However, the influence of chocolate may also be attributed to the sugar content, as it may be responsible for increased levels of insulin-like growth factor-1 (IGF-1), IGF-binding protein, and androgen [47,48], as a result affecting keratinocyte proliferation and apoptosis, accompanied by increased sebum production, which is similarly indicated among potential acne-promoting mechanisms [49]. The gene discussed is IGF1; the disease is acne.