Some studies confirm that chocolate causes acne while others refute the claim. So, which one is it?

"The truth is, we don't really know at this point," a dermatologist and fellow of the American Academy of Dermatology, Dr. Patricia Farris, told CNN.

Researches point out that highly glycemic foods, rich in refined carbohydrates and sugar, are unhealthy for the acne-prone skin, because they increase blood sugar which in turn produces high insulin; that leads to a rise in androgens hormone and to more sebum production.

Sebum keeps the skin moist, but when the glands generate too much of it, the oil can combine with dead skin cells and become trapped in pores leading to blackheads, whiteheads and pimples.

A study by the Chocolate Manufacturers Association of the USA confirmed the association between chocolate and acne.

"We found that, on average, people had about five more pimples with the ingestion of chocolate," study author Dr. Gregory R. Delost of the Department of Dermatology at University Hospitals, Cleveland Medical Center, said.

In another study conducted in 2016, researchers investigated an ounce of 99% cacao dark chocolate intake, without added sugars or milk, on 25 people and discovered that it caused acne to acne-prone males when consumed daily.

"We did not conclude that chocolates cause acne, as this condition is caused by multifaceted factors. Our study suggests that dark chocolate 'exacerbates' acne in terms of lesion counts,” Study author Dr. Pravit Asawanonda, professor and chair of dermatology at Chulalongkorn University in Bangkok, Thailand claimed.

Cocoa's flavonoids are known to be anti-inflammatory, but dark chocolate also contains cocoa butter, which consists of fats known as oleic acid and stearic acid.

"The pathogenesis of acne is complicated. ... It's not just one thing. There's a buildup of skin cells at the opening of the hair follicle that causes sebum to be trapped inside. Bacteria proliferate in the sebum and triggers inflammation around the hair follicle. You've got this four-pronged pathogenesis, and that's what makes it so complicated to tease out independent variables. But nutrition plays a role. I think we can safely say that avoiding chocolate addresses only one piece of a very large puzzle,” Farris added.