So unfortunately… this is a thing. I don’t know why, and the internet doesn’t really know why it happens either or what to do about it.
There are a whole bunch of reasons out there about what might cause it. And the things that have worked for people. But as you’ll see if you keep looking, there isn’t much consensus out there.
So instead, what I’m going to talk about is what theories make the most sense to me. Why I have come to believe them, and why in my experience they have been debunked.
Now this was not the post/video I was planning to do this week. So, there isn’t as much research in this one as there is in my other posts.
I have gotten this keto rash 4 times in the past 14ish months since starting keto. The previous times, I looked everywhere for solutions, but this isn’t as widely discussed as something like the keto flu.
Which means there aren’t as many home remedies.
By now, I know that it isn’t forever. My experience with the keto rash is that it last about 3 weeks. The first week I can start to feel a few bumps in my neck that irritate me slightly.
Then over the next few days a full breakout will happen. All along my neck and the middle of my chest.
Then depending on how much I scratch or leave it alone. They will start to fade and go away. With the dark spots themselves taking a couple of weeks to heal.
Now what makes the keto rash such a mystery is that not everyone who goes into ketosis will experience it. If you’re like me, it comes and goes. But for others its there for as long as they are in ketosis, which can be very frustrating.
I have tried things to prevent it and things to treat it when its already too late.
Let’s talk about the first time it came into my life.
After coming home from the gym one day, I didn’t shower right away. For some reason I fell asleep on the couch instead.
Then a few days later my neck started to irritate me, and I had no idea why. A few days after that, I had a full-blown rash.
Why would taking a nap matter? Well of course it doesn’t, it’s the sleeping in sweat that matters.
While doing my research, I found that ketones in sweat are slightly acidic. So keeping sweat on you for a long period of time while being in ketosis can lead to irritation in some of your more sensitive skin areas.
In hindsight, I had woken up from that nap hot and sweaty, even more so than when I actually drifted off in the first place. And the way I was napping, face down with a pillow under my neck in the same spot the bumps had shown up, it made perfect sense.
Why I no longer believe that to be the issue. Well since then I have made sure to never keep sweat on me for any extended period of time. If I can’t shower right away after a workout, I will take a cat bath (with wipes) and keep it clean.
I don’t sleep in hot rooms where I would wake up sweaty and still, it has come back 3 times after that. All when the sweat thing would have made no sense.
Next theory is that when you store fat, you store toxins as well. As you lose weight and burn off that fat, those toxins get released back into your body as well.
If you lose a lot of weight quickly, then you release a lot of toxins. Maybe more than your liver/kidney or whatever organ can handle. And then it might show up in your skin.
This one also made sense because of the timing of the second breakout. The first time was after losing my first 20 pounds on keto in about 3 weeks. Months later I had lost about 10 pounds in 10 days.
At the time I was watching a lot of Dr. Berg on YouTube and he recommended ox bile for the reasons I explained above.
In a couple weeks my rash cleared up and everything was fine. So maybe this theory was the one, Dr. Berg hadn’t steered me wrong since starting keto, why would he start now.
But yet again, while taking ox bile along with my other supplements of cod liver oil, turmeric and curcumin, and vitamin D… my keto rash came back.
So, this time, I had no rapid weight loss. I was actually experiencing my first extended plateau since starting keto and intermittent fasting at the time.
Back to the drawing board, and google, to see what else it could be.
The next thing that was true all three times were my ketone levels were above my normal range, 2.5 and above. With maybe some exceptions due to a biased memory.
But this one made sense too, especially when compared to some of the previous theories. High ketones levels along with rapid weight loss can mean there were a lot of toxins in my sweat.
Even if I didn’t leave it on my body for a long time, working out every day, even sometimes twice a day could have meant an accumulation over time.
The only reason I don’t fully believe in this one is because it has happened when I wasn’t that keto. Its happened when I was somewhere in the high 1s or low 2s. So why wouldn’t it happen during times I’ve been in the 3s or even at a high of 4.7.
But like anything else, its probably a connection of multiple factors, and you might not need all of them to be present for the rash to occur.
This time around I am a little more strict than usual. And recently when I tested was as high as 2.7.
This makes sense because I spent most of the summer in and out of keto. I was also eating at the higher end of the carbs I’m allowed while still being in ketosis.
In the past, I would usually introduce carbs back in until the rash went away, and then go back into keto.
I’m not planning on doing that this time around.
What I am doing is using a body wash made for body acne that has salicylic acid, and a facial scrub used to exfoliate on my neck. As well as rubbing Vaseline on it overnight to keep it from drying out and scabbing.
Throughout the year I get really bad chapped lips during the night, so I use Vaseline lip therapy overnight, so I don’t wake up with a bloody lip. I’m just using that same logic on my neck to see if that works.
I’m also currently reading The Dorito Effect, and in it the author Mark Schatzker mentioned that scurvy was due to a lack of vitamin C. Among other things, the point was that nutrient deficiencies can result in rashes and other abnormalities.
Although I do have a lot of vegetables that supposedly have vitamin C, there isn’t much I do to get it on purpose.
So, I started taking a pill along with my other supplements to make sure it isn’t an accidental nutrient deficiency from restricting carbs and not purposefully putting what I lost back in.
That’s all I have for now. I didn’t really take pictures because up until now that was never an instinct of mine.
But if it comes back, I will give an update and I’ll be a bit more… graphic.
