Can keto or low-carb diets cure acne?

Girl  with problem and clear skin.

Most people follow a low-carb or keto diet expecting to lose weight, achieve better blood sugar control, and/or lower their blood pressure. In most cases, these are exactly the type of results that occur.

However, some individuals may also experience an unexpected bonus: improvement in skin quality, including a decrease in the frequency and severity of acne.

Indeed, there’s emerging evidence that this way of eating may help control acne due to its effects on hormonal health.

How does acne develop?

Although nearly 90% of adolescents and teens have acne, it’s fairly common in adults as well. In fact, it’s estimated that in Western countries, around 50% of people in their 20s and 30s struggle with acne. On the other hand, it’s very rare in many cultures who follow traditional diets.

Acne develops as a result of complex interactions that take place within the skin. Sebaceous glands located in the skin’s outer layer are connected to hair follicles. These glands produce sebum, an oily substance that lubricates the hair and skin cells, which are constantly being shed and replaced.

acne

In the case of acne, this system is impaired. Elevated levels of androgens (male hormones) cause increased sebum production, leading to oily skin. In addition, skin cell production ramps up, and dead skin cells aren’t shed in the normal fashion. Instead, these cells combine with excess sebum, causing blocks or plugs. While this process is occurring, bacteria that feed on sebum also enter the picture.

Similar to the gut microbiome, skin maintains its own bacterial balance. One type of bacteria known as P. Acnes lives deep within the hair follicles and is normally present in the outer skin layer in small amounts. However, during acne, concentrations of P. Acnes increase dramatically, causing inflammation that leads to whiteheads, pustules and cysts.

The role of diet in acne

Up until the 1960s, based on early studies, diets high in sugar and refined carbs were believed to worsen acne. However, after experimental research failed to show a link between specific foods and acne, diet was no longer considered much of a contributor.

Today, the tide has turned yet again, in light of mounting research published within the past decade suggesting that carbohydrates may be the main dietary culprit in acne due to their negative effects on hormonal regulation.

For instance, a 2007 controlled study in 43 young acne-prone men by Smith, et al, found that a low-glycemic-load diet led to a greater reduction in acne lesions than a higher-glycemic-load diet. What’s more, the low-glycemic-load group experienced a decrease in androgen and insulin levels, improvement in insulin sensitivity, and weight loss. By contrast, the other group had increases in weight, insulin levels, and insulin resistance.

It’s important to point out that this wasn’t really a low-carb diet; the low-glycemic-load carbs accounted for about 44% of the total dietary intake. Would there have been an even greater improvement with a low-carb or keto diet providing less than 15% of energy from carbs?

Low-carb and ketogenic diets for acne

Although controlled research on carb restriction for acne has yet to be done, many people have reported that their skin has become much clearer as a result of following a low-carb or keto diet.

Moreover, there are logical reasons why minimizing carb intake would be helpful for acne sufferers.

A 2012 article by Italian researchers discusses the potential benefits of ketogenic diets for acne, including the following:

  • Reduction in insulin levels: Elevated insulin levels stimulate increased production of skin cells, sebum, and androgens – setting the stage for acne eruptions. Ketogenic diets decrease insulin levels, often dramatically.
  • Anti-inflammatory effects: Inflammation drives acne progression. Very-low-carb and ketogenic diets have been shown to reduce inflammation.
  • Decrease in IGF-1 (insulin-like growth factor 1): Ketogenic diets decrease levels of IGF-1. Like insulin, IGF-1 increases sebum production and has been found to play a large role in acne.

In a compelling 2013 review on therapeutic uses of ketogenic diets for various conditions, Paoli, et al, state that although the emerging evidence for the use of keto diets in acne is promising, randomized controlled trials (RCTs) are needed to confirm these benefits.

Keto or low carb: Which is best for acne?

As there aren’t yet any studies on stricter low-carb or keto diets for acne at this time, it’s difficult to determine the degree of carb restriction needed to achieve the best results. Similar to losing weight or reducing blood sugar, the necessary carb reduction for potential acne control likely varies from person to person. It’s possible that stricter low-carb diets are more effective.

Tips for maximizing the benefits of a keto or low-carb diet for acne

Below are some additional dietary tweaks that may or may not be useful. They are based on preliminary evidence, small studies that need to be repeated to know for sure whether the suggested effects are real.

  • Consume fatty fish often: Long-chain omega-3 fatty acids found in fish are anti-inflammatory and have been credited with possibly improving acne. The best sources include salmon, mackerel, sardines, herring and anchovies.
  • Eat low-carb vegetables: Leafy green and cruciferous vegetables may help promote hormonal regulation and improve skin health. Notable dermatology researcher Bodo Melnik recommends a Paleo diet rich in vegetables for acne management.
  • Avoid or limit dairy: Dairy has been shown to increase levels of insulin and IGF-1. Although skim milk seems to have the the strongest link to acne, cheese has also been implicated as a potential issue.
  • Drink green tea: Green tea is the best source of the antioxidant EGCG (Epigallocatechin gallate). A 2016 study found that green tea extract appeared to significantly reduce acne lesions in adult women with moderate to severe acne.
  • Avoid or limit dark chocolate: Although earlier studies showed no difference in acne response when chocolate was compared to other sweets, a 2016 study found that even virtually sugar-free 99% dark chocolate might significantly worsen breakouts in acne-prone men. For this reason you may want to limit even dark chocolate intake, just to be safe.
  • Focus on fresh low-carb foods: Even if you don’t eat sugary and starchy foods, you may still be consuming ingredients that can cause skin issues. Bologna and other processed meats often contain sugar, corn syrup, fillers or other additives that raise insulin levels and potentially provoke inflammation. Stick to fresh food whenever possible, and read labels on processed meats and other packaged foods.
  • Give the diet some time: Paradoxically, some people report a worsening of acne shortly after starting a keto or low-carb diet. However, this appears to be short-lived and may be part of the keto-adapatation process. Overall, breakouts seem to improve with carb restriction long term in the vast majority of people.

Summary

While the evidence is still somewhat preliminary, there are many reasons to believe that low-carb and keto diets can improve acne. Feel free to read several stories below from people who have tried it, and to use our free guides linked below to get started.

By choosing nutrient-dense low-carb whole foods that minimize insulin levels and reduce inflammation, you may be giving yourself the best shot at clearer, healthier skin.

Trying a low-carb diet is safe, and besides the cost of buying real food, it’s also free. So why not try it out for a few weeks, and see what happens to your skin?

Have you already tried a low-carb or keto diet for acne? Feel free to leave a comment below, and share your experiences.


Franziska Spritzler, RD

Stories

  • Keto and intermittent fasting: "I am completely blown away by the changes"
  • The global poster girl for the carnivore lifestyle
  • Acne (and IBS) vanished with a diet change
  • "For the first time in 15 years I'm free of acne"

Try it

Low carb for beginners

Keto for beginners

Low-carb basics

Earlier

“A combination of LCHF and paleo healed my skin”

“Within three months of starting a well-formulated ketogenic diet, all flares were gone!”

Comments

10 Comments

  1. Chantel
    I can attest to LCHF improving my acne. Used to get lots of cyctic acne around my period. Since being on LCHF, it has vastly improved. Not quite 100%, but I no longer see it as a problem or ashamed by it.

    Apart from better skin, LCHF is the best thing I ever could have done for many reasons. My only regret is that I didn't start it sooner.

  2. Elaine
    Is soy ok on low carb like alpro almond milk
  3. Jill
    What about hair loss, specifically androgenic alopecia which is linked to elevated androgens or a sensitivity to a normal amount of androgens? I am a woman and have been suffering from this for the past few years. I have lost 70% of my hair and my hair no longer grows at all anywhere. My hairline and temples are the hardest hit and the hairs are stunted and stuck at various short lengths, like 1/2 inch to 2 inches. This has been devastating. I have been trying to do low carb but the stress over my hair puts me in a constant sugar binge eating cycle. I have seen articles that show a connection between insulin resistance and inflammation from a high sugar and wheat diet and androgenic alopecia. But I haven't seen any definitive articles about sugar being the cause, just a contributor to a problem that is genetic. I saw one article that was pretty bleak and it said that once the damage to the hair is done, nothing can reverse it. The article suggested a possible prevention of future hair loss but stated that regrowth was not possible. I don't have celiac or hashimotos so I don't believe that its a reaction to gluten. I have seen a few specialists and will be starting an anti androgen program but I would love to know if anyone has reversed androgenic alopecia with a low carb diet or if there is any new research about this.

    BTW, I did suffer with acne as a teenager but it was not extreme. I have been on a high sugar overeating diet my whole life. But just my hair is suffering, I have seen no increase in acne. I don't understand why my hair would be so terribly affected while my skin has not been.

  4. Jill
    Just wanted to add that I routinely hear that low carb diets CAUSE hair loss so it scares me that I might lose even more hair if I go low carb. I have gone low carb twice in the past for short periods of time, one month and ten weeks. I was suffering from the hair loss and non growing hair before starting. But the stories about people losing tons of hair from low carb as well as from fasting are really frightening for someone in my situation.
  5. Nan
    I just visited my dermatologist who commented on how hydrated and healthy my skin is, for someone my age (late middle). I used to have dry skin, got rashes, and with a low carb sometimes keto diet, and normal moisturizing, my skin has very few wrinkles. And my fine hair has never been healthier. I'm convinced diet is important to the health of our largest organ, the skin.
  6. Bob
    58 and have mild life long acne. 6 weeks of keto, intermitent fasting, and my acne disappeared, lost 15 pounds so far and I swear my wrinkles are less. skin feels smooth, looks cleaner, bags under eyes and bruised look below eyes dissapaiting. Back pain better. lost 3 inches on waist. i will credit keto with the acne although I'm guessing wheat is a big part of that.
  7. No carb believer
    Strictly followed a Keto diet for 16 weeks. Lost 20 lbs, plus the big surprise... My skin was the clearest it’s been in my adult life...went from some adult facial acne and bad scalp eczema even with use of expensive prescriptions to completely clear skin to ...no acne, no eczema... to the point I forgot where I put the prescription bottles because I no longer needed them ! Started really noticing a difference about 4weeks into diet.
  8. KK
    LCHF did not cure my acne, so, I tried going gluten free and it worked. Seems I had Dermatitis herpetiformis, as in, coeliac decease with symptoms on the skin. According to Wikipedia: "Estimates of DH prevalence vary from 1 in 400 to 1 in 10,000. It is most common in patients of northern European/northern Indian ancestry, and is associated with the human leukocyte antigen (HLA) haplotype HLA-DQ2 along with coeliac disease and gluten sensitivity."
  9. Eva
    I have suffered from quite severe acne for 37 years (I am 49). I tried everything, but nothing worked. After starting the ketogenic diet for completely different reasons, to my surprise my acne disappeared within four weeks. I have now been almost completely acne free for nine months. The only instances I will have a flare up is when I cheat and have anything containing wheat, even if it is only a tiny bit, such as wheat protein in a veggie burger.
  10. TeeDee
    I follow a ketogenic diet with zero grains because gluten causes me breakouts, but the worst for my skin now is dairy. The thing is, the dairy didn't become an issue until about age 59-60 (61 now), so one never knows when the body will finally say, "enough". For a little while, I could get away with having some aged cheddar, but even that causes very inflamed pustules to break out on my cheeks and forehead (never on my chin or nose, for some reason). I eliminated the cheese and my skin cleared up. I tried a small piece after about 2 weeks and it was ok, but when I tried another small slice a few days later, the pustules returned, so now I either have to steer away from all dairy for good, or at most have a sliver once every week or two...It sucks, but the health benefits and skin's appearance while on a ketogenic diet far outweigh the little sacrifices.

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