I’m currently in the midst of an experiment for fat loss and body recomposition using a variation of a cyclic ketogenic diet called the Carb Nite Solution, which essentially has me in ketosis for the entire week with a single day where I am required to do an aggressive carb re-load within a window of 6-8 hrs.
I wanted to provide an update on the effects of this diet on prurigo pigmentosa, which is the rash that many of us have discovered appears when we are in a state of ketosis.
During the 1st week of my experiment I noticed that a few of the spots that signaled the rash started to appear as my blood ketone level crossed over into the nutritional ketosis range (> 0.5 mmol). Slowly more and more red dots would appear on my chest and back the longer I remained in ketosis. Within the few days immediately following my carb re-feed, the rash disappeared immediately. I decided to take some pictures in order to document this effect. You can click directly on them for full resolution versions.
I’ve also included my blood ketone records here for reference
10/13 – The morning of my week 1 Carb Nite. As you can see there are a few of the typical red dots of the rash in my upper back and mid chest. At this point it wasn’t itchy at all. Unfortunately by this was the day I had run out of ketone strips so I didn’t have a blood ketone measurement. However my blood ketone measurement from the day before was 0.9 mmol, well within the range for ketosis.
10/14 – The evening immediately following my week 1 Carb Nite. You can see the rash is already starting to fade. Things look a little different because I used a flash for this one. You can also see some scratches along my back from my BJJ training! Again I wish I hadn’t run out of ketone strips, but considering what I ate the during my Carb Nite, there was absolutely no way I was in ketosis.
10/15 – Two days after my week 1 Carb Nite and you can see the rash has almost completely disappeared. There are only a few dark spots remaining. Still no ketone strips. today.
By the following day, even the dark spots were gone. No trace of prurigo pigmentosa at all! At this point I stopped taking pictures regularly.
However, I noticed that as my experiment progressed a pattern emerged. Approximately 4-5 days after my carb re-feed, around when my blood ketones jumped into the ketotic range the rash would reappear. Faintly at first as in the pictures above, but the following day, it would become worse. More red dots and darker red dots than the previous week. Then 2-3 days after my Carb Nite, the rash would disappear completely. I’d have 1-2 days of clean skin, and then as I re-entered ketosis, the rash would come back. Again, faintly at first, and then more aggressively.
This pattern has been pretty consistent throughout my entire cyclic ketogenic experiment. Here are a few random snap shots:
10/24 – This was taken 5 days after my week 2 Carb Nite with my blood ketones measuring 1.3 mmol. Due to the lighting, it doesn’t show that well but the rash has spread to my mid and lower back.
11/1 – This was taken 7 days after my week 3 Carb Nite. My blood ketones measured 0.6 mmol. You can see that there are more red dots and they appear darker than previously.
At this point I’m thinking about playing around with two options:
1. Keep things as is and continue my cyclic ketogenic experiment for weight loss and body recomposition and see where this takes me. I wonder exactly how bad the rash will get the longer this continues? There’s only one way to find out…
2. Try a course of antibiotics (Doxycycline or Minocycline), which are reported to treat the rash effectively. The only question I’m not entirely sure of is if the treatment is temporary, ie will the rash return? Or will it permanently make the rash go away so that I can stay in ketosis and be rash-free for good?
The results of these options may also yield insights into the potential causes of this rash.
What do you think I should do?