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5 Common Skin Rashes That Can Be Caused By COVID, According To Dermatologists
The main signs of COVID-19 are respiratory symptoms, like congestion and a cough. But COVID-19 can also cause skin rashes, dermatologists say. And the coronavirus is just one of many viruses that may lead to itchy and even painful skin issues.
While a rash can be a part of a viral illness, that doesn't mean the virus is directly affecting your skin, Dr. Andrew Walls, dermatologist at Brigham and Women's Hospital and assistant professor of dermatology at Harvard Medical School, tells TODAY.Com.
The rash is actually a result of "the virus activating your immune system to a high degree as it's combating the virus," Walls explains.
A rash isn't a common COVID-19 symptom, but it can be yet another manifestation of your body's immune response to the virus. And viral rashes aren't unique to COVID-19, experts say.
Rashes like these are sometimes called viral exanthems, Dr. Jeffery Gehlhausen, Ph.D., assistant professor of dermatology at the Yale School of Medicine, tells TODAY.Com. The connection between viral illnesses and rashes is far from new, and the term "viral exanthem" now encompasses an entire category of well-known skin conditions.
"This (link) is something that we've known about for, honestly, centuries," Gehlhausen says. Other viral illnesses — measles, chickenpox and hand, foot and mouth disease, for instance — frequently include a rash.
So, if you think your itchy skin rash may be related to a recent COVID-19 infection, you certainly wouldn't be the first.
Here are the kinds of skin rashes that COVID-19 and other viruses may cause — and when to talk to your doctor.
COVID skin rashes Hives Hives are an itchy skin rash that can appear near the end of a viral infection.Getty ImagesHives, also called urticaria, are often related to allergic reactions. But hives can also appear after a viral infection, including COVID-19.
Hives may look like raised and itchy red, pink or flesh-colored bumps. The rash can occur in isolated patches or large clusters. And hives can appear pretty much anywhere on the body, including your back, chest, legs and face, Walls says.
Unlike other rashes, Hives tend to "move around your body quite a bit," Walls says. You could have hives for several days, but the rash may move every day, he adds.
When hives are related to a viral illness, like COVID-19, they tend to appear near the end of your infection, Walls says. Typically, the rash shows up when your fever breaks and it feels like you're finally turning a corner.
Hives are generally a mild rash and aren't worrying, Gehlhausen says. If your hives require treatment because they are severe or intensely itchy, the first-line option is antihistamines, he explains.
Morbilliform rash (measles-like) A measles-like rash is an example of a typical viral exanthem, meaning a rash caused by a viral illness such as COVID-19.Getty ImagesOne specific type of viral exanthem that dermatologists have seen with COVID-19 is a morbilliform rash, meaning a measles-like rash.
Measles rashes tend to look like small raised bumps that eventually coalesce into larger rashes, which can affect much of the body, before gradually fading away, as TODAY.Com explained previously.
More generally, a typical viral exanthem is a rash made up of smooth, raised pink dots which can collect into larger patches, Walls says.
There can be a lot of variation from person to person. For example, while some people only have a small area of their body covered, others might have very large areas with the rash. And, in some cases, the rash is very itchy. But others may find that, aside from the rash itself, they're completely asymptomatic.
Often, the rash starts on the back or chest. Over the next few days, the rash then spreads to the extremities. Then the rash reaches a peak, fades away and peels, "almost like a sunburn," Walls says.
Coxsackie-like rash
COVID-19 can lead to a rash that resembles that of the Coxsackie virus, also called hand, foot and mouth diesease.Ivan-balvan / Getty ImagesDermatologists have also seen COVID-related rashes that resemble those caused by the Coxsackie virus, also called hand, foot and mouth disease.
"These are fixed, small, painful, sometimes itchy oval blisters that develop on the hands, feet and the inside of the mouth," Walls explains, "often without a whole lot of rash elsewhere."
However, this is an "uncommon skin manifestation for COVID," Walls adds.
More recently, some strains of the Coxsackie virus have caused "more unusual rashes that may affect a larger body surface area," Gehlhausen says. In other cases, the rash may affect less common areas, like just appearing on the buttocks, he adds.
"Obviously, COVID has evolved over time," Gehlhausen says, "so you may see different distributions of the rash as a result of that."
COVID toes Early in the pandemic, people reported developing chilblains on their feet, also called "COVID toes."Matias Fabbri / Getty ImagesYou may remember a lot of talk about "COVID toes" early on in the pandemic. But it's not something dermatologists see a lot of these days, the experts say.
Chilblains — the technical term for COVID toes — is a skin condition that seemed uniquely linked to COVID and not to other viruses, Walls explains. "Sometimes it was linked to autoimmune diseases ... And it was thought to be associated with cold exposure," he adds.
The condition causes small areas of skin on the feet and hands to become swollen, itchy and painful, the Mayo Clinic says. The affected areas may also blister and become temporarily discolored.
Today, experts don't see COVID toes very often, they tell TODAY.Com. That could be because people have stopped reporting it, the virus has mutated and is no longer causing the issue, or there was never a link to begin.
For now, "researchers are still looking at whether the swollen, discolored toes are caused by COVID-19," the American Academy of Dermatology says. "It's possible that COVID toes develop when the person's immune system reacts to the virus that causes COVID-19."
Vasculitis Cutaneous vasculitis is a vascular rash that can be caused by COVID-19.Jodi Jacobson / Getty ImagesVasculitis is an autoimmune condition caused by inflammation of the blood vessels, an it can present as a rash.
Experts have seen some cases of vasculitis with COVID-19, particularly small cell vasculitis, which is the "least destructive" version of the condition, Walls says.
We know that SARS-CoV-2 can affect the cardiovascular system and make blood clots more likely, Gehlhausen says, so it's not surprising that we see vascular rashes in some patients. Generally, he says, vasculitis-type rashes occur in people with more severe infections.
Small cell vasculitis has been linked to many other conditions as well, including bacterial infections (even strep throat) as well as antibiotics and other medications, Walls says. "A huge array of things have triggered small vessel vasculitis in people," he explains.
Thankfully, the condition typically appears as a single episode that fades away on its own. But some people have cases that linger for months or recur down the line, Walls says.
Can COVID trigger or exacerbate other skin issues?In addition to causing temporary skin rashes, COVID-19 infections can also exacerbate or trigger a recurrence of pre-existing skin conditions you may already have.
That includes chronic skin conditions like psoriasis and eczema, the experts say. Interestingly, these can also flare after a COVID-19 vaccine, Gehlhausen says.
Illnesses, including COVID, are also known to trigger conditions such as shingles and cold sores due to HSV (herpes simplex virus), Walls says. These conditions "like to reactivate when something else is running you down anyway," he explains, which could be not getting enough sleep, stress in your personal or professional life or another illness, like COVID.
COVID skin rashes in childrenKids can get skin rashes due to viral infections, including COVID-19. In fact, children are "a little more prone to these skin reactions with viruses than adults are," Walls explains.
"Kids who are experiencing these viruses for the first time are going to be prone to getting these sort of things," Gehlhausen explains. For instance, dermatologists see a lot of kids with various forms of hives-like rashes, such as urticaria multiforme, alongside a viral infection, he says.
When to see a doctor for COVID skin rashes"If you have a rash and COVID, it is absolutely worthwhile to go to see your primary care physician and discuss it with them," Gehlhausen says.
That said, if you have one of the more common rashes — like hives or a measles-like rash — those aren't necessarily "anything scary or concerning," he adds. "They're just types of rashes we know are associated with COVID, so it wouldn't prompt us to manage the virus any differently."
And, if it's on the milder end, you may be able to treat it at home with over-the-counter antihistamines or pain medication.
If your rash is severe, covers a large area of your body or is especially painful or itchy, you should definitely check in with a doctor or dermatologist, Walls says. They may be able to prescribe medications, like topical antihistamines or steroids, to help your skin heal.
The other concerning scenario is if you are generally feeling very unwell along with the rash. For instance, if you have a bad headache, high fever and trouble breathing and a rash shows up, Walls recommends checking in with a health professional.
What Causes Foot Rash?
A foot rash can occur due to an allergic reaction or infection. A person can treat some rashes, such as athlete's foot and contact dermatitis, with over-the-counter (OTC) medications. In some cases, prescription medication may be necessary.
However, other types of foot rashes, such as cellulitis may require medical intervention.
In this article, we list a few common causes of foot rashes along with their symptoms and treatment options.
Tinea pedis, more commonly known as athlete's foot, is a highly contagious fungal infection that develops on the feet.
A fungus calledTrichophyton causes athlete's foot. This fungus thrives in warm, moist environments, such as shower floors and the inside of shoes.
Athlete's foot often leads to itchy, burning skin between the toes. Other symptoms include:
Treatment of athlete's foot
Most people can treat athlete's foot with an OTC antifungal treatment, usually an oral tablet, liquid, or cream. However, more severe infections may require prescription-strength medication.
Topical steroids, such as hydrocortisone, can help reduce inflammation and relieve itching and soreness.
Contact dermatitis is a rash that occurs when a substance irritates the skin or produces an allergic reaction.
Substances that may cause contact dermatitis include:
Treatment of contact dermatitis
People can avoid the substance they think is causing contact dermatitis to see whether their rash clears within 1 to 3 weeks. Antihistamines and topical corticosteroids may help relieve symptoms.
Poison ivy, poison oak, and sumac grow in wooded and marshy areas. Their sap contains an allergen called urushiol.
Urushiol can trigger an allergic skin reaction or contact dermatitis. About 50% to 75% of adults in the United States are allergic to urushiol.
Symptoms of a poison ivy, poison oak, or sumac rash include:
Treatment of poison ivy, poison oak, and sumac rashes
Poison ivy, poison oak, and sumac rashes usually clear up by themselves within a few weeks.
If someone believes that they have had exposure to urushiol, they can remove the oils immediately by washing themselves and their clothes with soap and water.
OTC topical treatments, such as calamine lotion and hydrocortisone, can help relieve itching and swelling. A doctor may prescribe an oral antihistamine to lessen the allergic reaction.
Dyshidrotic eczema, or dyshidrosis, is a common form of eczema that causes itchy blisters on the palms of the hands and soles of the feet.
According to the National Eczema Association, dyshidrotic eczema is twice as common in females as males.
Treatment of dyshidrotic eczema
There is currently no cure for dyshidrotic eczema. Treatments for this skin condition involve reducing symptoms and preventing secondary infections and other complications.
A doctor may prescribe a topical steroid to reduce swelling and itching. Botox injections can lessen sweating and excess moisture in the hands and feet, which can prevent infections.
At-home treatments for dyshidrotic eczema include:
Although HFMD is most common among young children under the age of 5, anyone can develop the infection.
HFMD usually leads to small spots appearing on the hands and feet, as well as mouth sores. Other symptoms include:
Treatment of hand, foot, and mouth disease
There are no specific treatments for HFMD. People may be able to manage symptoms with OTC medication that reduces fever and pain.
Drinking cold liquids can help keep people hydrated while soothing a sore throat.
According to the Centers for Disease Control and Prevention (CDC), most people with HFMD get better within 7 to 10 days.
Cellulitis is a bacterial infection that develops in the deep layers of the skin and on the lower legs and feet. Symptoms include:
People with light skin tones may notice reddened skin in the affected area, and people with darker skin tones may notice skin that is darker than the surrounding area.
Treatment of cellulitis
Cellulitis can develop suddenly and can be life threatening without treatment.
Doctors usually prescribe antibiotics to treat the bacterial infection responsible for cellulitis. Other beneficial at-home treatment options include:
Scabies is a skin condition that occurs when microscopic scabies mites burrow into the upper layer of the skin. These mites then feed on skin cells and lay eggs. People who have not had scabies before may develop symptoms within 3 to 6 weeks of exposure. People who have previously had scabies may develop symptoms in1 to 4 days.
A scabies infestation can lead to a skin rash and intense itching. The affected area of skin may develop pimple-like blisters or thick, crusty scales.
Treatment of scabies
People cannot treat scabies with at-home remedies. A doctor must prescribe topical medications that kill scabies mites.
After starting treatment, people should disinfect their bedding, clothing, and any other fabrics that they regularly use. This will help prevent recurring infestations.
People should contact a healthcare professional if their foot rash is painful or interferes with their daily activities.
Parents and caregivers should see a healthcare professional if a child or infant develops a skin rash or blisters.
It is important for a person to seek medical attention straight away if their rash does not improve with treatment or they develop a fever.
There are numerous possible causes of foot rashes, ranging from allergic reactions to infections. Most cases clear up on their own, but OTC medications can help relieve swelling, itching, and pain during recovery.
A person should speak with a doctor if they have a foot rash that does not respond to treatment or they develop signs of an infection.
WCSD: Three Rash Cases Confirmed To Be Hand, Foot, Mouth Disease
RENO, Nev. (KOLO) - Update on March 3: The Washoe County School District has updated their outbreak numbers for schools in the district:
Update on Feb. 28: The Washoe County School District says its three cases of rashes are Hand, Foot, Mouth Disease.
According to the CDC, the disease causes fever, mouth sores, and a skin rash. Most people who get the disease get better on their own in 7 to 10 days.
The list of schools now on outbreak status as of Feb. 28 is:
Update on Feb. 27: The Washoe County School District is updating the number of schools that have been placed on outbreak status.
They say two schools have had the entire school affected by respiratory outbreaks, while one has had the entire school affected by a gastrointestinal outbreak. Meanwhile, two have had their entire school affected by respiratory and gastrointestinal outbreaks.
16 classrooms have been affected by respiratory outbreaks, four have been affected by gastrointestinal issues, and three classrooms have been affected by a rash.
Update at 6:45 p.M.: Washoe County School District Officials are giving an updated count on schools impacted by illness outbreaks. They say, four total schools are impacted, including 2 for respiratory illnesses only, 1 for gastrointestinal illnesses only, and 1 for both.
Update at 3:14 p.M.: The WCSD has added one school to its list of schools that are on outbreak status.
The district did not name the school but added one school due to a gastrointestinal outbreak.
Original Article: The Washoe County School district says five of their schools are on outbreak status. One for both respiratory and gastrointestinal illnesses, two for just respiratory illness and two for just gastrointestinal illness.
In addition, they say 19 other classrooms are also listed on outbreak status, fifteen of them for respiratory and four for gastrointestinal illness.
We have reached out for more details on which schools are under the status, and what steps are being taken to mitigate the spread. We will share that when it becomes available.
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