Few of us the in West would change the comforts of modern civilization to the nomadic existence of Eskimos. In this post I’ll outline their rationale for using low carb diets to treat acne and show how they fit into the bigger picture of acne.
Though acne is usually seen as androgen-mediated disease, in many cases it’s actually driven more by insulin (though there are cases where it’s driven by thyroid hormones or estrogens). Insulin also plays a part in activation of the mTor pathway that acts as a mastermind regulator behind acne. Allowing students (who already ate a lot of sugar) to eat as much candy, chocolate and sodas as they wanted in one sitting and observing no incidence of acne. It’s interesting to note that all the successful studies include diets that reduce insulin. The paper had an interesting table that perfectly highlighted why low carb diets can be helpful in acne, diabetes and other conditions. Little disclaimer, the paper didn’t specify whether these are post-meal or fasting values (I presume fasting) or the sample population. The range for normal diet is also in the pre-diabetic range, meaning significantly higher risk of developing type-2 diabetes later on in life. By now it should be clear that insulin is an important factor in acne, but please don’t think it’s the only one.
Without going into details (detailed explanation of the graph here), acne starts with oxidative damage (inflammation) to squalene, a fatty acid in sebum.
Insulin stimulates sebum production and increases the proportion of squalene in sebum – reduction in insulin does the opposite. The take-away from this is that you shouldn’t think of low carb diet as a be-all-end-all solution to acne.

Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. The condition used to be unknown among Eskimos, but one can see it readily amongst teenagers on the streets of Inuvik, Frobisher Bay and Cambridge Bay. Going from: “1 meal of high protein, high fat and practically no carbohydrates with frequent nibbling the rest of the day on fish” to “3 rich meals a day and seemingly endless sweet drinks, candies, and chocolates. I should say that the papers focus on ketogenic diets but the argument also stands for low carbohydrate and carbohydrate restricted diets, and I don’t think ketogenic diets are necessary for getting clear.
Traditionally scientists have been reluctant to investigate the connection between diet and acne, and we only have a limited evidence to draw from.
The unsuccessful studies on the other hand just replaced one form of sugar with another or added some sugar to a diet already high in sugar. The table showed blood sugar and insulin level ranges for normal (typical Western) and low carb diets.
So don’t look at the individual figures too carefully, rather look at the differences between low carb and typical Western diet. When dietary carbohydrates are reduced to minimum insulin levels drop significantly; though some protein foods also increase insulin, notably dairy products. This of course means you have more sebum on your face that’s constantly exposed to inflammatory damage (think UV rays, air pollution, skincare products, etc.) Without sufficient antioxidant protection sebum will suffer oxidative damage and you’ll get acne. They can be especially helpful for acne patients who are overweight or otherwise insulin resistant, because high insulin level stimulates skin cells and release and bioavailability of androgens and IGF-1, the two other hormones linked to acne. In some cases acne is linked to PCOS, other hormonal abnormalities or is not caused by hormonal issues (think gut problems or stress). They work on one part of the ‘acne formula’, and while reducing insulin level may help your skin a lot, you should take a broader view and also address the other aspects behind acne.

I can promise that in 10 minutes (the time it takes you to read the next 2 articles) acne finally starts making sense - and you know how to boot it out of your life.
I do my best to use credible sources, but medical research is complex and I can't guarantee the information on this site is error-free. When Canadian Eskimos started moving into towns and permanent settlements many notes changes in their health. It not only directly stimulates skin cells to produce more sebum and keratin but it also increases the secretion and bioavailability of other hormones related to acne.
I another post I went over all the diet-acne studies, but I’ll briefly summarize them here. Cordain and Lindberg observed no acne among the traditional people living in the island of Kitava in Papua New Guinea. First, there’s a certain physiological minimum blood sugar level that the human body requires to function and survive.
Research has quite clearly shown that there can be no acne without initial oxidative damage to sebum. Studies show that low GI paleo or Mediterranean style diets also work for insulin resistance and the kind of metabolic abnormalities behind acne. Though the people ate very high carbohydrate diet (70% of calories from carbs) they mostly ate low glycemic index root vegetables and fruits, with less than 0.2% of calories coming from ‘Western foods’.
Sebum oxidation leads to blocked pores, allows bacteria to colonize them and sets the stage for acne, for details, see this paper.

Low level diabetes symptoms 8 dpo
Sugar diabetes type 3
Glucose test strips at target


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