Does Dairy Contribute to Teen Acne?

Acne vulgaris is extremely common during adolescence, and many ask whether diet—including dairy—plays a role. Over the last two decades, observational studies and meta-analyses have examined whether milk, skim/low-fat milk, or other dairy intake is associated with acne in teens and young adults. Below are five notable studies (and a few reviews) with links and main findings.

1. High school dietary dairy intake and teenage acne (Burris et al., 2005)

Link: PubMed abstract — High school dietary dairy intake and teenage acne PubMed
Key points:

  • This observational study looked at high school students’ self-reported dairy intake and prevalence of acne, adjusting for age, BMI, etc.

  • They found a positive association between total milk intake and acne (prevalence ratio 1.22 for highest vs lowest category) and a similar (though somewhat weaker) trend for skim milk. PubMed

  • The authors hypothesized that hormones or bioactive molecules in milk might partly explain this association. ScienceDirect+1

2. Milk consumption and acne in adolescent girls (Adebamowo et al., 2005)

  • Among adolescent girls, those with higher milk intake (≥ 2 servings/day vs <1/week) had higher prevalence of acne:

    • Total milk: PR ≈ 1.20 (95% CI 1.09–1.31)

    • Whole milk: PR ≈ 1.19

    • Low-fat milk: PR ≈ 1.17

    • Skim milk: PR ≈ 1.19 PubMed+2eScholarship+2

  • The associations held even when excluding girls using hormonal contraceptives. eScholarship+1

3. Milk consumption and acne in teenaged boys (Danby et al. / cohort from Growing Up Today Study)

Link: PMC full text — Milk consumption and acne in teenaged boys PMC
Highlights:

  • This prospective cohort among boys (aged ~9–15 at baseline) investigated dairy intake and subsequent acne risk.

  • The highest vs lowest intake of skim milk was associated with prevalence ratio ≈ 1.19 (1.01–1.40). PMC

  • The authors discussed the possibility that skim milk or low-fat milks contain hormonal or bioactive constituents that could influence acne development. PMC

4. Consumption of dairy in teenagers with and without acne (Shen et al. / J Am Acad Dermatol, 2016)

Link: PubMed abstract — Consumption of dairy in teenagers with and without acne PubMed+1
Main results:

  • In this case-control style study, participants with acne reported significantly higher consumption of low-fat/skim milk, but not full-fat milk, compared to those without acne. PubMed

  • No significant differences were seen in overall dairy intake, saturated fat, glycemic load, or BMI between groups. PubMed

  • The authors caution that this is cross-sectional and self-report, so causality can’t be inferred. J Am Acad Dermatol+1

5. Dairy consumption and acne: a case-control study in Kabul, Afghanistan (Aalemi et al.)

Link: Full text — Dairy consumption and acne: a case control study in Kabul Dove Medical Press
Key findings:

  • Among youth aged 10–24, consuming whole milk ≥ 3 days/week was associated with moderate-to-severe acne (OR = 2.36, 95% CI 1.39–4.01). Dove Medical Press

  • Low-fat milk also showed a positive but weaker association (OR = 1.95, 95% CI 1.10–3.45). Dove Medical Press

  • The study also found that having a family history of acne strongly increased risk (OR ≈ 4.13 for siblings). Dove Medical Press

Meta-Analyses and Systematic Reviews

Because individual studies may have limited power, meta-analyses help synthesize results across many studies. A few of the more relevant ones:

  • “Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-analysis” (published in Nutrients)
    This review included 14 observational studies (n ≈ 78,529). They reported that dairy intake was associated with higher odds of acne: OR ≈ 1.25 (any dairy), OR ≈ 1.28 (any milk), OR ≈ 1.22 (whole milk), OR ≈ 1.32 (low-fat/skim), and OR ≈ 1.22 for cheese, OR ≈ 1.36 for yogurt. PMC+1

  • “Dairy intake and acne development: A meta-analysis”
    This meta-analysis found positive relationships for dairy overall, total milk, whole milk, low-fat milk, and skim milk. The OR for skim milk was particularly strong (OR ≈ 1.82). PubMed+2ScienceDirect+2

  • “Diet and acne: A systematic review” (JAAD International, 2022)
    This more recent review found that the evidence for dairy is less consistent across populations, and suggested that dairy's pro-acne effects may be more pronounced in Western-diet populations. JAA International+1

Interpretation, Mechanisms, and Limitations

What these studies suggest, and what they don’t

  • Many observational studies point to a positive association between milk (especially skim or low-fat) and acne in adolescents.

  • The associations are modest (i.e. not huge effect sizes) and vary by dairy type, population, sex, and study design.

  • Causation is not established: confounding factors (diet overall, sugar, glycemic load, hormones, lifestyle) could influence both dairy intake and acne risk.

  • Some studies show no association or weaker links, especially for yogurt, cheese, or fermented dairy.

  • Meta-analyses suggest that the association is present, but heterogeneity, publication bias, and study quality issues remain.

Proposed biological mechanisms

Researchers propose several pathways by which dairy might influence acne:

  1. Hormones / growth factors in milk

    • Milk naturally contains low levels of androgens, estrogens, and insulin-like growth factor-1 (IGF-1), which might stimulate sebum production or follicle keratinization.

    • Skim and low-fat milks may have relatively higher insulinogenic proteins (whey) and fewer fat-soluble inhibitory compounds.

  2. Effect on insulin / IGF-1 axis

    • Dairy proteins, especially whey and casein, may increase insulin and IGF-1 signaling, which can upregulate pathways (e.g. mTOR) that promote sebaceous gland lipogenesis.

    • Elevated IGF-1 levels have been associated with acne severity in some studies.

  3. Inflammation / microbiome effects

    • Some hypothesize that dairy may induce low-grade systemic inflammation or alter gut microbiota in susceptible individuals, which could contribute to cutaneous inflammation.

  4. Interaction with glycemic load / diet

    • Dairy may interact with high glycemic diets (which themselves impact insulin/IGF pathways), exacerbating the effect.

Limitations & caveats to keep in mind

  • Observational nature — none (to date) are randomized controlled trials where dairy intake was manipulated with acne as a primary outcome.

  • Self-reported diet — recall bias, misreporting, measurement error.

  • Population-specific effects — associations may differ by ethnicity, genetics, baseline diet, or geography.

  • Publication bias / heterogeneity — positive findings are more likely to be published; meta-analyses detect heterogeneity.

  • Reverse causality — e.g. teens with acne might change their diet (though less likely for milk).

  • Effect size modestness — dairy is unlikely to be the sole or dominant driver of acne for most individuals.

The body of evidence suggests a modest but consistent positive association between milk (especially skim/low-fat) consumption and acne in adolescents. However, the evidence is not definitive proof that dairy causes acne, and responses likely vary by individual susceptibility, overall diet, hormonal milieu, and genetics.

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