Lisa goes keto for 3 months and gets keto rash… maybe? [Definitely]

[Lisa’s story is similar to mine.  I went keto and was doing great for a few months losing weight, feeling good, when all of a sudden this rash appeared out of nowhere.]

I broke out in a rash about 10 days ago. I started the keto diet about 3 months ago. The rash is on my arms my torso, with focus on either side. It has also started on my upper thighs. I was probably less than 20 g of carb a day and feeling great. I found some great products that were very low carb such as bread and desserts, so that helped keep my carbs down. This rash is a real bummer.

I have upped my carbs for a couple of days now and no improvement. I am eating more veggies and today I had whole wheat bread (now I feel bloated). My weight has gone up a few pounds too. I was at my ideal weight. I lost about 10-12% of total body weight.

I started on doxycycline yesterday. Also, chlorella and probiotics.

The rash appears better in the mornings then gets worse and itches more as the day goes on.

So do I continue to up the carbs?

How can I keep the proper macros with protein and fat?

Or keep my macros all equal 50g 50g 50g?

Not sure what to try. Most people say that the rash dissipates with higher carbs but mine has not. Or do I tough it out..? I could try the bile salts.. I have been putting coconut oil on the rash to help with the itchiness. It seems to help.

[The rash typically dissipates after increasing carbohydrate intake, however it isn’t exactly well documented how many carbs to take.  In my case I dramatically increased my carbs, taking in 300-400 gm per day for a few days to ensure I was completely out of ketosis.  In my case it was around day 3 that’s when the rash had noticeably gone away.  By days 7-10 only a little bit of hyperpigmentation was left.

This was when I first had real proof that the rash was diet related.  I went keto again and the rash came back.  Ate carbs and the rash went away.  Classic keto rash behavior.  

In Lisa’s case I would’v liked to know how much she upped her carbs by.  Was it enough to push her out of ketosis for sure?  If she only increased it by 30-50 gm, that might not have been enough.

If she increased her carb intake dramatically like I did and the rash still remained… then I would be concerned that it isn’t keto rash.  Many rashes can have a similar appearance such as pityriasis rosea, what I was initially misdiagnosed with.

On top of this, she also started on doxycycline which is an antibiotic that has been shown to successfully treat keto rash.  This also worked in my case and I was able to return to eating keto without having to deal with the rash… for a while.

If Lisa still has the rash AFTER taking doxycycline AND increasing her carbs, then it’s definitely not keto rash.]


I only took the antibiotic for about 10 days and halved the dose. I’m pretty tiny at 115 lbs. the rash went away after 7 days but I increased my carbs too. I can’t say how much but I tried to keep protein either the same amount or higher and fat the highest. I’m down to lower carbs again but having sweet potatoes regularly. 2-3x per week.

[Looks like it’s definitely keto rash!]

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