True or False, Chocolate Causes Acne?

Woman holding chocolateWith Halloween just a few weeks away, there is always excitement surrounding all the treats that will be received and consumed. It’s a time when we give ourselves permission to indulge in our sweet tooth. A large portion of those treats are bound to be various types of chocolate. Before you indulge in those treats there is always one question that comes up frequently: Does chocolate cause acne? This is a very controversial topic and a longstanding debate in dermatology.

Before getting into the debate, it is important to know that there are four main factors that cause acne: oil production, dead skin cells, clogged pores and bacteria. In addition to this, there are several factors that may worsen acne, such as hormones, stress, and certain medications like corticosteroids, androgens, or lithium. Another factor that may worsen acne is diet. There are studies that show acne can be triggered by dairy products and carbohydrate-rich foods. Both dairy and sugar have been shown to cause changes in blood sugar and hormone levels.

Evidence against the claim:
Surprisingly, there are very few studies that specifically examine chocolate in relation to acne breakouts. One of the first studies dates all the way back to 1969. Researchers performed a study on 65 individuals where one group was given a chocolate bar that contained over 10 times the amount of chocolate normally found in a candy bar whereas another group was given an identical candy bar that contained no chocolate. The number of acne breakouts was counted before and after the candy bars were eaten and they found no difference between the two groups. Therefore, they concluded that eating chocolate had no significant effect on acne as well as on oil production.

Another study performed in 1971 examined acne triggers. The researchers gave 27 students four specific foods and drinks that were considered common acne triggers for a whole week. These foods and drinks included chocolate, milk, roasted peanuts and soda. The researchers found no significant change in acne breakouts. It is important to note that some major flaws of this study were the small study size and short duration of the study.

Evidence for the claim:
Fast forward to over forty years later, researchers shed new light depicting a correlation between acne breakouts and chocolate consumption. One of these studies, published in 2014 by the Journal of Clinical and Aesthetic Dermatology, examined 14 men between the ages of 18 and 35. Each person was given six capsules daily of either pure cocoa or gelatin. They found that the group who consumed the pure cocoa capsules had more acne breakouts consisting of whiteheads, blackheads, pimples and cysts than the gelatin capsule group. However, similar to the study performed in 1971, the flaw of this study was the small study size.

Another study published in 2016 by the Journal of American Academy of Dermatology looked at 54 college students who were randomly assigned to receive a milk chocolate bar or 15 jellybeans. The study found that eating chocolate exhibited a greater increase in acne breakouts versus eating jellybeans. While these studies seem to show a link that chocolate causes acne breakouts, it will take more definitive research to truly validate the claim.

My conclusion based on the information I found regarding chocolate being a direct cause of acne breakouts:  FALSE

The real culprits are diet and hormonal changes. It is important to note that foods that are high in sugar and high in fat content, which chocolate definitely has, can increase the body’s oil production. This, in turn, will trigger inflammatory responses in the body and can lead to those dreaded acne breakouts. When you need a chocolate fix, try sticking with dark chocolate since it does not contain as much sugar as other variants of chocolate and is loaded with antioxidants.

Jo-Anne Bustamante, PA-C
Board Certified Physician Assistant

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