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Entering ketosis has some amazing side effects on the body, like increased energy, a reduction in inflammation, and sharp mental clarity. It does, for some, come with a few downsides as well. If you’ve recently entered ketosis and find yourself itching like crazy, you could have what’s referred to as a keto rash.

Prurigo Pigmentosa

Keto rash, scientifically referred to as prurigo pigmentosa, is a rare inflammatory disease that causes itchy red or pink bumps on the back, torso, armpits, and neck. Occasionally, keto rash can also appear on the face, neck, and hands.

What Causes Keto Rash?

There are several theories about what causes keto rash, but research has definitively shown a clear link between ketosis and the presence of these itchy bumps. A European study in 2011 shows that, out of 16 patients with prurigo pigmentosa, 8 of them showed a clear history of fasting or ketogenic diet and the presence of this rash, while 6 were actively in ketosis.1

A drastic reduction in carbohydrates, whether by fasting or ketogenic diet, causes the production of ketones, so it’s reasonable to deduce that ketones are responsible for most instances of prurigo pigmentosa.

Treating Keto Rash

The most obvious solution for treating keto rash is to get out of ketosis by eating carbohydrates. However, sabotaging your health and weight loss goals isn’t the only way to treat keto rash.

Like any rash, heat and sweat seem to aggravate the condition. So, keeping the rash area clean, dry, and sweat-free should help the itching improve tremendously. Washing with cool water and gentle soap, patting the skin dry afterward, and applying hydrocortisone cream is a popular treatment that has been effective for some.

Under a physician’s care, the keto rash has also shown to improve using minocycline or doxycycline treatments because of the anti-inflammatory properties found in both of these antibiotics.

How Long Will Keto Rash Last?

If you opt to push through, stay in ketosis, and deal with treating your keto rash, it won’t last forever. With the proper care, keto rash typically lasts anywhere from 2 to 4 weeks in most people that suffer from the condition. If you opt to drop out of ketosis and eat carbohydrates, the rash should resolve much faster. However, it’s important to remain mindful that the keto rash could return if you opt to fast or begin your keto diet again.

The painful, persistent itch associated with the keto rash can be a real blow to your ketogenic diet goals. However, with some patience and careful attention to your skin, you can push through and maintain ketosis. Have you had to deal with keto rash in the past? Let us know how you dealt with it in the comments below!


The content on this website should not be taken as medical advice and you should ALWAYS consult with your doctor before starting any diet or exercise program. We provide nutritional data for our recipes as a courtesy to our readers. We use Total Keto Diet app software to calculate the nutrition and we remove fiber and sugar alcohols, like erythritol, from the total carbohydrate count to get to the net carb count, as they do not affect your blood glucose levels. You should independently calculate nutritional information on your own and not rely on our data. The website or content herein is not intended to cure, prevent, diagnose or treat any disease. This website shall not be liable for adverse reactions or any other outcome resulting from the use of recipes or recommendations on the Website or actions you take as a result. Any action you take is strictly at your own risk.

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