Valentine's Myth: Chocolate Causes Acne

For decades, the idea that chocolate causes acne has been both debated and dismissed. (Fulton et al, 1969) Some swear that indulging in chocolate triggers breakouts, while others remain skeptical. But what does published research actually say? Recent studies provide compelling evidence that chocolate—especially dark chocolate—may indeed exacerbate acne, though the findings are not entirely conclusive. Let’s break it down in simple terms.

The Case for Chocolate Worsening Acne

Several studies have tested whether chocolate impacts acne, and the results are concerning for chocolate lovers.

A 2024 study by Daszkiewicz et al. found that consuming just 50g of dark chocolate (85% cocoa) daily significantly increased acne severity in 92 young adults following an anti-inflammatory diet. The participants' acne scores worsened after four weeks of chocolate consumption.
Delost et al. (2016) observed a similar effect in college students. Those who consumed a milk chocolate bar experienced a notable increase in acne lesions compared to those who ate jellybeans, suggesting that the effect was not due to sugar alone.
Caperton et al. (2014) took things a step further by testing pure cocoa in capsule form on acne-prone men. Their findings showed a clear dose-dependent relationship: more cocoa meant more acne lesions.
Vongraviopap & Asawanonda (2016) found that eating 25g of ultra-dark chocolate (99% cocoa) daily led to a significant increase in both inflammatory and non-inflammatory acne within just two weeks.

These studies suggest that chocolate—whether milk or dark—can worsen acne, possibly due to compounds found in cocoa itself rather than just sugar or dairy.

The Case Against Chocolate Being a Major Culprit

Not all studies agree that chocolate is to blame.

Zalzala et al. (2024) found no significant link between chocolate consumption and acne in a study of 235 participants, though some acne sufferers reported eating chocolate more frequently.
Landro et al. (2012) also failed to find an association between chocolate intake and acne risk in an Italian population.
A large-scale study from NutriNet-Santé (2020) initially found a connection between milk chocolate and acne but lost significance after adjusting for other dietary factors. Surprisingly, dark chocolate even showed a weak negative association before adjustments.
Dougan et al. (2014) suggested that white chocolate (which contains dairy and sugar) might be more problematic for acne than dark chocolate, which had no significant effect.

Why Might Chocolate Cause Acne?

If chocolate does indeed worsen acne, the next question is: why? Researchers have proposed several possibilities:

Inflammatory Compounds in Cocoa – Chocolate contains bioactive compounds that may trigger inflammation in the skin. (Caperton et al. 2014)
Increased Bacterial Activity – A study by Chalyk et al. (2018) found that consuming dark chocolate increased bacterial colonization on the skin, which could contribute to acne.
Dairy and Sugar in Milk Chocolate – While dark chocolate might be the main suspect, milk chocolate also contains dairy and sugar, both of which have been linked to acne in some studies. (Landro et al. 2012, Dougan et al. 2014)

However, it's worth noting some of the oldest data we have suggests chocolate has no impact on sebum production, a potential factor contributing to acne. (Fulton et al. 1969)

A Deeper Analysis of the Data Trends

The trend across these studies suggests that when people eat chocolate daily in a controlled setting (like clinical trials), their acne tends to get worse. This is especially clear in studies where participants were given a specific amount of chocolate each day for several weeks, and their acne was measured before and after.

On the other hand, large population-based studies that rely on self-reported chocolate intake don’t consistently find a strong link. These studies ask people how much chocolate they usually eat and compare it to their acne severity, but they don’t control what participants eat directly. Because of this, other factors (like diet, lifestyle, or memory errors) might make it harder to see a clear connection between chocolate and acne in these studies.

So, while controlled experiments suggest that eating chocolate daily can make acne worse, broader observational studies don’t always support that conclusion. There are benefits to considering both methodologies when trying to answer this question. On the one hand, controlled trials give us the best look at how adjusting one variable (chocolate consumption) leads to the development of acne. But, in a real world scenario, most of us aren't eating a daily regimented amount of chocolate, so it may not reflect typical practices of those eating chocolate - population based studies may provide better insight.

The Verdict: Should You Give Up Chocolate?

While the evidence is still mixed, several high-quality studies suggest a link between daily chocolate consumption and acne worsening. If you’re prone to acne, eat chocolate frequently, and notice breakouts after eating chocolate, cutting back might be worth trying. However, there is no evidence that people with little or no acne experience or develop acne if consuming chocolate, or that small amounts of intermittent chocolate consumption contributes to acne in acne susceptible individuals. If your acne doesn't improve after cutting back on the cocoa bean, don't be surprised, there are many other things that are more likely contributing to your acne.

Do you need help with acne? You can obtain an online consultation from Bridge Dermatology if you currently reside in California, Connecticut, Illinois, or Nebraska.

Dr. Ryan M. Trowbridge, MD, MS, MA

DermMythBuster

P.S. Have you come across any new or conflicting research on this topic? Please share—I’d love to explore it further with you!

Citations

Afnan, B., Asim, S., Amer, M., Soomro, S., Khan, A., Khan, R., & Kaikaus, M. (2021). Significance of diet in acne vulgaris patients attending dermatology clinic at Dow University of Health Sciences, Karachi. Journal of University Medical & Dental College, 12(4). https://doi.org/10.37723/jumdc.v12i4.582

Chalyk, N., Klochkov, V., Sommereux, L., Bandaletova, T., Kyle, N., & Petyaev, I. (2018). Continuous dark chocolate consumption affects human facial skin surface by stimulating corneocyte desquamation and promoting bacterial colonization. The Journal of Clinical and Aesthetic Dermatology, 11(9), 37-41.

Daszkiewicz, M., Różańska, D., & Regulska−Ilow, B. (2024). The relationship between chocolate consumption and the severity of acne lesions: A crossover study. Foods, 13(13), 1993. https://doi.org/10.3390/foods13131993

Delost, G. R., Delost, M. E., & Lloyd, J. (2016). The impact of chocolate consumption on acne vulgaris in college students: A randomized crossover study. Journal of the American Academy of Dermatology, 75(1), 220–222.

Dougan, P., & Rafikhah, N. (2014). Dark and white chocolate consumption and acne vulgaris: A case-control study. Asian Journal of Clinical Nutrition, 6, 35-40.

Fulton, J. E., Plewig, G., & Kligman, A. M. (1969). Effect of chocolate on acne vulgaris. JAMA, 210(11), 2071–2074. https://doi.org/10.1001/jama.1969.03160370055011

Landro, A., Cazzaniga, S., Parazzini, F., Ingordo, V., Cusano, F., Atzori, L., & Naldi, L. (2012). Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults. Journal of the American Academy of Dermatology, 67(6), 1129-1135. https://doi.org/10.1016/j.jaad.2012.02.018

Penso L, Touvier M, Deschasaux M, et al. Association Between Adult Acne and Dietary Behaviors: Findings From the NutriNet-Santé Prospective Cohort Study. JAMA Dermatol. 2020;156(8):854-862. doi:10.1001/jamadermatol.2020.1602

Vongraviopap, S., & Asawanonda, P. (2015). Dark chocolate exacerbates acne. International Journal of Dermatology, 55(5), 587-591. https://doi.org/10.1111/ijd.13188

Zalzala, S. H., Ali, B. M., & Fahad, Z. S. (2024). The Relationship between Vitamin D, Body Mass Index and some Dietary Products with Acne Vulgaris; A Case-Control study in Baghdad/Iraq. Journal of Contemporary Medical Sciences, 10(1). https://doi.org/10.22317/jcms.v10i1.1459