What is the treatment for keto rash?

From the Research

The treatment for keto rash (prurigo pigmentosa) typically involves discontinuing or modifying the ketogenic diet, with most cases resolving after diet cessation or modification, as reported in a case report and literature review published in 2021 1.

Key Points to Consider

• The keto rash, also known as prurigo pigmentosa, is a rare inflammatory dermatosis that can be triggered by the metabolic state of ketosis, with an average onset of 31 days after initiating the ketogenic diet and subsiding 18 days after diet cessation 1.
• Discontinuing or modifying the ketogenic diet is often effective in resolving the rash, with the addition of carbohydrates (around 50-100 grams per day) potentially helping to alleviate symptoms.
• If dietary changes are not effective, topical or oral antibiotics, such as tetracycline, may be prescribed to treat the rash, with doxycycline (100mg twice daily for 7-14 days) being a commonly used and highly effective option.
• Maintaining proper hygiene, such as showering after sweating and wearing loose-fitting clothing, can help prevent irritation and reduce the risk of developing the keto rash.

Treatment Options

• Discontinue or modify the ketogenic diet to reduce ketone production and alleviate symptoms.
• Add carbohydrates to the diet (around 50-100 grams per day) to help resolve the rash.
• Use topical anti-itch creams containing hydrocortisone for temporary relief.
• Consider oral antibiotics, such as doxycycline or minocycline, if dietary changes are not effective.

Important Considerations

• The keto rash can occur in individuals of any ethnicity, with cases reported in patients of Middle Eastern, Caucasian, Hispanic, Asian, and African descent 1.
• Early diagnosis and treatment are crucial to achieve optimal patient outcomes and prevent long-term complications.
• Consult a dermatologist for personalized treatment if the rash persists or is severely uncomfortable, as they may recommend other anti-inflammatory medications or treatments specific to the individual's situation.