Successful Treatment of the Keto-Rash by a Visitor to this Site


Every once in a while people will contact me about a rash that they think might be keto-rash. I do my best to respond to all of them, and sometime I hear back and sometimes I don’t. Well here’s a case where someone with a rash tried treating it by increasing their carb intake and provided wonderful followup.

In early December I received this e-mail from a visitor named Apryl:

“I found this page by Googling “low carb diet rash”… after breaking out into a rash under my breast and rib cage area. It wasn’t itchy at first but now it is getting itchy and spreading.

It showed up within days of dropping my carb intake to 20g net. ( was around 100g before and also included grains) I have tracked my calories and foods on fitness pal app so I know for sure the timing coincides.

My weight is down to almost 130 now so I am going to up my carb intake to at least 150. Using fruit and other high carb veggies… sweet potato and plantains. Which I have been missing 🙂

Hopefully it will start to show improvement. I’ve never tested with strips as to whether or not I was in ketosis.

Just curious (to the owner of this blog)… How many carbs per day were you consuming when the rash started to show improvement? and did you add back grains as those carbs?”

I replied by saying that I noticed the rash began to abate when I ate at least 100 gm of carbs, however whenever I noticed the rash coming on I normally ate far more than 100 gm.

I asked her how things were going and a few days later this is what she said:

“This is only my second day upping my carbs. No improvement yet. Totally stressing me out too haha.

Benadryl doesn’t really seem to affect it either.

I’m gonna shoot for 100 grams also. Because that’s about where I was before I dropped to 20 net. And when I was at 100 I was still having small amount of grains as well as wheat.   I’m not going to stop any other foods I been eating just add back carbs with fruit and veggies.

I honestly think that the rash is almost an immune response. The weirdest thing. Was so happy to find our blog though. My rash looks just like yours and is in the same area. I will try and send a pic… I happen to have some diaper rash ointment with zinc oxide and smothered that on there so it looks faded but really it is super red. “

Apryl was even kind enough to send a picture (included above).  About 4 days later, she sent me a follow up email:

“It got better within days! Thank goodness. I’m saying in the range between 75 and 100 grams of carbs and around 1500 calories. I’m convinced it wasn’t a food allergy, as I only added foods back in.

I still think it was an immune reaction. I also read somewhere that there is a rash brought on by low cholesterol. Can’t remember the name of the rash but you should easily come across it if you google.

I hope more people come forward and this thing gets figured out before we cause any unneeded permanent damage to ourselves [Emphasis mine].

I wonder a lot about the immunity association and the antibiotics you took. If they helped because it helped with inflammation and not because it was a rash from bacteria.??? Who the hell knows! Haha “

When I asked Apryl what she thought of this post so far, she added:

 “I would definitely emphasize that I didn’t not add grains back into my diet and that I also eat dairy… Mostly fermented dairy. And that I was not eating any grains when I was in ketosis.

Also, I was eating this way (Paleo’ish… Grain free and sugar free) for about a month BEFORE the rash set it. It just showed up once I dropped from around 100 to a strict 20 carbs.

I have not to tried to induce the rash again by dropping to that level like you have. I feel like my diet is much more nutrient dense at 100 to 150 carbs. I also did not gain back any weight eating this way.

I fluctuate between 130 and 135. I may try extra low carb again in the future and see what happens. If I do I will send you an update. Thank you so much for all your hard work.”

I was so glad to hear that she was able to treat her rash and discovered what worked for her to both maintain her weight while keeping the rash away (carbs in the range of 75-100 gm).

Getting this sort of follow up goes a long way in helping others who are dealing with the same thing.

If you think you are experiencing the same thing and are willing to share your experience please don’t hesitate to contact me.  The more cases we can organize and put together the better!


Connect With Others

More posts are also trickling in on the Keto Rash Facebook Community, so feel free to chime in over there. If you don’t have a Facebook account, you can try posting in the Keto Rash Forums.

Support This Site

Keeping this site running takes quite a bit of time, so if you've found this site helpful, please consider making a small donation. Anything will help, even a cup of coffee!
(Visited 6,911 time, 3 visit today)


  1. Esmée La Fleur

    Ketosis causes you body to burn body fat. Toxins are stored in body fat. Toxins that have been stored in fat cells for decades can be broght back into circulation when a Ketogenic diet is adopted. I have the skin version of celiac disease. I have not eaten gluten containing foods for 20 years. But, when I adopted a Ketogenic diet, I broke out with the celiac skin rash within days of being in Ketosis. This tells me that 1) I am definitely burning body fat; and 2) toxins can be stored in our fats cells for a very long time; and 3) unpleasant symptoms that occur when first implementing a Ketogenic diet are not necessarily “caused” by the Ketogenic diet itself, but from the toxins that are being liberated from our fat cells and brought back into circulation for elimination. Add more carbs back to the diet simply stops this process and the toxins stay in the fat cells where they have been stored for so long.

    1. (Post author)

      This is a mechanism that a lot of people seem to subscribe to.

      The only issue I have with this theory is if the rash is simply a release of toxins… why does the use of antibiotics solve this? Antibiotics shouldn’t do anything to the stored toxins within fat cells right?

      Also I tend to think the use of the word ‘toxins’ is too general. What exactly are these toxins? Bacterial lipopolysaccharides? Heavy metals? Environmental pollutants? Dormant microbes? Who knows! Nothing has been consistently isolated yet.

      Another thing is, what about people who lose weight without going into ketosis? People can lose weight while eating carbs (aka biggest loser style) or with super high doses of exercise… and this weight loss comes from the mobilization of stored body fat also which doesn’t seem to cause the rash to occur. While I don’t personally subscribe to these methods of weight loss, I’m just throwing these out there as an example.

      These are just some of the issues I have with the ‘release of toxins’ theory. It doesn’t mean that I’m right… and it doesn’t mean that I’m wrong either. It just means that I haven’t seen enough evidence/data to prove it one way or another.

  2. Esmée La Fleur

    i cannot speak for others experiences, obviously, but I know from my own that what I am experiencing is definitely a celiac skin rash. I had it for 8 years non-stop before I figured out it was caused by gluten/gliadin containing foods. Once I removed these from my diet,mThere rash went away completely within three weeks. It has only resurfaced periodically during fasting and now with a Ketogenic diet. The reason I believe it is a release of gluten/gliadin proteins that have been stored in my fat cells is because the rash does not last. It is less intense than when I was actually eating gluten/gliadin containing foods on a regularly basis I all those years ago. The rash was intense and never went away or lessened during the 8 years that it plagued me. Now, when it resurfaces, it is temporary and fleeting. What I find interesting is that it has been more prominent with the initiation of a Ketogenic diet on which I have actually gained 5 lbs of body fat during the first month (I was underweight, so a good thing for me), than when I did my fasts and lost body fat. As I understand it, it takes a dietary fat to detoxify cellular fat. So, by adopting a Ketogenic diet and increasing my fat consumption to a degree that I have done before, while simultaneously forcing my body to become a fat-burner and use stored body fat as needed (especially while I sleep), more of the gluten/gliadin proteins are being liberated from my fat cells for elimination than what occured during the fasts I have done. On the fasts, I wasn’t in Ketosis, but I was not giving my body the dietary fat it need to transfer and carry the gluten/gliadin proteins out their storage place and out of my body for elimination. It may be that what these others are experiencing with their rashes is an entirely different phenomenon, but I still think that a natural detoxification process could be going on with some of them. It is an idea with exploring. I guess it would depend on how long the rash lasts. But the only way to fairly assess it would be to stay in Nutritional Ketosis (confirmed by blood ketone meter) consistently for a length of time and see if it is something that goes away on its own after a few weeks or months with out coming out of Ketosis.

    1. (Post author)

      Thanks for the input!

      I’m not entirely clear on one thing you’re saying. Do you have celiacs disease? People with celiacs can have an associated skin rash called ‘dermatitis herpetiformis’

      which is something else altogether and seems to be more severe.

      Not sure if this is the case with you though!

  3. Esmée La Fleur

    i apologize for the typos, but I could not find a way to edit the text. One of my sentences above should read: “…after increasing my dietary fat consumption to a level that I have NOT done before…” Hopefully that will make it clear.

  4. Esmée La Fleur

    Yes, what I have is dermatitis herpetiformis, or DH, which is the skin manifestation of celiac. The name is inaccurate, though, because it has nothing to do with “herpes,” but they did not know that when they named it…LOL. I just think it is astonishing that these gluten/gliadin proteins can remain tucked away in fat cells for so many years. How many other toxins is this true of?

    1. dsharpe

      I believe Esmee is totally correct. I also have celiac related “dermatitis herpetiformis”. It took me a while to figure it out, and my dermatologist was no help. I have been paleo for a year and got the rash once I really started to clean up my diet and when I unknowingly ate gluten at restaurants. But they also treat this with antibiotics. Steroids do nothing for the rash, but a long treatment of antibiotics supposedly works. I opted not to go that route (did not want to destroy months of work to get healthy gut microbes) and instead used charcoal pills, epsom salts baths, and hot saunas to get rid of the gluten protein or toxin trigger I ingested. It worked beautifully! Now that I have been “bulletproof” for a 4 months, I occasionally get a rash even when I know I have been eating gluten free and now I realize it is when I go into to very low carb cycles. I think it is definitely due to a fat released toxin. I figured this out from Dave Asbury’s podcast and found this site.

      Now the mystery is cleared up!! Too bad science and medicine has not caught up with these issues. I am a biologist and scientist and it bugs the crap out of me that modern medicine is so out of touch with this !!

      1. Esmée La Fleur

        Thank you for sharing your experience dsharpe. :o)

      2. chris coetzee


        I started low carb diet this past January and started to develop ketorash. From reading through your historic post in this regard I tried some doxy medication which I had on hand for malaria prevention. I found the doxy only slightly relieved my symptoms (less itchy) but did not remove the rash. I also got introduced to Kiefer’s Carb Bites in one of your other blogs; long story short I have been carbing it for the passed 3 weeks and guess what the ketorash is gone plus I lost some centimeters in the process.

        1. (Post author)


          Sorry I missed your comment! I find it interesting that the doxy didn’t help, but the carbs did!

          Are you still keto rash free?

  5. valarie mceuen

    Is there anyone out there who has experienced a rash on their face, particularly on the left and right of the chin and on both temples? I have been on the Atkin’s diet for 6 days and this has just appeared. It doesn’t itch but rather feels a little stingy and feels tight. I know it is not caused by other factors such as new cleansers or makeup.

Comments are closed.