Rash and Skin Disorders
A rash is an area of swollen, irritated skin that manifests in different patterns and varying shades of red, purple or brown. Some rashes are caused by allergic reactions to the environment, food or medications, while others appear because of a skin disorder or underlying disease or infection. Some clear up on their own, but others are chronic and require treatment to control symptoms.
Most rashes are not life threatening, according to the American Academy of Dermatology. They may be treated with over-the-counter antihistamines, lotions or cortisone creams that relieve itching and swelling. These may go away on their own after a few days or weeks.
For example, a common type of rash is contact dermatitis. It causes redness and itching in reaction to an environmental irritant that touches the skin such as poison ivy, soap, cosmetics or household chemicals. It’s usually treated by over-the-counter medicines and staying away from the irritant that triggered the rash. It is uncomfortable but isn’t serious or contagious.
However, some rashes can be signs of serious health problems or allergic reactions. For example, a rash called Stevens-Johnson syndrome (SJS) is a medical emergency. SJS is caused by a severe allergic reaction to a medication and can be life threatening.
Dermatologists or allergists are doctors that specialize in rashes and skin problems. Always consult a medical provider before treating a serious rash on your own to avoid making the condition worse.
Hives or urticaria is a very common type of itchy, red or skin-colored rash that sometimes burns or stings. It usually appears as welts, bumps or plaques called wheals on the skin. They can appear on any part of the body, move locations, change shape or disappear and reappear.
Chronic hives appear almost daily and may last months, while acute hives may last only a few days. This rash is typically caused by an allergy to a drug or food but other causes include stress or infections.
Hives usually goes away on its own. But serious cases that last longer may require a shot or oral medication. Rarely, hives can cause swelling in the airways, making it difficult to breathe.
- Antibiotics such as penicillin and NSAIDs such as aspirin and ibuprofen
- Bites or stings from insects
- Blood transfusions
- Certain foods, especially eggs, peanuts, shellfish and nuts
- Certain plants
- Exposure to latex
- Infections caused by bacteria, such as urinary tract infections and strep throat
- Infections caused by viruses such as infectious mononucleosis, hepatitis and the common cold
- Pet dander
- Pressure, heat, cold, sun exposure, exercise or physical stimuli
Treatment consists of antihistamines, cool compresses to relieve itching and topical corticosteroids or anti-inflammatory medications such as prednisone.
Contact dermatitis happens when the skin encounters an irritant such as poison oak or poison ivy, a household chemical, hand sanitizers, soaps or certain metals such as nickel or gold. Sometimes, the reaction might occur after sun exposure.
- Blisters or bumps that may or may not be filled with clear fluid
- Irritated, red and swollen skin
- Skin that feels hot or tender
The rash can appear hours or days after contact with the irritant. Washing the skin with soap and water immediately after contact with the irritant may help. Doctors may prescribe creams or oral medication to help the skin heal and control itching.
Allergists may be able to perform a patch test to figure out what is causing the irritation. The patch contains common irritants such as hair dye, rubber or fragrances. Patients wear the patch for about two days, then the doctor checks for results.
Eczema, also called atopic dermatitis, is a chronic long-lasting disease that manifests as a rash with redness, swelling, cracking and extreme itchiness. Usually it appears on the arms, legs, and cheeks. It can affect anyone at any age, but usually begins in childhood.
The rash comes and goes, and sometimes it disappears completely. When the rash is active, it’s called a flare. It’s a common disease, and about 18 million American adults have the disease, according to the National Eczema Association.
- Scaly, dry skin
- Rash that appears on the cheeks, legs and/or arms
- Flares come with open, weepy or crusty sores in severe cases
Treatments include medications, skin care to avoid dry skin, and phototherapy — a type of therapy that uses ultraviolet light to control rashes.
Psoriasis is an autoimmune condition that manifests as a scaly, flaky, itchy, burning rash. People with psoriasis have skin cells that grow too fast. This causes the cells to pile up on the skin’s surface, causing redness and inflammation.
It typically affects the scalp, knees and elbows, but it can appear in any location according to the National Psoriasis Foundation — even the genitals and fingernails. It’s also associated with other diseases such as depression, heart disease and diabetes.
Common symptoms of psoriasis include thick, raised patches of skin called plaques. These patches can be light pink or deep red and are covered with a layer of silvery, dry skin called scales. The way it looks and specific symptoms vary depending on the type of psoriasis.
Treatment includes oral medications, topical ointments and creams and phototherapy.
Lupus is a long-term autoimmune disease that causes the immune system to attack healthy cells and tissues. It affects internal organs, joints and skin. People with lupus often have a butterfly-shaped rash on the nose and cheeks. There are four kinds of lupus: systemic lupus erythematosus (SLE), cutaneous lupus, drug-induced lupus and neonatal lupus. SLE is the most common kind.
Lupus can affect anyone, but it most often occurs in women ages 15 to 44. Because lupus is an autoimmune disease, it affects the entire body.
- Butterfly-shaped rash on cheeks and nose
- Chest pain when taking deep breaths
- Hair loss
- Joint pain and swelling
- Mild fevers
- Sensitivity to sunlight
- Sores in the nose or mouth
Lupus medications include nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs such as hydroxychloroquine, corticosteroids such as prednisone and BLyS-specific inhibitors such as belimumab.
Heat rash, or prickly heat, is a red, itchy rash made of small “prickly” feeling bumps that look like a cluster of pimples or small blisters. It’s most common in children but can happen to anyone. Humid, hot weather triggers this rash.
It is most likely to appear on the groin, neck, in the creases of elbows and armpits. Heat rash happens when excessive sweat gets trapped in pores. It typically goes away in three or four days.
Staying cool and dry is the best treatment for heat rash. Cool compresses and wearing loose clothing soothes it. Using creams or ointments can block pores, so doctors don’t recommend them. But a light lotion like calamine may help the itch.
Rashes Caused by Infection or Disease
Sometimes a disease or infection triggers a skin rash. Infections may be bacterial, viral or fungal.
Shingles manifests as a painful rash with blisters on one side of the face or body. These blisters take seven to 10 days to scab and heal, according to the Centers for Disease Control and Prevention. But before the rash appears, there will be tingling, pain and itching in the affected area. Other symptoms include fever, headache, upset stomach and chills.
The hallmark sign of chickenpox is an itchy rash that affects the entire body. Fluid-filled blisters that eventually scab over often accompany it. The illness lasts four to seven days. People who have been vaccinated still get the disease, but it is milder.
Because people with HIV have compromised immune systems and use medications that affect the immune system, they may develop an itchy, red rash. This can be caused by an infection or medication reaction. Most of these rashes go away on their own, but some medication-induced rashes might be serious. Make sure you talk to your doctor.
In addition to headache, high fevers, red watery eyes and cough, people with a measles viral infection develop a red, spotty rash all over their body about three to five days into the infection. It usually begins on the face and spreads downward all the way down to the feet.
Syphilis is a sexually transmitted disease that manifests as skin sores at the original site of infection, typically around the genitals, anus or mouth. As it progresses, it may cause a skin rash and swollen lymph nodes.
Roseola is an illness caused by a virus and it typically affects children between the ages of six months and two years old. Children will have a high fever and break out in a skin rash as the fever breaks. The rash appears as pinkish red, raised spots on the trunk. These spots turn white when touched. Roseola can spread to the face, neck, legs and arms.
The hallmark symptom of Lyme disease — a disease caused by the bite of an infected tick — is a rash called erythema migrans. It happens in 70 to 80 percent of people with Lyme disease. It appears like a bull’s-eye, and may spread up to 12 inches across. It is rarely itchy.
Rashes Caused by Medications
One of the side effects of medications can be a skin rash. Some are minor reactions that disappear in a few days without treatment. But others can be life threatening.
Non-allergic amoxicillin rash is a common side effect of the antibiotic amoxicillin, especially if it’s the first time someone takes the medication. About five to 10 percent of children taking it will develop this rash, according to OakLeaf Clinics. It’s not typically dangerous and clears up in about three days. The rash appears like pink spots that may be slightly raised on the trunk, but may spread to the face, legs and arms.
Allergic amoxicillin rash is more dangerous and starts within two hours of the first dose. It is usually very itchy and may cause breathing problems.
Stevens-Johnson Syndrome (SJS)
Stevens-Johnson Syndrome (SJS) is a severe skin reaction that most people get in response to taking a medication. The first sign of the disease is a fever with flu-like symptoms. Then, a blistering, peeling skin rash develops, resembling a severe hot water burn.
It is raw and very painful. It starts on the chest and face, and then spreads to other body parts. It damages mucous membranes in the mouth, leading to difficulty swallowing and trouble breathing. It may also spread to the genitals, eyes and urinary tract.
SJS is potentially fatal and requires emergency medical treatment.
Erythema Multiforme Major (EMM)
Erythema multiforme major (EMM) is a type of erythema skin rash that occurs in response to medication, similar to SJS. It comes with fevers, red itchy spots all over the body and sores in the mouth, genitals and lips. The spots may resemble a bull’s-eye, with a red ring around a red center.
Like SJS, EMM is a medical emergency and may be fatal.
Some skin disorders may resemble rashes, but don’t have the typical symptoms of other rashes.
Vitiligo may resemble a rash because it causes patches of skin discoloration, but it’s not a rash. It is a condition that causes skin to lose color. It causes milky-white patches of skin on the face, hands, feet and arms. People with vitiligo may also have hair that runs white on their head, beard, eyelashes and eyebrows.
Rosacea is a skin condition that may also affect the eyes. It causes pimples and redness on the face and is common in fair-skinned people. Other symptoms include a swollen nose, small red lines under the skin, frequent flushing, thick skin, and itchy dry eyes.
When to Seek Treatment
Most rashes are not life threatening, but some symptoms may signal a more serious condition. The American Academy of Dermatology recommends that people seek medical help if they have any of the following symptoms.
- The rash covers the entire body
- You have signs of infection, such as swelling, yellow or green fluid, crusting, pain, warmth or a red streak coming from the rash
- You have pain in the rash
- Blisters in the rash turn into open sores, especially if it’s around the mouth, eyes or genitals
- The rash comes with a fever, a potential sign of an allergic reaction or infection (shingles, measles, scarlet fever)
- The rash appears suddenly and spreads rapidly
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