What is the Keto Rash?

Symptoms and Stages of Keto Rash

Although it’s visually unappealing, keto rash is not life-threatening. It resembles other skin conditions like eczema and dermatitis and is often found on areas such as the neck, back, chest, shoulders, torso, and armpits. While it can also affect the face and extremities, it is not as common.

The rash often forms in a symmetrical pattern, creating a net-like distribution on both sides of the body. Unfortunately, exposing the rash to heat, sweat, friction, or other irritants can worsen the symptoms. But don’t worry, with the right treatment, you can alleviate the discomfort caused by keto rash

Causes of Keto Rash

The exact cause of keto rash, also known as prurigo pigmentosa, is not yet fully understood. However, the prevalent theory is related to the production of a ketone body called acetone. Many studies and anecdotal evidence from keto forums suggest that people who experience the rash are typically those who follow a ketogenic lifestyle or have conditions that promote ketone production.

The symptoms of keto rash usually start as soon as a person enters ketosis and go away within a day or so after increasing their carbohydrate intake and exiting ketosis. In some studies, insulin was found to accelerate the healing process of the rash. The rash is known to worsen in warm weather and after exercise due to increased sweating and tends to be located in areas where the body sweats the most.

The hypothesis is that when first entering ketosis, the body produces more acetone than usual, which cannot be used and is thus excreted through the breath and sweat. When acetone is released in high concentrations through the sweat, it can irritate the skin and cause skin inflammation, leading to the symptoms of keto rash. This theory is further supported by the fact that topical acetone exposure has been known to cause skin irritation and dermatitis

Who Is Most At Risk From The Keto Rash?

Here are some of the most common factors that put individuals at a higher risk:

Newcomers to the Keto Diet: People who are new to the ketogenic diet and transition too quickly to a low-carb, high-fat diet are more likely to develop keto rash. The sudden change in diet can cause the body to produce a large amount of ketones, which can lead to skin irritation and the development of keto rash.

A history of Skin Conditions: Individuals with a history of skin conditions, such as eczema or dermatitis, are more likely to develop keto rash. This may be because the skin is already predisposed to irritation and inflammation.

Weakened Immune Systems: People with weakened immune systems, such as those undergoing chemotherapy or with HIV/AIDS, are more likely to develop keto rash. This may be because their immune systems are unable to fight off skin infections and skin irritation.

Sweating excessively: People who sweat excessively, particularly in warm weather or during exercise, are more likely to develop keto rash. This may be because sweat excretes acetone, which can irritate the skin and lead to the development of keto rash.

People with Vitamin and Mineral Deficiencies: People who do not get enough essential vitamins and minerals in their diet, such as vitamin B and magnesium, are more likely to develop keto rash. This is because these vitamins and minerals play a crucial role in skin health and their deficiency can lead to skin irritation and inflammation.

How Long Does It Last?

The duration of a keto rash varies from person to person. Some people may see the rash disappear within a few weeks, while others may have to deal with it for several months or even years.

The length of time the rash persists depends on whether the underlying cause is addressed. If not, the rash is more likely to persist.

On the positive side, the keto rash could potentially go away in just a matter of one to two weeks. However, for some individuals, it may return every time they follow the ketogenic diet.

The duration of the rash can range anywhere from a couple of weeks to several months or years, with the outcome largely dependent on addressing the causes and triggers.

How To Treat The Rash

If you experience a keto rash, here are five ways to treat it:

Increase Carbohydrates: The best way to alleviate the rash is to stop ketosis by eating more carbohydrates. Artz suggests incorporating fiber-rich fruits and vegetables like bananas and leafy greens to rebalance your gut microbiome.

Follow an Anti-inflammatory Diet: Prurigo pigmentosa is an inflammatory condition, so following an anti-inflammatory diet can help fight it. Complex carbohydrates in whole grains, beans, legumes, fruits, and vegetables can reduce inflammation, as well as foods rich in healthy fats like salmon and olive oil, nuts, and berries.

Take Antibiotics: If you have a medical condition like epilepsy that requires you to stick to the keto diet, antibiotics may be used to treat the rash without ending ketosis. However, if you do not have a medical condition, it is best to change your eating habits instead of taking medication, says Artz.

Adjust Your Exercise Routine: Exercise has anti-inflammatory properties and may help resolve the rash quickly. Opt for low-impact exercises like walking or yoga, but avoid endurance exercise for over two hours as it may worsen the rash.

Coconut Milk and Aloe Vera Smoothie

Step 1

Blend together the coconut milk and aloe vera gel until smooth.

Step 2

Add in the avocado, turmeric powder, chia seeds, protein powder, vanilla extract, and sweetener (if using)

Step 3

Blend until smooth and creamy

Step 4

If desired, add in a handful of ice and blend again until smooth.

This smoothie is a great way to incorporate the anti-inflammatory benefits of turmeric and the moisturizing effects of aloe vera into your diet. The avocado, chia seeds, and protein powder also provide healthy fats, fiber, and protein to help you stay full and satisfied.