I've struggled with acne since I was 12 years old; my family first dismissed it as a "heat rash," then came the mostly innocuous comments from my peers like "what happened?" I also had to deal with the occasional "pizza face" or "you really should wash your face" sort of things. Needless to say, it bothered me.

I started seeing a dermatologist when I was 15. Aside from over-the-counter stuff from Neutrogena, Proactiv, Acne.org regimen, home remedies like lemon juice, raw honey, the insides of egg shells as a mask, etc., I've been prescribed doxycycline, tetracycline, clindamycin,differin, retin a, tazorotene, and accutane at different points over the last 13 years. At best, I had slight or temporary relief.

About six months ago, I switched to a low carb diet. I've played with my diet for years and wanted to try it in the past, but it's so inconvenientfor people I spend time with. Anyway, I started full-on under 10 carbs per day--spinach, arugula, almonds, salad dressing with no sugar were/are all the sources of carbsI have that aren't fiber. I immediately stopped breaking out and my skin cleared completely within a couple of weeks, save for hyperpigmentation.

During these last six months I've kept a log, at least weekly, sometimes more frequent. I've cheated a couple of times and EVERY single time, I broke out. Literally ONE slice of pizza and I broke outwith no less than 7 pustules over the course of the following week.ONEhamburger bunand I broke out with 5 pustules, fried breaded shrimp--another 5. It starts within hours and continues, like I said, for about a week, even when I don't mess up again.

I want to experiment with lower glycemic foods like quinoa (which I really miss), but having acne gives me a lot of anxiety and I am able to interact with people (required by life) with much less stress when my skin is not insane, so honestly, I'm worried about experimenting.

I know I should bring this to my doctor, but does anyone know if there's anything I can do so I can have some carbs and not break out? I'm 5'8 and weigh 125 pounds at this point. Is it possible I have diabetes??

TL;DR
if you're desperate to clear your skin, DROP carbs. But be prepared to severely limit where you can go to eat, to inconvenience those you might eat with or not even eat with them, and to miss a lot of really good foods.

also, if you can, explain to me why my body reacts in this way and if there's anything I can do about it.