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  5. Keto Diet Rash: Causes, Symptoms & Treatment

Did you know that a keto diet that focuses on consuming foods low in carbs and high in fat, comes with its own set of unwelcome side effects?

The Ketogenic diet, as a principle, gives more importance to ketones derived from fat. Ketones are a source of energy for your body, produced by the liver. In a keto diet, the body relies on the energy from Ketones with very little carbohydrate consumption.

Because a keto diet is so restrictive, health experts suggest that it's not an appropriate plan to follow long-term. The reason being side effects such as fatigue, diarrhea, keto flu, a distinct keto breath, and even keto rashes. Read on to learn more.

What Is Keto Rash?

Keto rash, also known as Prurigo Pigmentosa, is an inflammatory skin condition caused by an excess of ketones in the body. It is considered a rare skin disorder.

Apart from people who follow a diet deficient in carbohydrates, keto rashes can also appear among people who are fasting, people with diabetes, and those undergoing post-bariatric surgery.

What Does Keto Rash Look Like?

A keto rash will manifest in the form of red, itchy, papules on your body. It usually appears on the neck, chest, and back in a reticular pattern. [1]

While keto rashes look red initially, as they progress, they could turn a darker shade, often looking brownish in the last stages.

Keto rashes are commonly misdiagnosed as signs of eczema since they both manifest in the same physical form.

Symptoms Of Keto Rash

Watch out for any itchy, red spots or bumps on your chest, back, and neck. Remember that keto rashes come with a netlike pattern around them. While they may appear red at first, they slowly turn dark, leaving pigmentation in the form of brown patches where the red spots used to be.

If you have been noticing rashes that cause irritation and are persisting for more than a week, consult a doctor to diagnose the exact cause correctly.

Where Does Keto Rash Appear?

A keto rash usually appears as red, itchy papules on the neck, chest, and back in a net or web-like pattern. They could also appear on your upper back, abdomen, and armpits.

Stages Of Keto Rash

1. Early Lesion

Prurigo pigmentosa evolves or progresses through three stages in a span of about two weeks. You will see red, itchy bumps with a net or web-like pattern around them in the first stage. Don’t ignore this symptom, especially if you have diabetes or are on a low-carb diet as it could be a sign of the early stage of a keto rash.

2. Fully Developed Lesion

In the second stage, prurigo pigmentosa progresses to swollen, pale red bumps. This stage is also associated with a lot of skin irritation.

3. Late-Stage Lesion

The itchy, swollen pale red bumps further evolve, and you will notice both papules (bumps without liquid) and bumps that are pus or liquid-filled.

After the late-stage comes the post inflammation period, during which the papules and vesicles (fluid-filled bumps) will dry up and become crusted, leaving behind brown discoloration or pigmentation.

What Causes Keto Rash?

When you’re on a keto diet, you consume very little carbs. It is important to recall here that the body uses glucose from carbs to produce the energy it needs.

In a scenario where the carbohydrate intake is minimal, the body ends up relying on the ketones derived from fat instead.

When excess ketones are produced, it leads to a condition known as ketosis, which is one of the consequences of a low-carb diet commonly found among those who have diabetes. A keto rash is one of the most common side-effects of ketosis.

How To Get Rid Of Keto Rash?

An obvious first step would be to increase your carbohydrate intake by making changes to your diet. By boosting your carbohydrate intake, you have a chance at controlling ketosis. Several studies have proven the link between keto rashes and a low-carb diet. [2]

Research also proves that prurigo pigmentosa can be resolved with the resumption of a higher carbohydrate diet. [3]

Foods rich in carbohydrates, also known as the good carbs, include whole grains such as quinoa, and brown rice, nuts such as hazelnuts, walnuts, almonds, peanuts, and legumes such as peas, lentils, kidney beans, and fruits such as apples and strawberries.

Consult a doctor to identify and eliminate any food allergens or nutritional deficiencies from your present diet.

How Long Does Keto Rash Last?

Keto rashes progress over time. Typically, they can last up to two weeks. If you have been noticing red, itchy papules on your neck, chest, or upper back that have been persisting for more than a week, it is time to set up an appointment with a dermatologist.

Prevention & Care

Treatment is the best way to ensure that keto rashes do not recur. In addition to boosting your carbohydrate intake through dietary changes, certain antibiotics can also effectively treat keto rashes, especially in the early, inflamed stages. However, there is no treatment for the discoloration or patchy pigmentation that is left behind by the inflammatory skin condition.

Try to avoid any strenuous activities that could make you sweat, and hot showers as these activities can sometimes make the rashes worse. Use only gentle products for your skin and get them approved by a certified professional before using them.

Wrapping Up

Remember, up until now, your body has been relying on carbohydrates for energy. So, cutting carbs cold turkey is never advisable. Other diets, such as the Paleo diet, which is high in protein and low in carbs, have also been known to induce prurigo pigmentosa. [4] It is crucial to always consult a dietician before embarking on a diet plan such as the low-carb, high-fat keto diet.

Begin By Knowing Your Skin

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