What Causes Keto Rash?

Update: after some experimentation it really is likely to be a B2 deficiency.

Update 2: Yep, it’s B2.

My inquiring mind wants to know.

Histamine reaction?

Poor fat metabolism? Low bile production?

Incomplete fat adaptation?

Subclinical B2 deficiency?

H. Pylori infection?

She says topical black seed oil helped her… and black seed oil is known to combat H. Pylori infections – and there has apparently been a Chinese study I need to source that found H. Pylori in skin samples taken from people who were suffering from the Keto Rash.

Is H. Pylori the missing link in keto rash?

Here we are, an American study:

Identification of Helicobacter pylori in skin biopsy of prurigo pigmentosa

A 23-year-old Chinese man presented with a 3-year history of a pruritic eruption. On examination, pink urticarial papules associated with hyperpigmented reticulated patches were noted on his neck, back, and upper chest. Histopathology revealed vacuolar interface dermatitis and numerous gram-negative rods within a dilated hair follicle. The organisms were reactive with anti-Helicobacter pylori immunohistochemisty. The histologic findings and clinical presentation support the diagnosis of prurigo pigmentosa. Additional testing demonstrated a positive urease breath test and serum H. pylori IgG antibodies. The patient was referred to gastroenterology and treated with appropriate antibiotics. After treatment, esophagogastroduodenoscopy revealed chronic gastritis without evidence of H. pylori infection and his skin showed reticulated hyperpigmented patches without evidence of active inflammatory papules. Although previous reports have associated prurigo pigmentosa to H. Pylori gastritis, this is the first report of H. pylori organisms identified in a skin biopsy of prurigo pigmentosa.

People have also reported that when they underwent antibiotic treatment, their rashes have cleared up. H. Pylori is an absolute bitch of an infection to treat with antibiotics, so this should be fun.

But then later on in the same video she claims that bile salts were what finally allowed her to be rid of the rash for good.

So then, if I attempt to treat H. Pylori, will that result in the resolution of the issue? Or maybe it would be a multi-pronged approach in which two or more problems must be treated simultaneously in order to resolve it.

Maybe H. Pylori is an aggravating factor along with poor fat metabolism due to insufficient bile production.

Or… maybe it’s just a Vitamin B2 deficiency.