Does the ketogenic diet clear acne?

Does the ketogenic diet help or aggravate acne? The ketogenic diet is quickly becoming a popular diet to help balance hormones, normalize insulin levels and heal PCOS.  But does it help or aggravate acne?  This is a question I am asked often because the results of the diet can be so mixed.  Some women find that the ketogenic diet virtually erases their acne, while other women experience the worst break-outs of their life.  Why does this happen?  We’ll get to that in a minute, but first, let me give you a brief overview of the ketogenic diet. What is the ketogenic diet? The ketogenic diet changes the body’s fuel source from glucose (sugar) to ketones (fat).  This is accomplished by removing most carbohydrates from the diet so that the body has no choice but to start burning fat as its fuel.  As the body starts to efficiently burn fat many hormonal systems in the body may start to normalize. The ketogenic diet has been used therapeutically since the 1920s, typically to help heal neurological conditions such as Epilepsy, Parkinson’s Disease and Autism.  More recently, the diet is being used to balance insulin and hormone levels, helping conditions such as metabolic syndrome, obesity, diabetes and PCOS. The breakdown of the traditional ketogenic diet looks something like this:

• 70-80% Healthy Fats (coconut oil, avocado, butter, ghee, olive oil, etc.)
• 5% Non-starchy Vegetables (broccoli, cauliflower, leafy greens, carrots, etc.)
• 15-20% High Quality Protein (organic beef, chicken, fish, etc.)

  When is the ketogenic diet helpful for acne? If insulin dysregulation is the main root cause of acne the ketogenic diet can be really helpful.  As the body goes into ketosis, insulin levels will start to normalize and inflammation and androgens in the body will start to recede.  Some women with PCOS may find the ketogenic diet completely clears their acne. When does the ketogenic diet aggravate acne? Often acne is multi-factorial, and multiple systems need to be supported and nourished to clear up the skin.  In this case, the ketogenic diet may not successfully clear acne.  If any of the following three conditions are a part of your acne, you may want to avoid doing a strict ketogenic diet.

1. Dysbiosis – If digestion is an issue, or if you have dysbiosis, the ketogenic diet may not be helpful.  In order to heal acne, the gut must be healed and dysbiosis must be cleared.  And recent research has indicated that following a strict ketogenic diet may not be beneficial for the microbiome.  In fact, a high fiber diet is needed to nourish the microbiome, and the ketogenic diet does not promote eating enough carbohydrates, even from non-starchy vegetables.  To maintain a healthy microbiome, 40-100g of carbohydrate are needed per day, whereas the ketogenic diet promotes only 20-30g of carbohydrates per day (carbohydrates are limited in the ketogenic diet so that the body is able to transition into a state of ketosis, or fat-burning).
2. Constipation – As just discussed, the ketogenic diet does not include a lot of fiber, and fiber is need to promote regular bowel movements. If constipation is an issue for you, it is essential to reduce constipation in order to clear your acne.  Reducing your fiber intake is not the best strategy, as this can often make it worse.
3. Inefficient detoxification – Many people that experience acne tend to have difficulty detoxing efficiently. In fact, research has uncovered certain genetic polymorphisms (SNPs) that are common in acne patients, resulting in inefficient liver detoxification.  When consuming the ketogenic diet the liver is required to work very hard breaking down the fat and producing the ketones.  This can lead to an over-burdened liver, which can result in more acne.  If your liver needs support to achieve clear skin, the ketogenic diet may result in an aggravation of acne.

In my clinical experience, most acne patients experience at least one of the above three contributors to acne, and I find that the ketogenic diet is not a good strategy to get rid of acne for everyone. What diet actually clears acne? After working with acne patients for over 10 years as a naturopathic doctor, I have put together a diet that helps balance hormones and insulin levels, supports the liver, heals the gut and removes constipation.  The most important part of the diet is reducing sugar and starchy carbohydrates, and increasing non-starchy carbohydrates, fats and protein.  If you are interested in learning more about the diet, please check out my 7-Week Clear Skin program!