Yes, Chocolate Causes Acne: It's all Hormonal ~ and not the way you think

Written By:

Dr. Chantelle Davidson, Pharm. D

In the current age of misinformation, chocolate and it’s acne causing potential is the real O.G. It turns out, there has been all sorts of misinformation out there about chocolate and its ability or inability to cause acne; and the crazy part is it has been happening for the last EIGHTY years! 🤯  

[rather listen than read? 😬 hear this story in our plant powered podcast: Kiss My Grass ] 

 For those of you who want to get right to it, yes, eating chocolate can make your acne worse 😳 and yes, even if its the darkest most sugar-free chocolate you can get your hands on: still worse acne. Read more to find out why ⤵️

If you are reading this blog, then you are probably hoping this isn’t true and want to keep blissfully eating your chocolate and not feel a least bit bad about new pimples that arrive afterwards. 😨 I’m sorry, I wish it wasn’t true either.

Unfortunately, if you are already prone to acne, chocolate can increase the incidents of new pimples. I will explain how new studies in chocolate science have proven this, and WHAT YOU CAN DO TO STOP IT, or at least slow it down. 

First of all, we need to address the misinformation, because it is still being perpetuated to this day! Maybe you need to help pass this along to a skeptical friend. Even though the old “proof” has been debunked for decades, it still gets cited in many arguments. Let me give you the back story. In the late 1960’s a group of chocolate enthusiast started an organization called “The Chocolate Association of America.” They set out to save chocolate’s deteriorating reputation among American teenagers. There was a nasty rumor going around yesterday’s youth that chocolate was causing acne! Well, those men in that group set out to prove it all wrong. 

The Chocolate Association of America pooled some funds and paid for a chocolate study to be conducted. The researchers enrolled 65 men in a chocolate-acne study where they gave half of the men an entire chocolate bar to eat every day, while the other half ate a ‘placebo bar’ containing no cocoa. Meanwhile, the men all ate the same diet, just to make sure last nights dinner wan’t the culprit. This went on for three months. In the end of the three months, they determined that there was ‘no difference’ in the placebo group and the test group. The real nail on the coffin came when they managed to have their study published in the ever prestigious journal of The American Medical Association. This journal is as close to medicines version of the Supreme Court as you can get. If they publish it, then it must be fact. And so this chocolate trial stood as the sole proof that chocolate does not cause acne for nearly a century. 

 Unfortunately, this was 1968, and scientific or ethical standards back then were not a strict as they are today. This study has so many holes, it is practically see-though. 

Let me lay our the highlight real of flaws: 

First up: Talk about a complete conflict of interest. The Chocolate Association of America were a bunch of executives from the Mars Chocolate Company (at the time the largest chocolate factory in the United States), and they had huge finical stakes in making sure American teenagers kept pumping their faces full of their companies’ chocolate candy bars. 

Second: Who were these test subjects? Turns out they were prisoners! Thats a bit odd, I guess we know how they managed to get all 65 men to eat the same food each day. Ouch. The real drama with the test subjects though is that the researchers didn’t disclose their ages, or even if any of these men were prone to acne in the first place. There also wasn’t photo documentation of beginning or end. We really have no way of knowing what were the standards used in the study to determine if the acne was worse or not worse. 

Third: The placebo bar had three times as much fat and sugar as the chocolate bars. Holy moly! Three times! I wonder if the the men in the placebo group may have had even more acne than the control group. If you want to read the whole study  click here. 

Given the three issues above, this trial wouldn’t stand a chance in todays rigorous scientific standards. Since this infamous chocolate study was conducted, many more studies have been preformed, and unfortunately with mixed results. The jury has been hung for nearly a century on whether chocolate causes acne or not. Until today. I am going to put this whole issue to rest, because I am lucky enough to have years of science, new studies, and new breakthroughs in physiology on my side. 

The argument of whether chocolate causes acne is complex, because chocolate is complex and acne is complex.  Looking for the overlaps between the two is the key to the answer. 

Let us start with what is in chocolate. Typically a chocolate candy bar contains, cocoa, dairy, fat and sugar. Now, I realize, the number of ‘chocolate’ variations here are almost endless. It could be vegan, sugar-free, dairy free, 99% cocoa, etc…. I am here to tell you, all of that does not matter, cocoa is the culprit, and I will explain how in just a minute. 

First we need to address the old clues and how they were just supporting actors for the main character cocoa. In the past, science looked towards the dairy connection and theorized consuming the milk proteins whey and casein were the cause. While these proteins have been shown to increase acne (see here) ¹ one would have to eat so much chocolate in order to consume that much of the dairy proteins, or at least be super duper sensitive to these proteins, that if just doesn’t add up. This problem is really only seen in body builders who consume large amounts of whey protein supplementation. 

The next theory makes a lot more sense, but is not the sole problem causer. Many people blame the sugar in the chocolate bars. There have been multiple studies that link spikes in sugar to increases in acne (see here). Sugar is a given.

Then there is the added fats to chocolate bars and candies. After all, cocoa is a powder, in order for it to become soft and melty in mouths (not our hands), it needs some fat. Science has also shown that eating diets rich in omega-6 fats (found in chocolate candies, fast food, and pizza) also increase acne (see here) ². Finally, there have also been studies that show that people who have diets with high glycemic indexes (white rice, white bread, high sugar) also have more acne compared to those who do not (see here). ³ Lastly, and straight to the source, there have been several studies that gave test subject just straight up cocoa powder in capsules, no sugar, no fat, just cocoa, AND their acne was made much worse too! (See here). ⁴ What all these studies have proven is that there is an observational link between what we eat and what happens on our skin. This is the key. 

How is what we eat affecting our skin? This is the real question. Finally, science has figured this out. It comes to no surprise to teenagers (and parents suffering from teenagers), that our skin (among other changes during puberty) is sensitive to hormonal changes. The human skin is affected by estrogen, testosterone, human-growth hormone, and insulin. Wait, what? Did you say insulin? Yes, Insulin. Insulin has been the overlooked link this entire time. 

Let me lay out some facts: puberty is brought on by a high levels in several hormones. When the body begins to secretes higher amounts of estrogen, the body takes on feminine features. When the body secretes high levels of testosterone, the body takes on masculine features. However, hormones play a role in many more processes, especially in the follicles of the skin. Which also happens to be the site of oil production. Both of these hormones are known to cause acne (see here  ⁵ and here), ⁶ mainly because they stimulate more oil production in the sebaceous glands below the surface of the skin, at the site of the hair follicles. These sex hormones cause more oil production. 

In addition to sex hormones, another hormone in high amounts during puberty are human growth factor and insulins-like-growth factor-1 (IGF-1). These two hormones are linked to causing the oil in the glands to be more waxy, more solid, and therefore more prone to getting stuck below the surface and causing a clog (see here). ⁷  To make matters worse, during puberty, teenagers experience an increase in insulin production, as much as thirty percent more than the years before and after puberty. ⁸  When there is a spike or increase in insulin, our body converts a portion of this hormone to insulin-like-growth-factor-1 (IGF-1). We already know that high levels of IGF-1 brought on by high levels of insulin, make the sebaceous oil thicker and thus more prone to clog pores. This explains how fats and sugars found in chocolate candies are linked to acne through our hormonal system that affects our oil glands in the skin, because fats and sugars cause insulin to spike. 

What is the link with cocoa? We learned earlier, that studies with just cocoa powder also saw a rise in acne, without sugar and fats. This is where we need to circle back to insulin. In 2018, a brilliant researcher wanted to find out the mechanism of how cocoa powder was helping his diabetic patients maintain a more healthy blood sugar level. This is when he stumbled across the answer to the acne mystery as well. When he exposed human beta cells, the ones responsible for making and secreting insulin, to cocoa, he found that the tired and under producing beta cells made more insulin. (See here) ⁹  While this is great news for diabetics who are lacking sufficient insulin, this is bad for people who already have enough insulin and who are prone to acne. 

 When a ‘normal’ person eats something with cocoa in it, the beta cells in the body produce extra insulin. Remember, a portion of this extra insulin will be converted into IGF-1. Also remember when the body has increased levels of IGF-1, it causes an increase in volume of oil production as well as a thicker waxier composition of oil. Thus creating clogs in the pores and more acne. Therefore, cocoa indirectly causes more and thicker oil in the human hair follicles, this is why and how chocolate increases acne: through increased insulin, then IGF-1, then more thick oil. 

 So what can you do about this? It turns out, you can combat this insulin surge by consuming higher amounts of fiber, especially around the time you consume cocoa. Studies have shown that diets high in fiber combat the insulin -> IGF-1 conversion. ¹⁰  Also, studies have shown that when people eat diets with low glycemic index (like whole grains, lean proteins, legumes, and veggies)  have smaller sebaceous glands and produce less oil. ¹⁰ 

Can you still eat chocolate, even if you are acne prone? Yes, you can avoid some of the causes of acne by eating a low glycemic diet, high in fiber most of the time because this will minimize the surges in insulin and therefore limit the amount of IGF-1 stimulating your oil glands. There you have it, just one more reason to follow a healthy diet. Also, how cool for cocoa’s insulin secreting properties!?! Plant Power. 

Written By : 

 Dr. Chantelle Davidson. Pharm. D. 

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