Foods that spike insulin production like refined sugar and carbs and excessive dairy, (especially whey protein powders), a concentrated form of dairy. The trigger appears to be related to insulin and insulin-like growth factor 1, IGF-1. These hormonal pathways are associated with many metabolic and physiologic abnormalities when they are altered. Insulin is the main hormone driving glucose sugar balance in the blood and ultimately the deposition of fat. IGF-1 structurally looks like insulin and has growth and anabolic effects on the human body. This goes on to stimulate sebum production and keratinization, creating the conditions for acne development.