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Basic research on the causes of acne vulgaris NewLinks its occurrence to rising testosterone levels during puberty. This results in enlargement of the sebaceous glands, which can eventually lead to the development of comedones (blackheads). The American Academy of Dermatology has stated acne is not a dietary disease and following the strictest diet will not by itself clear the skin. Yet the idea that diet, and specifically chocolate, is implicated in the etiology of acne remained widespread within the medical profession until recently. Among the first to question the NewLink between chocolate and acne were researchers from the University of Missouri in the 1960s. Grant and Anderson attempted to induce an acne flare-up in eight individuals with mild to moderate acne by feeding them a large amount of chocolate, and failed. The authors discredited the assertion that chocolate causes acne.

A larger study of 65 subjects reported excessive intake of chocolate and fat did not alter the composition or output of sebum from subaceous glands or affect the course of acne. Upon review of studies purporting to show that high carbohydrate or high fat diets aggravate acne, the authors concluded such claims are unproved and that the sebaceous gland has a high degree of autonomy. In two articles, Shalita has stated there is no evidence that food, including chocolate, has a direct role in the pathogenesis of acne.

In an extensive review of research on chocolate and acne conducted in 1978, Fries concluded that the general trend of published reports suggested that chocolate ingestion was unrelated to the cause of acne. As cited in the Journal of the American Medical Association: "Diet plays no role in acne treatment in most patients...even large amounts of chocolate have not clinically exacerbated acne." The paucity of recent research on chocolate and acne reflects the widespread acceptance of earlier studies that acquitting chocolate of any contributing role in acne.

*Bibliography of scientific journals referenced here available upon request.