant increase in acneiform lesions after chocolate consumption, with a positive correlation between the amount consumed and number of lesions developed 4
Mechanism of Action
- Chocolate may contribute to acne through multiple pathways:
- Stimulation of corneocyte desquamation (skin cell shedding)
- Promotion of bacterial colonization on the skin surface
- Potential inflammatory effects
- Possible impact on insulin and insulin-like growth factor-1 (IGF-1) levels
Clinical Recommendations
Dietary Guidance for Acne Patients
- For patients with acne, especially those who are acne-prone:
- Consider reducing or eliminating chocolate consumption, particularly dark chocolate
- Monitor for personal correlation between chocolate intake and acne flares
- Incorporate this dietary modification as part of a comprehensive acne management plan
Other Dietary Factors to Consider
- Low glycemic load diets have shown benefits for acne management through:
- Reduced sebum production
- Decreased inflammatory lesion counts
- Reduced size of sebaceous glands 5
- Dairy consumption, especially skim milk, has been associated with acne development 6, 5
- A meta-analysis of 14 observational studies found a positive relationship between acne and milk intake 6
- Whey protein supplements may trigger acne and should be discontinued if acne occurs 6
Important Considerations
Patient-Specific Factors
- The effect of chocolate on acne appears more pronounced in:
- Young men
- Individuals with acne-prone skin
- Those with existing acne
Timing of Effects
- Changes in acne severity can be observed as early as 2 weeks after regular chocolate consumption 2
- Dietary modifications typically take 10-12 weeks to show improvement 5
Integrated Approach
- Dietary modifications should complement, not replace, conventional acne treatments
- The American Academy of Dermatology acknowledges the growing evidence for dietary interventions in acne management, particularly regarding glycemic load and dairy 5
Conclusion
The evidence strongly suggests that chocolate consumption, particularly dark chocolate, can exacerbate acne in susceptible individuals. This effect is well-documented in recent clinical studies and appears most significant in young men with acne-prone skin. While chocolate is not the sole cause of acne, it can be a contributing factor that patients should be aware of when managing their condition.