The low-carb, high-fat keto diet can get you into ketosis. Ketosis is a metabolic state in which your body might experience some side effects – including keto rash.

Keto diet rash is a rare form of inflammatory skin condition or dermatitis. The medical term for it is prurigo pigmentosa. It can appear on people who are in the early stages of ketosis. Although it’s itchy and uncomfortable but not life-threatening or dangerous at all.


The keto rash looks like itchy, raised bumps on the skin that can be red, brown, or light pink in colour depending on the stage it’s in. The rash may resemble contact dermatitis or an allergic reaction but it can be distinguished by a dark brown pattern left on the skin that remains after the inflammation subsides.

The most common site for keto rash is your upper body, and it typically shows up on the neck, back, armpits, and chest.


The exact cause of the rash is unconfirmed but several studies suggest that being in a state of ketosis could be a possible cause of this condition.

Other possible causes or triggers could be hormonal changes that can occur during pregnancy and menstruation, a complication of bariatric surgery and few external factors (skin trauma, allergens etc.) The rash often gets worse on exposure to heat, and after exercise due to increased sweating.


As the root cause is not clearly defined, the treatment for keto diet rash is debatable. However, you can try these methods to alleviate your symptoms :

1.Give It Some Time.

If it has developed as a side-effect of getting into ketosis, allow the rash to heal by itself. Let it run its course! In most cases, keto rash recedes on its own.

2.Increase Carbohydrates Consumption

Keto rash can be eased by adding carbs back into your diet. Increase carb intake just enough to take your body out of ketosis for a few days. This will decrease your ketone blood levels. Check if the rash starts healing.

3.Eliminate Allergens

Some keto-friendly foods may increase the risk of provoking food allergies. Some common allergenic foods are eggs, dairy, tree nuts, peanuts, seafood, etc. Eliminate one of these food groups from your diet every 3-4 weeks and see if your rashes heal.

4.Supplement Your Diet With Nutrients

Generally while following a keto diet, you may miss out on vital nutrients. Deficiency of nutrients, such as vitamins A, B12, and C, often causes skin issues. To rule out any deficiency related causes, supplement your diet with vitamins and minerals.

5.Incorporate Anti-Inflammatory Foods

Keto rash would not occur without an inflammatory response. Fight inflammation with Vitamin D, fish oil, prebiotic, and probiotic supplements.

6.Avoid Skin Irritants & Sweating

Stay away from chemicals that irritate your skin, never scratch the rashes, avoid wearing tight clothes that might rub against the rash and don’t scrub or exfoliate the affected area. Also, avoid excessive heat and sweating as the acetone in sweat is a major rash trigger.


It is unclear if keto rash can be prevented altogether. But as we know the possible triggers now, here are some tips that can be followed :

1.Start Slowly

Reducing carbs drastically may be a trigger for a keto rash. Decrease the carb consumption gradually and let your body adjust first.

2.Be Alert To Minor Rash Symptoms

The moment you notice any sign of rashes appearing on the upper part of your body, increase your carb intake. Don’t let them aggravate.

3.Start Taking Supplements

Ensure adequate intake of key minerals to avoid deficiencies. This will prepare you to deal with the increased levels of ketones and also lower the risk of getting a keto rash.


By Dr Seema Nanda