What is it, what it means and how to treat it

  • A keto rash, aka prurigo pigmentosa, is a rash that results in red spots on the torso and back.
  • The rash occurs because eating a keto diet can trigger inflammation in your body.
  • A keto rash is a sign that you need to stop ketosis if you are dieting for non-medical reasons.
  • Visit Insider’s Health Reference Library for more tips.

The keto diet has a series of potential health benefits, but it can also come with unintended consequences, including rash.

This rash is a form of dermatitis called pigmentary prurigo, and it triggers raised red spots on the back, shoulders and abdomen.

The cause is unclear, but the rash usually goes away within a few weeks once you stop ketosis, but can leave long-lasting skin discoloration.

Fortunately, most people who try the

keto diet

will not experience the rash. “Keto rashes are very rare,” says Marina peredo, MD, a dermatologist with Skinfluence.

But if you do develop it, here is what you need to know about the causes of keto rash and how to get rid of it.

What causes the rash?

The rash most commonly occurs in young Asian women, but research shows It can happen to anyone, especially if they are on a keto diet.

Prurigo pigmentosa also appears in people who:

  • Have eating disorders like anorexia
  • Have autoimmune disorders, including Sjogren’s syndrome
  • are pregnant

Doctors are not sure exactly what causes the rash, but it is believed that a change in the gut microbiome due to sudden changes in eating habits may contribute, says Kristi artz, MD, medical director of Spectrum Health Lifestyle Medicine.

“Healthy gut microbes typically thrive on high-fiber foods that are often removed from a keto diet,” she says.

What if I have a keto rash?

Usually, the rash is a sign that you need to stop ketosis because it isn’t good for your body, says Artz.

The rash is a sign of inflammation and may indicate that the keto diet is causing inflammation elsewhere in your body, she says.

“The keto rash is just one more manifestation of the inflammation that is often produced by following a keto diet,” she says.

Here are five ways to get rid of a keto rash. Some require that you ditch the keto diet, but if you have to stick to it for medical reasons, there is some advice for those circumstances as well.

1. Eat more carbohydrates

Stopping ketosis will help relieve the rash. To end ketosis, you simply need to eat more carbohydrates. But the type of carbohydrate you eat matters.

Artz recommends focusing on high-fiber fruits and vegetables like bananas and leafy greens to help rebalance your gut microbiome.

“Reintroducing whole plant foods that are high in fiber will likely lead to a decrease in total body inflammation and resolution of the rash,” she says.

2. Eat anti-inflammatory foods

Prurigo pigmentosa is a form of inflammation, so following an anti-inflammatory diet can help fight it.

“The complex carbohydrates found in whole grains, beans, legumes, fruits and vegetables are beneficial for health and fight inflammation,” explains Artz.

Along with complex carbohydrates, foods high in healthy fats like salmon and olive oil, as well as nuts and berries are all part of an anti-inflammatory diet.

3. Take antibiotics

If you have a condition like epilepsy that requires you to follow a keto diet, changing your eating habits is not an option.

In this case, you may be able to treat the rash without ending ketosis using



Doctors aren’t sure why antibiotics work, but they are thought to change the movement of white blood cells around the rash, reducing symptoms.

If you don’t have a medical reason for dieting, it’s better to listen to your body and change your eating habits rather than taking medication, says Artz.

4. Adjust your exercise routine

Exercise has powerful anti-inflammatory properties and can help resolve the rash quickly, explains Artz. Opt for low-stress exercises like walking or yoga.

There is one exception: endurance exercise lasting longer than two hours may promote ketosis and possibly worsen the rash, says Peredo. If you exercise for long periods of time, consider cutting back on excess until the rash resolves.

5. Filling in nutritional deficiencies

Most keto diets are not well balanced and can lead to impairments in some nutrients. This, in turn, can cause skin conditions, including dermatitis, although this is different from the keto rash.

“Keto diets high in animal protein and fat followed over a period of time can cause deficiencies in vitamin C and other antioxidants and micronutrients found in whole plant foods,” says Artz.

Filling in deficiencies with a more balanced diet and possibly a multivitamin can help treat keto rashes.

Treating keto rashes and when to see a doctor

As long as your rash persists, you should hydrate the region, says Peredo. Try to avoid touching or rubbing it and opt for loose clothing, she says.

general keto rash resolves itself in a few weeks to stop ketosis, but it can leave a reticulate pattern – similar to a leaf or a giraffe – on your skin indefinitely.

If your rash spreads across most of your body or doesn’t seem to resolve after you quit the keto diet, see a doctor, says Artz.

You should also see a doctor immediately if the rash is accompanied by fever, chills, or other worrying symptoms.

Insider’s takeaway

Keto rashes are rare. Doctors aren’t sure why this is happening, but they believe changes in the gut microbiome and resulting inflammation, caused by lack of fiber, may be contributing to it.

The rash is an indication that your body cannot tolerate the

ketogenic diet

well, says Artz, and the best treatment is to stop ketosis, unless you are on a keto diet for some medical reason.

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