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KETO HELP

What Is Keto Rash? [8 Ways To Get Rid Of It]

One thing I wondered about when I first started the ketogenic diet was why certain parts of my body seemed to break out in what appeared to look like hives, except it didn’t itch. 1In my case it didn’t itch, but that may not apply to your experience.

I’ll admit, I panicked slightly, but after digging up on the research I learned that keto rash was one of the common, though unpleasant, side effects of a ketogenic diet.

What is keto rash?

Keto rash also known as prurigo pigmentosa is a rare inflammatory disease that looks similar to eczema and dermatitis.

It is a red itchy rash that typically shows up on areas obstructed by clothing such as your neck, back, chest, shoulders, torso, armpit areas.

For people who experience keto rash, it will usually appear within a few days to two weeks of starting the keto diet or following a keto meal plan.

KETO RASH PINTEREST COVER

What causes keto rash?

The actual cause of keto rash is unknown, but we can speculate what the cause is based on anecdotal evidence.

  • One such cause may be excessive ketone formation as showed by when people developed the rash.
  • Nutrient deficiencies of various vitamins and minerals resulting from excluding many foods.
  • Since keto rash forms in areas where sweat commonly accumulates, maybe ketones themselves irritate the skin. This can be a problem for those who may suffer from night sweats on keto.. This can be a problem for those who may suffer from night sweats on keto.. 2The neck, back, chest, shoulders, torso, and armpit are common areas
  • Since the majority of toxins are stored in our fat cells, another theory is the release of toxins 3Mercury, DDT, estrogen disruptors, etc. due to burning fat.
  • Certain bacteria and yeast feed off of carbohydrates, removing carbs can cause aggravation and lead to rashes.

A few speculative anecdotes based on when keto rash appears:

  • It occurs early when people first enter ketosis, especially when weight loss is most rapid.
  • Keto rash has been known to occur in people with uncontrolled diabetes.
  • During prolonged, intermittent fasting, or excessive fasting.

What does keto rash look like?

What keto rash looks like can vary from person to person in location and severity. As for myself, it didn’t get too bad nor did it itch.

You will notice itchy, elevated red skin lesions on areas such as the back, chest, sides of the body, neck, and armpits. The rash will often be symmetrical and appear within a few days to weeks of beginning a ketogenic diet for most.

You might associate the visual appearance of keto rash to more common skin conditions like dermatitis or eczema.

Symptoms of keto rash come in four stages.

  1. Light pink, mildly itchy raised bumps.
  2. The bumps turn into clusters of papules that may be filled with a liquid or pus. This is when people typically experience more itchiness. 4A papule has distinct borders, and it can appear in a variety of shapes and when clustered together, form a rash.
  3. The rash will become brown and crusty as the rash resolves, almost like a scab.
  4. Last, as the scabs go away, you are left with a net-like pattern of dark spots that might remain once the rash is healed.

Keto rash images

I sourced these images from the Journal of the European Academy of Dermatology and Venereology

This keto rash picture displays the four stages of keto rash

KETO RASH STAGES

Looks scary, but is keto rash dangerous?

You might have to deal with the annoyance and embarrassment of having an ugly rash.

That said, while keto rash does look unpleasing and sounds uncomfortable, the rash itself isn’t dangerous.

How long does keto rash last?

How long the rash will stay varies from person to person, but it can last two weeks to a few months. For myself, the worst parts of it (stage 1 and stage 2) lasted two weeks.

It’s usually the latter stages that last the longest. You can think of it like a bad zit on your face that once healed still leaves a dark mark that stays around.

How to get rid of keto rash

Since there is no concrete evidence to support why keto rash happens in the first place, there is no one absolute keto rash cure or treatment.

With that, there are few things that may ease the symptoms based on good old user experience and educated methods.

Be patient

Keto rash goes away on its own with no intervention after a few weeks. Again, it usually goes away after a week or two from my experience.

Eat some more carbs!

Yup, you read that correctly.

Add back in just enough carbs to kick yourself out of ketosis, not an excuse to a free for all carb binge.

If your goal is to lose weight… Get it in your head that  you don’t have to be in ketosis to lose weight  as long as you’re still in a caloric deficit. 5Eating less than your maintenance calories.

You can test if being in ketosis is triggering the rash by increasing carb intake about 50-100 grams to get out of ketosis. If the rash beings to resolve itself, lower your carbs back down and assess if the rash returns.

If the rash doesn’t return, then keep on trucking!

If the rash returns, maybe try a more low-to-moderate carbohydrate approach. Perhaps a full-blown ketogenic diet may be out of the question for you.

If you have your heart set on living a ketogenic lifestyle, there may still be hope. There is a reason to believe having high levels of ketones (deep ketosis) causes the rash to appear.

While you don’t have to abandon a ketogenic diet altogether, you may want to try levels of increased carbs and protein. You want your carbs to be low enough to maintain ketosis without having blood ketone levels elevate to high.

Stop fasting

We have known ketogenic diets to reduce hunger and induce satiety, which makes it such a great diet for fat loss.

People who follow ketogenic lifestyles inevitably begin toying with the idea of fasting, whether intermittent or prolonged. I sometimes wonder if people fast for the health benefits or they’ve now developed eating disorders and are just desperate to lose weight as quick as possible.

Keto rash has been correlated with fasting, so ease up on that.

Wear lose-fitted clothing.

Keto rash appears on areas that tend to be covered by clothing where sweat might build up.

If it’s the ketones in the sweat that are irritating your skin, avoid tight fitted clothing, especially during exercise.

De-stress

KETO RASH 9 WAYS TO DESTRESS

Sometimes skin conditions can be triggered by stressful situations. Dieting itself is a stress, combine that with starting a new diet and your bodies perception of stress is amplified.

Many people who have experienced keto rash often reported that it intensified during periods of high stress which can compromise your immune system.

Try some of these destressing suggestions

Elimination diet

Did you do a complete overhaul on your diet and introduce foods you never used to eat?

The following keto-friendly foods trigger allergies in certain individuals:

  • Dairy (yogurt, cheese)
  • Eggs
  • Peanuts
  • Tree nuts (macadamia nuts, almonds)
  • Shellfish (oysters, crabs, mussels)

You can even try the ultimate elimination diet and go carnivore for a brief period while adding back in foods to see if they trigger a reaction.

Address deficiencies

Done correctly, keto is one of the most nutrient dense diets you can be on. Some people also think keto is just eating bacon and eggs.

Make sure you are varying your food sources and getting a wide variety of vegetables and fat sources like fish oil in your diet. For a more complete list of keto-friendly foods, you can check out my keto foods list.

Last resort, consider antibiotics

There may be therapeutic reasons you need to stay in deep ketosis or the symptoms don’t seem to resolve on its own. Talk to your doctor about the potential risks and benefits of taking medication to clear up your rash.

While this doesn’t address the root cause of the rash, it may help ease your current symptoms.

Keto rash take home

Keto rash affects more than people on ketogenic diets. There are reports of the same rash by people who’ve been fasting and those with uncontrolled diabetes.

What exactly causes keto rash is still speculative at best, but we can assume it may have to do with having high levels of ketones in the blood.

That said, keto rash is more annoying and unsightly than it is dangerous or life-threatening.

You can still live a ketogenic or low carb lifestyle, but you may want to raise your carb and/or protein intake to keep your ketone levels out of the medium-high range.

How many carbs and how much protein you will need to raise your diet by will vary from person to person. The only way to know to know for sure is through experimenting. If you’ve never checked your ketones you can find out how to measure ketosis in my write up.

Let me know in the comments below if you’ve experienced or are experiencing keto rash and what you may have done to resolve it or any questions.

What Causes Keto Breath? [And How To Fix It]

Something I wondered when I first started a keto diet was why my breath had a new odor and even a certain taste to it. If I could notice a different smell on my own breath… I can only imagine what everyone else was smelling. 

What is keto breath?

Keto breath is often one of the unwanted side effects of a keto diet that results in an almost metallic taste and smell in the mouth, similar to that of nail polish. 

Keto breath pinterest cover

What causes keto breath?

In short, while on a ketogenic diet your primary fuel source switches from glucose (sugar) to ketones (fat). 

The liver makes three types of ketones:

  1. Acetone
  2. Acetoacetate
  3. Beta-Hydroxybutyrate (BHB)

One way in which we excrete acetone from the body is through the breath. Therefore, you’ll often have that acetone scent, much like nail polish, but  typically during the first few weeks of a ketogenic diet. 

It‘s not all doom and gloom though. First off, this probably means you are in a state of ketosis, and second, keto breath eventually resolves on its own within a couple weeks.

How long does keto breath last?

From my experience, keto breath will typically last a few weeks.

During the first weeks of a ketogenic diet, your body isn’t as efficient at using ketones just yet. Because of this inefficiency, the body tends to “waste” ketones in the sense it excretes them, through the breath and urine, without using them. 

If you’ve ever heard about “keto-adaptation” or becoming “fat-adapted,” this is a period of about 3-4 weeks when your body is becoming accustomed to using fat as its primary fuel. Certain enzymes and transporters within your body must be upregulated to use ketones more efficiently. 

It‘s usually after this period of keto-adaptation that keto breath goes away. Your body becomes more efficient at using ketones which means less waste through breath and urine.

Once you become keto-adapted, keto breath tends to go away. This is usually a period of about 3-4 weeks but can be shorter or longer depending on the individual.

What does keto breath taste like?

Not only is keto breath characterized by a particular smell, but you may notice a certain taste. Many people report an almost sweet metallic taste in their mouth when starting a ketogenic diet.

Similar to the fruity acetone smell, this too will go away once your body switches its source of energy from glucose to ketones leaving less to be excreted as waste.

So now you might wonder, is there a keto breath cure? Can I speed up the timetable?

Yes and no, let’s see what I mean.

How to get rid of keto breath

Since ketosis breath is often a result of being inefficient at using ketones, the only true way is to become keto adapted. Since time is the only surefire way of allowing one to become fat adapted, there may still be ways we can expedite this process.

Exogenous Ketones and MCT Oil

Exogenous ketones can be a great way to upregulate the transporters in our body. By artificially increasing our blood ketones, we may bypass the time it takes for our blood ketones to rise naturally and upregulate the transporters needed for ketones to be used versus wasted.

Most ketone supplements use beta-hydroxybutyrate (BHB) as the main ingredient since BHB is the most efficient ketone body relative to acetoacetate and acetone.

I recommend: Perfect Keto BHB

Another popular way if you don‘t want to go the BHB route is increasing your MCT Oil consumption. MCT Oil can moderately raise BHB levels, but only after your body converts it in the liver. 

MCT‘s are an indirect route versus exogenous ketones but accomplishes the same concept in the grand scheme of things. 

I recommend: Viva MCT Oil or Perfect Keto MCT Oil Powder

Exercise

Beyond reducing our carb intake and eating relatively high fat, we can speed up keto-adaptation by including exercise.

Going back to raising BHB within our body, some studies point out that exercise has the potential to increase BHB levels. 6Sleiman et al., 2016 

Fasting

Keto and intermittent fasting go together like peanut butter and jelly. While we fast, our body increases fatty acid mobilization. 2Just a fancy way of saying that your body increasingly relies on fat stores to provide energy. 

As you can see, the above methods share one thing in common. All the methods aim to increase levels of blood ketones, BHB in particular.

How to cure keto breath in the meantime

Chew some sugar-free gum or keto friendly breath mints

Almost all sugar-free gum and mints should relatively be ok. I‘d probably avoid mints and gums sweetened with maltitol as it has been shown to have the same effect on blood sugar as regular table sugar.

And goes without saying, but I’ll say it anyway, don‘t go crazy chewing up packs of gum and eating boxes of mints every day.

Drink water… a lot of it! 

At the beginning of a ketogenic diet, many people find themselves slightly dehydrated. When we reduce our carbohydrate intake we also flush out a lot of water. 

A dry mouth combined with acetone will make for an even more pungent combination.

Increase your oral hygiene AKA, brush your teeth more frequently and/or use mouthwash.

Not only will good oral hygiene rule out the possibility of just having bad breath, but every little bit helps. 

You may also want to use this as a good time to start or increase your frequency of tongue scraping.

Lastly, simply wait… BE PATIENT

Sometimes it may be impossible to get rid of keto breath with any interventions and the only answer is to give it enough time. Besides, it‘s only a few weeks in the grand scheme of things.

Wrapping up keto breath

So if you find yourself wondering is keto breath temporary?

The answer is a resounding yes! Exercise patience, use the tips provided to help speed up keto-adaptation and be rest assured it will come and go before you know it.

What does your breath smell like when you're in ketosis?

When in ketosis, people often report an almost fruity, acetone like scent on their breath.

How do you get rid of ketone breath?

The only real way to get rid of ketone breath is to be patient and let time run its course. Ketone breath usually goes away once you become efficient at using ketones for energy.

What causes ketone breath?

Ketone breath is caused due to the inefficiency of ketone use at the beginning of a diet. One of the ketone bodies, acetone, is expelled via the breath.

Does keto diet make your breath stink?

Depending on your definition of “stink,” it does have a particular odor.

How do I stop keto breath?

There is no way to stop keto breath from happening, it will either happen or not.

Does keto breath ever go away?

Yes, keto breath will go away once you become keto-adapated, or efficient at using ketones for energy.

Is bad breath a sign of ketosis?

Bad breath in particular isn't a sign of ketosis. However, if it's a new scent that coincided with starting a ketogenic diet, then it may be.

How do you beat keto breath?

You beat keto breath by with patience. Keto breath will usually go away after 3 – 4 weeks on its own.

Does everyone get bad breath in ketosis?

Not everyone shares the same fate when it comes to keto breath. Some individuals never get the fruity smell or metallic taste in their mouth.

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