Chocolate causes acne
The relationship between chocolate and acne has been debated for decades. Older controlled studies found no link, but more recent small trials have found that high-cocoa chocolate consumption may increase acne lesions in some people, possibly through immune or glycemic mechanisms rather than the chocolate itself.
What we know
The claim that chocolate causes acne was studied rigorously in the mid-20th century. A 1969 study in JAMA - for decades considered definitive - examined acne in participants given either chocolate bars or placebo bars with the same calories and fat, and found no difference in acne development. This led to the widespread dismissal of the chocolate-acne link by dermatologists.
However, the 1969 study had methodological limitations including small sample size and use of cocoa butter in the placebo. More recent small studies have reopened the question. A 2016 study found a statistically significant increase in facial acne lesions in college students 48 hours after consuming chocolate compared to a jelly bean control group (+4.8 vs. -0.7 lesions). A double-blind placebo-controlled study on men with acne found increased comedones and pustules after pure chocolate consumption.
The potential mechanisms are still debated. Some researchers point to the high glycemic index of chocolate (particularly milk chocolate), since high-glycemic diets have more robust evidence as an acne trigger than chocolate specifically. Others point to potential pro-inflammatory effects of certain cocoa components or the sugar and dairy in milk chocolate. Dark chocolate has a lower glycemic index and has not been as specifically implicated.
The current state of evidence is that the chocolate-acne link, while plausible, is not definitively established. It may be real for some individuals or under specific conditions, and the effect is likely small. Acne causation is multifactorial, involving hormones, genetics, sebum production, and bacterial colonization.
Common claims
- Eating chocolate causes or worsens acne in everyoneNot established for all; evidence mixed
- The chocolate-acne link was proven false by a 1969 JAMA studyStudy had limitations; newer evidence is mixed
- Dark chocolate is as acne-causing as milk chocolateUnclear; dark chocolate has lower glycemic index
- Diet has no effect on acneHigh-glycemic diets do have evidence for acne worsening
Evidence hierarchy
All sources
- Effect of chocolate on acne vulgarisJAMA / JAMA Network · 1969
- Chocolate consumption may make acne vulgaris worseAmerican Academy of Family Physicians · 2017
- Double-blind placebo-controlled study assessing the effect of chocolate on acne (JCAD)Journal of Clinical and Aesthetic Dermatology / PMC · 2014
- The relationship between chocolate consumption and skin healthFoods / PMC · 2024