Why Keto Rash Happens and How to Fix It

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First, if you have a rash with the description above, see a dermatologist for an evaluation and possible diagnosis. “Prurigo pigmentosa is frequently misdiagnosed. It’s often mistaken for other conditions, like eczema, contact dermatitis, or others,” says Dr. Chu. The downside of this is that keto rash won’t respond to topical steroids, which may be recommended for other skin conditions, he says. It’s important to tell your provider about new lifestyle changes, including to your diet.

The treatment for keto rash (prurigo pigmentosa) is antibiotic therapy, says Maher. Doxycycline is the antibiotic most often used. It is a tetracycline antibiotic that reduces bacteria, and it’s often used to treat acne.

 In addition to its bacteria-killing properties, the antibiotic also helps decrease inflammation, Maher points out. It’s not clear, however, if it’s the antibacterial or anti-inflammatory properties that makes this medication effective, he says.

Typically, antibiotics are given orally. But you may be able to use topical antibiotics if there is a reason you can’t or would like to avoid taking oral antibiotics, says Maher. Always discuss the best option for you with your provider.

Another treatment for the keto rash is to quit the keto diet, says Kopelman. It’s something that’s been shown to clear the rash in case studies.

 “We’ve seen that the rash subsides and resolves after stopping the diet. The rash might leave residual hyperpigmentation for a few weeks, but that will gradually fade,” she says.

Whether you can stop the keto diet depends on why you’re following it in the first place. For example, if you’re on the keto diet voluntarily, the keto diet might not be right for you.

But if you’re following the keto diet to treat a specific medical condition and your healthcare provider recommends remaining on it, you don’t necessarily have to stop just because you get this rash, adds Maher. “The rash is not a harmful condition,” he says.

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