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So you’ve been following the Keto diet, and then you hear about this “Keto rash” – a side effect some people suffer while in ketosis. But what is it, really? What brings it on? What does Keto rash look like? Does it cause Ketosis rash on face? What are the indications? How long does it last? How can you dodge it? And how can you manage and heal it if it does occur?

We’ve got all the answers for you in this comprehensive guide to Keto rash. Read on for everything you need to know about this pesky side effect!

What Is Keto Rash?

One of the less desirable side effects of following a ketogenic diet is the development of a network-like rash known as Keto rash or prurigo pigmentosa (PP). Keto rash typically manifests itself as a red, itchy rash on the upper arms, back, chest, and neck. It’s similar to having a craving for sugar in the midst of a very strict diet; it’s annoying, but it’s not serious. Continue reading to know what causes it and how you can prevent and cure Keto rash.

While PP has historically been reported primarily in Asia, a study published in The Journal of clinical and aesthetic dermatology found cases occurring in patients of Middle Eastern, Caucasian, Hispanic, Asian, and African descent.

What Causes Keto Rash?

The source of Keto rash or prurigo pigmentosa (PP) is something of a quandary, but certain interior and exterior factors have been proposed. The most plausible cause is likely to be the ketones in a high-fat diet. This kind of eating routine, like the strict ketogenic diet, is extremely low in carbs but high in protein and fat.

After someone follows this dietary pattern for a sufficient amount of time, their body begins to utilize their fat for fuel instead of carbs. The body changes fats into ketone bodies. Going into ketosis from the Keto diet or extreme fasting could be the cause of the Keto rash. Other potential factors that trigger Keto rash may be a lack of essential nutrients on Keto due to abstaining from certain food groups.

In some patients, prurigo pigmentosa has been connected to systemic diseases such as Sjogren syndrome and eating disorders like anorexia nervosa. It has also been reported in people who have atopy, as well as in expectant mothers.

Stages of Keto Rash: What Does Keto Rash Look Like?

Early Lesions

In the early stage of this skin rash, there are slightly red and itchy bumps around your neck, back, and shoulders. It may be mistaken as merely a scratch or a short-term rash.

Fully Developed Lesions

As the rash advances, the symptoms heighten with more redness, itchiness, and raised bumps. You will notice multiple lesions, some with liquid, and some with puss.

Resolving Lesions

As the rash begins to subside, the redness, itching, and bumps will lessen. Scaly papules will be visible and the lesions will darken.

Late Lesions

Eventually, the skin will be marked with a net-like pattern of dark spots larger than freckles, which is known as reticulated hyper-pigmentation. This indicates that the rash is almost completely gone; however, the pigmentation may stay for a long time but eventually, your skin will return to its original state.

What Are the Symptoms of Keto Rash?

Itchy, raised skin lesions that can be red, pink, or brown characterize a Keto rash. The rash might have pimples or blisters that are leaking or crusted over and can appear on the neck, chest, or back.

With time, it can worsen and you might even feel like it’s burning or stinging. The skin may occasionally also get thicker or scaly. A network-like pattern will remain after the red bumps have disappeared, and as the inflammation fades over time, a brownish discoloration will result.

How Long Does Keto Rash Last?

So now that you know what Keto rash is, you’re probably wondering how long it lasts and what the stages are. Well, a case report published in the Journal of clinical and aesthetic dermatology suggests that the typical symptom of Keto rash showed up about a month after initiating a new diet, and faded away after around three weeks following the diet suspension.

It usually happens in stages. First, you’ll experience red patches on your skin that may be accompanied by itching or burning. This is usually followed by blisters that are filled with fluid. These blisters may itch or be painful and they can appear in large areas of your skin or just small patches. The third stage of Keto rash is the crusting stage – where the blisters dry up and form a crusty layer on the affected area of skin. Finally, once all the blisters have dried up and formed a crust, they will slowly start to flake off and reveal healthy new skin underneath.

How to Treat and Cure Keto Rash

When it comes to treating Keto rash, try the following techniques:

Try Giving Your Body Time To Heal Itself

It appears that if you just stick with the Keto diet and give your body a few weeks to adjust, the Keto rash might clear up all on its own. A research paper in the Journal of Dermatology mentions that for those who didn’t get any treatment, the signs went away of their own accord in a few weeks.

This strategy is especially effective for those who are just starting out with the Keto diet. It is quite a large lifestyle change, after all, and your body needs a bit of time to become accustomed to producing ketones. The longer you stay in ketosis, the better your body will be able to adjust.

Try Increasing Your Carbohydrate Intake

If you’re looking to get some relief from Keto rash, adding a few more carbs to your diet could help balance your intake of macronutrients and reduce the production of any unhelpful byproducts in the body.

A 2018 study showed that increasing carb intake had a positive impact on the symptoms. But if you want to stay in a state of ketosis, then eating more carbs may not be the best move. However, you could try upping your carb intake just enough to exit ketosis for a few days and see if the rash improves. If it does, lower the carbs and get back into ketosis. If the rash creeps back up, it could be a sign your body is sensitive to ketones.

The Medical Case Study published in the Hawai’i Journal of Medicine & Public Health shed light on the emergence of prurigo pigmentosa in two Asians on the Keto diet. In the first case, a healthy 43-year-old Chinese-American female began manifesting the symptoms of prurigo pigmentosa only three weeks after she began her weight management journey with 20g of net carbs every day. She developed lesions that took the form of erythematous papules, but the rash disappeared shortly after she resumed a higher-carb diet and has not returned in the twelve months since then.

The second instance concerned an 18-year-old Japanese male with intractable seizures. He received a traditional ketogenic diet with a 2:1 ratio of fat to carbohydrates and protein. In other words, this guy was eating twice as much fat as he was carbs and protein combined in order to try and treat his seizures. After nine days, he ended up with a pruritic rash that was consistent with prurigo pigmentosa. By the 14th day, the rash had worsened with increased redness around the lesions, but when his carb intake was increased by 90g daily, the pruritus and erythema improved.

Try Eliminating Keto-Friendly Foods Which May Cause Allergy

The Keto diet primarily emphasizes low-carb, high-fat dishes. It is also possible that a rash may be caused by an allergic reaction to a Keto-friendly food.

As fate would have it, many of these same foods are generally known to trigger allergies. This includes shellfish like oysters, clams, and crab; dairies like cottage cheese, full-fat yogurt, almonds, and macadamia; peanuts; eggs; and fish like tuna and salmon. With food allergies being a source of inflammation, it’s wise to shun any foods you’re allergic to that may be exacerbating your rash symptoms.

If you think you might be allergic to some of the Keto foods, you can try an elimination diet to figure it out. Start by nixing the items from your food journal that you think could be causing a problem – maybe just dairy products, if that’s your hunch. Give it a few days and see if the rash clears up. If not, continue taking out the other possible culprits one at a time until the rash is gone. If the rash returns when you reintroduce a food, you’ve found your trigger!

Try Eating A Variety of Foods To Avoid Any Nutrient Deficiency

A lack of essential nutrients could be linked to some inflammatory skin conditions. This is especially true for people on a ketogenic diet, which is low in carbohydrates and high in fats. Vitamin A, B-12, and C deficiencies have been associated with both acute and chronic skin issues.

So if you’re on the Keto diet and want to give your skin a helping hand, try adding these goodies to your plate: liver, carrots, spinach, citrus fruits, bell peppers, strawberries, almonds, avocado, olive oil, oysters, beef, chickpeas, fatty fish, such as salmon, and flaxseed oil. Hey, no one said looking amazing was easy!

Try Eating Anti-inflammatory Foods or Supplements.

If you’re on a Keto diet and you’re suffering from Keto rash, try adding some anti-inflammatory foods to your meals! Inflammation can cause skin rashes, and munching on anti-inflammatory goodies can help lessen it.

Examples of these are fatty fish like salmon, mackerel, and sardines; nuts and seeds, such as almonds, walnuts, and chia seeds; turmeric, a spice usually used in Indian cooking; berries like blueberries, strawberries, and raspberries; and leafy greens, like spinach, kale, and collard greens.

You can also take anti-inflammatory supplements to give your skin an extra boost. Probiotics, prebiotics, vitamin D, and fish oil have all been found to help reduce symptoms of dermatitis. So if you want to enjoy a happier, healthier you, consider adding these to your diet – it’s worth a shot!

Visit a doctor if nothing works for you

If home remedies fail to eliminate the Keto rash, a trip to the doctor may be necessary. In general, minocycline and doxycycline are used to treat prurigo pigmentosa, though dapsone can also be effective; however, minocycline is preferred over dapsone because it has fewer side effects and can keep the rash at bay for longer.

How To Prevent Keto Rash?

Here are some top tips to dodge that pesky Keto rash:

Ease into it: Going cold turkey on carbs can throw off your body balance, leading to itchy rashes. A slow and steady approach is the way to go.

Hydrate: Keep your skin in tip-top shape with plenty of water.

Avoid the irritants: Fragranced soaps and other personal hygiene products can cause skin flare-ups. So, skip ’em.

Say goodbye to processed food: The unhealthy fats and added sugars in processed foods can cause inflammation in your body. So, say no to these nasties and your skin will thank you.

Keep an eye on the symptoms: Keep an eye on your skin and any changes it may be going through.

Add some supplements to your diet: To make sure that you don’t get the Keto rash, it’s important to give your diet a nutrient boost! Adding in minerals, vitamins, and more can help keep deficiencies at bay.

FAQs About Keto Rash

Who is most likely to get Keto rash?

The Keto rash, better known as prurigo pigmentosa, is a common side-effect of a really stringent, low-carb diet – but it can still manifest even if you’re just in ketosis.

Is Keto rash permanent?

No way! Keto rash is nothing more than a passing skin issue that can occur when you’ve been on a ketogenic diet for a while. Most people find that the rash disappears all on its own in a few weeks or so, although the time it takes to go away may be different for each individual.

In some circumstances, the rash may not vanish if the underlying problem is not tackled. To make sure it does not hang around, it’s essential to keep an eye on your symptoms and get professional advice if the rash doesn’t fade away or gets worse.

Is Keto rash dangerous?

Generally, it’s not anything too serious – just a temporary, treatable condition that may be a bit uncomfortable and irritating. The typical rash is red, itchy, and bumpy, and may show up on the chest, back, and arms.

But if you’re noticing extreme itching, swelling, or redness, it’s probably best to consult a doctor – these could be signs of an allergic reaction or another skin condition that needs treatment.

Does Keto cause rash on the face?

There is no solid scientific proof of a connection between Keto diet and ketosis rash on face. However, some Keto dieters could get “Keto rash.” On the upper arms, back, chest, and neck, it frequently manifests as a red, itchy rash, but never on the face!

Although the exact reason for this rash is unknown, some hypotheses contend that ketones, a deficiency in specific nutrients, or inflammation brought on by the foods ingested while following the Keto diet is to blame.

How is Keto rash diagnosed?

It’s easy: just take a trip to the dermatologist and have them inspect the affected area – this will help them figure out if it’s Keto rash or something else with similar symptoms.

Conclusion

To put it simply, Keto rash or prurigo pigmentosa is a skin condition that can occur when a person follows a ketogenic diet, though it’s not connected to Ketosis rash on face. The exact cause of this problem is a bit of a puzzle, but it could be due to the body producing ketones. Symptoms of the Keto rash include irritated, red, and bumpy skin patches. If you think you might be dealing with the Keto rash, you should go see a dermatologist for diagnosis and treatment.

To reduce the chance of getting the Keto rash, you should switch to a Keto diet gradually, steer clear of irritants, say no to processed food, drink lots of water, and make sure to get enough vitamins. Even though the Keto rash isn’t necessarily serious, it can be unpleasant and bothersome – but it’s nothing that can’t be managed with the right treatment.