Does dairy cause acne?

Growth factors can cause acne, either androgens or anything acting on the insulin receptor (including IGF-1) that enhance androgen signaling. Dairy is currently weakly suspected to contribute via the above, but not enough evidence exists to support a strong relationship.

Our evidence-based analysis features 20 unique references to scientific papers.

Written by Kamal Patel
Last Updated:

Dairy and Acne

Mechanisms

Acne, or as it is technically called Acne Vulgaris, has historically been linked to dairy (being 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 HM. The acne problem. South Med J. (1949)
  2. ^ Melnik BC. Evidence for acne-promoting effects of milk and other insulinotropic dairy products. Nestle Nutr Workshop Ser Pediatr Program. (2011)
  3. ^ Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentiation. Endocrinology. (1999)
  4. ^ Aizawa H, Niimura M. Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne. J Dermatol. (1995)
  5. ^ Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. (2005)
  6. ^ Hoppe C, et al. High intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boys. Eur J Clin Nutr. (2004)
  7. ^ Salehi A, et al. The insulinogenic effect of whey protein is partially mediated by a direct effect of amino acids and GIP on β-cells. Nutr Metab (Lond). (2012)
  8. ^ Melnik BC. FoxO1 - the key for the pathogenesis and therapy of acne. J Dtsch Dermatol Ges. (2010)
  9. ^ Kim SJ, et al. Glucose-dependent insulinotropic polypeptide (GIP) stimulation of pancreatic beta-cell survival is dependent upon phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB) signalling, inactivation of the forkhead transcription factor Foxo1, and down-regulation of bax expression. J Biol Chem. (2005)
  10. ^ Melnik BC. Is nuclear deficiency of FoxO1 due to increased growth factor/PI3K/Akt-signalling in acne vulgaris reversed by isotretinoin treatment. Br J Dermatol. (2010)
  11. ^ Melnik BC. The role of transcription factor FoxO1 in the pathogenesis of acne vulgaris and the mode of isotretinoin action. G Ital Dermatol Venereol. (2010)
  12. ^ Makrantonaki E, Zouboulis CC. Testosterone metabolism to 5alpha-dihydrotestosterone and synthesis of sebaceous lipids is regulated by the peroxisome proliferator-activated receptor ligand linoleic acid in human sebocytes. Br J Dermatol. (2007)
  13. ^ Smith TM, et al. IGF-1 induces SREBP-1 expression and lipogenesis in SEB-1 sebocytes via activation of the phosphoinositide 3-kinase/Akt pathway. J Invest Dermatol. (2008)
  14. ^ Fan W, et al. Insulin-like growth factor 1/insulin signaling activates androgen signaling through direct interactions of Foxo1 with androgen receptor. J Biol Chem. (2007)
  15. ^ Melnik B. {Acne vulgaris. Role of diet}. Hautarzt. (2010)
  16. ^ Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. (2009)
  17. ^ Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. (2012)
  18. ^ Danby FW. Acne and milk, the diet myth, and beyond. J Am Acad Dermatol. (2005)
  19. ^ Adebamowo CA, et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol. (2005)
  20. ^ Adebamowo CA, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. (2008)