The Pros and Cons of the Ketogenic Diet for Your Skin
Potentially helping with acne and weight loss
Edited By:Raja Sivamani , MD, MS, AP
What Is the Ketogenic Diet?
The ketogenic diet also called the “keto” diet or “nutritional ketosis,” is a diet that consists of high fat, moderate protein, and very low carbohydrates. It is similar to the “Atkins” or “low carb” diet. A standard ketogenic diet has a daily calorie breakdown of 75% fats, 20% protein, and only 5% carbohydrates. There are many variations of the ketogenic diet, such as athletes scheduling their carbohydrate intake around workouts, or people cycling very low carbohydrate days with higher carbohydrate days. The ultimate goal is to shift the body’s metabolism to become efficient at metabolizing fat.
How Does the Ketogenic Diet Work for Weight Loss?
By drastically reducing our intake of carbohydrates and replacing them with fats, our bodies go into a metabolic state called “ketosis” where we begin producing molecules called ketone bodies. Normally our bodies convert carbohydrates into glucose, which triggers an insulin release from the pancreas, after which the glucose is rapidly taken up by our cells and used for energy. However, when the body is deprived of carbohydrates, we instead begin burning fat for fuel. In this process called ketogenesis, the liver converts fat into molecules called “ketones,” which the brain uses for energy. High insulin levels suppress the process of ketogenesis, preventing stored fat from being converted to ketone bodies and used for fuel. Therefore, in order to be effective, followers of the ketogenic diet must consume close to zero carbohydrates. Clinical studies have found that people who followed a ketogenic diet lost over twice as much weight over six months as people following a traditional “low fat,”low-calorie diet.
What Do You Eat on the Ketogenic Diet?
Foods to Avoid on the Ketogenic Diet
- In general, any high carbohydrate foods should be limited
- High sugar foods: soft drinks, juice, smoothies, desserts, candy, etc.
- Refined grains and starches: bread, rice, cereal, pasta, pizza
- Fruit: fruit should be limited when on the ketogenic diet due to high sugar content, but small portions of berries are allowed
- Beans and legumes
- Starchy vegetables: potatoes, carrots, peas
- Processed foods: “diet foods” or “low fat” versions of foods are highly processed and often packed with added carbohydrates
- Condiments: sauces and condiments should be carefully selected according to the carbohydrate content on the food label
- Processed fats: mayonnaise, salad dressings, etc.
- Alcohol: alcohol can prevent the body from being in ketosis and should be avoided
- “Sugar-free” diet snacks: many sugar-free processed foods contain high levels of sugar alcohols, which can also prevent ketosis
Ketogenic Approved Foods
- Meat and fish
- Grass-fed butter and cream
- Unprocessed cheese
- Nuts and seeds
- Organic virgin oils: coconut oil, extra virgin olive oil, avocado oil, etc.
- Low carbohydrate vegetables: green vegetables, onions, peppers, cruciferous vegetables
- Herbs and spices
What Are Potential Pros the Ketogenic Diet May Have on My Skin?
The ketogenic diet may have the ability to improve acne. Although a topic of debate for many years, it is now widely accepted that high glycemic and high sugar diets can worsen acne severity and frequency of breakouts. Therefore, by following a ketogenic diet, insulin spikes are reduced and could potentially improve acne in people who are susceptible to breakouts caused by high glycemic foods.[9,10] It may also help with plaque psoriasis. One published report examined the role of a ketogenic diet in the management of psoriasis. The authors reported a case of a woman who found improvement when adding a ketogenic diet to standard medications within one month of starting the ketogenic diet.
In addition to weight loss and improving skin conditions, several clinical studies have found the ketogenic diet to be beneficial to a variety of other health conditions, including seizures, diabetes, cancer, and even Alzheimer’s disease.[6,7]
What Are Potential Cons the Ketogenic Diet May Have on My Skin?
There are few reports about how the ketogenic diet can negatively impact the skin. Only one published report described the eruption of a rare itchy skin disease called prurigo pigmentosa in a 17-year old Caucasian male after following a strict ketogenic diet.
People who begin following a ketogenic diet may experience unusual changes in their body. These symptoms should be discussed with a physician or other healthcare provider.
- “Fruity” smelling urine and breath
- Flu-like symptoms (fatigue, headache, body aches) during the first few days of ketosis – this may go away after approximately one week. Changes in bowel habits (usually constipation) – it is important to consume plenty of fiber and water while following a ketogenic diet
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- Freeman JM, Kossoff EH, Hartman AL. The ketogenic diet: one decade later. Pediatrics.2007;119(3):535-543; PMID: 17332207.
- Phinney SD, Bistrian BR, Evans WJ, et al. The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism.1983;32(8):769-776; PMID: 6865776.
- Fukao T, Lopaschuk GD, Mitchell GA. Pathways and control of ketone body metabolism: on the fringe of lipid biochemistry. Prostaglandins Leukot Essent Fatty Acids.2004;70(3):243-251; PMID: 14769483.
- Brehm BJ, Seeley RJ, Daniels SR, et al. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab.2003;88(4):1617-1623; PMID: 12679447.
- Mawer R. The Ketogenic Diet 101: A Detailed Beginner's Guide. Link to research. Accessed February 9, 2017.
- Zhou W, Mukherjee P, Kiebish MA, et al. The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer. Nutr Metab (Lond).2007;4:5; PMID: 17313687.
- Gasior M, Rogawski MA, Hartman AL. Neuroprotective and disease-modifying effects of the ketogenic diet. Behav Pharmacol.2006;17(5-6):431-439; PMID: 16940764.
- Paoli A, Grimaldi K, Toniolo L, et al. Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol.2012;25(3):111-117; PMID: 22327146.
- Smith RN, Mann NJ, Braue A, et al. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol.2007;57(2):247-256; PMID: 17448569.
- Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol.2009;18(10):833-841; PMID: 19709092.
- Castaldo G, Galdo G, Rotondi Aufiero F, et al. Very low-calorie ketogenic diet may allow restoring response to systemic therapy in relapsing plaque psoriasis. Obes Res Clin Pract.2016;10(3):348-352; PMID: 26559897.
- Michaels JD, Hoss E, DiCaudo DJ, et al. Prurigo pigmentosa after a strict ketogenic diet. Pediatr Dermatol.2015;32(2):248-251; PMID: 24372546.