Glycemic Load and Acne

  • Robyn Smith
  • Neil Mann

Core Messages

  • Acne affects 80–90% of individuals during puberty, which is a period associated with a normal decline in insulin sensitivity (Bloch et al, J Pediatr 110:481–487, 1987). Hyperinsulinemia stemming from insulin resistance may play a key role in activating a hormonal milieu conducive for acne development.

  • Acne remains relatively unknown among non-Westernized societies existing on low-glycemic-load diets, and prevalence rates increase when a previously unaffected society is exposed to refined, high-glycemic-index carbohydrates.

  • Low-glycemic-load diets may represent a unique dietary strategy for alleviating acne symptoms through improving insulin metabolism.


Placebo Cholesterol Sugar Obesity Depression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Aizawa H, Niimura M. Elevated serum insulin-like growth factor-I (IGF-I) levels in women with postadolescent acne. J Dermatol. 1995;22(4):249–52.PubMedGoogle Scholar
  2. Aizawa H, Niimura M. Mild insulin resistance during oral glucose tolerance test (OGTT) in women with acne. J Dermatol. 1996;23:526–9.PubMedGoogle Scholar
  3. Bendiner E. Disastrous trade-off: Eskimo health for white civilization. Hosp Pract. 1974;9:156–89.Google Scholar
  4. Bloch C, Clemons P, Sperling M. Puberty decreases insulin sensitivity. J Pediatr. 1987;110:481–7.PubMedCrossRefGoogle Scholar
  5. Bornet F et al. Insulinemic and glycemic indexes of six starch-rich foods taken alone and in a mixed meal by type 2 diabetics. Am J Clin Nutr. 1987;45:588–95.PubMedGoogle Scholar
  6. Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepidandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. 2005;141:333–8.PubMedCrossRefGoogle Scholar
  7. Ciotta L et al. Clinical, endocrine and metabolic effects of acarbose, an a-glucosidase inhibitor, in PCOS patients with increased insulin response and normal glucose tolerance. Hum Reprod. 2001;16(10):2066–72.PubMedCrossRefGoogle Scholar
  8. Colagiuri S, Brand-Miller J. The ‘carnivore connection’ – evolutionary aspects of insulin resistance. Eur J Clin Nutr. 2002;56:S30–5.PubMedCrossRefGoogle Scholar
  9. Cordain L et al. Acne vulgaris – a disease of Western civilization. Arch Dermatol. 2002;138:1584–90.PubMedCrossRefGoogle Scholar
  10. Cormia F. Food sensitivity as a factor in the etiology of acne vulgaris. J Allergy. 1940;12:34–41.CrossRefGoogle Scholar
  11. Deplewski D, Rosenfield R. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentiation. Endocrinology. 1999;140:4089–94.PubMedCrossRefGoogle Scholar
  12. Deplewski D, Rosenfield R. Role of hormones in pilosebaceous unit development. Endocr Rev. 2000;21:363–92.PubMedCrossRefGoogle Scholar
  13. Dunaif A et al. Profound peripheral insulin resistance, independent of obesity in polycystic ovary syndrome. Diabetes. 1989;38:1165–74.PubMedCrossRefGoogle Scholar
  14. Eming S et al. Targeted expression of insulin-like growth factor to human keratinocytes: modification of the autocrine control of keratinocyte proliferation. J Invest Dermatol. 1996;107:113–20.PubMedCrossRefGoogle Scholar
  15. Foster D, Nagatani S. Physiological perspectives on leptin as a regulator of reproduction: role in timing puberty. Biol Reprod. 1999;60:205–15.PubMedCrossRefGoogle Scholar
  16. Foster-Powell K, Holt S, Brand-Miller J. International table of glycemic index and glycemic load values. Am J Clin Nutr. 2002;76:5–56.PubMedGoogle Scholar
  17. Fulton J, Plewig G, Kligman A. Effect of chocolate on acne vulgaris. JAMA. 1969;210(11):2071–4.PubMedCrossRefGoogle Scholar
  18. Godsland I et al. The insulin resistance syndrome in postmenopausal women with cardiological syndrome X. Br Heart J. 1995;74:47–52.PubMedCrossRefGoogle Scholar
  19. Goulden V, Clarke SM, Cunliffe WJ. Post adolescent acne: a review of clinical features. Br J Dermatol. 1997;136(1):66–70.PubMedCrossRefGoogle Scholar
  20. Holt SH, Miller JC, Petocz P. An insulin index of foods: the insulin demand generated by 1000 kJ portions of common foods. Am J Clin Nutr. 1997;66:1264–76.PubMedGoogle Scholar
  21. Homko C et al. Insulin secretion during and after pregnancy in patients with gestational diabetes mellitus. J Clin Endocrinol Metab. 2001;86:568–73.PubMedCrossRefGoogle Scholar
  22. Ibáñez L et al. Hyperinsulinemia and decreased insulin-like growth factor-binding protein-1 are common features in prepubertal and pubertal girls with a history of premature pubarche. J Clin Endocrinol Metab. 1997;82:2283–8.PubMedCrossRefGoogle Scholar
  23. Jenkins D, Wolever T, Taylor R. Glycaemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 1981;134:362–6.Google Scholar
  24. Kazerooni T, Dehghan-Kooshkghazi M. Effect of metformin therapy on hyperandrogenism in women with polycystic ovary syndrome. Gynecol Endocrinol. 2003;17:51–6.PubMedGoogle Scholar
  25. Kolodziejczyk B et al. Metformin therapy decreases hyperandrogenism and hyperinsulinemia in women with polycystic ovary syndrome. Fertil Steril. 2000;73:1149–54.PubMedCrossRefGoogle Scholar
  26. Liu S. Intake of refined carbohydrates and whole grains in relation to risk of type 2 diabetes mellitus and coronary heart disease. J Am Coll Nutr. 2002;21:298–306.PubMedCrossRefGoogle Scholar
  27. Lucky A et al. Acne vulgaris in early adolescent boys: correlations with pubertal maturation and age. Arch Dermatol. 1991;127:210–6.PubMedCrossRefGoogle Scholar
  28. Ludwig D. Dietary glycemic index and obesity. J Nutr. 2000;130 Suppl 2:280S–3.PubMedGoogle Scholar
  29. Luque R, Kineman R. Impact of obesity on the growth hormone axis: evidence for a direct inhibitory effect of hyperinsulinemia on pituitary function. Endocrinology. 2006;147:2754–63.PubMedCrossRefGoogle Scholar
  30. Mackie B, Mackie L. Chocolate and acne. Aust J Dermatol. 1974;15:103–9.CrossRefGoogle Scholar
  31. Miller D, Emans S, Kohane I. Follow-up study of adolescent girls with a history of premature pubarche. J Adolesc Health. 1996;18:301–5.PubMedCrossRefGoogle Scholar
  32. Moran A et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes. 1999;48:2039–44.PubMedCrossRefGoogle Scholar
  33. Moran A et al. Association between the insulin resistance of puberty and the insulin-like growth factor-I/growth hormone axis. J Clin Endocrinol Metab. 2002a;87:4817–20.PubMedCrossRefGoogle Scholar
  34. Moran A et al. Association between insulin resistance of puberty and insulin-like growth factor-I/growth hormone axis. J Clin Endocrinol Metab. 2002b;87:4817–20.PubMedCrossRefGoogle Scholar
  35. Pijl H et al. Altered neuroregulation of GH secretion in viscerally obese premenopausal women. J Clin Endocrinol Metab. 2001;86:5509–15.PubMedCrossRefGoogle Scholar
  36. Powell D et al. Insulin inhibits transcription of the human gene for insulin-like growth factor-binding protein-1. J Biol Chem. 1991;266(28):18868–76.PubMedGoogle Scholar
  37. Pulido J, Salazar M. Changes in insulin sensitivity, secretion and glucose effectiveness during the menstrual cycle. Arch Med Res. 1999;30:19–22.CrossRefGoogle Scholar
  38. Qu X-D et al. Influence of body mass index and gender on growth hormone (GH) responses to GH-releasing hormone plus arginine and insulin tolerance tests. J Clin Endocrinol Metab. 2004;90:1563–9.PubMedCrossRefGoogle Scholar
  39. Reynolds R et al. Effect of the glycemic index of carbohydrates on Acne vulgaris. Nutrients. 2010;2:1060–72.PubMedGoogle Scholar
  40. Schaefer O. Pre- and post-natal growth acceleration and increase sugar consumption in Canadian Eskimos. Can Med Assoc J. 1970;103:1059–68.PubMedGoogle Scholar
  41. Schaefer O. When the Eskimo comes to town. Nutr Today. 1971;6:8–16.CrossRefGoogle Scholar
  42. Shaw J, White L. Persistent acne in adult women. Arch Dermatol. 2001;137:1252–3.PubMedGoogle Scholar
  43. Singh A et al. Effect of insulin-like growth factor-type I (IGF-I) and insulin on the secretion of sex hormone binding globulin and IGF-I binding protein (IBP-I) by human hepatoma cells. J Endocrinol. 1990;124:R1–3.PubMedCrossRefGoogle Scholar
  44. Smith R et al. A low glycemic load diet improves symptoms in acne vulgaris patients. A randomized controlled trial. Am J Clin Nutr. 2007a;86:107–15.PubMedGoogle Scholar
  45. Smith R et al. The effect of a high protein, low glycemic load diet versus a conventional, high glycemic load diet on biochemical parameters associated with acne vulgaris. A randomized, investigator-masked, controlled trial. J Am Acad Dermatol. 2007b;57:247–56.PubMedCrossRefGoogle Scholar
  46. Stathakis V, Kilkenny M, Marks R. Descriptive epidemiology of acne vulgaris in the community. Australas J Dermatol. 1997;38:115–23.PubMedCrossRefGoogle Scholar
  47. Sydney University: The official website of the glycemic index and GI database. 2010. Accessed 2010.
  48. Thiboutot D, Lookingbill D. Acne: acute or chronic disease? J Am Acad Dermatol. 1995;32:S2–5.PubMedCrossRefGoogle Scholar
  49. US Department of Health Education and Welfare. Skin conditions of youths 12–17 years. United States. In: Data from the National Health Survey. Series 11. Number 157. DHEW Publication No. 76–1639. Rockville: DHEW; 1976.Google Scholar
  50. Welsh S, Davis C, Shaw A. USDA’s food guide: background and development. United States Department of Agriculture, Human Nutrition Information Service. Publication Number 1514. Hyattsville: MD; 1993.Google Scholar
  51. White C. Acneform eruptions of face: etiologic importance of specific foods. J Am Med Assoc. 1934;103:1277–9.Google Scholar
  52. Williams T et al. Impaired growth hormone response to growth hormone-releasing factor in obesity. A pituitary defect reversed with weight reduction. N Engl J Med. 1984;311:1403–7.PubMedCrossRefGoogle Scholar
  53. Willis D et al. Modulation by insulin of follicle stimulating and luteinizing hormone action in human granulosa cells of normal and polycystic ovaries. J Clin Endocrinol Metab. 1996;81:302–9.PubMedCrossRefGoogle Scholar
  54. Wise F, Sulzberger M. The role of the general practitioner in the modern treatment of acne ­vulgaris. In: The 1933 year book of dermatology and syphilology. Chicago: The Year Book Publishers; 1933. p. 7–12.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Baker IDI Heart and Diabetes InstituteMelbourneAustralia
  2. 2.School of Applied SciencesRMIT UniversityMelbourneAustralia

Personalised recommendations