10 Reasons You’re Getting Acne on Keto

10 Reasons You’re Getting Acne on Keto

So you recently went keto and you’re still experiencing acne – I’ve been there.

While it might seem frustrating that even after switching to a “healthier” diet and you still find yourself breaking out, there’s nothing to worry about.  With a few quick tweaks to the ketogenic diet, you can easily eliminate just about every root cause of acne.

You’ve already done the hard part: eliminating most carb sources.  Carbs trigger the release of insulin, a hormone largely responsible for acne.  Just by going keto you’ve made a great first step in eliminating acne.  These tips are hopefully all you need to beat the last of your acne with the ketogenic diet.

1. You’re eating too much dairy

Despite being low in carbohydrates and technically keto-friendly, dairy is arguably the single most problematic food group when it comes to acne.

Related: Why (most) dairy causes acne

Dairy contains large amounts of hormones, including insulin, IGF-1, and IGFBP-3, that trigger the body to produce excess skin cells and sebum oil that can clog pores.  In addition to being loaded with insulin-like hormones, dairy actually produces a large insulin spike in the body despite not having many carbs (remember, insulin is the master hormone behind acne).  A cup of milk producing a higher insulin spike than white bread.  Yikes.

Not only does dairy cause hormonal acne, but it can damage your gut and cause inflammation too.  Intolerance to lactose, the sugar in dairy, is extremely common, affecting more than half the world population.  Lactose intolerance can be a driver in chronic inflammation, the process largely responsible for inflamed pimples.  On top of that, the body also has a difficult time digesting dairy protein (casein and whey).  In some individuals, they may even permeate the intestinal lining and lead to leaky gut syndrome.

For these reasons, cutting out dairy is crucial for clear skin.  Unfortunately, when people go keto they oftentimes load up on dairy in place of other nutritious foods.  Some people may find that they can tolerate raw, grass-fed, organic dairy, but you’ll never know if it’s behind your acne until you try cutting it out first.


2. You’re too stressed out

Changing your diet can be stressful.  You’re cutting out old favorites, scrambling to find new recipes, and putting on a balancing act to keep it all together.
The keto diet can be particularly stressful because it (usually) requires you to be meticulous about counting carbs.
Combine keto with intermittent fasting and you get a whole new level of stress:
“You mean I have worry about when I can eat too?”
Stress triggers the hormone known as cortisol to be released.  Cortisol triggers a waterfall of nasty effects for acne:
On top of the physical stress of changing your eating habits, if you’re adding on a lot of mental or emotional stress you could definitely see a spike in acne.
My tip?  Don’t worry so much about the macros, especially at the beginning.  So what, you had 40g of net carbs instead of 20g – don’t sweat it, you’ll do more damage worrying about the extra carbs than the carbs themselves.

3. You’re not eating enough vegetables

It’s not uncommon for new keto dieters to embrace a meat, dairy, and fat-heavy lifestyle when they go full-blown keto.

As enticing as it sounds to eat only bacon and eggs for all your meals, and while it’s technically still keto, that can be a real nightmare for acne – you won’t be getting nearly enough phytonutrients, minerals, and antioxidants to fight ance.

Eating plenty of vegetables is the key to combatting this issue.  Many vegetables are high in vitamin A, C, E, and K, as well as minerals like potassium, magnesium, and copper, all essential nutrients for clear skin.

A lot of people on keto are concerned with the carbohydrate intake associated with vegetables, but the simple fact of the matter is that most carbohydrates in vegetables come from fiber, which doesn’t count towards your net carb count.  Also, if you’re eating so many carbs through other foods that you can’t eat vegetables, then you’re probably not eating a balanced ketogenic diet in the first place.

Personally, I never found myself kicked out of ketosis from eating vegetables, even in huge quantities.  My recommendation would be to consume at least 8oz of vegetables per day, or about 8 “servings”.  Kale, spinach, romaine, broccoli, cauliflower, celery, chard, and asparagus are all great keto-friendly options.

4. You’re eating low-quality meat

On a diet where meat is a staple at just about every meal, it’s easy to consume boatloads of low-quality meat.  While it might seem extreme to only consume high-quality meat, there are tons of good reasons for it:

If you can’t afford these options it’s not the worst thing in the world, but if you can I’d definitely recommend purchasing higher-quality meat, it can make a pretty huge difference in your skin.

Here’s the quick-and-dirty guide to buying acne-friendly meat:

  • Beef: Organic, grass-fed
  • Chicken: Organic, free-range
  • Pork: Organic, pasture-raised
  • Seafood: Wild-caught
  • Eggs: Organic from free-range/cage-free chickens


5. You’re “detoxing” or adapting

“Detoxing” is one of those new-age health words that I really don’t like – it has a pseudo-scientific aura around it that takes away its credibility.

With that being said, one common argument for acne on keto is that your body is removing and filtering out toxins stored in fat.

This hypothetically makes sense.  Toxins are generally stored in fat, so when you begin to break down your own fat (instead of fat from food) for energy, you’re bound to release toxins as well.  Whether or not these “toxins” can create acne is unproven.

What is more likely the case, in my opinion, is that adaptation to the keto diet, which takes weeks and sometimes even months, can create stress on the body (and mind) which in-turn creates acne.

If you’ve been running off carbs/glucose for the vast majority of your life and all of a sudden you decide to change it up and burn fat for fuel, your body is going to need time and resources to adapt.  This can be stressful for the body, which in turn may create acne.


6. You’re getting poor sleep

This was a big contributor to my post-keto acne.

A lot of people experience poor sleep when transitioning to a ketogenic diet.  It’s worth noting that many people experience much better sleep too.

Personally, I found myself waking up dozens of times per night when first becoming fat adapted.  I thought it would subside, but it lingered on no matter what.

Using magnesium at night helped considerably, as did intermittent fasting, but it my sleep was still considerably worse than when I was on a lower-carb Paleo diet (~50g net carbs per day).

If you’re still struggling, you can try having a very small amount of raw honey before bed or consuming low-sugar fruits (blackberries, raspberries, strawberries, blueberries) with your last meal of the day.  As a last resort, you could also try carb-cycling and utilize a cyclical ketogenic diet, where once a week you consume around 150g of net carbs.

7. You’re eating too many nuts

Nuts can seem like a no-brainer on keto.  They’re (generally) low in carbs, have adequate amounts of protein, and are extremely filling.

The problem with nuts is that most of them contain either high amounts of inflammation-causing omega-6 fatty acids or too much phytic acid, an antinutrient that prevents the absorption of several minerals, including zinc and magnesium.

That being said, nuts have some redeeming qualities too.  Many nuts are high in antioxidants, magnesium, fiber, and gut-healing prebiotics, not to mention they taste great.

Not all nuts are created equal when it comes to acne.  I’d recommend reading my in-depth article on nuts and acne here.

The key with most nuts is moderation.  Use them as a snack, and treat them almost like you would a supplement and you shouldn’t run into any issues.

The notable exception to this rule for keto-friendly nuts is macadamia nuts, which has very little phytic acid and very little omega-6 fatty acids.  While I still wouldn’t recommend eating a whole bag at once (I’m guilty of this on several occasions), macadamias are about the best nut you could eat for acne.

8. You’re eating the wrong fats

Hmm, ranch sauce has pretty much no carbs, which makes it keto friendly.  That means it shouldn’t be a problem for my skin, right?

Wrong.  Not all fats and oils are created equal, and when it comes to acne, most vegetable oils (soybean, corn, sunflower) besides and the products that contain them (salad dressings, artificial fats, packaged/artificial snacks) are one of the worst foods you could eat.

Vegetable oils are loaded with omega-6 fatty acids that can lead to chronic inflammation.  These fats and oils trigger an inflammatory response from the immune system, which can lead to angry, red pimples.

Butter that isn’t organic and grass-fed can also be problematic due to the high concentrations of hormones.  The same goes for non-grass-fed beef tallow and non-pasture-raised lard.

Instead of vegetable oils, go with healthy fats, like extra-virgin olive oil, coconut oil, grass-fed ghee butter, grass-fed beef tallow, and avocado oil.

Related: Top 5 healthy fats for acne-prone skin


9. You have a thyroid problem

The thyroid helps regulate your metabolism, body temperature, mood, and the immune system.  An improperly-functioning thyroid can lead to a multitude of symptoms, including acne:

  • Anxiety
  • Hair loss
  • Dizziness
  • Fatigue
  • Feeling too hot or too cold
  • Dry skin
  • Pale skin
  • Weakness

The ketogenic diet has been shown to decrease the amount of T3 thyroid hormone produced, which can lead to a condition called hypothyroid.  When most people go keto they also naturally consume fewer calories – calorie restriction is problematic for the thyroid as well and can lead to hypothyroidism.

I personally experienced symptoms of hypothyroidism after going full-blown keto with intermittent fasting.  What was the fix?

More safe carbs.  If you want to stick to keto and you’re experiencing thyroid problems, try having a once a week carb re-feed where you consume ~150g of net carbs.  Alternatively, you could go with a low-carb but not ketogenic diet.  That’s what I did, and quite frankly I actually felt better doing a low-carb diet than when I was on keto.  I stuck to safe starches like sweet potatoes and plantains, and would just consume ~50g of net carbs per day instead of ~20g.


10. You haven’t given it enough time

To become truly fat adapted is going to take weeks, if not months.

When you go keto, even after previously being on a low carb diet, it’s a pretty big change for your body to adapt to.  It’s going to take time to see results.

Stressing out about not seeing the results you want within the first few weeks is just going to make things worse.

It takes upwards of 30-60 days for skin cells to die off, shed, and new ones to reach the surface.  That’s just one cycle.  If you have existing acne and just switched to keto, it’s going to take a little while to see results.  It may even get worse before it gets better.  But if you follow these tips and stick with it, I can guarantee you that you’ll see some pretty profound results.


Bonus tip: Intermittent Fasting

While most people will find the ketogenic diet to be sufficient for fighting acne, others may find that even after months they’re still experiencing breakouts or not seeing the results they’d like.

In this case, one thing you could try is intermittent fasting, where you shorten the period of time throughout the day you eat.  It can be as simple as skipping breakfast.

The benefits of intermittent fasting are huge:

  • Lower inflammation
  • Autophagy (recycling of old cells)
  • Increased insulin sensitivity
  • Increased oxidative stress resistance

I wrote a full guide on intermittent fasting for acne here.

I would not recommend intermittent fasting to anyone who recently switched to the ketogenic diet.  Just going keto is a big shift for your body to go through, adding intermittent fasting can make it even more extreme.  However, if you’ve been on keto for a while and want to take it to the next level, I’d highly recommend intermittent fasting as a great next step.

Diet Blueprint Thumbnail@2x


Everything you need to start eating an acne-free diet, all on one page.  Get permanently clear skin from within.

  • Quick, simple, understandable
  • The best foods to eat for clear skin
  • The foods you need to avoid

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