Skin Rash

What is a skin rash?

A skin rash occurs when skin becomes red, inflamed and bumpy. Some skin rashes are dry and itchy. Some are painful. Many things can bring on a skin rash, including viruses, bacteria, allergens and skin conditions like eczema.

How common are skin rashes?

Almost everyone develops at least one skin rash during their lifetime. It’s extremely common to sometimes feel itchy or have red, bumpy skin for a little while.

Who might get a skin rash?

Everyone — from infants to senior citizens — can get skin rashes. Infants are prone to diaper rash and cradle cap. Children are prone to atopic dermatitis and catch rash-inducing viruses, such as fifth disease. And older kids or adults can develop contact dermatitis as skin becomes sensitive to allergens or irritants over time.

What are the types of skin rashes?

There are many different types of skin rashes, including:

• Contact dermatitis: This form of dermatitis occurs when your body reacts to a substance that it doesn’t like. Lots of people are allergic to fragrances, preservatives, nickel (often found in costume jewelry) and poison ivy. Common irritants include soaps, detergents, chemicals and household cleaners.
• Eczema: Also called atopic dermatitis, eczema often develops in infancy and often gets better as a child grows. It tends to run in families (genetic). People who have asthma or allergies are more likely to have eczema, too.
• Hives: Also called urticaria, hives cause raised, red, itchy skin welts. You may get hives if you have an allergic reaction to airborne allergens or insect stings. Extreme temperature changes and certain bacterial infections can also bring on hives.
• Psoriasis: This lifelong skin disorder causes a thick, scaly rash. The rash often forms on the elbows, knees, lower back, scalp and genitals. Psoriasis can be inherited.
• Viral: Skin rashes are a common symptom of many viral conditions, such as chickenpox, measles and molluscum contagiosum.

What causes a skin rash?

Many things can cause skin rashes, including:

• Allergens in the environment.
• Bacterial infections, such as strep throat.
• Skin conditions like eczema.
• Irritants.
• Viruses.

What are the symptoms of a skin rash?

Skin rash symptoms vary depending on the type and cause. Rashes can develop in one area of the body or all over. A skin rash may be:

• Dry.
• Blistering.
• Blotchy.
• Burning or stinging.
• Flaky or scaling.
• Hive-like (welts).
• Inflamed or swollen.
• Itchy.
• Painful.
• Red.

How is a skin rash diagnosed?

Because so many things can cause a skin rash, diagnosis can be tricky. Your healthcare provider will examine the rash, assess your symptoms and take a medical history. You may undergo tests, such as:

• Biopsy: Your healthcare provider can take a small sample (biopsy) of your skin or other tissue to check for the presence of a virus or bacteria.
• Allergy test: Allergy tests, such as skin prick (scratch) tests and patch tests, identify allergens. Prick testing is helpful for the diagnosis of urticaria; patch testing is helpful for the diagnosis of allergic contact dermatitis. In these tests, your healthcare provider exposes your skin to small amounts of allergy-causing substances and observes for a reaction. You might be tested for just a few allergens or many at once. You have an allergy if the skin turns red, swells or develops a rash.
• Blood tests: Some skin diseases can be caused by antibodies circulating in your blood, which may be detectable by blood tests. Other rashes may be the manifestation of another systemic illness, and blood tests need to be done to check for involvement of other organ systems.

How is a skin rash managed or treated?

Treatment for skin rashes depends on the cause. It can take several weeks for the rash to go away. Skin rash treatments include:

• Allergy medications: Oral antihistamines, a type of allergy medication, reduce itching.
• Anti-inflammatory creams: Hydrocortisone creams like Cortizone® soothe inflammation and itching.
• Immunosuppressants: If the skin rash is from eczema or an immune system response, medicines can reduce the reaction. Calming it can minimize inflammation (irritation).
• Oatmeal baths: Soaking in a warm bath with colloidal oatmeal can relieve dry, itchy skin rashes. Look for colloidal oatmeal bath products, such as Aveeno®, at your local drugstore.
• Steroids: If symptoms persist, your healthcare provider may prescribe a topical steroid cream or an oral steroid like prednisone. Steroids ease inflammation and itchiness.
• Topical immunomodulators: These medications change (modulate) your body’s immune system response to allergens. Prescription medications include tacrolimus ointment (Protopic®) and pimecrolimus skin cream (Elidel®).

What are the complications of a skin rash?

They’re bothersome and unsightly, but skin rashes usually respond well to treatment. They rarely cause serious problems. Potential issues include:

• Anaphylaxis: A severe allergic reaction can cause a skin rash and a life-threatening condition called anaphylaxis. Extreme swelling (angioedema) from anaphylaxis can close air passages. People in anaphylaxis need an immediate epinephrine injection (EpiPen®) to counteract this allergic response. If you’ve ever felt your throat or mouth swelling when you get a rash, talk to your healthcare provider about whether you need to carry an EpiPen®.
• Infection: Scratching an itchy rash can break open the skin, allowing germs to get in. Scratching puts you at risk for developing a bacterial skin infection.

How can I prevent a skin rash?

You might lower your chances of developing a skin rash if you:

• Avoid known triggers, such as allergens and irritants.
• Don’t share personal items or clothing with anyone who has a virus that causes a rash.
• Use mild, fragrance-free, hypoallergenic soaps, cleansers and moisturizers.
• Wash hands immediately after coming into contact with a known allergen or irritant.

What is the prognosis (outlook) for people with a skin rash?

Depending on the cause, some skin rashes go away with treatment. Skin conditions like eczema and psoriasis cause chronic, recurring skin rashes that need ongoing care. Treatments can soothe pain, inflammation and itching.

When should I call the doctor?

You should call your healthcare provider immediately and seek emergency care if the skin rash:

• Comes with severe trouble breathing that could indicate anaphylaxis.
• Appears suddenly.
• Covers your body.
• Spreads rapidly.
• Occurs with a fever.
• Blisters or forms open sores.
• Looks infected (red, warm or swollen with yellow pus).

What questions should I ask my doctor?

If you have a skin rash, talk to your healthcare provider. You may want to ask:

• Why do I have a skin rash?
• When will the rash go away?
• Should I get an allergy test?
• What are the best treatments for a skin rash?
• What steps can I take to prevent skin rashes?
• What are the best treatments for an itchy or painful skin rash?
• What over-the-counter cleansers and moisturizers do you recommend?
• Should I look out for signs of complications?

Summary

How much a skin rash affects your life depends largely on what’s causing it. It’s hard to avoid viruses and bacteria, but you can avoid allergens and irritants that you know bother you. Whatever the cause, most rashes are annoying but treatable.

Some skin conditions, like psoriasis, are lifelong and need more care. Your healthcare provider can identify what’s causing the skin rash. Talk to your provider about how to minimize exposure to rash-causing triggers. Your provider can customize a treatment plan to address your specific symptoms and rash type.