One of the biggest appeals of the ketogenic diet is that, while challenging, it has fast results, particularly when it comes to things like weight loss, long-lasting energy, and increased focus. However, it also comes with some not-so-pleasant side effects. Ever heard of the keto rash?
Before ditching the diet at the prospects of itchy red bumps, the keto rash, while annoying, is not at all dangerous and is both treatable and preventable.
In this article, we’re going to take a closer look at the keto rash, its symptoms, causes, treatments, and how you can help avoid it altogether.
The scientific term is known as prurigo pigmentosa, and is considered to be a rare inflammatory skin disease. Studies have shown that there is a strong correlation between long periods of fasting and ketosis, and developing the keto rash, hence it’s moniker .
Some characteristics of the keto rash include itchiness and discomfort, and it typically appears on the back, torso, chest, and neck. It manifests as red, brown, or light pink bumps, with the color depending on the severity of the rash.
The lack of research on prurigo pigmentosa makes it difficult to pinpoint the exact cause, but it’s widely believed that the keto rash tends to occur in areas where sweat has accumulated and usually happens in the beginning stages of ketosis. This can cause irritation in some people when the skin comes in contact with the skin.
Some other potential causes of the keto rash include:
- Nutrient deficiencies
- Histamine or allergy intolerance
- Detoxification during ketosis
Studies also suggest a correlation between the keto rash and insulin resistance of type 2 diabetes.
All in all, information out there about the keto rash is pretty sparse, but it can happen and so you should be made fully-aware of what symptoms you can expect.
While it be alarming to suddenly find your body coated in itchy and uncomfortable bumps, the good news is that this particular rash is not life-threatening. It’s a completely natural reaction that sometimes occurs when entering ketosis.
This naturally-occurring rash also comes with some natural solutions that can help alleviate symptoms or clear it up completely.
1. Increase your carb intake
If you’re experiencing the rash while in ketosis, try upping your carb intake to 50g by eating more clean carbs like fruit or starchy vegetables. While this has the potential to toss you out of ketosis, it may also be the most effective way to battle the rash.
Keto-dieters have claimed that the rash typically clears up within 2-3 days of adding more carbohydrates to their diet. Be advised, dieters have also reported the rash can sometimes reappear as soon as they re-enter ketosis.
If this is happening to you, try making an appointment with a naturopathic physician to check your heavy metals count and see if detoxification could be the root cause.
2. Drink Bone Broth
You might not think it, but bone broth is a keto diet superfood. Not only does it fill up your belly, but it also contains natural anti-inflammatory nutrients such as proline and glycine.
Since the keto rash is an inflammatory skin condition, it makes sense to eat plenty of foods that help reduce inflammation.
3. Fish Oil and Fatty Fish
Wild fish such as mackerel, salmon, and sardines contains a great amount of omega-3s which means they also have solid anti-inflammatory benefits for the skin.
Wild fatty fish is great for the ketogenic diet, but try supplementing it with fish oil as well if you are experiencing the keto rash. This will give you a much-needed boost of anti-inflammatory nutrients.
4. Anti-Inflammatory Superfood Supplements
Another great way to combat and alleviate keto rash symptoms is with anti-inflammatory superfood supplements, such as spirulina or chlorella.
Spirulina is a blue-green algae and chlorella is a single-celled green algae. Both contain a solid amount of omega-3s along with an anti-inflammatory omega-6 essential fatty acid called gamma-linolenic acid (GLA). These can be taken in pill or powdered form.
Be advised, when opting for algae supplements, be sure they’re tested for heavy metals like mercury. The last thing you want to put in your keto rash-encumbered body is more heavy metals. Most high quality supplement companies will have this information on their websites.
5. Avoid Sweating
Raising your body temperature can worsen the keto rash, so try modifying your exercise routine to something more light and less strenuous in the early stages of ketosis so you aren’t sweating as much, which can trigger the keto rash.
Similar to most rashes, the keto rash will go away on its own with time. Give it a few weeks so your body has time to adjust, especially if you’re new to the keto diet.
The more often your body experiences ketosis, the more quickly it will adapt to the production of ketones.
Keto-dieters have reported that the rash will typically clear up within weeks while receiving no treatment at all.
Whether or not you’ve experienced the keto rash before, you’re probably wondering how to prevent it.
Unfortunately, since there isn’t much research on the subject, there are no clear and absolute avenues of prevention.
With that said, however, there are steps you can take to minimize the risks.
1. Don’t rush into ketosis. It’s best to transition slowly, especially if you’re new to the diet, by gradually reducing your carb intake rather than dropping carbs completely.
2. Keep a lookout for rash symptoms and signs. As soon as you notice any bumps or rash-like symptoms occurring, up your carb intake to prevent your rash from worsening.
3. Take supplements. Consider supplementing your diet to avoid any vital nutrition deficiencies.
The keto rash is fairly rare and chances are, you’ll never have to experience it. But if you do, remember that there is no cause for alarm. It is completely non life-threatening and will typically clear up on its own within a few weeks.
Don’t let the keto rash scare you away from a diet that can yield so many wonderful health benefits!
 Oh YJ, Lee MH. Prurigo pigmentosa: a clinicopathologic study of 16 cases. J Eur Acad Dermatol Venereol. 2012 Sep;26(9):1149-53. doi: 10.1111/j.1468-3083.2011.04263.x. Epub 2011 Sep 20.
 Kubota Y, Koga T, Nakayama J. Bullous prurigo pigmentosa and diabetes. Eur J Dermatol. 1998 Sep;8(6):439-41.