It’s time to crack the case of the mysterious keto and acne connection. Some fans of the high-fat diet say it cures pimple problems. Others say the keto diet for weight loss worsens breakouts and causes more blemishes. 

Who’s correct? Is it a skin-wrecker or an acne cure?

In my dermatology practice, I’ve seen many skin issues, cures, and fads come and go.  Let’s break down the facts about if the keto diet is a cause or a cure for acne.


How does diet affect skin health?

When zits start to surface, it’s almost everyone’s first reaction to reach for a cream, cleanser, or mirror to pop them — as a dermatologist, that last one makes me cringe. Before you start slathering on the miracle cures, it’s helpful to look at underlying causes.

Acne can have many surprising triggers, from what you wear to sleep quality, and can even be caused by exfoliating too often! 

However, one major lifestyle factor that affects skin health, acne, and aging is your diet.

When we eat foods that are inflammatory, stay dehydrated, or don’t get the nutrients that we need, our skin can suffer. We need plenty of vitamins, hydration, and whole foods to stay healthy, and often our skin issues are an indicator of a problem with our gut health or a dietary imbalance. 

While experts are still learning all of the complex links between snacks and skin, preliminary findings show how important the relationship is.

Armed with that knowledge, we can look at the ketogenic diet as something that affects us from the inside out. I’m a strong proponent of taking care of your mind, body, and spirit at the same  time. 

Remember that a massive dietary change of any kind will likely take some getting used to, and to be gentle with yourself as you monitor your responses.


Here’s the evidence that keto may help with acne.

Here’s a good question for you as you’re weighing the pros and cons of your skincare regimen versus ketosis: why are you going on the diet? Some may use it medically as an effective way to treat type 2 diabetes or even to decrease seizures

It should go without saying that it’s important to talk with your doctor and possibly even a nutritionist or dietician before you approach a dietary change of this size. A dietician can tell you that this low-carb diet completely changes the fuel your body uses to function! 

Specifically, I’d advise against using this diet simply to manage acne.

Nevertheless, there is some preliminary evidence that a low-glycemic diet could reduce acne by evening out hormones and increasing an insulin-binding growth factor, which lowers insulin (blood sugar) levels. 

Reducing carb intake can lower the glycemic load on the body, potentially resulting in greater insulin sensitivity and less acne. Additionally, another small study showed that a ketogenic or low-carb diet may diminish inflammation as well.

While these results may sound promising, it’s important to remember that even these studies say that more research is needed. The information on keto as an acne treatment is extremely limited.

The diet looks somewhat promising in cases of hormonal or insulin-related acne (too much insulin can result in too much sebum production, which clogs pores). So, if your acne isn’t related to blood sugar or hormones, there’s simply not much evidence that keto will affect it.


For some people, keto might make acne worse (or give you a rash).

Sorry, but keto isn’t a cure-all for acne and weight loss — in fact, it may worsen your breakouts and inflammation. This isn’t true for everyone, but there’s plenty of science to back it up. Let’s check out the research.

Dairy products, which are featured prominently as fats in most keto diet recipes, can trigger acne, which may be better treated with a fruit, vegetable, and fish-focused diet. 

In fact, all that dairy can cause an overproduction of sebum, clogging pores and creating more whitehead woes. With the low carbohydrate limits needed to stay in ketosis, it may prove difficult to get sufficient amounts of the recommended fiber, vegetables, and fruits.

Additionally, in rare cases, ketogenic diet has caused prurigo pigmentosa, or “keto rash,” which is an itchy, red, raised patch of bumps especially common in adult women. It’s also common to see darkened skin, which may not fade when the rash does.  

For those who adopted the diet hoping to see skin benefits, keto rash can be quite the opposite effect. The rash cannot be treated without coming out of ketosis.

Two other potential pitfalls when it comes to skin and keto: dehydration due to losing so much water weight, which can cause the skin to look sallow and thin, and greater inflammation due to the high-fat diet, which may even worsen existing skin conditions like acne, eczema, and more.

What’s more, too many fats, even healthy ones like avocado, can eventually overload your digestive system, unable to be processed. This means that they’ll come out in other ways– like through your pores, which could then become clogged. 

That’s right: that sebum production we talked about may get far worse on a ketogenic diet.

So give your gut and your detoxification processes a break and slow down on the fats if you can. A handful of almonds or some perfectly ripe avocado won’t hurt, but potentially overloading your body with dairy and processed fats certainly could.

Even in the concerns, you can still take some of the keto diet’s perks. It certainly wouldn’t hurt to lower your glycemic intake and steer clear of refined sugars, even without entering ketosis. Trust me, your skin will thank you for the clean eats.


How to Optimize Keto for Healthy Skin

If you do decide to try keto, do it in a way that prevents acne and breakouts. Be sure to avoid processed items: read the label on your coconut oil and stock up on those anti-inflammatory, fiber-rich veggies.

Be sure to get the other nutrients your skin needs by eating leafy greens or fatty fish that are rich in vitamin A and omega-3 fatty acids that tend to your skin. Here are my ten nourishing foods for healthy skin.

Finally, be sure to read up on my five steps to eliminating dairy. Many keto recipes pack in the fats through dairy, but as we read above, your skin needs the exact opposite.


Other Ways to Support Glowing Skin on Keto

Even though diet and hydration plays a major role in your everyday glow, there are plenty of other ways to promote gorgeous skin:

There are so many avenues to keep your skin radiant and cared for, and the ketogenic diet is just one option. In my opinion, the facts point to keeping whole foods, healthy fats, and a well-rounded diet to support your skin. 

Whatever you choose for yourself, I’m cheering you on as you make meaningful changes each day.



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