If going on keto meant drastic changes to your diet and eating habits – it’s natural that the sudden changes may cause side effects. Some of the most common keto side effects include leg cramps, headaches, digestive problems and keto rash, which I’m going to discuss in this article.
Most of the time side effects are temporary and pass within a couple of weeks. However, it is important to take care of your health, so if any diet, including keto causes side effects or other inconveniences it is important to look into them. Sometimes symptoms like a rash can be a keto rash but in some cases it can unveil some serious health issues.
Don’t get spooked now! Most likely what you have is a simple keto rash and nothing more serious. I just wanted to acknowledge that it’s important to listen to your body.
In this article I will talk about keto rash symptoms and what causes it. Later we will discuss possible ways to prevent the keto rash from happening and ways to treat it.
Keto Rash Symptoms
In more medical terms, keto rash is also called prurigo pigmentosa. It’s a quite rare inflammatory skin condition whose cause is yet to be found out. The most common symptoms and characteristics of the keto rash is red and itchy skin (rash) often seen around the neck and trunk.
Even though it is still unknown what causes the rash, according to several studies made in the past, women get this skin condition more frequently. To be more precise, women get the keto rash 2,6 times more than men and it is more common among women from Asia. (1)
Most common symptoms of the keto rash can include:
- Usually a keto rash looks similar to a regular allergic skin rash. Usually it can be itchy, pink to red colored rash. It is common for the rash to occur primarily on the chest, abdomen, armpits, torso and upper back.
- The pink to red colored spots usually form a symmetrical pattern on both sides of your body. The pattern tends to have a web or net-like appearance.
- Once the rash passes, you may find a dark brown pattern that looks similar to freckles, on the skin in the places where the rash originally was placed.
- Can become worse if exposed to high heat, sweat, sun and other factors that could irritate the skin.
Overall, keto rash is not a deadly or life threatening condition and it should pass within a couple of weeks if you take the necessary means which we’ll discuss later in this article.
Course and Stages of Keto Rash
Based on scientific research, the keto rash or prurigo pigmentosa has 4 main stages that each person who has it goes through if the skin condition is not treated:
- Early lesions – the skin starts having light pink, slightly raised skin lesions. To make it easier for you to identify – it looks similar to a minor scratch or a small rash. Due to that, the first stage of the keto rash is often difficult to identify and is ignored by most people.
- Fully developed lesions – that’s the stage when most people actually notice that they have the rash. During this keto rash stage, the lesions become the so called papules which are more pronounced and turn red. Sometimes papules turn into cysts with liquid inside them.
- Resolving lesions – during this stage, the rash starts to pass. The papules start to get brownish and the liquid ones start dissolving.
- Late lesions – during this stage your skin starts to look like it has larger freckles. This means that you’re almost fully healed. In some time the freckles will disappear and your skin will return to normal.
How Long Does Prurigo Pigmentosa Last?
Keto rash can last from a couple o weeks to several years. Everything depends on whether you treat the condition or ignore it. Some people can get the rash every time they follow keto, others may have it once or twice.
NOTE: if you don’t take care of healing your keto rash symptoms and eliminating the cause of it, most likely the rash won’t disappear on its own.
What Causes Keto Rash?
As mentioned before, the cause of prurigo pigmentosa is currently unknown. However, there are studies that found connections between the state of ketosis and prurigo pigmentosa. (2)
The researches connect to a small molecule found in our bodies – acetone. Acetone is the smallest and simplest ketone. This ketone can be found in various plants, animals and our bodies. It is best known for its abilities to dissolve paint and nail polish.
When acetone is produced in our bodies, it doesn’t do any harm. However, if you put acetone from the outer environment into your body then it may cause health issues.
When you enter the state of the ketosis, your body starts producing more ketones. This means also producing more acetone. The acetone may be excreted through our sweat. That means it gets in contact with the skin and can potentially irritate it which could lead to a rash.
Most common Keto Rash Causes
Here you will find a list of some of the most common reasons that could actually cause prurigo pigmentosa:
- Allergies – if keto required sudden and drastic changes to your food selection – there may be some ingredients that you could be sensitive to. Try eliminating several or one by one for a week and see if it helps with the rash.
- Low carb / keto diet – as mentioned before, going low carb and entering ketosis means that your body produces more acetone which can cause the keto rash.
- Lack of nutrients – going ona diet means that you may start lacking some nutrients. Lacking vitamins and omega-3 oils could lead to skin irritation and rash.
- Other (non-keto related) – to figure out whether external reasons are behind it, you will need to examine your schedule and recent changes to it. Maybe you started going to the pool or visiting a sauna? Public places often include irritants in water and in hot air. So, maybe you simply need to change your schedule.
How to Prevent it?
If you’re interested if it is possible to prevent keto rash from happening, the answer is most likely yes. Even when your keto rash is just starting – it could still be possible to prevent it. Here you will find several ways that can help you prevent prurigo pigmentosa:
- Reduce your carbohydrate intake slowly – if you cut out carbs from your life instantly, it may cause a lot of stress to your body. The stress caused to your body can cause the keto rash. That’s why it is best to reduce your carbohydrate intake step by step and enter ketosis slowly. This way you may be able to prevent prurigo pigmentosa.
- Check your body for minor rash symptoms – since you already know that keto rash exists, by checking your body from time to time you have a higher chance to spot it at early stages. When you spot the skin condition in an early stage, it could be easier to stop it and reduce the symptoms.
- Supplement your diet correctly. By supplementing your diet you will help prevent keto rash as well as other keto flu symptoms that occur due to low carbohydrate amount in your body.
- Consult a doctor – if you notice any symptoms or have worries – always consult with a specialist. Your doctor could even recommend a diet and nutrition specialist that could help you follow the keto diet in a healthy manner.
Overall, most of the people don’t get the keto rash and have no problems with following the diet from the very beginning. However, for the first 2-3 weeks be sure to follow these tips listed above. This way your body will be better prepared for a strict keto diet with very low carbs in it. When your body is prepared, naturally you reduce the stress on it and risks of getting the keto rash.
How to Treat Keto Rash?
The best way to treat a condition is by eliminating the cause. Keto rash is not an exception. So, since we already discussed some reasons behind prurigo pigmentosa, let’s see how we can eliminate them:
- Increase carbohydrate intake – as mentioned before, quickly reducing your carbohydrate intake can cause stress to your body. Stress combined with quickly increasing number of ketones in your body could lead to getting the keto rash. Try eating 50-100g of carbohydrates per day and see if it helps. If the rash goes away, slowly reduce the number to enter ketosis again.
- Try finding allergens in your diet – there is a possibility that you are sensitive to some products that you newly added to your diet. So, the fastest way to identify the potential cause of the rash is eliminating newly added products (those that you didn’t eat before keto) one by one from the diet. Follow your body and see if it fixes the situation.
- Take proper care of your skin. Make your you moisturize your skin and don’t expose it to extreme hotness as well as extreme coldness. Bad weather conditions can cause irritation for your skin.
- Supplement your diet – using supplements and vitamins will help prevent malnutrition that can lead to keto rash. Be sure to minerals, such as pottasium and magnesium, vitamins, including A and D and Omega 3 oils. All of these combined will make your skin healthier, improve metabolism, reduce inflammation and make your overall health better.
- Reduce inflammation – you can do it in two ways: by eating anti-inflammatory foods, such as fatty fish and vegetables, dressed with olive oil and turmeric. All of these products have anti-inflammatory effects on your body.
- Eliminate other irritants – as mentioned before, if you added new activities to your schedule – they might be the reason why the keto rash started. So, if you joined a local pool – take a few days off, if you started taking many sunbaths – keep yourself away from the sunlight.
Keto Rash – Overview
To sum up, what’s important for you to know is that keto rash or prurigo pigmentosa is not a life-threatening condition. It’s more annoying than dangerous. The skin condition follows 4 stages, after which it should disappear completely. Since the main cause of the rash is currently unknown – there is no one cure. However, there are links between the ketogenic diet and keto rash.
Keto rash can, in fact, be caused by following a low carb diet. That is why, sometimes it can be reversed simply by increasing your carbohydrate intake.
In order to avoid this skin condition you can slowly reduce your carb intake. This way you won’t cause your organism the stress and most likely will avoid getting prurigo pigmentosa.
If you have worries or questions – always consult your doctor. You should always consult with a specialist if you have any uncertainties of questions about your health.