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Is Pizza Bad for Acne?

Follow These Suggestions to Enjoy Pizza When You Have Acne

By: Dan Kern, Acne.org Founder & CSO
Last updated: July 02, 2019

The Essential Information

The dermatological community still does not know whether diet impacts acne. Until we have better studies, everything regarding diet and acne is still unclear. However, we do have some initial evidence that points toward the possibility that:

When it comes to pizza, it contains a high glycemic crust and cheese, and is high in calories. However, it can also be loaded with potentially beneficial ingredients like vegetables. So, as with most things in life, it comes down to moderation. From the evidence we have, it is probably not a great idea to eat pizza as a main part of your diet if you are acne-prone, but having a slice or two on occasion may be perfectly fine.

If you want to enjoy pizza in the most responsible way, choose a thin crust variety and load it up with veggies!

The Science

Scientists do not know whether diet impacts acne. This means that we do not know, for sure, whether pizza causes acne. However, researchers have studied the impact of various ingredients that are used to make pizza on acne. This evidence points towards the possibility that:

  • High glycemic foods, like the pizza crust, may not be the best idea if you have acne.
  • Dairy products, like the cheese, might also not be ideal for acne. But, less is known about dairy's effect on acne.
  • High caloric foods might not be ideal for acne.

But eating pizza is truly only a concern if you eat too much of it. If eaten in moderation, pizza is probably fine for acne.

Eating pizza is only a convern if you eat too much of it. If eaten in moderation, pizza is probably fine for acne.

So, what does the research say about pizza ingredients and acne? As you read this list, keep in mind again that we are not saying you should never eat pizza, and the jury is very much still out regarding any impact of diet on acne.

Pizza Components and Acne

  • Pizza crust: Bread of any kind, including pizza crust, may not be ideal for acne.
  • Cheese: While there is less evidence showing that dairy products might not be ideal for acne, there are hints that point toward that possibility.
  • Sauce: Vegetable-based foods are probably beneficial for acne, but pizza sauce is a combination of vegetables and high glycemic sugar, so it's a mixed bag.
  • Toppings: Depends on the type of toppings:
    • Meat toppings: Meat is low glycemic and thus should not be bad for acne. But pepperoni and sausage contain lots of calories, and eating a lot of calories may not be good for acne.
    • Vegetable toppings: Vegetables are probably beneficial for acne, so load up your pizza with veggies!

IMPORTANT: Nobody knows how diet affects acne. What we are about to go into is not scientific fact. We are years away from knowing whether diet does in fact directly affect acne, and if so, to what degree. But, let's go ahead and explore each of these ingredients in more detail and see how they might possibly affect acne.

Pizza Crust - High Glycemic Load Food That May Not Be Ideal for Acne

The pizza crust may not be ideal for acne because it is a high glycemic load food.

The glycemic load is a measurement that determines whether a food will cause an increase in the amount of sugar in your blood. High glycemic foods cause a lot of sugar in the blood, and low glycemic foods cause a small amount of sugar in the blood. For example, eating white bread causes a lot of sugar in the blood, so it is a high glycemic food. On the other hand, eating green peppers does not cause a lot of sugar in the blood, so it is a low glycemic food.

Pizza crust is a high glycemic load food. This means that when you eat pizza crust it causes a lot of sugar in the blood.

So, what does this mean for acne?

Well, scientists have performed several studies to examine whether eating high glycemic load foods causes acne. Most of these studies have found that people who eat a lot of high glycemic load foods develop more acne. However, these studies only examined a small number of people, so more research is needed.

To learn more about the studies on glycemic load and acne, click below.

Expand to read details on studies

Studies on Glycemic Load and Acne

How to lower the glycemic load: Since pizza crust is a high glycemic load food, it may not be an ideal food choice for people with acne. However, if you want to still eat pizza crust, there is a way you can bring the glycemic load of pizza crust down. To decrease the glycemic load of pizza crust all you have to do is eat the pizza crust with lots of low glycemic foods, like vegetables. By loading up pizza lots of vegetable toppings you can decrease the glycemic load. This will then decrease the amount of sugar in your blood, which will help decrease potential impacts on acne.

Cheese - Dairy Product That Might Not Be Ideal for Acne, But We Really Do Not Know

According to some initial hypotheses from some dermatology researchers, any dairy product, including the cheese on pizza, might not be ideal for acne.

Journal of the Academy of Nutrition and Dietetics

According to authors of a 2014 article in the Journal of the Academy of Nutrition and Dietetics, "Milk may contribute to acne development because of the hormonal, carbohydrate, or protein content. Milk contains a magnitude of hormones, including reproductive, nonreproductive, and growth hormones, which may individually or synergistically influence acne development."8

In other words, milk has a lot of hormones, and these hormones might potentially trigger more acne.

Since cheese is made from milk, it also contains these hormones. But is there any concrete research that confirms cheese is not ideal for acne? No. Scientists have not studied the effects of cheese on acne. Specifically, cheese contains active cultures which may be beneficial for the gut and thus may lead to better health, including skin health. However, since cheese is made from milk, it is possible that if milk ends up in fact being bad for acne, cheese may also suffer the same fate.

To learn more about the studies on dairy and acne, click below.

Expand to read details on studies

Studies on Dairy and Acne

These studies were mainly performed through questionnaires that asked people about their diets and acne. Questionnaires are not a reliable method of obtaining data because people can say whatever they want on a questionnaire. A better research method would be a randomized controlled trial where scientists divide participants into two groups: one group that consumes dairy and one group that does not consume dairy in order to determine whether dairy causes acne. Until more randomized controlled trials are performed, we will not be sure about what effect, if any, dairy products, including cheese, may have on acne.

Sauce - It's Mixed Bag

Pizza sauce is often made with tomatoes and other vegetables, spices, and sugar. Each of these may have a different impact on acne.

Tomatoes and other vegetables

Vegetables, including tomatoes, are high in antioxidants. Antioxidants are vitamins and minerals that protect the body from inflammation. Since acne is an inflammatory disease, antioxidants might help reduce acne symptoms.12,13

Since pizza sauce is made from tomatoes and other vegetables, it contains antioxidants. So, the antioxidants in pizza sauce might be a good thing for acne.

Spices

It's unclear if spices play any role in acne. For now, we can assume they do not have much effect.

Sugar

Sugar is a high glycemic load food. This means that eating sugar will cause an increase in the amount of sugar in your blood. This may not be ideal for acne.

The amount of sugar in pizza sauce varies. Some sauces contain a small amount of sugar, while other sauces contain a larger amount of sugar, and it is usually impossible to know.

Pizza sauce containing a small amount of sugar is probably best. This is because if the pizza sauce contains a large amount of sugar, then it will have a higher glycemic load. But, remember pizza sauce also has antioxidants, that could be beneficial for acne. So, it's a mixed bag.

Pizza sauce may be beneficial for acne due to the antioxidants, but if it has too much sugar it may not be ideal for acne.

Meat Toppings - High-Caloric Food that May Not Be Ideal for Acne

Foods that contain a lot of calories, like pizza, may not be ideal for acne. Meat toppings also contain calories, so adding meat toppings to pizza results in even more calories.

How might a high-calorie diet affect acne? Researchers believe that eating lots of calories may affect certain hormones involved in acne. These hormones include insulin hormones, which help to regulate the amount of sugar in the blood. Research has found that eating a high-caloric diet increases the amount of insulin hormones, while eating a low-caloric diet decreases the amount of insulin hormones. This is important for acne because insulin hormones control skin oil production. So, the more insulin there is, the more skin oil there is, which might lead to more acne. Since eating a lot of calories may increase the level of insulin hormones, a high-calorie diet may not be ideal for acne.14-17

Since adding meat to pizza increases the total amount of calories, just keep this in mind.

Vegetable Toppings - High in Antioxidants and May Be Beneficial for Acne

Vegetables may be beneficial for acne because vegetables are high in antioxidants.

Just like the vegetables in pizza sauce may be beneficial to acne, adding extra vegetable onto pizza may also be beneficial for acne. This is because vegetables contain antioxidants, which can helps protect from ROS molecules and lower inflammation.

So, if you like the taste, don't hesitate to add lots of vegetables to your pizza!

So, Should I Eat Pizza if I Have Acne?

Pizza contains some ingredients that may not be ideal for acne, like the crust, cheese, and high calorie meat toppings. But, it also contains other ingredients that could be beneficial to acne, like tomato sauce and vegetables. So, it is hard to say how pizza impacts acne. From the evidence we have, it's probably fine to eat a slice or two on occasion, but gorging oneself on pizza may not be the best idea.

Fun Ways To Keep Enjoying Pizza

If you do choose to eat pizza, try to choose pizza that contains:

  • Thin crust: Thin crust pizza contains less bread. This will help lower the glycemic load and decrease the impact on blood sugar levels.
  • Lots of vegetables: Eating lots of vegetables on your pizza is a great way to add antioxidants to your diet.

And perhaps most importantly, consider your calories and eat in moderation. A sudden increase in calories can increase insulin hormones that could lead to a breakout.

The Best Pizza for Acne Thin Crust Pizza with Lots of Vegetable Toppings

References:

  1. Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. "A low-glycemic-load diet improves symptoms in acne vulgaris patients: A randomized controlled trial. American Journal of Clinical Nutrition. 2007; 86(1): 107-115
  2. Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. "A low-glycemic-load-diet versus a conventional, high-glycemic-load diet on biochemical parameters associated with acne vulgaris: A randomized investigator-masked, controlled trials. Journal of American Academy of Dermatology. 2007; 57(2): 247-256
  3. Smith RN, Mann N, Makelainen H, Roper J, Braue A, Varigos G. "A pilot study to determine the short-term effects of a low glycemic load diet on hormonal markers of acne: A nonrandomized, parallel, controlled feeding trial." Molecular Nutrition Food Research. 2008; 52(6): 718-726
  4. Smith RN, Braue A, Varigos G, Mann NJ. "The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides." Journal of Dermatological Science. 2008; 50(1): 41-52
  5. Zaenglein AL, et al. "Guidelines of care for the management of acne vulgaris." Journal of the American Academy of Dermatology. 2016; 74: 945-973.
  6. Reynolds RC, Lee S, Choi JY, et al. "Effect of the glycemic index of carbohydrates on acne vulgaris." Nutrients. 2010; 2(10): 1060-1072
  7. Bronsnick T, Murzaku EC, and Rao BK. "Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer." Journal of the American Academy of Dermatology. 2014; 71: 1039.
  8. Burris, J., Rietkerk, W. & Woolf, K. Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults. J Acad Nutr Diet 114, 384 - 392 (2014).
  9. Melnik, B. C. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol 8, 371 - 388 (2015).
  10. LaRosa, C. L. et al. Consumption of dairy in teenagers with and without acne. J Am Acad Dermatol 75, 318 - 322 (2016).
  11. Cerman, A. A. et al. Dietary glycemic factors, insulin resistance, and adiponectin levels in acne vulgaris. J Am Acad Dermatol 75, 155 - 162 (2016).
  12. Briganti, S. & Picardo, M. Antioxidant activity, lipid peroxidation and skin diseases. What's new. J Eur Acad Dermatol Venereol 17, 663 - 669 (2003). 
  13. Sanchez, A., Calpena, A. C. & Clares, B. Evaluating the Oxidative Stress in Inflammation: Role of Melatonin. Int J Mol Sci 16, 16981 - 17004 (2015). 
  14. Pasiakos SM, et al. "Appetite and endocrine regulators of energy balance after 2 days of energy restriction: insulin, leptine, ghrelin, and DHEA-S." Obesity. 2011; 19: 1124-1130.
  15. Henning PC, et al. "Effects of acute caloric restriction compared to caloric balance on the temporal response of the IGF-1 system." Metabolism. 2013; 62: 179-187.
  16. Pasiakos SM, et al. "Appetite and endocrine regulators of energy balance after 2 days of energy restriction: insulin, leptine, ghrelin, and DHEA-S." Obesity. 2011; 19: 1124-1130.
  17. Henning PC, et al. "Effects of acute caloric restriction compared to caloric balance on the temporal response of the IGF-1 system." Metabolism. 2013; 62: 179-187.

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