The ketogenic diet has been therapeutically employed from antiquity and is still utilized today in many disease states. With the boom of the complementary and alternative health movement over the last two decades, an interest in the lay population has grown in regard to dietary and lifestyle means of preventing and treating disease and enhancing health and human performance. The ketogenic diet, whether exclusive or intermittent, has been purported by health professional and lay person alike to meet these demands. In this review article, we look to the current literature for proven and possible mechanisms by which ketones and a ketogenic diet may be utilized in dermatology and direct our readers to pursue further research for this promising potential treatment option