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This question originally appeared on Quora. Answer by Tatiana Aynbinder.

Sugar by itself does not cause acne per se. There are many reasons that acne can form and hormonal fluctuations in the body (hormonal acne) can be a significant factor for your breakouts. Acne has many possible culprits: Therefore, it is imperative to see a qualified dermatologist to assess your acne as well as skin type and put you on a specific skin care regimen tailored just for you. However, I do believe that acne is best treated with a comprehensive approach. Along with in-office medical treatments, at-home skin care medications and creams, a healthy diet and lifestyle also helps to promote healthy skin.

Here are some useful insights as to why sugar may be bad for your skin and further exacerbates your acne breakouts.

Let's examine how sugar affects your skin. Sugar’s oxidative properties can provoke acne and breakouts. Sugar and foods high on the glycemic index (meaning foods that, once ingested, convert quickly into glucose and cause your body's insulin levels to elevate) lead to a burst of inflammation that goes throughout your entire body. Foods high in sugar and saturated fats — like white bread, candy, fried foods, ice cream, sodas, and anything else with a main ingredient of sugar — cause spikes in your body's insulin levels that further exacerbate inflammation. Steep insulin spikes increase the production of skin oils and contribute to the clogging of follicles, which can worsen skin complexion.

Your body breaks down "simple carbohydrates”, like refined sugars and white flour, rapidly converting them into glucose, which then floods the blood stream. When this occurs, your body reacts by producing insulin to counter the glucose insulin levels spike, leading to inflammation-producing enzymes which attach to your body's collagen through an oxidative process known as glycation. This process breaks down collagen and elastin, contributing to aged, sagging and wrinkled-looking skin. Glycation not only increases the appearance of aging, but also can aggravate particular skin conditions such as acne and rosacea. (Glycation also occurs internally, affecting connective tissue and joints!)

The more sugar in a person's diet, the more likely it is that the body will eventually develop insulin resistance. Understanding which foods are high on the glycemic index scale (and how quickly they cause blood sugar levels to rise after digestion) help us to develop a healthy diet as well as improving skin complexion. Foods high on this scale should be avoided as much as possible.

Excess sugar in your diet makes it more likely that you’ll develop insulin resistance, which can manifest as excessive hair growth (hirsutism), production of dark patches on the skin, and aggravation of acne breakouts. We know that high blood sugar spikes in your body pump up the production of insulin. To bring down these spikes, your body responds by producing androgen hormones, which further aggravate acne. When this happens for an extended period, your body begins to lose sensitivity to insulin, causing insulin resistance. This means you have to pump out even more insulin to bring the blood sugar down. If this process spirals out of control, it can lead to further complications for your skin. Understanding the glycemic index scale (which ranks how quickly blood sugar levels rise after ingesting various foods) is essential for making the right choices for your skin when it comes to sugar in your diet.

Two key points regarding how sugar affects skin are as follows: sugar triggers inflammation, and also binds to collagen, degrading skin cells. The lower your consumption of sugar and other high-glycemic foods, the better your skin will look and feel. A rise in insulin levels in your bloodstream triggers changes that can lead to the growth of pore-clogging cells and excess production of oil in your skin glands - not to mention other serious health issues, such as diabetes.

Now for the good news: by making some healthier dietary choices and lessening your refined sugar intake, you can take a comprehensive approach to maintaining beautiful, healthy-looking skin from the inside out. Healthy eating also complements the topicals solutions, treatments, and medications that you already use for maintaining healthy skin and controlling your acne. We know that there is a connection between the foods you eat and your skin’s susceptibility to breakouts.

Make smart choices - choose foods with a lower glycemic index such as vegetables, or foods with natural sugars like fruit and whole grains. These are just a few of the healthier foods that won't cause those high spikes of insulin production in your body. And look at the Glycemic Index for different foods. You might be surprised.

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