Like all lifestyle and diet changes, keto has some known side-effects. Nothing serious, of course, but keto rash can be one of them. Keto rash, as it’s aptly named, is uncommon, but does occur on some people, especially during the first stages of Ketosis. It’s not a big issue, and it’s very treatable – in fact, it’s preventable, too!
Understanding the rash
The keto rash is a inflammatory skin disease that may occur while an individual is on their keto diet or in ketosis. The rash is a type of dermatitis that is most common in young women and teens, and even more common in young Asian women. Its formal name is prurigo pigmentosa, though there is some debate whether the keto rash and prurigo pigmentosa are exactly the same skin condition.
The rash’s appearance
The keto rash appears as a red rash, usually in spots, that takes on a web-like appearance. The rash can be found on the upper back, the chest, or the abdomen. The spots will be raised, and depending on the stage of the rash, they may appear pink, red, or brown. It is not life-threatening and does not look dissimilar to a rash caused by eczema.
Less common areas affected by the rash include the neck, underarms, and face. Some have also experienced it on their hands; but this is much less likely.
Once the rash fades, the individual may be left with a dark brown pattern of the rash on their skin.
The stages of the rash
In the first instance, the rash may appear as light pink skin lesions. These then develop to red lesions that look infected, and much more aggressive. This second stage is the one that concerns most who suffer from the keto rash because some instances of keto rash have included cysts over a wide area.
When the rash is resolving itself, it will appear dark and crusted, perhaps even scaly. It’s not a pleasant or appealing process, but again, the rash isn’t harmful.
Finally, your skin will be left with a pattern of darker spots where the lesions were. These will be a little bigger than freckles and appear in their original web or net-like pattern. The skin will eventually return to normal.
There is no set frame of time for how long a keto rash may last. Some last for a week or two, others have lasted for months. The best way to treat it is to address the cause of the rash; which could be ketosis, itself (but this is the worse-case scenario).
Causes and worsening rashes
The production of ketones in some individuals seems to be one of the reasons the rash appears. For those in ketosis that get the keto rash, it often appears once the individual reaches ketosis and stops once they exit ketosis.
Insulin can help speed up the healing of the rash, but sweating can irritate the rash and make it much worse.
When ketones are created, our body also creates acetone, which is sweated out through our pores; exposing our skin to it. Acetone may cause the inflammatory response that causes the keto rash, but this is just one theory among many.