It’s said that a marriage in Hollywood is successful if it outlasts milk. Then the golden anniversary must be when the marriage outlasts acne milk caused.
There’s now good evidence to say that milk causes acne. Studies show higher rates of acne in those who drink more milk. Furthermore, milk increases the hormones that increase sebum production, skin cell growth and aggravate acne. Even a paper published by Nestle says they need to produce milk that causes less acne if they want to keep selling it.
In this post I’ll give you a good overview of all you need to know about dairy causing acne. Including clear explanation of studies and how it happens. Finally we’ll look at some milk alternatives and whether those are better for your skin.
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Read moreMilk-acne studies
Studies have established drinking milk correlates with higher rates of acne. If statistics wasn’t your strong suite, this simply means that those who drink more milk also tend to have more acne.
The first study to link dairy to acne used data from the famous Nurse’s Health Study, and found that those who drank more milk as teenagers had higher rates of acne. But when it comes to acne this study is next to worthless. The problem is it used dietary recall. Do you remember what you ate last week? Last month? Last year? Exactly. The adult nurses in this study were asked to recall how much milk they drank as teenagers.
This is the study that Dr. Mark Hyman touts as the smoking gun evidence that milk causes acne. At best this study suggests dairy may be linked to acne, but as scientific study it’s so weak we can’t conclude much from it.
The authors of the first study followed up with two better studies. This one with teenage girls and this one with teenage boys. In both of these studies they followed the study group for 3 years. During each year they asked them to fill a food frequency questionnaire, basically asking how often you currently eat certain foods.
Both studies found very similar results. Those who drank more than 2 servings of milk per day were 20% more likely to suffer from acne than those who drank less than 1 serving per week. Not exactly earth-shattering results, but this shows it’s likely milk and dairy products aggravate acne.
I suspect that these studies may understate the risk in adults. These studies used teenagers and acne is very common during that time because of raging hormones. Milk affects these same hormones, so during teenage milk may not increase your risk of getting acne that much.
An Italian study done with little bit older subjects supports this. This study used adolescents and young adults, and found 78% higher risk of acne in those drinking more than 3 servings per week.
I should note than all the above studies found skim milk to be worse than full-fat or low-fat milk.
Summary
If we get technical we can say none of these studies proves milk causes acne (correlation doesn’t equal causation, and studies like these only find correlations). But in real-life, practical terms they are enough to seriously suspect milk. Especially when you consider that milk taps to the same hormones that cause acne.
How milk causes acne
There results from the above studies take on a different meaning when we look at biological plausibility of milk causing acne.
Research in the past 2 decades has underscored the role hormones play in acne, and especially insulin and insulin like growth factor 1 (IGF-1). Elsewhere I cover in detail how these hormones affect acne, but for now it suffice to say that these hormones and acne go hand in a hand. Higher hormone levels usually mean more acne.
IGF-1
Studies show that milk and dairy products increase IGF-1 levels. One study in older adults showed that 3 servings of milk per day for 12 weeks increased IGF-1 levels by 10%. Another study showed 16% higher IGF-1 levels in those who drank 1-2 servings of milk per day as compared to those who drank only rarely.
Studies on acne patients have shown correlation between IGF-1 and acne. IGF-1 has been shown to increase sebum production, make skin pores more visible and increase skin cell growth.
Insulin
You are probably familiar with glycemic index, it measures how quickly certain foods increase blood sugar levels. Insulin index does the same for insulin. It measures how much 240 calorie portion of a particular food increases insulin levels. White bread was used as reference food with index value of 100. Here are insulin index values for a few foods:
- White bread 100
- White rice 79
- Eggs 31
- Beef 45
- Yogurt 115
As you can see yogurt really skyrockets insulin levels, even more than white bread. Now they probably used commercial yogurt with added sugar. So the value will be somewhat lower for unflavored, sugar-free yogurt. Still, it’s alarmingly high.
Why insulin is bad? Like IGF-1, it can stimulate hormonal acne, but it also increases bioavailability of IGF-1.
Milk allergy and lactose intolerance
Some people are allergic to milk. The immune system reacts to proteins in milk, usually casein, and treats them as invaders. Symptoms include rash and other skin problems. It’s possible that allergic reaction to milk also triggers acne.
Milk allergy also comes in a less severe form, known as milk protein intolerance. The problem is that common food allergy tests don’t detect this. Milk protein intolerance also triggers an immune response, and symptoms are similar to milk allergy.
Lactose intolerance is yet another way milk can cause acne. Instead of causing immune response lactose intolerance contributes to gut problems. Wikipedia article on lactose intolerance says it’s a significant cause of irritable bowel syndrome. Because lactose isn’t digested properly it feeds the bacteria in the gut and possibly leads to bacterial imbalance in the gut. I’ve written in detail about how gut problems can cause acne.
Even Nestle admits milk causes acne
You might think that the world’s largest producer or milk products would rush to deny any possible links between milk and acne. In that case you would be wrong. A 2011 paper published in Nestle Nutritional Workshop Series explains all the ways milk can cause acne. It’s pretty much what we discussed above. Milk increases insulin and IGF-1 levels that then leads to acne.
Here’s a quote from the paper.
Both, restriction of milk consumption or generation of less insulinotropic milk will have an enormous impact on the prevention of epidemic western diseases like obesity, diabetes mellitus, cancer, neurodegenerative diseases and acne.
Melnik BC.
Evidence for acne-promoting effects of milk and other insulinotropic dairy products.
Nestle Nutr Workshop Ser Pediatr Program. 2011;67:131-45. Epub 2011 Feb 16.
Basically what they are saying is that to avoid acne people should drink less milk, or Nestle should develop milk products that don’t skyrocket insulin levels.
What about milk alternatives
By now there’s ample evidence that to say that milk causes acne. But what about alternatives, like milk from or made of soy, almonds, goats, etc? Are they safer for your skin? I can’t say for sure, but here are some pointers:
- To my knowledge goat’s milk doesn’t increase insulin levels as much as cow’s milk. So it should be safer.
- There’s a lot of debate about soy. Some say soy decreases testosterone levels and has a feminizing effect in men. I wrote a detailed post about soy, and after looking at all the studies the hormonal effects of soy are weak to nonexistent. Soy allergies are fairly common, and that’s by far the most plausible way that soy could cause acne. But other than allergies, there’s no good reason to believe soy or soy milk causes acne.
- Almond, rice and other ‘milks’. Other than possibly high sugar content, I can’t think of a way these alternative milks could harm your skin.
Did I miss some dairy alternative? Please post to the comments below and I’ll add it here.
Is it ok to eat yogurt?
Homemade and ‘live’ yogurts are a good source of probiotic bacteria, and as such can help with gut problems. So they can be good for the skin. But what about the hormonal effect of milk? Do the positive effects of yogurt outweigh the negative effect?
There’s some reason to believe that yogurt and other processed dairy products don’t have as strong hormonal effect as pure milk does. For example, fermentation deactivates a large portion of IGF-1 in milk. Also studies that found higher IGF-1 levels in milk drinkers showed no effect from yogurt or cheese.
That said, yogurt will cause a temporary increase in insulin levels, see the discussion about insulin index above. But unlike milk it may not cause long-term increase in baseline IGF-1 levels.
That’s about all we can say. Unfortunately there’s no way to tell whether yogurt is good for your acne or not. I would say that if sugar aggravates your acne, then it’s likely that yogurt also does. Sugar aggravating acne shows your acne responds to insulin and IGF-1. There are other cases where acne is more inflammatory in nature. In those cases the gut healing effect of yogurt might help the skin. I remember at least one study where fermented dairy beverage helped acne.
So use that as a rough guideline, but it’s by no means accurate for everybody.
Conclusion
So does milk cause acne? I think we can safely conclude it causes acne for some people. All the studies I’ve seen show higher rates of acne in people who drink more milk. Milk is also known to increase both insulin and IGF-1 levels, and both of these hormones are linked to acne. Less common ways are allergic reactions to milk and gut problems as a result of lactose intolerance.
Goat’s milk is usually promoted as a safer alternative to cow’s milk. Soy allergies are fairly common, but in allergy-free people soy milk shouldn’t be a problem. Similarly almond, rice and various other alternative milk products should be acne safe.
Yogurt has both beneficial and harmful effects on the skin. It’s a good source of probiotic bacteria and can help with gut problems. The fermentation process mitigates some hormonal problems, but it’s still a dairy product and will spike insulin levels. You have to judge it experimentally.
I hope you found this post informative. Please share your experience with milk in the comments below.
Toggle references
- Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults.
- High school dietary dairy intake and teenage acne.
- Dietary changes favorably affect bone remodeling in older adults.
- An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods.
- Milk Intake, Circulating Levels of Insulin-Like Growth Factor-I, and Risk of Colorectal Cancer in Men.
- Dietary Correlates of Plasma Insulin-like Growth Factor I and Insulin-like Growth Factor Binding Protein 3 Concentrations.
- The effects of dairy processes and storage on insulin-like growth factor-I (IGF-I) content in milk and in model IGF-I-fortified dairy products.
- Milk consumption and circulating insulin-like growth factor-I level: a systematic literature review.
- Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women.
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Hi, just wanted to say that I traced my acne quite clearly to dairy (basically an elemination diet with some dairy reintroductions/challenges).
Furthermore I can say that in my case, cheese from raw cow milk causes only very very very little acne, while similar cheese from pasteurized milk causes quite clearly acne for me.
BTW, dark chocolate (without milk) is OK for me, while milk chocolate causes acne.
And ghee (clarified butter) seems OK for me too – so if it is hormones from milk, they are not in the fat faction. To speculate: I suspect that it is not hormones, but the immunoglobulins from the milk that are the problem.
Hi Tony. Thanks for sharing your experience. It’s always nice to get real feedback and reports from readers.
I agree with you that it’s rarely the fat portion of the milk that causes acne. Some people may struggle with allergic reactions to milk and that causes acne for them, but for most people I think it comes down to milk proteins and their effect on IGF-1 and insulin levels.
I’d like to hear more about your suspicion that it’s not hormones but immunoglobulins that cause the problem for you? Can you talk a bit more about that and what are you basing the assumption on?
It’s also interesting that you’ve noticed the difference between dairy products made from raw and pasteurized milk. Raw milk usually comes from smaller producers that most likely treat their animals better. Perhaps the differences in growing practices cause some differences in the milk. I’m not aware of any compelling evidence for that though.
Just yesterday I was doing some cursory research on the possibility that chocolate can cause acne. And I mean pure chocolate with no milk or sugar added. I’ll do a post about it later, but coco seems to spike insulin levels, and that can contribute to acne for some people.
Its demoralizing to hear that milk may make acne worse after being taught in school that it was once considered the healthiest/most complete drink in the world… I’ve had severe acne and used antibiotics heavily to treat it. Although the antibiotics definitely reduced my acne and sometimes completely cleared it up, I was never told about the side effects of antibiotics. I’m (well used to be) also an extremely heavy milk drinker (6-7 cups a day) and never thought twice that milk, the holy grail of drinks, could cause me to be so self conscious of my skin. Not to rant too much but the dermatology system is a bit messed up. My doc prescribed antibiotics to treat my acne, but it didn’t treat the core of the problem which may be my diet. This information needs to be published in newspapers and magazines so the general public can hear about these studies and hopefully in turn force the large milk producers to take better care of their cows and produce healthier milk
I agree that this is frustrating. And this is by far not the only issue I have with current dermatological practices, at least with regard to acne. If a layperson like me can put these things together then certainly a trained doctor could do a far better job. I just don’t understand why more dermatologists don’t stay up to date with research.
There’s no doubt that milk is highly nutritious, so in that regard you’ve been taught correctly, but it also has unfortunate side-effects. I don’t think the issue is how dairy producers treat cows, though that leaves a lot to be desired. Milk is inherently acnegenic. It contains hormones and substances that ‘hook into’ pathways that lead to acne. This is true even for milk produced with organic and most humane means.
I was wondering about using Almond milk as a substitute for cows milk but was concerned about the high – no, huge – Omega 6 content of the Almond and its inflammatory effect on acne. The Almond has the highest by far Omega 6 (as opposed to Omega 3) content of all the nuts. Would Almond Milk be a better substitute for dairy milk? I’m hoping I wouldn’t be going from the frying pan into the fire by using Almond Milk even though some articles state a milk substitute like Almond Milk would be a better alternative than dairy milk in people with acne. Any thoughts?
That’s a potential concern, though I haven’t looked at how much omega-6 fats there are in almond milk. I would be more concerned about the total amount of omega-6 than the ratio.
Also, the question about the importance of omega-3:6 ratio is far from settled. There’s some evidence to show it doesn’t matter and there’s some to show it does matter. I think in this case it’s prudent to assume it is a valid concern and try to maintain a balance between omega-3 and -6 fats.
Regardless of the omega-6 content of almond milk I would say it’s better than cows’ milk. The real problem with dairy is that it spikes insulin level. Almond milk without added sugar probably doesn’t do that.
I also can’t say whether omega-3:6 ratio has any effect on acne. It may, but there’s no data to show either way. My advice is to treat it as a potential concern, but I wouldn’t put too much emphasis on it.
Thanks much, Seppo.
Hi. Wow. I have been reading your website and am blown away by the information. I have a 19 year old son who suffers from acne. He’s currently on a long term maintenance antibiotic therapy and two prescription topicals. His derm says there is no connection with milk intake – i brought it up a few years ago when i read something about the connection. My son does consume a lot of milk and his diet isn’t that great — bread, juices, milk, cereal, etc. interesting about the glycemic thing and acne. I will talk to him about that. I’m also reading a book about the gut and just how important a healthy one is for good health and i am alarmed about my son’s use of antibiotics….I read your blog about green tea. Is it possible to make our own mask or solution using tea bags? Any way, your site is very professional and I appreciate your honesty. Best regards.
Glad to hear you like the site, Rhonda. I can kinda understand when derms say there’s no proven connection between foods and acne. The data is still somewhat preliminary and not strong enough to base generalized treatment recommendations on.
That said, there’s no excuse to categorically deny any connection. That’s just being lazy. They should at least inform people about a possible connection – even if the data is not yet rock solid.
Agree on the importance of gut health. For me, gut health is one of the biggest influences on my scalp acne. If I eat something that aggravates my gut I can invariably expect a painful breakout on my scalp a day or two later.
Seppo, it’s interesting you mention scalp acne. That seems to be the only problem I have and have had for years now. Three different derms and many different topicals, antibiotics don’t seem to work. The antibiotics worked but almost immediately after stopping the scalp acne comes back. Haven’t taken antibiotics for a couple of years now and it was only for 2 or 3 weeks. Interesting that I never had any scalp problems until I hit 40 or so and even when I had bad acne problems in my teens and twenty’s I never had a zit on my head. Very weird. I have absolutely no gut problems and my general health is excellent. The derms say it is probably hormonal and not a whole lot they can do. Any “magical” topical solutions (I’ve think I’ve tried them all) that you find worthwhile? I just stopped drinking milk because of the possible “hormonal” connection but I guess I will have to wait and see. This scalp acne is very bizarre to me because like I said I never got it until way into my adult years.
Similar story here. Antibiotics work, but acne comes back within a week of stopping the meds. Now that I think about it, my scalp acne started after Accutane. Accutane got rid of my severe back acne, but my joy was short-lived as acne came back on my scalp.
I thought I had no gut issues until I really started paying attention. Not saying that’s the case with you, but it’s an angle worth looking into.
The only topical solution that has worked for me is to avoid chemicals that irritate my scalp. So I had to switch to sulfate-free shampoos.
I have been working on the assumption that I am lactose intolerant for a while now. It took a while to figure out, but as long as I use the lactase enzyme pills whenever I eat anything dairy, I don’t have the horrible gas, bloating etc. digestive difficulties I was having. Having said that, I still have dark circles under my eyes, painful knees and yep acne (at age 50) Actually, even more acne now than ever before in my life, including my teen years. Growing up I lived in farm country and we drank raw milk at home. When I left home and moved to the city I no longer had raw milk, but also wasn’t drinking very much milk at all so didn’t have many problems. Over the years acne came and went and I really wondered why as an adult and not as a teen but didn’t think too much about it until recently when the lactose intolerance became a problem. Since switching to lactose free milk, I have noticed an increase in general malaise that does not appear to be related to anything else. I know exactly how much milk I consume as I am the only one drinking from the 4 litre jug I buy each week! (works out to about 16 oz per day consumed as liquid milk or in other foods prepared using milk) So after reading this article and a few others covering my other symptoms as they relate to milk allergy, I have decided to give milk a pass for now and see if things clear up.
Let us know how it works out for you!