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Why is the keto diet causing rash to the skin?

Sometimes a red, itchy skin rash can be caused after a ketogenic diet, which people commonly refer to as keto rash.

For keto rash the medical term is prurigo pigmentosa.

The keto rash is distinctive because it forms patterns that resemble networks across the skin. The upper body is typically influenced by this.

Researchers still don’t know exactly why a ketogenic diet causes inflammation of the skin, but they believe this rash may be linked to ketosis. Many different treatments and lifestyle changes may provide relief from the symptoms.

We discuss keto rash in more detail in this article including its appearance and how to treat it.

What is a keto rash?

Keto rash is a type of itchy, and painful dermatitis.
Keto rash is a type of itchy, and painful dermatitis.

Keto rash is a rare form of skin inflammation, or dermatitis. It is a itchy rash that occurs on the upper body.

One possible cause of keto-rash is a ketogenic diet. This diet is increasing in popularity because ketosis provides a range of potential health benefits including weight loss promotion.

The keto diet is extremely low in carbohydrates but high in fat and protein. When a person follows this eating pattern for sufficient time, their body begins breaking down body fat for fuel rather than carbohydrates. The body turns the fat into ketone.

When the body transfers its primary energy source to those ketone bodies, a individual has entered a ketosis state.

Most keto rash incidents were in Japan, and only 40 reported cases had been in other countries until 2011. The explanation for that may be that the disorder is less common to Western physicians.

The cause of keto rash is unknown but research suggests that being in a ketosis state may be a possible cause of the disease.

Fasting and diabetes can lead to ketosis, in addition to keto diet.

Other possible causes of a keto rash or triggers include:

  • hormonal changes that can occur during pregnancy and menstruation
  • a complication of bariatric surgery
  • skin friction


The keto rash develops on the skin as uplifted, red, itchy papules. Redness of the eye, or erythema, on dark skin can be more difficult to detect.

Rash is more common on the upper body and tends to affect the following:

  • chest
  • neck
  • back

Keto rash may mimic other skin conditions such as confluent and reticulated papillomatosis, contact dermatitis, and some reactions to the drug. Nevertheless, keto rash can be distinguished by the network-like pattern which remains on the skin as the red bumps begin to resolve.

The swelling should continue to decrease over time, leaving the skin a brownish discolouration.


Symptoms may be eased by moisturizing the rash area.
Symptoms may be eased by moisturizing the rash area.

For someone with keto rash there are several possible treatment choices.

Eating more glucose will usually solve the rash for keto rashes that occur due to ketosis, as this takes the body out of ketosis.

Administering insulin will reduce keto rashes in people with diabetes.

Research suggests antibiotics, such as minocycline or tetracycline, may also treat keto rash symptoms.

Keto rash can be caused by friction between fitted clothing and skin, so wearing loose fitting clothing can also reduce this.

To relieve symptoms, it is also helpful to follow general treatment advice for good skin care, such as:

  • avoid touching the rash where possible
  • keeping the fingernails short
  • moisturizing the area several times a day
  • avoiding contact with irritants, such as wool or strong detergents
  • preventing hot or humid climates
  • gently washing the skin and preventing excessive rubbing


Rash on the keto is rare. Scientists do not yet fully comprehend what causes the rash, but being in a ketosis state may be one possible cause. While similarities exist between keto rash and other skin conditions, this rash is unique because of the papules ‘ network-like structure.

People who develop keto rash following a keto diet or fasting can treat it by increasing their intake of carbohydrates. Doctors may also recommend topical or oral antibiotics to help in rash resolution.

Chukwuebuka Martins

Chukwuebuka MartinsĀ is a writer, researcher, and health enthusiast who specializes in human physiology. He takes great pleasure in penning informative articles on many aspects of physical wellness, which he then thoroughly enjoys sharing to the general public.

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