Can Keto or Low Carb Diets Cause Acne?

Does The Keto Diet Cause Acne?

the keto diet and acne

The keto diet has revolutionized the way people approach weight loss. What was once considered a crazy idea (that you could eat a high-fat diet and lose weight) has been shown time and time again to produce amazing, sustainable results. But is there even more to the keto diet than the ability to shed pounds while eating bacon?

Apparently so, as scores of people are reporting that the ketogenic lifestyle has also helped them finally get relief from their acne as well. But is this real or just a bunch of wishful thinking on the part of these folks?

To get to the bottom of these claims we need to get to the bottom of what causes acne in the first place and then see if there are any aspects of the keto diet that directly affect those causes.

How Does Acne Develop?

Acne develops when the sebaceous glands in the skin produce excessive amounts of sebum - an oily substance that gives your skin its waterproof nature.

But the sebaceous gland doesn't act on its own [1]. It's spurred to action by excessive amounts of testosterone and insulin. 

lady with acne

These are complex interactions with what are often mysterious causes, and they make getting an effective handle on acne extremely difficult. But you know what? There’s even more involved when it comes to the development of acne.

Elevated testosterone and insulin levels trigger the sebaceous gland to produce more sebum than our skin can handle. As a result that excess oil winds up clogging hair follicles and triggering acne. But that’s not all. All that hormone action also triggers a more rapid metabolic state and ramps up the production of skin cells. In fact, so many skin cells are produced that dead ones don’t have anywhere to go when they die, so they too wind up clogging hair follicles.

In addition (you knew there was more) bacteria that eat this skin oil also enter the picture. To them, the excess sebum production creates an all-you-can-eat buffet, and they multiply by the billions. Once the bacterial balance of your skin is thrown out of whack, it causes inflammation of those clogged pores and leads to the whiteheads and cysts we know as acne.

What Role Do Diets Play in Acne?

many different food groups

Diets play an enormous role in the development of acne. Even greater than the role played by genetics, which for a time was considered the primary cause. Researchers are now beginning to realize that, as is the case with many other health-related issues, it’s all about nutrition and what we eat [2].

In the past, clinical research on acne focused on the fact that many Westerners suffered from acne while native populations in far-flung islands and the frozen north did not. 

This was considered by many to be pretty convincing proof of a link between acne and genetics. Those assumptions, however, were turned on their head when members of these native groups began to leave the tundra behind and assimilate.

The Strange Case of Eskimo Acne

Not many adults would trade in our warm, cushy lives for the austere, nomadic lives lived by our friends in the North.

But in spite of the hardships inherent in Eskimo life they were long known to be free of at least one thing that plagues those of us in the lower 48: acne. 

lady on ice mountain

For many years researchers attributed this acne free skin to genetics. That is, until Eskimos began to adopt more settled lifestyles in Alaskan towns and villages

Once they settled in and began to eat a more standard Western diet many of them noticed changes not only in the way they felt but in the way their skin looked.

For the first time when they looked in the mirror, they saw acne staring back at them. At first, doctors and researchers were at a loss to explain it. But it didn’t take long before the culprit was unmasked.

In his 1971 article “When the Eskimo Comes to Town” Doctor Otto Schaefer explained what happened: 

From 1 meal of high protein, low fat and practically no carbohydrates with frequent nibbling the rest of the day on fish, the Eskimo family in settlements gets 3 rich meals a day and seemingly endless sweet drinks, candies, and chocolates.

Doctor Otto Schaefer

Although genetics are still believed to play some role in the development of acne, there was no amount of DNA that was going to stand up to that high carb, refined sugar (learn more about sugar intake here) onslaught.

Does the Keto Diet Cause Acne? Is it Bad for Your Skin?

The keto diet is not bad for your skin, and there is little evidence to suggest it will cause or aggravate a long term acne problem.

In fact, just the opposite. Still, any kind of abrupt dietary U-turn is bound to put stress on your system. 

girl thinking

Which is why health professionals recommend you make a gradual shift from one diet to another, instead of a sudden one [3].

There is no reason to think there is a keto diet-acne connection or that keto is going to cause you to develop chronic acne.

But there is anecdotal evidence to suggest that some people may experience short term breakouts after making a sudden switch to low carb foods and a high-fat diet.

pillow and tablet

These folks are in the distinct minority, however, and even they can reduce the chance of experiencing a temporary increase in pimples if they take the following common sense steps.

  • Drink water - The low-carb diets have a tendency to reduce moisture levels in the skin which means it’s really important to drink plenty of water. Especially if you are transitioning abruptly from your former diet to the ketogenic diet (find more here).
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    Limit the amount of dairy you consume - A lot of keto dieters lean pretty heavily on dairy products, but this might not be the best idea, at least when you are first starting out. There is scientific evidence that milk products may increase the risk of developing acne [4]. So cut back on the dairy at first. Then reintroduce it slowly and monitor the effects (if any).
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    Try a different cleanser - Dermatologist Dr. Joshua Zeichner recommends that women use a cleanser that employs salicylic acid or benzoyl peroxide. He says they will do a better job than most of removing dead cells from the surface of the skin while also killing acne-causing bacteria.
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    Exfoliate - Using a nighttime face wash that will clear the skin of excess oil, dirt and grime is a good idea for those switching to the keto diet. Exfoliating will help remove these problem-causing elements from the skin so that they don’t have a chance to take hold at a time when your body is already vulnerable due to diet-related changes.

In addition, it's recommended you adopt the following habits in order to ensure short term acne won’t bother you during the transition from a carb-heavy diet to a ketogenic one.

  • Change your pillowcases - Even if you dedicate yourself to washing your face thoroughly before you hit the sack once you lay your head down on a dirty pillowcase you pick up all the sweat and oil and grime that’s accumulated on the pillow since the last time you washed it. Not only that, but if you exfoliate right before going to bed your skin will be wide open and an easy target for bacteria, dirt, and oil from the pillowcase.
  • Keep your hands away from your face - Like your smartphone, your hands are dirt and bacteria magnets [5]. Pressing them against your face only serves to transfer all the microbes, oil and other contaminants you picked up with them directly onto the surface of your skin. Therefore, keeping them away from your head is crucial.
  • Clean your phone - According to Professor of Dermatology Dr. Zeichner 

Studies have shown that your cell phone is dirtier than a public toilet.

Dr. Zeichner

That's a pretty appalling fact and should be enough to convince you of the wisdom of cleaning your smartphone. If you don't keep your phone clean then every time you press it against your face, you're transferring dirt, oil, grime, and bacteria directly to your skin.

 The doctor recommends using an alcohol swab to clean your phone on a regular basis.

The bottom line is that some people may experience a slight uptick in pimples when making an abrupt transition from their old carb-heavy diet to keto low-carb diet.

But any such short term outbreaks can be effectively minimized by taking the above tips to heart.

So, is Keto Diet Good for Acne Then?

gorgeous girl with no acne because of fish

The keto diet is good for acne because it helps regulate insulin levels, as we talked about briefly a little earlier. This is a major benefit of the keto diet because insulin plays a crucial role in the creation of acne. For instance:

  • Insulin stimulates skin cell growth - Too much insulin can lead to skin cell creation in excess of what’s needed to replace ones that have died. The excess ones wind up blocking pores and promoting acne.
  • Insulin also stimulates the production of keratin - Keratin is a protein that causes cells to stick together. When it comes to skin cells too much keratin can lead to blocked follicles.
  • Insulin also promotes the production of sebum - “Sebum" is a fancy way to say "skin oil." The presence of sebum is the reason water runs off of you in the shower instead of being absorbed by your skin. Too much, however, will inevitably lead to acne.
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    Insulin stimulates testosterone production - Testosterone can contribute to all the effects listed here. Excessive amounts of insulin can also make the skin more sensitive to testosterone, aggravating the situation even more.

It may take some time for insulin levels to balance out after switching to the keto diet so don’t throw in the towel if you see a few pimples in the first couple of weeks after making the change.

Keep in mind too that acne is also linked to the overproduction of skin oil, oxidative damage, and toxins associated with your former diets and that it may take some time for these things to clear your body and their effects to wane.

Tips on Maximizing Your Keto Benefits to Fight Acne:

Besides all the dietary and lifestyle tips we already discussed there are other steps you can take that will help ease your transition from a carb-centric diet to the ketogenic diet. By making these part of your everyday life, you will optimize the anti-acne benefits of the keto diet.

green vegetables and salmon
  • Stick to low carb foods especially veggies - Green leafy vegetables and cruciferous vegetables are believed to help regulate hormones which can have a positive effect on skin health. Cruciferous veggies include cabbage, brussel sprouts, cauliflower, broccoli, turnip, watercress, arugula and more. They should be staples of your new keto recipes (check out our meal plans here).
  • Eat lots of fatty fish - Salmon, sardines, mackerel, anchovies and other similar, oily fish are known to be rich in long chain omega-3 fatty acids. Omega-3 acids are known for their anti-inflammatory properties, and this is believed to play a potential role in reducing acne. Sure, you may have a bit of bad breath from time to time but nothing a good breath mint won’t cure.
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    Try green tea - If you don’t already drink green tea, you should give it a try. Why? Because a study released in 2016 [6] found that green tea extract may play a potentially significant role in helping to reduce lesions in women with acne.
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    Limit dairy intake - We mentioned this before, but it bears repeating simply because so many keto dieters tend to lean on dairy foods. Dairy is suspected of raising insulin levels which, as we discussed above is a major factor in acne development.
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    Stay away from dark chocolate - A 2016 study simply titled “Dark Chocolate Exacerbates Acne” [7] pretty much says it all. The research found that even sugar-free dark chocolate played a major role in prompting acne outbreaks. So if Valentine’s Day is around the corner make sure your sweetheart knows to get you something other than dark chocolate.

Chances are you will not experience even a temporary uptick in acne symptoms after switching to the keto diet. In fact, the majority of evidence suggests that if you suffer from acne, you'll experience major relief by switching to keto. In the unlikely event that you do develop some pimples etc. after switching diets take the above tips to heart and be patient. It’s just a temporary side effect. It should pass.

Final Summary:

egg avocado and fruits

While some still contend that more study is needed the evidence to this point strongly suggests that the ketogenic diet can, in fact, help reduce the development of acne.

These conclusions are based on the fact that the low-carb diet, when practiced properly, does a generally excellent job of promoting weight loss and stabilizing insulin levels.

And insulin levels play a key role in triggering the forces that wind up generating acne. Finally, while it is not common, some people may experience a temporary increase in acne and other forms of skin inflammation when switching to the keto diet.

But by making common sense adjustments to their diet and lifestyle, any outbreaks can be minimized and should pass in time.

About the Author

Ryan is a personal trainer, athlete, health enthusiast, and entrepreneur. He is researching and expanding his knowledge about the ketogenic diet. He spends most of his time writing content about his new learnings of the ketogenic diet and shares it on Ketogenic Supplement Reviews. You can find me on: Facebook, Twitter and Pinterest.