brand logo

Am Fam Physician. 2017;95(2):122a-123

Clinical Question

Does eating chocolate really cause more pimples?

Bottom Line

This study found a statistically significant increase in facial acne lesions among college students 48 hours after ingesting chocolate instead of jelly beans (average compared with baseline: 4.8 new lesions vs. 0.7 fewer lesions, respectively). (Level of Evidence = 1b –)


These investigators enrolled 54 consenting college students with acne vulgaris who agreed to abstain completely from chocolate consumption for the duration of the study. No information is provided on the baseline severity of acne, but each participant provided a prestudy facial photo to allow lesion counting. Study participants randomly received (uncertain allocation concealment) a standard size Hershey's milk chocolate bar or 15 Jelly Belly jelly beans to provide an equal amount of glycemic load to each intervention group. Acne changes were assessed by a second facial photographic review 48 hours later by a dermatologist masked to intervention group assignment. After a four-week washout period, study participants received the opposite intervention from what they had in the first phase of the study (crossover design) and again had a facial photographic assessment performed before and 48 hours after the intervention.

No statistically significant group differences were noted in the number of acne lesions at baseline in both study phases. After each intervention, however, the chocolate consumption group had a statistically significant increase in acne lesions compared with the jelly bean group (+4.8 vs. −0.7 lesions, respectively).

Study design: Crossover trial (randomized)

Funding source: Self-funded or unfunded

Allocation: Uncertain

Setting: Outpatient (any)

Reference:DelostGRDelostMELloydJThe impact of chocolate consumption on acne vulgaris in college students: a randomized crossover study. J Am Acad Dermatol2016;75(1):220–221.

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to

This series is coordinated by Natasha J. Pyzocha, DO, contributing editor.

A collection of POEMs published in AFP is available at

Continue Reading

More in AFP

Copyright © 2017 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.