Blood Sugar, Insulin, and Acne: What the Research Shows
A look into how metabolism and blood sugar affect skin
You’ve tried countless cleansers, creams, and spot treatments—but your acne isn’t budging. What if the problem isn’t on your skin at all, but in your metabolism?
While breakouts are often blamed on clogged pores or bacteria, there’s growing evidence that internal imbalances, especially hormonal and metabolic ones, play a major role in adult acne.
One of the most overlooked root factors? Insulin resistance.
This common metabolic dysfunction doesn’t just affect blood sugar, it also disrupts hormones, triggers inflammation, and stimulates excess oil production. All of these changes can directly impact skin.
In this post, we’ll explore how insulin resistance contributes to acne, what signs to watch for, and why addressing it from the inside-out may be key to supporting your skin.
DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS POST DOES NOT CONSTITUTE AS MEDICAL ADVICE; IS NOT MEANT TO DIAGNOSE, PREVENT, TREAT, OR CURE ANY CONDITIONS OR DISEASE; AND IS MEANT FOR EDUCATIONAL PURPOSES ONLY. THE INFORMATION IN THIS POST DOES NOT REPLACE OR SUBSTITUTE THE ADVICE OF YOUR MEDICAL PROVIDER. SPEAK TO YOUR DOCTOR BEFORE STARTING ANY NEW TREATMENTS OR SUPPLEMENTS OR BOOK YOUR APPOINTMENT WITH ME TODAY.
What Is Insulin Resistance?
Insulin is the hormone that helps your cells absorb glucose (also known as sugar) from your bloodstream. When your cells stop responding well to insulin because of chronically high blood sugar, your body compensates by producing more of insulin, creating a state known as insulin resistance. This hormonal imbalance can quietly disrupt many systems in your body, including your skin.
Research published in 2012 suggests that insulin resistance may play a role in the development of acne in research subjects. Additionally, a 2023 study found that high blood sugar markers suggestive of pre-diabetes were linked to acne.
In clinic, I’ve seen patients whose blood sugar levels appeared normal based on lab results from previous providers, yet they still struggled with persistent acne. It wasn’t until we conducted more detailed blood sugar testing that we identified insulin resistance as an underlying issue.
And data published in 2023 suggests that high insulin is possible with normal blood sugar and normal hemoglobin A1c levels and that high insulin in this context may provide a “much earlier” indicator of blood sugar dysregulation and metabolic issues.
How Insulin Affects Your Skin
To explain why insulin and blood sugar impact acne and skin, a review article by Baldwin and Tan explains that higher insulin levels trigger an increases in
Androgens (like testosterone): Promotes oil production.
Insulin-like growth factor-1 (IGF-1): Stimulates oil production and speeds up skin cell turnover.
These hormone shifts set the stage for clogged pores. And, if there is bacteria in that pore, acne can turn inflamed.
Several studies now support the link between blood sugar, insulin resistance, and acne:
As mentioned earlier, a 2023 study found that high blood sugar markers (specifically hemoglobin A1c) suggestive of pre-diabetes were linked to acne
High-glycemic diets, which are reported to elevate insulin and IGF-1, have been to linked to acne independent of culinary traditions in a 2022 systematic review.
In 2022, researchers discovered that insulin resistance severity is linked to increased acne severity.
Women with PCOS (Polycystic ovary syndrome), a condition that has been suggested to involve insulin resistance, commonly experience acne because of elevated androgens.
These studies underscore the importance of taking a holistic approach to acne. For those dealing with stubborn breakouts, evaluating nutrition, lifestyle, blood sugar, and insulin levels can reveal key drivers that topical products alone can’t address. Even the most advanced skincare won’t stop insulin from fueling acne.
What does insulin resistance look like?
Insulin resistance often goes unnoticed until more obvious symptoms appear, such as signs of diabetes. According to National Institutes of Health, signs of diabetes include:
Increased thirst
Increased urination
Increased hunger
Changes in vision
Slow healing wounds
Frequent infections
And much more
Additionally, according to researchers, there are some issues associated with insulin resistance, such as:
High blood pressure
High cholesterol
Weight changes
Acanthosis nigricans: A skin issue where skin becomes darker because of high blood sugar, typically appearing in skin folds (back of neck, armpits, and groin).
And much more
So, these may be important clues to consider for anyone dealing with persistent acne and searching for the root cause.
In clinic, I’ve seen patients who had no idea they were insulin resistant until we ran the right labs. With many of those patients, their skin was one of the first signs that something deeper was going on with their metabolism.
What to Do Next
The good news is that insulin resistance is something you can work on with support from your doctor. Addressing it not only targets hormones that drive acne, but addressing it also supports your long-term metabolic and hormonal health.
There are several approaches that your doctor might speak to you about, like:
Being selective about the types of carbohydrates someone consumes
Eating meals in an order that optimizes post-meal blood sugar response
Incorporating exercise that someone’s body tolerates
Stress management
Prioritizing quality sleep
And much more!
In clinic, I help my patients personalize this approach. We start with bloodwork and layering in naturopathic approaches that include nutrition, lifestyle, and other natural and integrative approaches.
If your skin isn't responding to surface treatments, it could be worth exploring what your metabolism might be trying to tell you. Addressing insulin resistance could be the missing link in your acne journey and your overall wellbeing. Explore working with a licensed provider who understands both the science and the deeper strategy behind acne, blood sugar, insulin, and testing.
If you’re located in Los Angeles, you can find me at The Things We Do in Downtown Los Angeles. You can learn more about how I work as a California-licensed naturopathic doctor and how to book your visit with me by clicking the button below.
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