The allure of the low-carb lifestyle is undeniable, promising rapid changes and shedding pounds quickly. However, amongst the health and fitness community, a common side-effect has emerged: the dreaded "low-carb face" or "protein face". This look is often characterised by sunken eyes, hollow cheeks, deep nasolabial folds and an overall tired, prematurely ageing appearance.
While many popular diets suggest eliminating or drastically reducing carbohydrates for optimal health, this approach fundamentally misunderstands the role of complex carbohydrates in skin structure and cellular vitality. The real enemy is not the entire macronutrient group but refined sugar and
high-glycaemic (GI) processed foods. For true, lasting skin rejuvenation, whole-food carbohydrates are non-negotiable.
The sudden, hollow look associated with the "low-carb face" is not primarily due to fat loss but to acute
dehydration [1]. When you severely restrict carbohydrate intake (especially on ketogenic diets), the body rapidly depletes its stores of glycogen. Glycogen molecules are known to bind significant amounts of water; for every gram of glycogen stored, approximately three grams of water are held in the body [2]. As these stores are cleared, the body sheds this water weight, leading to a temporary visual effect of shrinkage or deflation in the face.
If you are looking for a dietary factor that genuinely accelerates skin ageing, look no further than a high intake of dietary fat, which is often implicated in driving systemic
insulin resistance. This metabolic dysfunction leads to elevated blood glucose (hyperglycaemia), which, in turn, triggers a destructive chemical reaction known as
Endogenous Glycation [3].
The primary targets of AGEs in the skin are collagen and elastin, the structural proteins responsible for firmness and flexibility. When AGEs cross-link with these fibres, they become stiff, brittle and unable to repair themselves effectively, much like hardened glue [3, 5]. This degradation process leads directly to:
- Loss of Elasticity: The skin sags and loses its youthful bounce.
- Wrinkle Formation: Stiffened collagen forms deep lines.
- A Yellowing Hue: In severe cases, high AGE accumulation can subtly change skin colour and clarity.
Far from being skin enemies, whole-food carbohydrates are essential to the daily mechanisms of repair, structural integrity and healthy ageing.
The skin is a highly active, constantly regenerating tissue. This intense cellular turnover, necessary for maintaining the protective barrier and repairing daily damage, requires a reliable source of energy [6].
- Primary Fuel: Glucose, derived from carbohydrates, is the core fuel source for skin cells and other cells involved in healing.
- Wound Healing and Fibroblasts: Adequate carbohydrate intake stimulates the production of growth factors (including insulin) and provides the Adenosine Triphosphate (ATP) necessary for fibroblast proliferation, the cells that manufacture new collagen and elastin [7, 8]. If your body is deprived of this preferred energy source, it must break down protein for fuel, potentially sacrificing vital skin-building blocks.
Collagen, the framework that gives skin its strength, is a protein. But its production relies entirely on co-factors found abundantly in carbohydrate-rich plant foods.
Vitamin C (ascorbic acid), found in fruits like kiwi, berries and citrus, is not only a powerful antioxidant but is an essential cofactor for the enzymes (proline and lysine hydroxylases) that stabilise and cross-link the collagen molecule's tertiary structure [9, 10]. Without sufficient Vitamin C intake, the body cannot manufacture stable, resilient collagen, directly leading to weakened skin and increased vulnerability to ageing [11].
- Oxidative Stress: Antioxidants (such as Vitamin A, C and E plus carotenoids) neutralise Reactive Oxygen Species (ROS) generated by UV radiation and pollution [10]. This shields skin cells from oxidative stress, a primary driver of premature ageing.
A major argument against carbohydrates is their link to skin issues like acne. However, scientific evidence points to the
glycaemic index (GI), not the total carbohydrate count.
High-GI foods (like white bread, sugary cereals and sweets) cause sharp spikes in blood sugar and insulin. This cascade can increase the concentration of
Insulin-like Growth Factor 1 (IGF-1), a hormone linked to increased
sebum (oil) production and
inflammation, which exacerbates acne [12].
In contrast, studies have shown that adopting a low-glycaemic-load diet can significantly reduce acne lesion counts and decrease IGF-1 levels, offering a clear path to healthier skin without carb restriction [13, 14].
The "low-carb face" is a powerful reminder that our skin reflects our internal environment. A face that looks prematurely tired or hollow is often one that is dehydrated, inflamed or simply deprived of the essential building blocks needed for maintenance and repair.
For a resilient, youthful complexion, the goal is not to fear carbohydrates but to choose quality. Focus on nutrient-dense, low-GI whole foods, such as legumes (beans, lentils), ancient whole grains (quinoa, oats) and a vibrant rainbow of vegetables and fruits.
By fuelling your body with these intelligent carbohydrates, you ensure your skin cells have the energy to repair, the Vitamin C to build stable collagen and the antioxidants to defend against the processes that accelerate ageing. The secret to healthy, radiant skin begins with balance and a deep appreciation for the vital fuel that nature provides.
- Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Blüher M, Stumvoll M, Stampfer MJ; Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008 Jul 17;359(3):229-41. doi: 10.1056/NEJMoa0708681. Erratum in: N Engl J Med. 2009 Dec 31;361(27):2681. PMID: 18635428.
- Kreitzman SN, Coxon AY, Szaz KF. Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition. Am J Clin Nutr. 1992 Jul;56(1 Suppl):292S-293S. doi: 10.1093/ajcn/56.1.292S. PMID: 1615908.
- Danby FW. Nutrition and aging skin: sugar and glycation. Clin Dermatol. 2010 Jul-Aug;28(4):409-11. doi: 10.1016/j.clindermatol.2010.03.018. PMID: 20620757.
- Zhang Y, Zhang Z, Tu C, Chen X, He R. Advanced Glycation End Products in Disease Development and Potential Interventions. Antioxidants (Basel). 2025 Apr 18;14(4):492. doi: 10.3390/antiox14040492. PMID: 40298887; PMCID: PMC12024296.
- Gautieri A, Passini FS, Silván U, Guizar-Sicairos M, Carimati G, Volpi P, Moretti M, Schoenhuber H, Redaelli A, Berli M, Snedeker JG. Advanced glycation end-products: Mechanics of aged collagen from molecule to tissue. Matrix Biol. 2017 May;59:95-108. doi: 10.1016/j.matbio.2016.09.001. Epub 2016 Sep 9. PMID: 27616134.
- Linus Pauling Institute. (n.d.). Skin Health. Oregon State University. Retrieved from https://lpi.oregonstate.edu/mic/health-disease/skin-health
- Canesso MCC, Cassini-Vieira P, Moreira CF, Luong S, Rachid MA, Martins FS, Teixeira MM, Vieira AT, Mackay CR, Barcelos LS. Dietary Fiber Improves Skin Wound Healing and Scar Formation through the Metabolite-Sensing Receptor GPR43. J Invest Dermatol. 2023 Sep;143(9):1850-1854.e6. doi: 10.1016/j.jid.2022.07.036. Epub 2023 Mar 23. PMID: 36965576.
- Spravchikov N, Sizyakov G, Gartsbein M, Accili D, Tennenbaum T, Wertheimer E. Glucose effects on skin keratinocytes: implications for diabetes skin complications. Diabetes. 2001 Jul;50(7):1627-35. doi: 10.2337/diabetes.50.7.1627. PMID: 11423485.
- Telang PS. Vitamin C in dermatology. Indian Dermatol Online J. 2013 Apr;4(2):143-6. doi: 10.4103/2229-5178.110593. PMID: 23741676; PMCID: PMC3673383.
- Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients. 2017 Aug 12;9(8):866. doi: 10.3390/nu9080866. PMID: 28805671; PMCID: PMC5579659.
- Linus Pauling Institute. (n.d.). Vitamin C and Skin Health. Oregon State University. Retrieved from https://lpi.oregonstate.edu/mic/health-disease/skin-health/vitamin-C
- Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. 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 Aug;57(2):247-56. doi: 10.1016/j.jaad.2007.01.046. Epub 2007 Apr 19. PMID: 17448569.
- Burris J, Rietkerk W, Woolf K. Acne: the role of medical nutrition therapy. J Acad Nutr Diet. 2013 Mar;113(3):416-430. doi: 10.1016/j.jand.2012.11.016. PMID: 23438493.
- Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007 Jul;86(1):107-15. doi: 10.1093/ajcn/86.1.107. PMID: 17616769.