Myth or Truth Does Chocolate Cause Acne

(Last Updated On: August 3, 2018)

Does chocolate cause acne? You might think that this question should have an easy, “yes” or “no” answer, but like so many health-related questions, the answer to this one is, “well it depends”.

In this article, we’ll go through what actually happens to your skin when you have acne and the factors that contribute to the condition. But first, we’ll make sure that we’re on the same page with our definition of chocolate.

Some Chocolate Bars Are Mostly Sugar

Some Chocolate Bars Are Mostly Sugar

Many of those tasty bars on the grocery store shelf don’t contain much chocolate at all. Instead, they’re a mixture of sugar, vegetable oil, colors and flavors.

The raw material for real chocolate – cocoa solids – comes from the cacao tree. Cocoa has a very bitter taste, so to make it palatable, the cocoa solids are mixed with varying amounts of sugar and other ingredients. The resulting chocolate is dark and still quite bitter.

Premium quality dark chocolate usually has the percentage of cocoa solids it contains displayed prominently on the front of the wrapper, for example, the 99% on Lindt Excellence Cacao.

Cocoa solids are expensive, while the cost of the other ingredients is fairly negligible in comparison, so the more cocoa solids in your bar of chocolate, the higher the price tag.

Milk chocolate will have a smaller percentage of cocoa solids – a good quality milk chocolate will have around 35% cocoa solids, and the milk will be full cream milk (in powdered form). Milk content will be in the region of 30 to 35%, which means that other ingredients make up the final one third of the chocolate bar.

Those ingredients will include an emulsifier (usually soy or sunflower lecithin), sugar, more fat in the form of butter or vegetable oil, and flavoring (most often vanilla).

Sugar is a major component of most chocolate bars. A standard Hershey Bar is over 50% sugar – a 43 gram bar contains 24 grams of sugar. Cadbury Milk Chocolate has a similar sugar content, with their 45 gram bar containing 25 grams of sugar.

So depending on which type of chocolate you’re prefer to eat, and the ingredients used to make your sweet treat, the question you really need answering is “what effect do these ingredients have on my skin?”

Before we get to the effects of those ingredients, it’s important to understand the process behind acne.

Acne Is A Complex Condition Involving Bacteria And Structurally Weak Skin

Acne Is A Complex Condition Involving Bacteria And Structurally Weak Skin

Everyone has a lively bacterial community living on every inch of their skin. This community is vital to health and well being, but sometimes the bacterial community is thrown out of balance, allowing one type of bacteria to achieve dominance. The most common bacteria found in cases of acne is P. acnes.

On healthy skin, P. acnes doesn’t cause problems, but in compromised skin, the bacteria causes an immune system reaction that results in the chronic inflammation associated with acne.

The P. acnes bacteria isn’t the only troublemaker around when you have acne. Healthy skin has a very important outer layer called the acid mantle. The acid mantle is formed from the natural oil that your skin produces (sebum) and the acids produced by bacteria.

The mantle locks moisture and nutrients into your skin and keeps bacteria, pollutants and other toxins out.

But when you have acne, your sebum can’t form a strong mantle and your skin is wide open to attack.

Let’s take a closer look at how this whole thing works.


presence of sebum

Though often identified (incorrectly) as the main cause of acne, the presence of sebum is actually helpful – as already mentioned, sebum helps to form the protective layer that’s so vital for healthy skin.

But when you have acne your skin is

  • producing too much sebum
  • producing damaged sebum

Sebum is made up of triglycerides (41%), wax esters (26%), free fatty acids (16%) and squalene (12%).

The two main culprits in this list are squalene and a free fatty acid called linoleic acid.



If you’re a user of higher-end skincare products, you may have noticed squalene on product ingredient panels. Squalene – undamaged squalene – is a vital component of healthy skin. But when squalene is damaged, it’s your worst enemy.

Damaged squalene has undergone a change caused by oxidation, and this oxidized, altered squalene is known as squalene peroxide. Squalene peroxide levels in your skin directly correlate to the severity of acne.

Healthy sebum, with its undamaged fraction of squalene doesn’t clog pores. Sebum with oxidized squalene does, it’s highly comedogenic.

Studies have shown that the level of squalene peroxide in the sebum of acne sufferers is almost 80% higher than in the sebum of people with healthy skin.

When researchers want to induce acne on lab animals, they apply squalene peroxide.

Linoleic Acid

Linoleic Acid

Linoleic acid is a crucial fatty acid. In the skin it maintains the flexibility of the pore wall and keeps it intact.

Skin which overproduces sebum has a lower concentration of linoleic acid than healthy skin. Studies have shown that the level of linoleic acid in the sebum of people with acne can be as much as 65% lower than the level in non acne sufferers.

When skin doesn’t have access to enough linoleic acid, the pore wall develops tiny holes which cause it to weaken. A weakened pore – overloaded with sebum – is likely to rupture, allowing the debris, bacteria and toxins from the clogged pore to flood into the surrounding tissue where they cause the inflammation that you know as acne.

These two components of damaged sebum – oxidized squalene and insufficient linoleic acid – work to deliver a one-two punch to your skin. Lack of linoleic acid weakens the pore wall and oxidized squalene causes the sebum to congeal and block the pore. As more sebum flows into the pore, the wall cannot hold and it ruptures.

Damaged Sebum Isn’t The Only Thing That Clogs Pores

Damaged Sebum Isn’t The Only Thing That Clogs Pores

The main protein in your skin is a substance called keratin. Keratin binds skin cells together. Squalene peroxide causes your skin to increase keratin production.

When everything is working properly, dead skin cells are continuously pushed out of the pores of your skin and brought to the surface where they are gobbled up by bacteria, worn away or washed off.

However, the overproduction of keratin causes dead skin cells to stick together instead of separating for smooth elimination.

Instead of the swift removal of dead cells, carried away one at a time by free flowing, healthy sebum, you have clumps of cells which can’t move in the thick sludge of a clogged pore. These clumps clog up the pore even more.

But that’s not all! Too much keratin also compromises the flexibility of pore walls and makes the already weakened walls brittle. These fragile walls simply can’t hold back the contents of a clogged pore and will inevitably rupture. But before the walls give way, the bulging pore provides the perfect breeding ground for bacteria.

P. Acnes – The Acne Causing Bacteria

P. Acnes - The Acne Causing Bacteria

The main bacteria involved in acne is called Propionibacterium acnes (or P. acnes for short). This is a common type of bacteria which we all carry, it lives inside our skin pores (which are actually hair follicles) and it usually doesn’t cause any problems.

But when pores become blocked with damaged sebum and clumps of dead skin cells, the bacteria have a limitless food supply which allows them to multiply wildly.

This rapidly growing microbial population and its by-products (enzymes and metabolic wastes or toxins) add to the bulk inside the pore.

Once sufficient numbers of bacteria are present, their enzymatic secretions and wastes cause further damage to your skin.

Enzymes secreted by the bacteria break down collagen and keratin, further damaging the integrity of your skin.

These secretions also alter the pH balance of your skin to make the area even more hospitable for their community. This disrupted pH causing more weakening of your acid mantle which allows other opportunistic bacteria to join the party on the inside.

When the weakened pore ruptures, the bacteria flow out into surrounding tissue. Once your immune system detects the bacteria, it swings into action sending out special immune cells on a search and destroy mission.

But the bacteria have other plans and being the ancient, resilient life-forms that they are, they have a sturdy defense mechanism to protect them from your immune systems best efforts.

Immune System Response And Inflammation

Immune System Response And Inflammation

Your immune system is a complex and wonderful thing, and it’s smart enough to recognize friendly bacteria from harmful pathogens. It also knows when friendly bacteria get into places where they shouldn’t be.

Take the friendly flora that lives in your gut as an example. Without these helpful bacteria, you wouldn’t be able to digest your food. As long as these bacteria confine themselves to your gut, all is well, but if your intestinal lining perforates and these bacteria get into your abdominal cavity, you’re in big trouble.

Your immune system sees the bacteria in your gut as ‘friend’, but if the same bacteria gets outside the gut, it instantly becomes ‘foe’.

The same thing happens with the P. acnes in your skin. Inside the pore, this bacteria is ‘friend’, outside the pore it’s ‘foe’.

Once the pore ruptures and spills its contents, your immune system readies the troops and sends them into battle. The troops, in this case, are white blood cells called neutrophils.

So far, so good, but unfortunately the bacteria are already one step ahead of your immune system.

One of the enzymes that the bacteria excrete to break down collagen and keratin is called protease. But protease isn’t a one trick pony, it also has the ability to kill the neutrophils that your immune system sends out.

In response, your immune system just keeps on sending out more neutrophils as it attempts to rid the tissue of the offending bacteria.

When your body mounts an immune response, inflammation is the unavoidable result. Blood vessels widen and blood flow increases to transport the white blood cells to the site of infection as quickly as possible. This increased traffic flow causes congestion.

When you have a cut on your arm, the area will redden and swell as your immune system sends infection fighting cells and skin rebuilding cells to the site of injury. The resulting inflammation is a necessary part of the healing process and is usually short lived because once the repair work is complete there is no longer any need for a continuing immune response in that area.

But because the P. acnes bacteria destroy the white blood cells sent out to defeat them, the clean up and repair job is never completed, and your immune system can’t stand down. This chronic inflammation produces the redness and swelling so characteristic of acne.

Quick Recap

pores become clogged with damaged sebum and clumps of dead skin cells

P. acnes, a normally harmless type of bacteria lives inside your pores. When pores become clogged with damaged sebum and clumps of dead skin cells, the bacteria have all the food they need to rapidly multiply.

The excess sebum, dead skin cells, and colony of bacteria cause the pore to swell, and because the pore walls are structurally weak and brittle, the increased pressure causes them to rupture, flooding the surrounding tissue with bacteria and toxic wastes.

Too much sebum with its damaged squalene and insufficient linoleic acid results in weak, clogged pores and a feasting ground for bacteria.

At this point, you might think, “Okay then, I need to steam my pores open to release the clogged sebum and dead skin cells, and then I need to apply some kind of antibacterial substance to kill the bacteria that my immune system is helpless against.”

While this approach will help to reduce the inflammation, it won’t stop the underlying process that is causing the acne in the first place. – the overproduction of damaged sebum. Take steps to tackle that problem and you’ll get your acne under control. Which brings us onto hormones.

Hormone Disruption

Hormone Disruption

It’s time to talk about hormones, and the two we need to talk about are testosterone and insulin.

Testosterone is an androgenic hormone present in both sexes, although far more prevalent in males.

Androgens increase the amount of sebum the skin produces. Researchers have found that people with acne produce almost 60% more sebum than those with healthy skin.

More sebum equals more squalene (and more squalene to get damaged), and less linoleic acid.

What about insulin? Insulin increases sensitivity of the skin to all of that extra testosterone which then sends sebum production into overdrive. But that’s not all.

Your skin has the ability to convert testosterone into an even more potent androgenic hormone called dihydrotestosterone. This process is carried out by converting enzymes in the skin, enzymes which boost their activity when high levels of insulin are present. Dihydrotestosterone causes even more sebum to be produced.

Insulin is released to control blood sugar levels, which have to be kept within strict limits. Too much sugar rushing into your bloodstream prompts your pancreas to release insulin which shuttles the sugar into fat cells where it can’t do any immediate harm.

Cutting out sugar (a major ingredient in chocolate) and other carbohydrate rich foods is known to be a helpful step you can take to clear up acne. This is because less sugar results in less insulin, which results in less testosterone and dihydrotestosterone, and less sebum.

A good eating plan to follow if you want to cut carbs is the Paleo Diet. This is rich in healthy vegetables, grass fed meat, and good fats like butter, coconut oil and olive oil, while low in grains, harmful vegetable oils, and simple carbohydrates.

Yes, this flies in the face of long-standing official nutritional advice which urges high consumption of carbohydrates and processed vegetable oils, but more recent research shows those guidelines to be seriously flawed.

To learn more about Paleo, head over to Mark’s Daily Apple where you’ll find expert advice backed up by research, and a supportive, lively community of fellow health seekers.

Excess insulin isn’t the only culprit behind elevated testosterone levels. If you already follow a low carb diet, other factors could be at work. These include estrogen and progesterone balance, thyroid health, leptin resistance and adrenal fatigue. For more information take a look at this article which takes an in-depth look at the causes of elevated testosterone in women.

To recap, we now know that two important hormones when present at too high a level cause excess sebum production. Excess sebum on its own won’t give you acne, it will give you greasy skin and weakened pore walls, but for acne to take hold the sebum needs to be damaged, which brings us to the last part of the acne puzzle, oxidative damage.

Lack Of Antioxidant Protection

Lack Of Antioxidant Protection

Oxidation is an unavoidable consequence of being alive. This process happens every second of every day of your life. Unchecked oxidation is extremely harmful, but happily our bodies have strong protection against the effects of oxidation thanks to antioxidants.

Antioxidants work to prevent oxidative damage in the first place and to stop oxidation that is already underway.

We use two types of antioxidants, those which we manufacture ourselves and those which we need to obtain through our diet. These dietary antioxidants include vitamin C and vitamin E.

Oxidized sebum is the consequence of having insufficient antioxidant reserves. The reasons for low antioxidant reserves are many.

Today’s food is nutritional inferior due to the way it’s grown, harvested and stored. Combating environmental pollution and sun damage uses a lot of your body’s antioxidants, as does stress and lack of sleep, allergies, illness, and chronic disease conditions.

Researchers investigating the link between low levels of antioxidants and acne found startling differences when they compared blood antioxidant levels of acne sufferers with those of non acne sufferers.

They found levels of vitamin A were 33% lower, vitamin C levels 40% lower, vitamin E levels 45% lower, and beta-carotene levels 65% lower in those with acne.

To prevent oxidation of the squalene in sebum, you must consume a diet rich in antioxidants. Good foods to choose include:

  • Purple and red grapes
  • Berries – blueberry, blackberry, raspberry, strawberry
  • Dark leafy greens – kale, collards, spinach, broccoli
  • Sweet potato
  • Carrots
  • Bell peppers
  • Green and black tea
  • Plums
  • Apples
  • Cherries
  • Kidney Beans
  • Nuts

Another way to boost important antioxidants is through dietary supplements. The most important skin antioxidants are vitamin C and vitamin E.

It’s easy to find a good vitamin C supplement, all you need to do is look for pharmaceutical grade ascorbic acid, either in powder form (most economical) or tablet form.

A good vitamin E supplement is a little trickier to pin down. Most vitamin E on sale contains only d-Alpha tocopherol, while the complete vitamin E that is found naturally in foods contains 4 different tocopherols and 4 tocotrienols.

D-Alpha tocopherol taken in isolation has no known benefits and there is some concern that it is actually harmful when taken regularly.

To get the full benefits of vitamin E from a supplement you should use a complete vitamin E complex that contains:

  • d-Alpha tocopherol
  • d-Beta tocopherol
  • d-Gamma tocopherol
  • d-delta tocopherol
  • d-Alpha tocotrienol
  • d-Beta tocotrienol
  • d-Gamma tocotrienol
  • d-delta tocotrienol

A good product combining all 8 factors is Vitacost Vitamin E & Tocotrienol Complex which is available from Amazon.

So Where Does Chocolate Fit Into All Of This?

Cheap chocolate candy bars are mostly sugar

Cheap chocolate candy bars are mostly sugar, which is a pro-oxidant and which will lead to insulin release.

The milk powder used in milk chocolate contains the milk sugar lactose, this is another simple sugar which will cause an insulin spike.

These bars also contain vegetable oils which are oxidized during production of the oil itself and further damaged when heated during chocolate production.

Any time you ingest oxidized foods, your body has to use up some of your precious antioxidant reserves to prevent damage. The more antioxidants your body has to use on these types of ingredients, the less it has available to prevent oxidation of your sebum.

As for cocoa, that all important ingredient in real chocolate, you’ll be glad to know that there is no evidence linking consumption to acne. There is however, plenty of research that shows that cocoa can combat inflammation, and that’s because cocoa is actually an antioxidant!

In its raw form cocoa has more 20 times more antioxidant power than blueberries. Once cocoa is processed, it loses some of that antioxidant punch, but if you choose high cocoa content, dark chocolate or raw, unprocessed cocoa nibs, you’ll actually increase your antioxidant reserves.

Eating low quality chocolate won’t cause acne by itself because as you’ve seen there’s a whole cascade of problems raging behind the scenes. If your diet is healthy, low in sugar and rich in antioxidants, indulging in your favorite treat now and then won’t cause you to break out.

But if you already suffer from acne, the added sugar in a low quality bar will push more insulin into your system, causing higher testosterone levels and excess sebum production. And that sebum will readily oxidize because your antioxidant levels are low.

Acne can be a difficult condition to get control of. If switching to a healthier diet doesn’t lead to improvements in your skin, it would be a good idea to follow the advice given in the article linked to in the hormone section of this page.

Written by Irina Radosevic MD
Irina graduated from the University of Belgrade, School of Medicine as a Doctor of Medicine (MD) and spent over 3 years working in the Clinical Hospital Center Zvezdara, in the Department of Emergency Medicine. She also undertook a postgraduate in Cardiology from the same University and had previously worked for over a year as a Physician and Nutritionist Dietitian for the Fitness club Green Zone. She eventually left her chaotic but fulfilling job in the ER to pursue her passion of writing, travelling and mountain climbing which has included writing a first aid course for the alpine club of Belgrade. Irina currently works as a VA for PintMedia focusing on medical and travel writing. Feel free to connect with Irina on LinkedIn and FaceBook. Her CV can be seen here.