Hello
@Steph001 - I had the WORST spots/breakouts for 5-6 MONTHS after going full-on grain- and sugar-free. Huge red spots would just appear on my cheeks - seemingly out of nowhere. If that wasn't enough at the same time I also had extreme hives (Keto Rash? possibly dermatitis herpetiformis?). But now, apart from the rash on the knuckle of one finger (I'm likely still coming into contact with gluten somewhere) my skin has cleared up. Like you I was pre-diabetic and unmedicated. Hold on, this will likely pass once your body has adjusted. Good luck.