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Prescription 2014: Chocolate for Skin Health

April 28, 2014 Written by JP    [Font too small?]

Arguably, the reputation of cocoa (Theobroma cacao) is at its high point in history, that is, at least from a health perspective. These days, it’s not uncommon to hear esteemed doctors and nutritionists recommend a daily serving of dark chocolate as part of a comprehensive, health promoting diet and lifestyle. And, because of this positive word of mouth, you can now find the largest selection of high quality, organic cocoa products in modern times. But, up until now, the health benefits attributed to dark chocolate consumption and/or supplementation have primarily focused on the inner workings of the body – i.e. cardiovascular health, cognitive function, diabetes and oxidative balance.

Today, I’m here to tell you that adding cocoa to your daily routine can do as much for your outer body as your inner physiology. However, before you go out and buy skin products containing cocoa butter, let me explain what a slew of recent studies tell us. Surprisingly, the scientific literature does not support the topical application of cocoa butter creams and lotions for healthier skin. For many years, pregnant women have applied such products to their bellies in the hope of preventing “stretch marks”. Unfortunately, at least two well designed studies refute the efficacy of this treatment.

The good news is that eating or supplementing with high-flavanol (HF) cocoa positively influences skin in multiple ways. For starters, research indicates that HF cocoa protects skin from UV damage induced by sun exposure. This is commonly known as “photoprotection”. This same variety of chocolate has been shown to increase dermal microcirculation and oxygen saturation. The net result of these desirable effects is skin that is moister, smoother and thicker. But, that’s not all. Modern reviews dispute the popular notion that chocolate is a contributing factor for inflammatory skin conditions such as acne and psoriasis. What’s more, preliminary data suggests that phytochemicals found in cocoa may lower the risk of various cancers, including basal cell carcinoma, a common form of skin malignancy.

As promising as this all is, the take home message isn’t to eat large amounts of conventional chocolate candy. Rather, in order to achieve the noted, skin specific health benefits from cocoa, I recommend looking for minimally refined products such as organic cacao beans or nibs, non-alkalized, pure cocoa powder and dark chocolate bars containing a minimum of 70% cocoa content and less than 10 grams of sugar per serving. As you may well imagine, the higher the cocoa content and lower the sugar, the better.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Prevention of Striae Gravidarum with Cocoa Butter Cream (link)

Study 2 – Cocoa Butter Lotion for Prevention of Striae Gravidarum: A Double-Blind (link)

Study 3 – Eating Chocolate Can Significantly Protect the Skin from UV Light (link)

Study 4 – Consumption of Flavanol-Rich Cocoa Acutely Increases Microcirculation (link)

Study 5 – Long-Term Ingestion of High Flavanol Cocoa Provides Photoprotection … (link)

Study 6 – Pilot Study on Which Foods Should be Avoided by Patients with Psoriasis (link)

Study 7 – Skin Therapy Letter: Does diet really affect acne? (link)

Study 8 – Cocoa Phytochemicals: Recent Advances in Molecular Mechanisms on … (link)

Study 9 – Selective Cytotoxicity of Synthesized Procyanidin 3-O- (link)

Study 10 – Increased Caffeine Intake is Associated with Reduced Risk of Basal Cell (link)

High Flavanol Cocoa Improves Skin Condition in Women

Source: J Nutr. 2006 Jun;136(6):1565-9. (link)

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Posted in Alternative Therapies, Food and Drink, Nutrition

10 Comments & Updates to “Prescription 2014: Chocolate for Skin Health”

  1. JD Says:

    I wish there were a drink (can or bottle) out there with the stuff in it. Maybe there is. I know there are quite a few sugar-free with natural sweetners dark chocolate products out there.

    Good information..thanks.

  2. JP Says:

    Hi JD,

    I’m not aware of any well formulated, “ready to drink” chocolate products. However, there are some high flavanol powders that can be mixed easily with water or other liquids. In my experience, they tend to cheaper and healthier than premixed cocoa drinks.

    Be well!


  3. JP Says:

    Update: An intriguing new study suggests chocolate may exacerbate acne in some:


    J Clin Aesthet Dermatol. 2014 May;7(5):19-23.

    Double-blind, Placebo-controlled Study Assessing the Effect of Chocolate Consumption in Subjects with a History of Acne Vulgaris.

    Objective: To assess the effect of chocolate on acne exacerbation in males between the ages of 18 and 35 with a history of acne vulgaris. Design: Double-blind, placebo-controlled, randomized, controlled trial. Setting: Single-site, outpatient, research, clinical facility at an academic research institution. Participants: Fourteen men between the ages of 18 and 35 were assigned to swallow capsules filled with either unsweetened 100-percent cocoa, hydrolyzed gelatin powder, or a combination of the two, at baseline. Measurements: Lesions were assessed and photographs were taken at baseline, Day 4, and Day 7. Results: Of the 14 subjects, 13 completed this Institutional Review Board approved study. A statistically significant increase in the mean number of total acneiform lesions (comedones, papules, pustules, nodules) was detected on both Day 4 (p=0.006) and Day 7 (p=0.043) compared to baseline. A small-strength positive Pearson’s correlation coefficient existed between the amount of chocolate each subject consumed and the number of lesions each subject developed between baseline and Day 4 (r=0.250), while a medium-strength positive correlation existed between baseline and Day 7 (r=0.314). No serious adverse events occurred. Conclusion: It appears that in acne-prone, male individuals, the consumption of chocolate correlates to an increase in the exacerbation of acne.

    Be well!


  4. JP Says:

    Update: Passing along a testimonial from a long time client:

    Hi JP,

    Two weeks ago I started applying the SHIKAI BORAGE THERAPY dry skin lotion to my forearms, hands and legs in the morning as I got up and at night before bedtime. When I apply this lotion I notice that it gets absorbed promptly and there is not a residual stickiness typical of other moisturizing creams.

    I am impressed of the improvement that my skin has experienced both in suppleness,strength and mini wrinkles. I used to start bleeding easily at any minor scratch and now it is not happening! Even if the bleeding stopped promptly it was still a nuisance. No more!

    Please feel free to share my success with other ladies in my age group (almost 77) and skinny complexion probably prone to have thin skin and being prone to easy bruising!

    Thank you much for your successful targeted prescription! Of course this treatment is becoming a daily habit for me to continue enjoying more youth like skin!

    Of course I am practicing also your recommendations of consuming a healthy diet and enjoying daily good dark unsweetened chocolate .

    Giuliana F.

    Be well!


  5. JP Says:

    Update: Dietary supplement improves appearance, health of aging skin …


    Journal of Photochemistry and Photobiology B: Biology; Volume 144, March 2015

    A dietary supplement improves facial photoaging and skin sebum, hydration and tonicity modulating serum fibronectin, neutrophil elastase 2, hyaluronic acid and carbonylated proteins

    “In the present study, administration of a dietary supplement containing Pycnogenol®, low-molecular-weight HA, collagen, glucosamine sulfate, chondroitin sulfate and coenzyme Q10 significantly improved facial photoaging, as assessed 2 weeks after the end of a 4-week treatment period. This finding coupled with a significant increase in sebum, hydration and tonicity, if compared with placebo. The improvement in facial photoaging also coupled with an increase in serum fibronectin and HA and a decrease in serum carbonylated proteins and neutrophil elastase 2. Our findings suggest a systemic modulation of these parameters that may represent biomarkers of photoaging pathology and could be used to monitor progression or improvement in this condition. The results from this study are in agreement with a previous investigation where a dietary formulation (BioCell Collagen®) administered for 12 weeks improved skin dryness/scaling and global lines/wrinkles with a significant increase in hemoglobin and collagen in skin dermis at 6 weeks and hemoglobin at the end of the study [16]. In summary, our dietary compound shows a synergistic efficacy of its individual ingredients in improving facial photoaging 2 weeks after the end of a 4-week treatment period. Pycnogenol®, HA, collagen, glucosamine sulfate, chondroitin sulfate and coenzyme Q10, which all possess a rationale of efficacy in modulating the ECM, can be put together in a dietary compound that produces an improvement in skin photoaging also modulating serum HA, carbonylated proteins, fibronectin and neutrophil elastase 2 levels. The clinical meaning of these parameters and their involvement in the photoaging pathophysiology at the systemic level warrant further investigation. Future studies will also address the long-term effects of the formulation used in this investigation in patients affected by photoaging. A limitation of our study is that the ELISAs we used do not allow to discriminate among different forms of some of the analytes that have been the object of our investigation.”

    Be well!


  6. JP Says:

    Update: Enjoying dark chocolate judiciously can improve the health of overweight individuals …


    Journal of Nutritional Biochemistry – February 25, 2015

    Natural cocoa consumption: Potential to reduce atherogenic factors?

    Short-term consumption of flavanol-rich cocoa has been demonstrated to improve various facets of vascular health. The purpose of the present study was to determine the effect of 4 weeks of natural cocoa consumption on selected cardiovascular disease (CVD) biomarkers in young (19–35 years) women of differing body mass indices (BMI; normal, overweight or obese). Subjects (n=24) consumed a natural cocoa-containing product (12.7 g natural cocoa, 148 kcal/serving) or an isocaloric cocoa-free placebo daily for 4 weeks in a random, double-blind manner with a 2-week washout period between treatment arms. Fasted (>8-h) blood samples were collected before and after each 4-week period. Serum was analyzed to determine lipid profile (chemistry analyzer) and CVD biomarkers (26 biomarkers). EDTA-treated blood was used to assess monocytes (CD14, CD16, v11b and CD62L), while citrate-treated blood was used to measure changes in endothelial microparticles (EMPs; CD42a−/45−/144+) by flow cytometry. Natural cocoa consumption resulted in a significant decrease in haptoglobin (P=.034), EMP concentration (P=.017) and monocyte CD62L (P=.047) in obese compared to overweight and normal-weight subjects. Natural cocoa consumption regardless of BMI group was associated with an 18% increase in high-density lipoprotein (P=.020) and a 60% decrease in EMPs (P=.047). Also, obese subjects experienced a 21% decrease in haptoglobin (P=.034) and a 24% decrease in monocyte CD62L expression in (P=.047) following 4 weeks of natural cocoa consumption. Collectively, these findings indicate that acute natural cocoa consumption was associated with decreased obesity-related disease risk. More research is needed to assess the stability of the observed short-term changes.

    Be well!


  7. JP Says:

    Update: A recent review …

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145303/ (full text)

    Nutrients. 2014 Aug 11;6(8):3202-13.

    Cocoa bioactive compounds: significance and potential for the maintenance of skin health.

    Cocoa has a rich history in human use. Skin is prone to the development of several diseases, and the mechanisms in the pathogenesis of aged skin are still poorly understood. However, a growing body of evidence from clinical and bench research has begun to provide scientific validation for the use of cocoa-derived phytochemicals as an effective approach for skin protection. Although the specific molecular and cellular mechanisms of the beneficial actions of cocoa phytochemicals remain to be elucidated, this review will provide an overview of the current literature emphasizing potential cytoprotective pathways modulated by cocoa and its polyphenolic components. Moreover, we will summarize in vivo studies showing that bioactive compounds of cocoa may have a positive impact on skin health.

    Be well!


  8. JP Says:

    Updated 12/29/15:


    J Int Soc Sports Nutr. 2015 Dec 15;12:47.

    Dark chocolate supplementation reduces the oxygen cost of moderate intensity cycling.

    BACKGROUND: Dark chocolate (DC) is abundant in flavanols which have been reported to increase the bioavailability and bioactivity of nitric oxide (NO). Increasing NO bioavailability has often demonstrated reduced oxygen cost and performance enhancement during submaximal exercise.

    METHODS: Nine moderately-trained male participants volunteered to undertake baseline (BL) measurements that comprised a cycle [Formula: see text] test followed by cycling at 80 % of their established gas exchange threshold (GET) for 20-min and then immediately followed by a two-minute time-trial (TT). Using a randomised crossover design participants performed two further trials, two weeks apart, with either 40 g of DC or white chocolate (WC) being consumed daily. Oxygen consumption, RER, heart rate and blood lactate (BLa) were measured during each trial.

    RESULTS: DC consumption increased GET and TT performance compared to both BL and WC (P < 0.05). DC consumption increased [Formula: see text] by 6 % compared to BL (P < 0.05), but did not reach statistical significance compared to WC. There were no differences in the moderate-intensity cycling for [Formula: see text], RER, BLa and heart rate between conditions, although, [Formula: see text] and RER exhibited consistently lower trends following DC consumption compared to BL and WC, these did not reach statistical significance. CONCLUSION: Chronic supplementation with DC resulted in a higher GET and enhanced TT performance. Consequently, ingestion of DC reduced the oxygen cost of moderate intensity exercise and may be an effective ergogenic aid for short-duration moderate intensity exercise. Be well! JP

  9. JP Says:

    Updated 1/4/16:


    Int J Dermatol. 2015 Dec 29.

    Dark chocolate exacerbates acne.

    The effects of chocolate on acne exacerbations have recently been reevaluated. For so many years, it was thought that it had no role in worsening acne. To investigate whether 99% dark chocolate, when consumed in regular daily amounts, would cause acne to worsen in acne-prone male subjects, twenty-five acne prone male subjects were asked to consume 25 g of 99% dark chocolate daily for 4 weeks. Assessments which included Leeds revised acne scores as well as lesion counts took place weekly. Food frequency questionnaire was used, and daily activities were recorded. Statistically significant changes of acne scores and numbers of comedones and inflammatory papules were detected as early as 2 weeks into the study. At 4 weeks, the changes remained statistically significant compared to baseline. Dark chocolate when consumed in normal amounts for 4 weeks can exacerbate acne in male subjects with acne-prone skin.

    Be well!


  10. JP Says:

    Updated 10/19/18:


    J Clin Aesthet Dermatol. 2018 Sep;11(9):37-41.

    Continuous Dark Chocolate Consumption Affects Human Facial Skin Surface by Stimulating Corneocyte Desquamation and Promoting Bacterial Colonization.

    Background: Nutrition can influence skin health. Dark chocolate possesses health promoting properties, but its consumption can exacerbate acne vulgaris in young people. Objective: We evaluated effects of continuous dark chocolate intake on morphological characteristics of the residual skin surface components (RSSCs) collected from the facial skin of young and middle-aged men. Methods: RSSC samples were taken from 17 young and 16 middle-aged men before and after a four-week consumption period of dark chocolate (10g per day). Lipid droplet size, corneocyte desquamation, and microbial presence levels were measured in the collected RSSC. The project was registered as ISRCTN89815519 in the ISRCTN registry (https://www.isrctn.com/). Results: Chocolate consumption caused a significant increase in corneocyte desquamation only in the group of young men, whereas Gram-positive microorganism presence significantly increased in both the young and middle-aged men, though this effect was noticeably stronger in the young men. Conclusion: Dark chocolate consumption appears to affect the facial skin of young men by enhancing corneocyte desquamation and promoting bacterial colonization of the RSSC. These changes might potentially contribute to acne development.

    Be well!


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