When it comes to diet and acne, there isn’t a more controversial topic than dairy.
For quite some time, dairy flew under the radar, and chocolate, greasy foods, and sugar took the blame for dietary acne.
Meanwhile, numerous studies have come out showing a possible link between diet and acne, yet none of them have looked at dairy specifically.
Still, a lot of people claim that cutting out dairy was the magic pill they needed to clear their skin.
There’s a good reason for this – dairy isn’t the nutritional powerhouse it’s hyped up to be and is one of the worst food groups when it comes to acne. Not all foods affect everyone the same way, but if there’s a single food group that’s likely to cause acne, it’s dairy. That being said, not all dairy is created equal, which is why I’ll also break down the best and worst dairy for clear skin.
How Dairy Causes Acne
Dairy causes acne by triggering several hormonal responses that lead to the formation of pimples. Dairy contains large amounts of the hormones IGF-1, IGFBP-3, and estrogen, all of which have been linked to acne. Despite having a low glycemic index, dairy is extremely insulinogenic and triggers a large insulin response, which further contributes to acne. The protein found in dairy, casein, has been shown to disrupt the gut lining. Dairy also contains large amounts of calcium, which impairs the absorption of other nutrients necessary for clear skin, including zinc.
Let’s break down each of these factors in-depth:
Dairy contains hormones that cause acne
The purpose of milk, whether it’s from a cow, sheep, goat, or human, is to nourish and develop newborns. What that means is that milk needs to have hormones that trigger growth. That’s good if you’re a newborn calf, but not so good if you’re a young adult.
There are three main growth hormones that cause problems for acne: IGF-1, IGFBP-3, and estrogen.
It’s really important to understand how IGF-1 works if you want to achieve clear skin. IGF-1 is a growth hormone, it regulates the rate at which the body creates new cells and replaces old ones.
IGF-1 is important when we’re growing, gaining muscle mass, or recovering from workouts. It signals to your body to replace all those worn-out and depleted cells with healthy, new cells. Some bodybuilders will supplement with IGF-1 for this reason (one reason many bodybuilders struggle with acne).
For acne, IGF-1 is generally a bad thing. Being a growth hormone, IGF-1 triggers your body to produce a ton of new skin cells. These skin cells are created far beneath the surface of the skin and slowly rise up over roughly 30 days. When this big batch of new cells reach the surface of the skin, they compete for space and resources and end up actually blocking the pore. This blocked pore is the perfect breeding ground for infection and inflammation to take hold and acne to form.
IGF-1 also triggers other hormones that tell our skin to produce more sebum oil. This sebum oil can easily become oxidized (damaged) and clog pores. Worse yet, IGF-1 actually decreases our ability to handle oxidative stress.
PS: Oxidation is a damaging process that affects tissues and cells throughout our body. When something becomes oxidized it’s usually not good.
When the oil (sebum) on the surface of the skin becomes oxidized, it becomes a pore-blocking powerhouse. We need antioxidants to prevent oxidation from occurring, and high levels of IGF-1 actually decreases our body’s ability to fight oxidation (R). So not only does IGF-1 trigger more skin oil to be produced, but it also hinders our ability to prevent this oil from becoming oxidized and blocking pores.
Just like nearly every other hormone under the sun, you need some IGF-1 to properly grow and repair, but not too much where it causes acne. The problem with IGF-1 is that it’s not hard to trigger way too much: eating carbs (grains, rice, sugar, etc.), large amounts of protein, or even getting stressed out is enough to trigger the release of IGF-1. Dairy directly contains IGF-1 and triggers insulin, which in turn tells the body to produce even more IGF-1.
The bottom line is that dairy can very easily trigger too much IGF-1 to be produced, which leads to clogged pores and oily skin.
IGFBP-3 controls how quickly your skin cells die off and get replaced. High levels of IGFBP-3 cause skin cells can stick to each other and form rough scales on the surface of the skin. These scales then end up blocking the pore from the outside air, making the pore prone to infection and inflammation.
Combine IGFBP-3 and IGF-1 together and you get a pretty nasty combination: too many skin cells are being produced, they stick to each other on the surface of the skin, and they are not being shed fast enough. The end result is that you have a ton of dead, rough, scaly cells on the surface of the skin blocking that block pores.
The link between estrogen and acne isn’t as clearly defined as the other hormones above, however, we’re starting to uncover more and more evidence.
Estrogen is the primary female sex hormone, but that doesn’t mean that only women have estrogen: men and women have both estrogen and androgens (male sexual hormones) in varying amounts.
The link between estrogen and acne comes into play when you consider the balance between estrogen and progesterone. Progesterone protects against too many male hormones being present in the body, particularly the hormone DHT.
DHT increases the production of sebum oil on the skin, which leads to more opportunities for clogged, infected, and inflamed pores to create acne. This is part of the reason why menstrual cycles tend to be accompanied by breakouts.
Dairy triggers the release of insulin
Insulin is a hormone that our body releases when we consume carbs. After you eat carbs, they get converted into fuel the body can use called glucose. Glucose then gets sent into the bloodstream, which is where insulin comes in. Insulin helps deliver and transport all that glucose to the muscles, tissues, and organs that need it to function.
Insulin by itself isn’t a problem, but when you consistently eat more carbs than your body can burn and trigger more insulin than you need, you set off a ruthless cycle of hormonal imbalances that lead to acne. Insulin doesn’t work alone, it triggers 3 other hormones that directly cause acne:
- IGF-1 – blocks pores, increases oil production, promotes inflammation
- IGFBP-3 – blocks pores
- IL-1 – promotes inflammation
Notice anything familiar? Dairy already contains the hormones IGF-1 and IGFBP-3 and it triggers the release of insulin, which in turn signals your body to produce even more IGF-1 and IGFBP-3. Yikes, that’s a lot of hormones!
Dairy is really deceiving in this regard because it doesn’t contain many (if any) carbs. Cheese, cream, and butter are all low carbohydrate foods with extremely low glycemic indexes. The glycemic index (GI) is a tool used to measure how large the change in blood sugar will be after eating a food, and thus how much insulin you’ll likely release. In theory, a low GI means a small insulin response and a high GI (65+) means a large insulin response.
This is not the case with dairy. Despite having a very low glycemic index due to its lack of carbohydrates, dairy produces an extremely high insulin response thanks to the proteins found in dairy: casein and whey.
|Glycemic Load (per 100g)
That’s right, just because a food doesn’t have any carbs doesn’t mean that it doesn’t elicit an insulin response. Casein and whey contain amino acids that trigger massive insulin responses, in fact, the lactose in dairy usually isn’t a problem when it comes to dairy.
Insulin is never good for acne, but when you combine it with the existing hormones found in dairy (IGF-1, IGFBP-3) you find yourself looking at a hormonal nightmare for acne.
Dairy can damage the gut
Maintaining proper gut health is crucial for clear skin and overall good health. A well-functioning digestive system ensures that we’re actually absorbing and using the nutrients we eat and protects us against inflammation-causing antinutrients.
Unfortunately, our gut has a really hard time handling the protein found in many dairy products, casein A1. Studies show that casein A1 can lead to inflammation, slow digestion, and aggravate symptoms of lactose intolerance.
The reason for this is that casein A1 can very easily penetrate the intestinal wall and enter the bloodstream due to leaky gut syndrome. In fact, casein A1 is actually fairly similar to gluten in this regard. When it enters the bloodstream, your body sends out an inflammatory response to attack the “threat”. This inflammatory response, if repeated consistently, can lead to chronic inflammation and an overactive immune system, the mechanism responsible for turning a simple acne infection into a huge, angry pimple.
The Calcium Dilemma
Believe it or not, the high levels of calcium in dairy can be a disaster for acne.
I know what you’re thinking – don’t we need calcium for strong bones?
While it’s true that we do need some calcium, it’s importance is likely overstated when compared to the risks of excessive calcium consumption. One study found little evidence that calcium has any negligible effect on bone fractures1https://academic.oup.com/ajcn/article/74/5/571/4737376.
On the other hand, studies show that calcium prevents zinc2https://academic.oup.com/ajcn/article/65/6/1803/4655507 (and iron) from being properly absorbed.
Zinc is by far one of the single most nutrients for acne. It plays a role in reducing inflammation, transporting vitamin A, improving sleep quality, and even insulin resistance.
- One study found that 30g a day led to nearly 50% less acne after 3 months3https://www.karger.com/Article/Abstract/51728.
- Another found that 54% of participants with acne were deficient in zinc. Only 10% of the non-acne group were deficient in zinc4http://www.jtad.org/2007/3/jtad71302a.pdf.
Statistically speaking, if you have acne, you’re likely deficient in zinc. If you’re eating dairy on a regular basis, that means you’ll be absorbing even less of the zinc you’re consuming due to the high concentrations of calcium in dairy. This is clearly a problem for zinc deficient individuals.
Lactose Intolerance and Dairy Allergies
Dairy is the single most common food allergy on the planet.
It’s estimated that 75% of the world population is lactose intolerant5http://www.pcrm.org/health/diets/vegdiets/what-is-lactose-intolerance. While there’s naturally-occurring lactose found in breast milk, however, we often lose the ability to handle lactose after the age of 2 or 3.
Lactose (and casein) intolerance leads to a wide array of issues – bloating, poor digestion, and inflammatory acne.
If you’re triggering an allergic response every time you consume dairy, you’re not doing your immune system (or your skin) any favors. Lactose intolerance combined with regular dairy consumption alone can be enough to cause acne. With over half the global population being lactose intolerant, it might be worth cutting out dairy just to see if you are lactose intolerant.
Putting It All Together – Should You Avoid Dairy Entirely?
The case is pretty clear, most forms of dairy pose several serious drawbacks when it comes to acne:
- Dairy contains hormones that clog and block pores
- Most dairy triggers a large insulin response, which in turn triggers even more acne-causing hormones
- Casein A1 is very similar to gluten and can damage the digestive system
- Calcium prevents zinc, a crucial nutrient for clear skin, from being absorbed properly
- More than half of the global population is lactose intolerant
Despite all of this, not all dairy is likely to trigger acne.
A few dairy products have some redeeming qualities, including healthy omega-3 fatty acids, antioxidants, and moderate levels of vitamins A, D, E, and K, all essential nutrients for clear skin.
The key is to choose the right form and the right quality of dairy to reap these nutritional benefits.
How to buy quality dairy for acne
When it comes to dairy, what the cow ate and how it was raised makes a huge difference when it comes to hormones and nutrition.
Here are the elements you want to look for in dairy:
Grass-fed and organic
Cows are meant to eat grass. When you feed them grains, corn, and vegetable feed, it really shows in the food.
The biggest benefit of buying grass-fed dairy is the abundance of healthy fats. Grass-fed dairy contains considerably more omega-3 fatty acids than conventional dairy. These omega-3 fatty acids help fight inflammation and bolster the immune system. In addition to having more omega-3’s, grass-fed dairy also has less inflammatory omega-6 fatty acids, so the inflammation caused by grass-fed dairy won’t be as significant as conventional dairy.
Pasteurization is a process in which heat is used to kill bacteria. Â This is good for killing bad bacteria that could harm us, but in the process, all the good bacteria will also be killed off. This excessive heat also makes some of the fats oxidized and unstable, including omega-6 fatty acids, which can contribute to acne and inflammation.
PS: If you’re concerned that raw dairy will kill you, check out this article by Dr. Chris Kresser.
Fermentation is a beautiful process that can really bring out a lot of positive health attributes in food. In the case of dairy, kefir and aged cheeses are great alternatives to other dairy products due to fermentation and aging.
They have more probiotics, less IGF-1, and generally less lactose than non-aged or fermented dairy products. It’s not worth going out of your way to consume fermented dairy, but if you insist on having dairy, fermented and aged is better than fresh.
You know what’s really bad for you? Low-fat dairy.
Instead of the healthy, naturally-occurring saturated fats found in full-fat dairy, low-fat dairy contains added sugar and oils to make the product taste good. This added sugar spikes insulin levels, which further contributes to acne and inflammation.
Goat & Sheep Dairy is Often Preferred
Goat and sheep dairy is usually better than cow dairy for a few reasons:
- Goat & sheep milk is a lot closer to human’s hormonal structure – by no means is it perfect, but it’s closer than cow’s milk
- Although it still contains casein, it doesn’t contain casein A1, the form of casein that can damage the gut
- The nutrients found in goat milk is absorbed at better rates than that of cow milk (R)
Many experts recommend substituting with goat milk if you’re allergic to cow’s milk, however, studies show that this probably isn’t the best idea6https://www.ncbi.nlm.nih.gov/pubmed/12882742. You can test it out for yourself, but there’s no guarantee it’ll be a sure fit.
The issue with goat and sheep dairy is that it can be hard to find pasture-raised, organic, high-quality products. I’ve been able to find some at my local co-op and Whole Foods, but if you don’t have access to health-focused grocery stores it’ll probably be hard. If you can’t find high-quality goat and sheep dairy I’d recommend avoiding it.
The Best & Worst Dairy Products For Acne
At the end of the day, there are only a few solid dairy choices out there for acne – realistically you’re going to run into issues with most dairy products if you make them a staple of your diet.
With that being said, some are much better choices than others…
Safe dairy for acne
Grass-fed Ghee Butter
Ghee is simply pure butterfat, which means it doesn’t have any whey, casein, or lactose. What this means is that it sidesteps all the major issues of dairy: Ghee won’t trigger any significant insulin response, contains very few omega-6 fatty acids, has plenty of antioxidants, and stable at high temperatures. Ghee stands alongside coconut oil, extra-virgin olive oil, beef tallow, and avocado oil when it comes to safe, healthy, and effective fats.
I generally make my own ghee, but if I’m in a crunch or know I won’t have time, I love 4th & Hearts Himalayan Pink Salt Ghee. It’s organic, grass-fed, and lactose-free.
Good dairy for acne
Grass-fed butter is almost as good as grass-fed ghee, except it contains small amounts of casein and lactose. Overall, these small amounts shouldn’t be enough to cause massive issues, but if you’re sensitive to dairy they can still pose some challenges for acne-prone skin.
Full-Fat Heavy Cream
Rejoice! Delicious heavy cream isn’t all that bad for your skin!
Okay, while heavy cream isn’t horrible for your skin, you shouldn’t be eating it on a daily basis.
Heavy cream is low in lactose, low in protein (casein and whey), low in calcium and even omega-6 fatty acids that contribute to inflammation. The only big negative with heavy cream is that it’ll still have IGF-1 in it, otherwise it’s a relatively healthy fat.
Okay dairy for acne
Kefir is a fermented dairy beverage that has a lot of commonalities to yogurt.
Kefir is better for your skin than yogurt for a few reasons:
- It has more strains of probiotics than yogurt
- It’s lower in lactose, omega-6 fatty acids, and protein than yogurt
- It’s high in retinol
Unfortunately, kefir isn’t perfect – it’s still going to have some IGF-1, casein, whey, and calcium. For this reason, kefir ranks higher than other dairy products but still isn’t as safe as other alternatives like ghee or butter.
Problematic dairy for acne
This is going to be a pretty long section, and for a good reason – most dairy can cause acne. If you still want to consume dairy outside of butter and ghee, tread with caution – some of these dairy products might not be a problem for you while others may cause really bad breakouts.
Milk’s extremely high in lactose, casein, calcium, and whey, and is extremely insulinogenic, which means it pretty much checks every box when it comes to causing acne.
There’s nothing found in milk that you can’t get from other foods, which is why it’s generally best to just stay away from milk. If you need to drink some kind of milk, I’d recommend coconut or almond milk as an alternative. Soy milk is almost as bad as regular milk when it comes to acne.
If you insist on drinking milk, go for raw, organic, grass-fed milk whenever you can and make sure you avoid skim milk.
With so many different types of cheese out there, it can be tricky to pinpoint exactly which ones pose the biggest threats to acne.
Pretty much all cheese contains significant amounts of casein and whey, proteins that trigger inflammation and damage the digestive system, however, many kinds of cheese are considerably lower in lactose and IGF-1 than other cheeses.
In general, aged cheeses contain less IGF-1 and more nutrients (like vitamin A) than young cheeses.
Here’s a list of attributes to consider when it comes to cheese:
- Goat and sheep cheeses are generally better than cow
- Aged cheese has less IGF-1 than young cheese
- Cheese lower in protein is ideal
Yogurt is interesting because for some people it can actually help get rid of acne. The reason for this is the probiotics typically found in yogurt, including s. thermophilus, l.bulgaricus, l. acidophilus, bifidus, l. rhamnosus, and l. paracasei.
While these probiotics are great, they come at a pretty significant cost. Yogurt is also high in lactose, casein, whey, and calcium, all of which contribute to acne.
For this very reason, I actually recommend taking a high-quality probiotic like RAW Ultimate Care that contains some of these healthy strains without all the negative side effects.
If you are going to use yogurt, try to stick to the following:
- Full-fat (low-fat yogurt usually has sugar & vegetable oils)
- Go with plain, non-flavored yogurt, and add raw honey or berries if you need to
- Greek yogurt is preferred – it’s high probiotics and healthy fats
Read the detailed guide on yogurt’s impact on acne.
Whey Protein Powder
Yep, most protein powder counts as dairy too – whey is simply milk protein.
One study found whey protein powder to trigger a larger amount of insulin than white bread7https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-9-48
Another found that whey dramatically increased IGF-18https://www.ncbi.nlm.nih.gov/pubmed/21590739
Dairy to avoid for acne
I’ll admit, Ice cream tastes amazing, but it comes at a huge cost.
In addition to all the other negative aspects of dairy, like IGF-1, high amounts of lactose, and casein, ice cream will also trigger a huge insulin spike just from the sugar that’s added. What you get is a double-dose of hormonal trouble: insulin, IGF-1, and other hormones are triggered by the dairy found in ice cream and the sugar.
That’s not to say you can’t occasionally indulge in ice cream – keep it to special occasions or indulge in a healthy keto ice cream recipe instead.
Wrapping it Up – Should You Avoid Dairy for clear skin?
The benefits of dairy are pretty small in comparison to the damage it can do to your health and your skin:
- Dairy contains the hormones IGF-1, IGFBP-3, and estrogen, all of which can contribute to acne
- Triggers a large insulin response
- Casein protein can damage the gut
- Contains high amounts of calcium, which can impair zinc absorption
- Allergy to dairy or lactose is extremely common
All of these factors are huge contributors to acne. Dairy is one of the only food groups that triggers just about every root cause of acne.
For these reasons, I’d generally recommend cutting out all dairy (except ghee) for at least 30 days. While it probably won’t take 30 days to see significant improvements, this will give your body a break so that if you decide to start adding dairy back into your diet you can easily isolate which products are giving you trouble.
If you decide you can’t give up your love of dairy, try and minimize the damage by buying high-quality dairy:
- Grass-fed & organic
- Full-fat is much better than low-fat
- Aged/fermented dairy is often better
- Goat & sheep dairy is preferred over cow dairy
- Ghee, butter, and heavy cream are the safest dairy products
If you want a quick and easy way to remember what dairy is safe and which dairy to avoid for clear skin, check out the GoodGlow Diet Blueprint. It has everything you need to get started eating an acne-free diet, all on one page.