Can a Low-Calorie Keto Diet Help Ease Acne?

In a small pilot study, some young women trying to lose weight on a low-calorie keto diet received an unexpected bonus: their acne began to clear up.

“These findings represent an opportunity to control a skin condition that affects most adolescents and many adults at some point in their lives, causing them stress, embarrassment, anxiety and low self-esteem, robbing them of their quality of life,” said the study's lead author. Luigi Barrea from the Telematica Pegaso University in Naples, Italy.

His team presented their results at the European Congress on Obesity in Vienna, Italy.

As Barrea's group explained, acne is considered a chronic inflammatory disease that affects the so-called pilosebaceous unit: the hair follicle, hair shaft and nearby sebaceous gland. Approximately 9% of the world's population suffers from acne, mostly during adolescence.

Acne has long been linked to obesity, perhaps because both conditions are associated with increased inflammation and oxidative stress, according to Italian researchers.

Can the keto diet combat this inflammation and oxidative stress?

"Although the role of diet in acne is controversial, the low-calorie keto diet is known to aid weight loss and create anti-inflammatory ketone bodies, which provide energy when food is low in carbohydrates, and also promote resistance to inflammation and oxidative stress," explained Barrea in a press release. “We decided to explore this potential treatment for acne.”

Their study was small: just 31 young women (ages 18–30) who were obese and had moderate levels of acne.

All women began a 45-day low-calorie keto diet (only 700–800 kilocalories per day). According to the keto regimen, 44% of calories came from fat, 43% from protein and only 13% from carbohydrates.

All women successfully completed the diet, reporting some mild “side effects” such as headaches and muscle weakness.

The weight loss results were impressive. Over 45 days, women on average lost about 8% of their body weight, with a similar percentage reduction in waist circumference, Barrea's team reported.

Acne also improved: on the Standard Global Acne Rating Scale, the average score improved by 41.5% over the course of the 45-day diet.

In addition, “participants also reported significant improvements in quality of life, with an average improvement of 45%,” the researchers reported.

Barrea's team said there is a scientific basis for improving acne. They found that markers of systemic inflammation, oxidative stress and gut microbiome health all improved. Improvements in inflammation and oxidative stress appeared to correlate with decreased acne severity, the team said.

“In this small pilot study, a 45-day low-calorie keto diet showed marked improvements in acne severity that seemed to be related to the diet's known antioxidant and anti-inflammatory effects,” Barrea concluded.

However, he stressed that the study was very small and since these results were presented at a medical conference, they should be considered preliminary until published in a peer-reviewed journal.

However, “if confirmed in larger, more robust studies, the low-calorie keto diet could be a valuable alternative to antibiotics and topical treatments to help the many thousands of people suffering from acne,” Barrea said.