Can the Keto Diet Help With Acne?

If you have acne, you’re not alone.

In Western countries, upwards of 90% of teens and 50% of adults suffer with acne [1]. As such, acne is seen as an almost universal condition. But did you know that in countries that eat traditional diets, the skin condition is a rarity?

Studies have repeatedly demonstrated that nonwestern populations that eat unprocessed low-glycemic foods have substantially lower rates of acne. In fact, in one study of residents of an island in New Guinea, over the course of roughly three years, researchers identified zero cases of subjects aged 15 – 25 with acne [2]. Yet they found that inhabitants of the island who left for more metropolitan areas developed acne. Studies like this have reignited an old debate about the role of diet in acne formation.

How is acne formed?

Acne is caused when tiny holes in the skin called hair follicles become clogged with dead skin cells and sebum, an oil that helps skin from drying out. When the follicles are blocked, they can become inflamed and infected, resulting in the formation of pimples, whiteheads, blackheads, or cysts. 

Various factors are known to aggravate acne, including hormonal changes, excess oil production, some oil-based cosmetics, certain medications, stress, and bacteria growth [3].

But what if simple dietary changes could help?

The Glycemic Index

The glycemic index is a tool that helps people manage their blood glucose levels, and thereby their insulin levels. 

Ketogenic and low carb diets are naturally low glycemic. Studies suggest that high glycemic foods can indirectly influence the development of acne. High glycemic foods cause a rapid increase in blood sugar levels, leading to an insulin response by the body. This insulin response can stimulate the production of insulin-like growth factors (IGFs), such as IGF-1.

Insulin-like growth factors affect cells throughout the body, including skin cells. IGF-1 is believed to promote something called “follicular epidermal hyperproliferation,” an excessive growth and accumulation of skin cells within the hair follicles [4]. This process contributes to the formation of acne lesions.

Diet and Acne

Those who eat a ketogenic diet often consider it a panacea, improving everything from fertility to mental health to neurological health and, surprisingly, even skin conditions. 

The keto diet is believed to help improve acne in several ways:

Reduced sugar intake: Ketogenic diets greatly reduce the consumption of processed foods, refined sugars, and carbs. Diets high in sugar and refined carbs can lead to inflammation and elevated insulin levels, which are strongly linked to acne development [5]. 

Decreased insulin levels: By limiting carbohydrate intake, the ketogenic diet helps reduce insulin production. Insulin can stimulate the production of sebum, an oily substance that can clog pores and lead to acne [6].

Lower inflammation: The keto lifestyle emphasizes consuming anti-inflammatory foods, such as fatty fish, avocados, and olive oil. Inflammation is associated with acne, and by reducing inflammation, the severity and frequency of acne breakouts may decrease [7]. Because of its anti-inflammatory nature, the ketogenic diet is an established therapeutic practice for other skin disorders, such as psoriasis [8]. 

Balanced hormone levels: Hormonal imbalances, particularly elevated levels of androgens (male hormones), can contribute to acne development [9]. Research shows that the keto diet can help regulate hormone levels, potentially reducing the occurrence of hormonal acne [10,11].

Takeaways

Acne is a common problem among Western populations that eat high glycemic diets. While more research is needed, there is evidence to suggest that a low carbohydrate or ketogenic diet can help improve acne symptoms. So if you’re looking for clearer skin, consider three simple rules: control carbohydrates, prioritize protein, and don’t fear fat.

References

1.  https://pubmed.ncbi.nlm.nih.gov/12472346/
2. https://www.researchgate.net/publication/221825592_Nutrition_and_Acne_Therapeutic_Potential_of_Ketogenic_Diets
3. https://www.ncbi.nlm.nih.gov/books/NBK459173/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847434/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287950/
6. https://pubmed.ncbi.nlm.nih.gov/27061046/
7. https://pubmed.ncbi.nlm.nih.gov/36779329/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016365/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969667/
10.  ​​https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334192/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664869/