Acne can feel random until you zoom out and look at metabolism. We’ve seen for years that insulin and acne are connected strongly enough that acne was once called “diabetes of the skin,” but the part most people miss is this: it’s not always high insulin. I walk you through the three distinct insulin patterns I see again and again in women with acne, and why choosing the wrong strategy can stall your progress or even make breakouts worse.
We start with the basics of what insulin does, then get specific about testing. Fasting blood glucose can look great while insulin is already dysregulated, so I explain why fasting insulin belongs on your lab list and how I interpret it alongside symptoms. Then we unpack the classic high-insulin picture often linked with PCOS, oily skin, cravings, energy crashes, and jawline acne, including how stress and cortisol can push insulin higher over time.
Next, we go into the pattern that surprises people: low insulin in a body that’s underfueled and depleted. If you’re training hard, eating “clean,” restricting carbs, waking at night, feeling cold, and dealing with low estrogen or missing periods, your acne may be asking for nourishment and rebuilding, not more restriction. Finally, we cover the “normal labs” pattern where fasting numbers look perfect, yet you crash after meals, get shaky, foggy, or hungry two hours later. That can point to gut-driven signals like GLP-1 and microbiome imbalance, meaning the deeper fix starts in the gut.
If you want a clearer roadmap, check out my free Clear Skin Masterclass linked in the show notes. Subscribe, share this with a friend who’s stuck, and leave a review so more people can find testing-based acne help.
Watch my FREE Clear Skin Masterclass to learn my method to heal chronic acne. Based on 20 years of healing acne as a Naturopathic Doctor.
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