"Future studies with a larger study group using dark chocolate as well as specific components of chocolate, such as the flavonoids coupled with more diligent documentation of the participants' diets and menstrual cycles may provide valuable and comprehensive dermatology guidance to acne patients" (Delost, Delost, & Lloyd, 2016).

The pimples increased with "the chocolate consumption group [having] a statistically significant (P < .0001) increase in acne lesions (+4.8 lesions) compared with the jellybean consumption group (−0.7 lesions)" (Delost, Delost, & Lloyd, 2016).

When they say all patients received both treatments they are referring to the "Crossover analysis was done 4 weeks later. There was no statistically significant difference in the number of acne lesions between the 2 groups when the crossover occurred (P = .322), which demonstrates adequate washout from the first part of the study" (Delost, Delost, & Lloyd, 2016).

"The link of chocolate to acne vulgaris was replaced by the theory that a high glycemic index may contribute to acne vulgaris. In this study, we attempted to revisit the controversial topic by assessing the development of new acne lesions following ingestion of chocolate versus a nonchocolate candy with a similar glycemic load." (Delost, Delost, & Lloyd, 2016).