There Is No Evidence That Drinking a Lot of Fluids Affects Acne One Way or the Other
The Essential Info
You’ve probably heard that drinking a lot of water is important if you want clear, youthful, and radiant skin. You’ll also hear this advice professed when it comes to keeping the skin clear of acne. However, research does not support this claim.
It is true that for people who drink inadequate amounts of water, increasing fluid intake can hydrate the skin. However, for those who already drink enough fluids, the body will just get rid of any additional water without any effect on the skin.
When it comes to acne, no one has looked directly at how fluid intake affects breakouts. However, some indirect evidence suggests that keeping the skin fully hydrated:
- [+] Improves wound healing, which may help acne lesions to heal faster
- [+] Increases absorption of topical acne treatments, which may slightly improve acne
- [-] Promotes the growth of acne bacteria in the skin, which might actually worsen acne
On balance, it looks like drinking more fluids neither improves nor worsens acne. However, more research is necessary to definitively answer this question.
How do you know if you are already drinking enough? Your body is perfectly primed to tell you. It’s as simple as this: If you feel thirsty, drink. When you’re no longer thirsty, stop. That’s it. Our bodies have an a perfectly evolved mechanism to tell us when we need more fluids, called thirst.
Warning For People with Impaired Kidney Function: Excessive water intake can be dangerous if you have impaired kidney function, so be sure to ask your doctor before you start increasing your fluids.
According to many articles and conventional wisdom, drinking a lot of water every day can boost your health in all sorts of ways, including giving you radiant, clear skin. These days, many people bring a sleek water bottle along wherever they go.
The theory behind hydrating for clear skin is simple: Water makes up almost two-thirds of an adult’s body, and as the largest organ in the body, the skin harbors about 20% of all the body’s water. It seems logical that if you drink more water, the extra liquid will go to your skin, making it healthier and better able to stay clear.
However, in reality, things are more complicated. The body tightly regulates its water balance, so drinking more water does not automatically result in more hydrated skin.
When it comes to acne, there is no evidence that drinking more helps. Let’s take a look at the evidence.
Does Hydrating Your Skin Help with Acne?
No studies have directly looked at whether drinking more water improves acne. However, we do know a lot about how acne develops, and we have some research on how hydration affects the skin. Putting together this information, we can infer that keeping acne-prone skin fully hydrated will:
- [+] Improve healing of acne lesions: Acne lesions, medically speaking, are small wounds. Any wound heals better in a moist environment, and acne lesions are no different.
- [+] Increase absorption of topical acne treatments: Water makes the skin more porous, so hydrated skin may be better able to absorb topical products used to treat acne.
- [-] Promote the growth of acne bacteria in the skin: Acne bacteria like a moist environment, so hydrated skin might allow these bacteria to multiply and thus actually worsen acne.
In other words, maintaining adequate hydration may improve acne in some ways while worsening it in other ways. On balance, it may not make a noticeable difference one way or the other.
If you want to learn more about the research behind this conclusion, expand the section below.
How hydrating the skin impacts acne: The full scoop
How Much Water Does the Body Need?
To help people determine whether they are drinking adequate amounts of water, health organizations in different countries have created some guidelines. These recommendations are based on the amounts of water the human body needs to function properly. For example:
- USA: The Dietary Guidelines for Americans recommend a minimum of 3.7 liters (about 15.5 cups) of water per day for men and 2.7 liters (about 11.5 cups) for women.
- Europe: The European Food Safety Authority recommends a minimum of 2.5 liters (about 10.5 cups) of water per day for men and 2.0 liters (about 8.5) for women.5
These are only guidelines, and depending on your body and activity level, you may not need more or less than this. Trust your body. Evolution has ensured an exquisite mechanism to know when you need to hydrate, called thirst. Drink when you are thirsty and you’ll be good to go. It’s as simple as that.
You can hydrate by drinking pure water or other liquids, such as juice, soup, milk, coffee, or tea. For drinks that are not 100% water, such as juice or milk, you may need to consume slightly more of them to achieve the same water intake.6
The Body Makes Sure It Has the Water It Needs
The body is so good at regulating its water content that the volume of water inside our bodies fluctuates by less than 1% over a 24-hour period.7 To achieve this, the body carefully balances the water it loses with the water it takes in.
If we lose a lot of water through sweat, our bodies act to replenish the water by making us thirstier and producing as little urine as possible. On the other hand, if we drink too much water, our bodies block our thirst signals and produce a larger volume of urine.
What this means is that you can’t outsmart your body. If you try to drink more than your body needs, it will just flush the excess water out over the course of the day. In other words, if you’re already drinking enough, hydrating more will just make you run to the bathroom more often, but it probably won’t do much else.
All about how the body maintains water balance
So when it comes to your water balance, your body is the boss. Having said that, you can still make an effort to drink more water even when you do not feel thirsty. The research is mixed on whether this will work to make your skin more hydrated. Let’s take a closer look, but as you read, remember that we don’t know whether extra hydration in the skin will improve or worsen acne.
After you drink water, your body distributes that water to the various organs in a fixed manner. About 1/5 of the water goes to the skin, where most of it ends up in the outer layer of the skin called the epidermis.
Some parts of the epidermis are actually 70% water.2
Therefore, you might expect that if you increase your water intake, a sizable chunk of the extra water will end up in the epidermis. In reality, things are not so cut and dry (no pun intended).
Three studies have looked at how increasing your water intake impacts the skin.5,9,10 Here is the take-home message from these studies:
- If you are currently drinking too little water, drinking more will likely make a difference: All three studies agree that if you up your water intake to meet the daily requirements, more water will go to your skin, making it thicker and more hydrated.
- If you are already drinking enough water, drinking more might not do much for your skin: The studies disagree on whether chugging even more than the recommended daily amounts will have any effect on the hydration of your skin. One study found that the extra water does make the skin even more hydrated, while another study concluded that it makes no difference to the skin.5,9
Expand the drawer below if you are curious to learn more about these three studies.
Drinking extra water might make your skin more hydrated: The full scoop
As we have seen, if your water intake is too low, drinking more water may be a good idea, though it probably won’t make any difference to your acne.
Is it Possible to Drink Too Much Water?
It is possible to overdose on water, which can lead to electrolyte imbalances and death, but this is extremely rare and almost always occurs only from water drinking contests during events like hazing at fraternities (beware! don’t do this!) or long periods of exercise combined with excessive fluid intake. In other words, just attempting to increase fluid intake to see if it helps your skin won’t cause you to overdose.
However, people with impaired kidney function need to be careful. Their kidneys cannot regulate water balance in the body, so the extra water can build up. Some of the excess water may flood into brain cells, causing them to swell up (so-called brain edema), which can result in death. If you have kidney problems, err on the side of caution and avoid drinking more than the recommended daily amounts.
What about Caffeinated Beverages?
If a large part of your daily water intake comes in the form of coffee, tea, cola, or other caffeinated drinks, you may be concerned about the dehydrating effects of these drinks. Let’s take a look at some research suggesting that you might not need to worry about this. [Side note: Drinking sugary soda is probably not ideal for acne.]
The dehydrating effect of caffeinated drinks may be negligible
Theoretically, caffeine can dehydrate the body in two ways:
- It stimulates the kidneys to lose more water in urine.
- It irritates the bladder, creating an urge to urinate.11
However, one study suggests that for a healthy person consuming several caffeinated drinks a day, the dehydrating effect of caffeine might be negligible.
In the study, 18 healthy adult men were given different combinations of water and various caffeinated drinks on 4 different days, keeping the total amounts of liquid the same each time. The researchers then tested how hydrated the men were after each combination of drinks. They found that the exact combination of drinks made no difference. The men were equally hydrated whether they had consumed some caffeinated drinks or only non-caffeinated drinks. Therefore, the researchers concluded that it is fine to consume caffeinated beverages as part of your recommended total fluid intake.12
However, it is important to keep in mind that the study was supported by a grant from The Coca-Cola Company, which may have biased the findings.
Expand to reveal details of study
What about the caffeine itself? Could it contribute to acne?
Caffeine may theoretically both help with acne and make it worse:
- [+] Caffeine may reduce inflammation: Applying caffeine topically to the skin seems to help with inflammatory skin conditions like eczema. Therefore, it is possible that drinking caffeine may help with acne, which is also an inflammatory disease, but this is a bit of a stretch and not backed by any science as of yet.
- [+] Caffeine may fight free radicals: Caffeine is an antioxidant, which means it can fight free radicals in the body (natural toxins that can contribute to acne). In other words, caffeine may reduce the chance of breakouts by getting rid of free radicals.13
- [-] Caffeine might increase the production of skin oil: Caffeine may trigger the body’s stress response, which may stimulate the body to produce hormones like cortisol. These hormones, in turn, may increase the production of skin oil. More skin oil means a higher risk of breakouts.
To sum up, the jury is still out on whether caffeine dehydrates the skin and if so to what degree, and the jury is also still out on whether caffeinated drinks help or hurt acne-prone skin. As I come across more research on this topic, I’ll bring it your way.
What about Alcoholic Beverages?
Alcoholic drinks and dehydration
Alcohol is a known diuretic, meaning that it stimulates more urine production. Therefore, consuming alcoholic drinks may cause dehydration if you do not compensate by drinking more water. The higher the concentration of alcohol in the drinks, the more water you need to rehydrate your body.11
Alcoholic drinks might make acne worse
Some scientists speculate that alcohol might contribute to acne, but there is currently no evidence to back up this idea.
One thing researchers have noticed is that alcoholics tend to get more skin infections.14 This may be because consuming a lot of alcohol somehow favors the growth of bacteria on the skin. It is possible that alcohol may also help acne bacteria to overgrow. However, this is only a theoretical idea that has yet to be tested by any studies.
Another idea is that alcohol paired with a high-fat diet (which can happen if someone regularly drinks alcohol while eating bar food) may increase inflammation and delay wound healing.7 As we have already seen, inflammation is a major culprit in acne, so increasing inflammation would tend to make acne worse. Delayed wound healing would also mean acne lesions might take longer to clear up. However, these ideas are based on studies in animals, so it is too early to say whether consuming alcohol together with high-fat food would actually worsen acne in humans.
In other words, we really don’t know whether alcohol consumption plays any role in acne.
The Bottom Line
If you do not drink enough water and are often thirsty, making an effort to drink more fluids may help to hydrate the skin and make it plumper.15 However, we don’t know whether this will affect acne one way or another.
Your body is very good at regulating its water balance, so just listen to your body’s thirst signals. There is no reason to overthink your water intake beyond making sure you’re not frequently thirsty.
- Lee, H. J. et al. Effects of cosmetics on the skin microbiome of facial cheeks with different hydration levels. MicrobiologyOpen 7, e00557 (2018). https://www.ncbi.nlm.nih.gov/pubmed/29193830
- Ousey, K., Cutting, K.F., Rogers, A. A. & Rippon, M. G. The importance of hydration in wound healing: Reinvigorating the clinical perspective. J. Wound Care 25, 124-30 (2016). doi: 10.12968/jowc.2016.25.3.122. https://www.ncbi.nlm.nih.gov/pubmed/26947692
- Daniels, R. Strategies for skin penetration enhancement. Strategies 10, 14 (2010). https://pdfs.semanticscholar.org/9287/b2f89129b993893520eb57a4a32b4a59860f.pdf
- Rodrigues Leite-Silva, V., Mandelli De Almeida, M., Fradin, A., Grice, J. E. & Roberts, M. S. Delivery of drugs applied topically to the skin. Expert Review of Dermatology 7, 383-397 (2014). doi:10.1586/edm.12.32 https://www.tandfonline.com/doi/full/10.1586/edm.12.32
- Palma, L., Marques, L. T., Bujan, J. & Rodrigues, L. M. Dietary water affects human skin hydration and biomechanics. Clin. Cosmet. Investig. Dermatol. 8, 413 – 421 (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529263/
- Dietitians of Canada. (2014). Guidelines for drinking fluids to stay hydrated. https://carleton.ca/healthy-workplace/wp-content/uploads/FACTSHEET-Guidelines-staying-hydrated.pdf
- Rosa, D. F., Sarandy, M. M., Novaes, R. D., Freitas, M. B., do Carmo Gouveia Pelúzio, M. & Gonçalves, R. V. High-fat diet and alcohol intake promotes inflammation and impairs skin wound healing in Wistar rats. Mediators Inflamm. 2018, 4658583 (2018). https://www.hindawi.com/journals/mi/2018/4658583/
- Je´quier, E. & Constant, F. Water as an essential nutrient : the physiological basis of hydration. Eur. J. Clin. Nutr. 64, 115 – 123 (2010). https://www.ncbi.nlm.nih.gov/pubmed/19724292
- Williams, S., Krueger, N., Davids, M., Kraus, D. & Kerscher, M. Effect of fluid intake on skin physiology: Distinct differences between drinking mineral water and tap water. Int. J. Cosmet. Sci. 29, 131 – 138 (2007). https://www.ncbi.nlm.nih.gov/pubmed/18489334
- Akdeniz, M. et al. Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients : An Explorative Study. Skin Pharmacol. Physiol. 31, 155 – 162 (2018). https://www.ncbi.nlm.nih.gov/pubmed/29614497
- Siu, S. Y., Ferzli, G. M. & Brody, N. Topical Green Tea Polyphenols and Caffeine as a Treatment for Acne Vulgaris. Ski. J. Cutan. Med. 1, 55 (2017). https://jofskin.org/index.php/skin/article/view/210
- Grandjean, A. C., Reimers, K. J., Haven, M. C. & Bannick, K. E. The Effect of Caffeinated, Non-Caffeinated, Caloric and Non-Caloric Beverages on Hydration. J. Am. Coll. Nutr. 19, 591 – 600 (2000). https://www.ncbi.nlm.nih.gov/pubmed/11022872
- Herman, A. & Herman, A. P. Caffeine’s mechanisms of action and its cosmetic use. Skin Pharmacol. Physiol. 26, 8 – 14 (2012). https://www.ncbi.nlm.nih.gov/pubmed/23075568
- Kostović, K. & Lipozenčić, J. Skin diseases in alcoholics. Acta Dermatovenerologica Croat. 12, 181 – 190 (2004). https://www.ncbi.nlm.nih.gov/pubmed/15369644
- Popkin, B. M., D’Anci, K. E. & Rosenberg, I. H. Water, hydration, and health. Nutr. Rev. 68, 439‐458 (2010). https://pubmed.ncbi.nlm.nih.gov/20646222/