Keto Rash: How Long Does It Last?

Keto rash, also known as prurigo pigmentosa, is an inflammatory skin condition that occurs when the body is in a state of ketosis and starts burning fat for energy instead of carbohydrates. It is characterised by red, itchy rashes that typically appear on the neck, chest, back, and abdomen. The rash is rare and not life-threatening, but it can be uncomfortable and frustrating to deal with. The good news is that there are several ways to treat keto rash and prevent it from reoccurring.

The appearance of red, raised papules on the skin

The keto rash is associated with a ketogenic diet, as well as diabetes, fasting, and post-bariatric surgery. It is believed to be caused by an excess of ketones in the body, although the exact cause is not yet known. The rash usually lasts up to two weeks, but in some cases, it can persist for several months or even years.

If you notice the symptoms of keto rash, there are several treatment options available. Firstly, increasing your carbohydrate intake can help to control ketosis and resolve the rash. This is because a low-carb diet is linked to the development of the rash. Reintroducing carbohydrates into your diet may be sufficient to alleviate the symptoms. Additionally, correcting nutrient deficiencies can help to improve skin health. Deficiencies in vitamins A, B-12, and C have been linked to inflammatory skin conditions. Ensuring adequate intake of these vitamins, as well as omega-3s, can support skin health and reduce inflammation.

Other treatment options include eliminating food allergens, incorporating anti-inflammatory supplements such as probiotics and fish oil, and practising good skincare habits. Using lukewarm water for bathing and showering, and gentle soaps and cleansers, can help to soothe inflamed skin. Keeping the skin moisturised is also important. If home treatments are ineffective, a doctor may prescribe antibiotics such as minocycline or doxycycline to clear up the rash.

To prevent the keto rash, it is recommended to gradually lower your carbohydrate intake instead of dropping it drastically. This allows your body to adjust to the new diet and may reduce the risk of developing the rash. Taking supplements and paying close attention to any rash signs are also recommended preventive measures.

The rash is most common on the chest, upper back, and neck

The keto rash, also known as prurigo pigmentosa, is an inflammatory skin condition that occurs mostly in young women, particularly those of Asian descent. It is characterised by itchy, red papules that form a symmetrical, web-like pattern on the skin. The rash is most common on the chest, upper back, and neck, but can also appear on the abdomen, armpits, and upper shoulders.

The keto rash typically progresses through four stages: early lesions, fully-developed lesions, resolving lesions, and late lesions. In the early stages, light pink raised skin lesions appear, which then develop into more aggressive red skin lesions with liquid or pus-filled cysts. As the rash starts to recede, the papules become crusty and darker in colour. In the final stage, the skin is left with a web-like pattern of dark spots, which may last for an extended period even after the rash has disappeared.

The exact cause of the keto rash is unknown, but it is associated with a ketogenic diet and being in a state of ketosis, where the body burns fat for energy instead of carbohydrates. Other factors that may trigger the rash include friction from clothing, sunlight exposure, and skin irritants such as chlorinated pool water.

If you are experiencing the keto rash, there are several ways to treat the condition:

• Wait for the rash to subside on its own. In some cases, the keto rash may resolve without any treatment after a few weeks.
• Reintroduce carbohydrates into your diet. Increasing carbohydrate intake can help control ketosis and improve rash symptoms.
• Correct nutrient deficiencies. Ensure you are consuming enough vitamins and minerals, such as vitamins A, B-12, and C, which are important for skin health.
• Eliminate food allergens. Identify and eliminate any foods you may be allergic to that could be worsening the rash symptoms.
• Incorporate anti-inflammatory supplements. Certain supplements, such as probiotics, prebiotics, vitamin D, and fish oil, have been found to help improve symptoms of dermatitis.
• Practise good skincare habits. Use lukewarm water for bathing and gentle soaps and cleansers to clean your skin. Keep your skin moisturised and protected from the sun and other elements.
• Consult a doctor. If home treatments are ineffective, a doctor may prescribe medications such as antibiotics or anti-inflammatory drugs to clear up the rash.

The rash is not contagious or dangerous

The good news is that keto rash is not contagious or dangerous. It is, however, an uncomfortable and frustrating skin condition.

Keto rash, also known as prurigo pigmentosa, is an inflammatory skin condition that occurs when the body is in a state of ketosis, burning fat for energy instead of carbohydrates. It is characterised by red, raised papules across the upper shoulders, back, and abdomen, and it is symmetrical and web-like in appearance.

The exact cause of keto rash is unknown, but it is associated with ketosis and there are several potential triggers, including:

• Drastically reducing your carb intake
• Excessive fasting
• Ketones
• Allergens
• Skin irritants

Keto rash can be cured and there are several ways to treat the condition:

• Waiting for the rash to subside—in some cases, the rash may go away on its own
• Reducing your intake of foods that trigger inflammation
• Consuming enough nutrients—nutrient deficiencies can greatly affect skin health
• Considering supplements—if getting enough nutrient-dense keto foods is difficult, taking multivitamins and other supplements may help
• Considering adding back carbs—if the rash persists, modifying your diet by increasing carbohydrate intake can be one way to counteract it
• Following skincare tips—for example, washing your skin with mild and gentle soap, not scratching the area, and applying a moisturiser

The rash is associated with being in a state of ketosis

The rash, known as prurigo pigmentosa, is an inflammatory skin condition associated with ketosis. It is characterised by red, itchy papules that form a web-like pattern on the skin, typically around the neck, chest, and back. The rash is rare, but when it does occur, it can be uncomfortable and frustrating.

Prurigo pigmentosa is thought to be caused by a combination of protein deficiency and high levels of circulating ketones. This is why some people develop the rash after extended periods of fasting or a low-carbohydrate diet. The exact cause of the rash is not yet known, but several potential triggers have been identified. These include:

• Drastically reducing carbohydrate intake, which can lead to rapid weight loss and ketone production.
• Excessive fasting, which can lower blood sugar levels and trigger ketosis.
• Ketones themselves, which may cause inflammation around blood vessels, resulting in skin rashes.
• Allergens in keto-friendly foods such as eggs, dairy, and seafood.
• External skin irritants such as chlorinated pool water, friction from clothing, and sunlight.

The rash typically progresses through four stages: early lesions, fully-developed lesions, resolving lesions, and late lesions. During the first stage, light pink raised skin lesions appear, which are often mistaken for scratch marks. In the second stage, the rash becomes more aggressive, with red skin lesions (papules) that may contain liquid-filled cysts. In the third stage, the rash begins to recede, and the papules become crusty and darker in colour. In the final stage, the rash is almost healed, but a web-like pattern of dark spots larger than freckles is left on the skin, which may last long after the rash has disappeared.

The good news is that there are several ways to treat prurigo pigmentosa:

• Waiting for the rash to subside on its own. In some cases, the rash may resolve within a few weeks without treatment.
• Increasing carbohydrate intake, which can help to control ketosis and reduce ketone production.
• Eliminating food allergens, as food allergies are a source of inflammation.
• Incorporating anti-inflammatory supplements and foods into the diet, such as probiotics, prebiotics, vitamin D, fish oil, and olive oil.
• Taking care of the skin by using lukewarm water for bathing and showering, and gentle soaps and cleansers.
• Talking to a doctor about medication, such as the antibiotics minocycline and doxycycline, which have been found to be effective treatments.

It is also possible to prevent prurigo pigmentosa by taking certain precautions when starting a ketogenic diet. These include gradually reducing carbohydrate intake, supplementing with vitamins and minerals, and paying close attention to any signs of a rash.

Treatment options include increasing your nutrient and vitamin intake

The keto rash, or prurigo pigmentosa, is a rare inflammatory skin condition that can appear in people who have recently started following a ketogenic diet. It is characterised by an itchy, red rash that occurs primarily on the neck, back, and abdomen.

If you are experiencing the keto rash, there are several treatment options to consider:

Increase Your Nutrient and Vitamin Intake

Nutrient deficiencies can play a significant role in skin health. When on the keto diet, it is important to ensure you are still getting vital nutrients. Acute and chronic skin conditions can occur if your body is lacking in essential micronutrients such as vitamins A, B-12, and C.

To combat this, be sure to eat plenty of vegetables and low-carb fruits. If this is challenging, consider taking a multivitamin or other dietary supplements. For example, you may need to supplement with the following nutrients while on the keto diet:

• Minerals: sodium, potassium, and magnesium
• Vitamins: vitamin D, vitamin A, and niacin
• Omega-3s: play a key role in reducing inflammation and improving skin health

Reintroduce Carbohydrates

If you believe that the keto diet is the cause of your rash, you may want to consider reintroducing carbohydrates. A 2018 study found that incorporating carbs back into the diet significantly improved rash symptoms. Even a moderately low-carb diet can help ease the rash while still allowing you to remain in ketosis.

Eliminate Food Allergens

Many foods emphasised in the keto diet, such as eggs, dairy, fish, and nuts, are also common food allergens. Food allergies can be a source of inflammation, so it is important to eliminate any foods you are allergic to that may be worsening your rash.

Incorporate Anti-Inflammatory Supplements

In addition to dietary changes, certain supplements may help the body fight inflammatory skin conditions. Probiotics, prebiotics, vitamin D, and fish oil supplements have all been used in clinical studies to help improve symptoms of dermatitis. Evening primrose oil is another supplement that has shown promising results for treating dermatitis.

Take Care of Your Skin

It is important to take good care of your skin, especially if you have inflammatory skin conditions. The National Eczema Association recommends using lukewarm water for bathing and showering, and cleaning with gentle soaps and cleansers. Keep your skin moisturised when dry and protected from elements such as hot sun or cold wind.

Talk to Your Doctor

If home treatments are unsuccessful in clearing up the rash, it may be necessary to visit your doctor. They may prescribe medications such as the antibiotics minocycline and doxycycline, which have been found effective in treating prurigo pigmentosa.

While the keto rash can be frustrating and uncomfortable, it is not considered life-threatening. By following the treatment options outlined above, you can help ease the rash and prevent it from recurring.

Frequently asked questions