Keto rash getting worse
Hmm, let me see. I was already strength training once a week, and didn’t change that - and didn’t decrease fats until… a year in or something like that. But if I wasn’t training, I prob would’ve done so sooner!
It was wild to experience my rash retreat so quickly in response to just an additional 20-30 carbs and being mindful of daily routines to ensure I got them in. And how it came back with a vengeance when I happened to eat just animal products (along with my usual Ginger supplementation) for a few days.
In eastern medicine, the skin expresses any liver stress/toxicity, and when topical cortisol steroid is used to suppress it drives any issues deeper eventually though it can help for some quick fixes sometimes.
It helped me a lot to have several used books from the cornerstone LCHF/keto physicians/researcher - I got them online - and get really familiar with their phasing approaches and validity. There is some kind of glandular soothing biochemistry related to the thyroid and carbs in females that I’ve read of. Also, supplementing with quality liver (or eating it) can really help support the liver as it heals with LCHF/keto! Keto physician Anna Cabeca MD’s book The Hormone Fix really helped me connect the dots on endogenous cortisol and acidification, and how veg and some fruit can really help the midlife female bod!
And just in general, the mineralization from using edible liquid clay is very soothing to several systems in the body internally, and fabulous for the liver either through a bath or poultice (as are activated charcoal, and castor oil, though more messy in certain ways). I’m a fan of the nourishing and detoxing remedies, and trying to do better at self-care lately - and soaking in a candlelit clay bath is pretty easy currently 
I use 3 cups powdered montmoriilonite or calcium bentonite liquified in a blender or shaking jar with lots of water before adding it to a hot bath, so as ensure there are no clumps for the plumbing etc. I’m such a devotee that I just had a 50lb bag of it delivered for cheap (it’s a racehorse feed supplement) - it’s a lovely rosy milk chocolate color when liquified. Mineralization is fun!!!
Wishing you good healing.
Thanks for the reply @SlowBurnMary.
I was desperate for some relief from my rash and the Aristocort has provided that, albeit short-term - it has at least stopped the oedema in my ankles that resulted form the hot swollen rash. But I would like to find a better solution.
I used to drink bentonite clay many years ago so maybe I can try that again. That, and I will probably have to increase carb as well and monitor blood ketosis levels.
I’m presuming that once I am out of ketosis, I am back to being a sugar-burner and would therefore need to reduce the fat I consume to avoid just storing the fat (again). Do you this is a fairly accurate presumption?
Yes, at least the cortisone stopped the edema. Clay mineralization is a good solution (and, there is even some science to the fact that clay helps move fat out and clay baths help reduce water weight). Topical Aloe Vera gel can be amazing for skin issues too.
Well, my understanding is that for a non-IR person who is well-established in fat adaptation, the phasing in of increased, yet still low, carbs doesn’t kick one out of ketosis per se. It simply creates more variability across the course of 24 hours. The body goes into ketosis every night - and will return to ketosis within about 24 hours of even a HC holiday binge. Another factor is how restricted eating windows (rather than frequent grazing 16 hours a day) really reduce general insulin spiking which enhances carb tolerance for some/many. And metabolic healing likewise enhances tolerance. The Drs. Eades (authores of the classic Protein Power, new edition is coming soon) allowed for pre-maintenance levels of up to 100-150g carbs per day, with the understanding that aiming for the keto cusp - moving in and out of deep nightly ketosis - was beneficial on a functional level for many folks.
But reducing the fat you take in can be a smart move for the slower metabolisms of midlife females in particular (unless you’re an endurance athlete!) Down to 50-60% fat (in foods and in cooking fats) rather than 65-80% helps access body fat for burning and also ensures that the brain is getting enough fat - because one does need a certain intake of fats to burn fats! To SAD folks, even 40-50% fat still seems very high!
Aloe vera, straight from the garden, is my first go-to for all things skin realated. In this case though it made little difference.
I think I need to do a little more thinking on how to approach keto and weight loss as I put up with rash for 2 months and there was no sign of it reducing, just getting worse. So maybe such low carbs is just not good for me. I love veges and salad but have significantly reduced there over months to get low carbs. Blood tests show all main minerals are ok, but I must be lacking something. Eating lots of veges, esp green ones, just feels right to me and I really miss them if I dont have them. I’m sure I could double my current carbs just with green veg and berries.’
On a lighter note- I dont need the keto urine sticks anymore because the itch tells me I am in ketosis!!!
I have the feeling it is a bit less fulminant. Maybe the raspberries are helping and the 22-23 carbs I am eating now daily instead of being under 20. I will continue with the ACV treatment on my skin and eating raspberries daily and then try to slowly phase out in a week or two. Maybe it is about being in ketosis gradually instead of such a shock to the system? But it is already feeling a bit less horrible. Still itchy, but not as crazy-making. And I am really enjoying the raspberries with whipped cream!!
@Paulene - Dont give up yet! In many reports I have heard, they say the keto rash is an expression of detox. They also say cortisone wont work. A friend of mine sent me a link to many treatments for itchy skin. I might try a zink cream as well. They mention ACV as well. Also lemon juice. Aloe vera against itch. The bottom line is that they dont really know what causes it, it is not dangerous or life threatening in any way- and so one has to ride it out IMHO and only address the itch. For me personally, I cannot stop eating keto. I just found netrition.com and ordered myself such wonderful keto foods. I am so excited about the sugar free ketchup! It is too delicious and the benefits are too great for my future health as well. I simply hope that it will subside and the sooner the better. 
I forgot to add that somebody on YouTube said a spinach smoothie made her keto rash go away. So I had some of that too. Puke. I could not stomach it so I only had a few bites- or swallows. She used frozen spinach which she thawed, and almond milk, and some vanilla flavoured protein powder that I dont have here so I just used a bit of vanilla extract, and some coconut oil. She put this in a blender and drank a cup. It certainly reminds me of all the smoothies recommended in regular diets. And why they never worked for me- I cannot fathom why anybody would want to drink a green smoothie made of vegetables which look like slime and is without taste. But we will certainly try ANYTHING at this point. I can only say I felt better yesterday- but I dont know if it was because of the spinach or the raspberries or the ACV or the black seed oil which I now use after the ACV to make my skin softer ( and for its anti-inflammatory benefits).
Good article. I have seen this before and it is astounding that asians have had this since the 1970s. They even ate low carb diets and I didnt even know they had LC diets back then. But the facebook site on keto rash referred to is even more interesting. Sadly nobody has written over there in like one year. There must be a reason for loss of interest- probably because the best cure is to eat carbs again and nobody else knows any more about it. I think in the end, the ketones make the difference because as they say there- other people lose weight on calorie restricted diets and dont get a rash. Their fat is burned too- so why the difference? What is it about the lack of carbs in our diet that makes this rash happen?
SIGH
I just did another round of ACV and black seed oil and have a bit of peace for now. I will have my raspberries again later on ( with cream- really yummy). I think one has to learn to manage until it subsides. I wonder about eating carbs for a while and then going into ketosis again- some people heal that way but with others I guess the rash returns. It is SO UPSETTING because things were going so well and it seemed so easy. Now it gets harder and harder when it should be that reaching fat adaptation makes it all easier.
Just keep in mind that the increased carb phasing is all about staying a LCHF fat-burner and not ever about becoming actually derailed in HC etc. So, if one is no longer suffering from a food addiction or IR - one can do it with success, based on all the work of the Eades and Atkins/Phinney/Volek/Westman. Because it’s really about keeping up a high functioning ability to transition into deeper ketosis, as every night the body goes into ketosis anyway - and there is an argument that maintaining adaptability is more important than metabolic downreg over the years. But one has to be well established in the fat adaptation at 100% before any such tweaks - and for older females it may well take 6 months or more - in some folks it takes a year or more.
Mindy Pelz DC, who has a ‘ketobiotic’ program for older keto adapted women, urges aiming for 100g on the weekends (via sweet potatoes, carrots, etc). And Ray Peat PhD makes the interesting point that insoluble fiber - such as that found in shredded carrots - as an aid in reducing endotoxins and hyperacidity (same as activated charcoal, liquid clay, etc). And apparently one raw carrot a day (dressed with a vinegar/fat) is powerful for counteracting estrogen dominance! The fiber binds to unused estrogen and other toxins on par with the actions of clay and charcoal. So, there are lots of amazing options from Mother Nature for helping lighten the load on the liver and glandular system.
why would one want to bind estrogen dominance? in older women?
and how should a carrot do this? shredded or not shredded? sounds like nonsense.
Ach, well it’s a big subject - estrogen dominance is actually a negative kind of imbalance - there are different kinds of estrogens too (circulating kind, and the kind kept in glands/organs). And women who’ve used hormonal BC for years may be more prone to it, as well as those who’ve been exposed to exogenous estrogens from certain supposed beauty creams and endocrine disrupting environmental toxins like BPAs (which researcher Rachel Carson so eloquently alerted western civ to many decades ago).
I explained the endotoxin/fiber thing - if you’re curious you can do your own further research, Peat has various heavily referenced articles online.
@SlowBurnMary
Stop throwing stuff at me you cannot explain. I understand about estrogen imbalance more than you know. But you throw information out that is over the top and then you run and hide. Just stop it. I find it annoying. Go answer somebody else’s questions but not mine because your answers are unclear and blurry - inflated and convoluted.
? I write as I see fit, for the benefit of the forum. If you want only particular folks to address your comments, you can tag them - otherwise forums are very improvisational. Take what works for you and leave the rest behind - and I’ll keep on keeping on. 
Bring back carrot salad! 1-carrot salad, on Sunday, no sugar. I’ll take it!
@Chantarella I read/heard recently that my pronounced pear-shape is a result of estrogen dominance. I’m trying to change that as much as my genetics will allow.
@Paulene
Believe me- you cant. Its NOT oestrogen dominance- its genetics.
Of course oestrogen gives every woman her feminine curves. After menopause they say the waiste goes first because of a lack of oestrogen. But how wide our hips are is genetic. (I always wanted a tiny butt too. Even when I once upon a time weighed 120lbs, I always had an a@@…but HEY. What with Kim Kardashian and JayLo- a booty is in style! )
Another question to you Paulene- have you noticed that the rash itches less after a meal? And what I am also noticing now is that it like wanders. I no longer itch between my boobs, but now my knees itch. And what is furthermore wierd- I ate those slim fast sweets, worried a lot about those hidden carbs, and right now my keto sticks have never been darker. So I am still in ketosis. MORE than usual. Go figure. if I can simply manage this without too much suffering then I am going to soldier through it in the hope it goes away sometime. I like eating keto too much.
I haven’t noticed but I also haven’t been looking for this. I did nootice increaee itchiness today and I have not been drinking much water today, and no ACV in my water.
I listened to a couple of podcasts on hormone changes leading up to menopause (that’s me). Facinating to hear about diff types of estrogen. If I can influence levels through diet that would be my preferred option.
@Paulene
Had peace from itching all day until it started again in the late afternoon. But it is milder- I hope it stays this way. I look like I have the measles or chicken pox. I bought some zink cream to try too. But I want to lose this weight and so I cannot take myself out of ketosis and have to find a way to live with this for the time being. But I have the impression that some lesions are healing off, while new ones developed in new locations, so I just dont know.
I went through menopause cold turkey.I did not want to take hormones as some women I know did. I like to keep things natural. But I have heard of women who eat lots of soy to combat hot flashes. Suppsedlymakes them a bit more bearable too. But one still has to go through with it and I wanted to get it over with and not drag it out.
Oh blimey - have just read this thread for the first time and I just wanted to send commiserations to you @Chantarella and @Paulene - it sounds horrid! I take my MIL to regular appointments with her dermatology consultant (allergic to everything, plus eczema and psoriasis), and I’m so grateful, touch wood, to not have anything itchy or sore myself.
Hugs!