Currently only limited research exists on the relationship between alcohol and acne. But several studies do report that alcohol may be associated with an increased prevalence of acne.
However, Dr Nerissa Moodley, a dermatology registrar at the University of KwaZulu-Natal, warns that these studies are not conclusive.
There are several ways alcohol may exacerbate breakouts. Dr Moodley explains how:
1. Changes in hormone levels
Alcohol consumption can increase testosterone and oestrogen levels. When hormone levels increase, your oil glands may produce more sebum which can clog pores and cause a breakout.
2. Bacteria growth
Studies show that Cutibacterium acnes (a bacterium that resides in the pilosebaceous follicles and contributes to the inflammatory response in acne vulgaris) metabolises alcohol and uses it as a fuel which may affect acne-prone skin.
Alcohol consumption can lead to inflammation. Increased levels of cytokines (these send messages to immune cells to fight harmful substances that enter the body, such as bacteria) can predispose individuals to develop acne and play an important role in the early stages of acne formation.
How hormones affect acne
Your hormones are responsible for producing sebum through the sebaceous glands in the skin.
“The main hormone responsible for increasing sebum production is dihydrotestosterone (DHT), which is converted from testosterone in the sebaceous glands by the enzyme 5-alpha-reductase,” explains Dr Moodley. “DHT is a more potent androgen than testosterone.”
When there is an increase in sebum production, sebum and keratinous matter collect in the follicles. This can cause a partial obstruction of the follicle, resulting in the formation of comedones, which are the primary lesions of acne.
Sebum also provides a growth medium for Cutibacterium acnes.
Diet and acne
Dr Moodley says the role of diet affecting acne is an evolving concept. “Recent studies suggest an association between dairy and acne. Dairy products contain carbohydrates and increase acne severity through diet-induced hyperinsulinaemia which stimulates increased levels of IGF-1 and thus androgens,” she says. Skim milk and whole milk have been implicated too.
“Dietary interventions using a low glycaemic load carbohydrates may have therapeutic effects in the treatment of acne because they have beneficial endocrine effects.”
She says there is no reliable evidence that eating chocolate is associated with an increase in prevalence or severity of acne.
But if you are worried that a food or alcohol is triggering your acne, Dr Moodley suggests eliminating it from your diet and monitoring the situation to see if there is a difference.
“Just remember that calcium present in milk is essential to bone growth and structure,” Dr Moodley warns.
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