Does dairy cause acne?

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Acne, or as it is technically called Acne Vulgaris, has historically been linked to dairy (and is the most commonly reported dietary association with acne[1]).

Acne can be furthered and made worse by excessive insulin secretion[2] and appears to also be exacerbated by IGF-1[3] and glucose-dependent insulinotropic polypeptide (GIP). In the case of IGF-1, there are repeated correlations between those with acne and higher serum IGF-1 concentrations.[4][5]

These systemic factors appear to be induced following dairy consumption with insulin, IGF-1,[6] and GIP (which acts to further induce insulin[7]) being increased to levels greater than that of an equicaloric portion of meat (as a comparative protein source).

When looking at serum anabolic factors, dairy protein appears to induce some of these factors to a greater degree than other protein sources

Insulin and IGF-1 both act upon the insulin receptor, the typical signalling pathway includes signalling via PI3K to mTOR/Akt which then induces nuclear ejection of FOX01.[8]

This nuclear ejection of FOX01 tends to be seen as anabolic, as the presence of FOX01 in the nucleus per se is anti-anabolic and ejection hinders its actions.[9][10][11] By facilitating anabolic signalling FOX01 ejection can augment androgen-dependent or insulin-receptor (mTOR dependent) anabolism, both the androgen pathway[12] and the mTOR/Akt pathway (downstream of the insulin receptor)[13] increase sebaceous lipogenesis (production of lipids in sebocytes, these cells being skin cells that have a high likelihood of acne production) and activation of the mTOR/Akt pathway can augment androgen signalling.[14]

Anything that activates mTOR/Akt can plausibly increase the efficacy of androgen signalling. Activation of the insulin receptor reliably activates mTOR/Akt (and IGF-1 also acts on this receptor) and is thought to be the main player as there are correlations between diet, insulin and IGF-1 (known to reflect the diet), and acne in humans

Interventions

A few studies have claimed that reducing total insulinogenic secretions of the diet (limiting grains and dairy) would be beneficial in acne control[15][16] or at least that the link between dairy and acne requires more investigation.[17][18]

When looking at surveys, there does appear to be an increased risk of acne associated with dairy products although the relative risk ratios (ranging from 1.12[19]-1.44 depending on dairy product or 1.10-1.19[20]) appears to be weak.

There is a plausible link between dairy consumption and acne but correlational research does not fully support this link; studies tend to be conducted in adolescents (rather than adults) and the results are not too in favor of a strong link; perhaps weak at best

There appears to be a more reliable link between IGF-1 per se than dairy products per se, and although the latter may spike the former current (limited) research does not support a strong relation between dairy and acne

Dairy By-products?

As both whey protein and casein protein are dairy byproducts, and thus can spike insulin and GIP levels, they are theoretically able to also induce acne.

References
1.^ROBINSON HMThe acne problemSouth Med J.(1949 Dec)
2.^Melnik BCEvidence for acne-promoting effects of milk and other insulinotropic dairy productsNestle Nutr Workshop Ser Pediatr Program.(2011)
6.^Hoppe C, Mølgaard C, Juul A, Michaelsen KFHigh intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boysEur J Clin Nutr.(2004 Sep)
7.^Salehi A, Gunnerud U, Muhammed SJ, Ostman E, Holst JJ, Björck I, Rorsman PThe insulinogenic effect of whey protein is partially mediated by a direct effect of amino acids and GIP on β-cellsNutr Metab (Lond).(2012 May 30)
8.^Melnik BCFoxO1 - the key for the pathogenesis and therapy of acneJ Dtsch Dermatol Ges.(2010 Feb)
14.^Fan W, Yanase T, Morinaga H, Okabe T, Nomura M, Daitoku H, Fukamizu A, Kato S, Takayanagi R, Nawata HInsulin-like growth factor 1/insulin signaling activates androgen signaling through direct interactions of Foxo1 with androgen receptorJ Biol Chem.(2007 Mar 9)
15.^Melnik B{Acne vulgaris. Role of diet}Hautarzt.(2010 Feb)
17.^Bhate K, Williams HCEpidemiology of acne vulgarisBr J Dermatol.(2012 Dec 4)
18.^Danby FWAcne and milk, the diet myth, and beyondJ Am Acad Dermatol.(2005 Feb)
19.^Adebamowo CA, Spiegelman D, Danby FW, Frazier AL, Willett WC, Holmes MDHigh school dietary dairy intake and teenage acneJ Am Acad Dermatol.(2005 Feb)
20.^Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, Willett WC, Holmes MDMilk consumption and acne in teenaged boysJ Am Acad Dermatol.(2008 May)