Keto Rash Explained [Plus How to Treat a Keto Rash]

  • Date: April 24, 2022
  • Time to read: 9 min.

The ketogenic diet is a low-carb, high-fat diet that includes very little carbohydrate. Although the keto diet has several potential health benefits, it can also have unforeseen repercussions, such as keto rash. Prurigo pigmentosa is another name for keto rash. In this article, we will explore what keto rash is, how to avoid it, and if you get it, how to get rid of it quickly.

What is Keto Rash?

Keto rash is a kind of dermatitis that causes raised red blotches.

These are often found on the back, shoulders, and abdomen, but can extend further.  

You will be pleased to know that keto rash is an uncommon inflammatory skin disorder that causes a red, itchy rash across the trunk and neck.

Brain fog, lethargy, electrolyte imbalance, and even a keto rash are all possible adverse effects of the keto diet at first.

For more on the common side effect of the keto diet and how to overcome them, we have put together this guide.

How to tell if you have keto rash?

Some of the symptoms include:

  • Itchy, red rash that mostly affects the upper back, chest, and belly. These can vary in size from 1-3 cm. It is most common for the rashes to be round in appearance, but this is not always the case. 
  • Papules are red patches that have a web-like appearance.
  • After the spots have faded, a brown pattern is visible on the skin.
  • It is common for the rashes to be itchy, both in the beginning and throughout the process, even as they are clearing up.

Can keto rash burn?

The rash is an indicator of inflammation, and it could mean that the keto diet is causing all the above-discussed symptoms on your skin.

The rashes are more likely to itch as opposed to feeling as though they are burning.

What parts of your body can you get a keto rash?

The keto rash is more frequent on the upper body, such as the;

  • Chest
  • Back
  • Shoulders
  • Neck

The can cause can cause redness, erythema, or raised, itchy blemishes on the skin. It can seem like skin irritation, such as eczema, or some medication reactions, among other things.

From experience, initially, the rash can look like a response to an allergic reaction. The good news is that the inflammation will subside as the red lumps go away. They will either fade and disappear or may leave a brownish discoloration on the skin.  

It is common for the blotches to form a network-like pattern as the red bumps fade away leaving the marked brown patches on the skin.

How soon does a keto rash develop?

Keto rash is a very rare case.

Researchers aren’t sure what causes the rash, although it’s conceivable that being in ketosis is one of the explanations, however, this is not the case.

Although there are similarities between keto rash and other skin conditions, this rash is distinguishable by the network-like configuration of the bumps.

You will be pleased to know that keto rash is a rare side effect of keto

It could be related to changes in gut bacteria connected with diet in certain persons for about 1- 2 weeks.

Keto Rash: My Personal Experience

From personal experience, I have been living a keto lifestyle for over a decade and have never experienced keto rash until year 11.

I had been traveling for a few weeks and I had not been able to get hold of clean keto foods. I had also wanted to try some of the local delicacies so I could try and recreate the keto version.

Anyway, despite my best efforts, I had fallen out of ketosis.  

When I got back home I was straight back to my keto way of living, however, knowing what I had done, I knew exactly what needed to be done in order to get back into ketosis quickly.

I had restricted my carb intake to around 15 grams per day, on day 3 I noticed rashes starting to form on my neck, check, the top of my arms, down the right-hand side of my stomach, and down onto the top of my right thigh.  

Read on to find out more about how I managed the rash and eventually got rid of it.

Shingles or keto rash [how to tell the difference]

The discomfort, stinging, or tingling in the area where the rash may later form is frequently the initial symptom of shingles.

Shingles can produce discomfort ranging from mild to severe, and the viral rash usually appears on the trunk.

On the other hand, blisters scab over in seven to ten days and heal in two to four weeks on average.

Other shingles indications and symptoms include:

  • Chills
  • Fever
  • Headache
  • stomach ache
  • Loss of vision

However, the keto rash is less severe.

The keto rash is completely and quickly treatable. The inflammation normally begins shortly after people enter ketosis and lasts a few days, or shorter if they eat too many carbs and exit ketosis.

The most prevalent signs and symptoms are the skin on the stomach, neck, and back skin are red and itching.

These rashes have a web-like texture.

Keto diet rash spreading [Should I be Worried?]

Keto rash usually goes away after a few weeks.

However, it can leave a reticulated pattern on your skin that may look like a leaf or, some have described it as the skin pattern of a giraffe.

See a doctor if your rash covers much of your body or doesn’t seem to be going away after you stop spreading after the first few days.

Not all doctors are well versed in keto, so make sure you make them aware that you believe that the rash may be a result of transitioning onto a LCHF (low-carb, high-fat diet) lifestyle.

You should contact a doctor right away if you have a rash with a high temperature, shortness of breath, or dark purple spots, as it is very unlikely that this is keto rash.

Consult your health care provider if your rash worsens or does not improve after 1-2 weeks.

How long does a keto rash last?

Keto rashes can get worse with time.

It’s impossible to say how long it will take for your keto rash to go away as everybody is different. Some people may only have to cope with the rash for a few days to weeks, while others may have to deal with it for several months or in some very extreme cases, years.

If you have keto rash, the best-case scenario is that it will go away in 1 to 2 weeks

My personal experience was that it took 5 to 6 weeks to clear up completely.

What is Keto Rash NOT?

Before we get into how to cure the keto rash, it’s important to break down some misinformation about it.

There are a lot of articles out there (on some of the top keto sites worryingly) that will provide you will a wild and wonderful array of reasons for keto rash

Here we have rounded up some of our favorite pieces of misinformation about the keto rash for you.

  • It is NOT a hygiene problem
  • It is NOT a skin problem
  • It is NOT a fungal infection
  • It is NOT a bacterial infection caused by a change in gut bacteria
  • It is NOT an inflammatory response to the keto diet
  • It is NOT because your body cannot ‘handle’ a keto diet/ nutritional ketosis.
  • It is not ketones leaking through the skin

This is a list of some of the most common myths about the keto rash. Another common piece of advice is to add exogenous ketone supplements to your diet, however, this will not help support your keto rash. No nutritional supplements are required in order to treat your keto rash.

In fact, the solution is simple and cheap – read on to find out more.

Check out this article for more keto facts and keto myths. Some will surprise you.

Now let’s get into how to cure keto rash.

Keto rash: how to cure it

There are a number of ways to cure a keto rash, some are preferable to others. Some of these will not help ‘cure’ the rash per se, however, they will help alleviate some of the symptoms.

  • Increase your carbohydrate intake just enough to get you out of ketosis for a few days to see if the rash goes away. You do not want to undo all of your hard work by binging on carbs and having a full-on cheat day, however, slightly increasing your carb consumption may assis.
  • Many dietary modifications increase the likelihood of triggering food allergies. Identifying and removing allergens from your diet is a good start. You should do this before starting a keto diet.
  • Supplement your diet with enough vitamins and minerals. The omega-3 fatty acids aid in inflammation reduction and skin health enhancement.
  • What happens in and around the skin cells stimulates the immune system, resulting in a keto rash. In line with the above consider increasing your intake of anti-inflammatory foods. Sardines, salmon, other omega-3 fatty fish, olive oil, and low-carb fruits are good options.
  • The chemicals in your detergent or the items you’re wearing can be exacerbating your rash. Avoid any chemicals or items that aggravate your skin. Loose clothing may be a good option too so as not to aggravate the rash. Although this will not cure your rash, it will help prevent it from getting aggravated, and, in turn, you itching it, which will only make it worse and last longer.
  • Bathe in Epsom salts (aka magnesium sulfate). Epsom salts have a long list of medical benefits when you read about them, it’s healing properties are one of these. This is my personal go-to. For me, it removed a lot of the reddening as well as soothing the skin
  • Aloe vera is your friend. Again, this is not going to cure the rash, but it will certainly help in soothing the itching and help with the healing process. Aloe vera is a great natural, hydrating moisturizer for the skin.
  • Emotional stress could also be a component of the keto rash. There is limited research to back this claim up, however, some people are adamant that this is a factor. If you feel you may be emotionally drained, meditation, breathing techniques, low-intensity exercise, and spending quality time with loved ones are all good ways to relieve stress.
  • According to some scientific studies, specific antibiotics are particularly efficient against keto rash. The only problem with this is that as keto rash is not a bacterial infection, antibiotics should not be required in order to clear it up. This is one for your own assessment and conversation with your doctor. My personal view is that when people have taken antibiotics, it has coincided with their keto rash naturally clearing up, and this is where the correlation has come from, your views may vary.
  • Increase your protein intake. This is actually one of the most effective ways to get rid of a keto rash, and we will go into it more below.

Protein and The Keto Rash

I am always surprised how little this is documented on the ‘big’ keto sites. There have been a lot of studies that have documented the link between the keto rash and a diet too low in protein.  

When you think about it, this makes sense. When you are getting started on a keto diet, your focus is all around hitting the macro of 20 grams of carbs a day.

We all do it.

We do not consider our protein intake or our fat intake, we just focus on the carbs.  

When you work out your keto macros, your protein intake will be calculated at 1 gram of protein per pound of body fat. If you increase this to 1.5 grams of protein per pound (so times your original figure by 1.5), this should be enough protein to clear up your keto rash.  

The solution is really that simple. Have a go and leave a note in the comments as to whether this worked for you or not. 

Will keto rash go away without treatment?

After a few weeks, the keto rash will likely go away without treatment. This is likely to take 4-6 weeks. You can help the speed of this by taking our advice and increasing your protein intake as well as looking after your rashes to ensure that they are not made worse by you scratching them.

Does keto rash come back?

There is no scientific research to support this. From being in the keto community for over a decade, it would appear that some people will get the keto rash on more than one occasion if they stop and start the diet multiple times.

However, a keto rash is a small price to pay for the benefits of ketosis and the keto diet.

Does keto rash scar?

The keto rash can leave brown marks or scars on the skin’s surface that may last a lifetime, this is not from the rash itself, but from the scratching of the rash, in a similar way to chicken pocks marking the skin when scratched.

Keto rash is rare, and it is rarely reported in dramatic cases. However, you do not need to suffer. Follow our simple advice on looking after the rash itself, whilst increasing your protein intake for a period and the rash should soon go away. As always though, if you have any concerns, please seek medical advice.

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