What Is Skin Rash?
![Skin rashes can be caused by many types of conditions, including infections, autoimmune disorders and other causes.](https://images.medicinenet.com/images/article/main_image/skin-rash-1.jpg?output-quality=75)
Skin rashes are abnormal changes in skin color, texture, or appearance that are usually a result of skin inflammation. Rashes may affect a localized area or occur all over the body.
There are many types of skin rashes. Some of the most common include:
What Are Symptoms of Skin Rash?
Symptoms of skin rashes depend on the condition.
Symptoms of eczema (atopic dermatitis) most often affect the hands, elbows, and "bending" areas such as the inside of the elbows and back of the knees and include:
- Itching
- Skin redness
- Flaking skin
- Dry, scaly, or crusted skin that can become thick and leathery from scratching
- Small, fluid-filled blisters that may ooze when scratched
- Infection of the areas of broken skin
- Plugged hair follicles that cause small bumps, usually on the face, upper arms, and thighs
- Darkening of the skin around the eyes
Symptoms of granuloma annulare tend to occur on the backs of the forearms, hands, or feet and include:
- One or more circle-shaped areas of small, red, firm bumps
- Center of the area is usually skin-colored
- Mild itching
Symptoms of lichen planus include:
- Shiny, flat bumps
- Bumps are purple or a reddish-purplish color
- Itching
- As spots heal, they may leave darker areas on the skin
- Hair loss (lichen planus on the scalp)
- Brittle or split nails or lines and ridges on the nails (lichen planus of the nails)
- Redness, painful sores, or patterns that look like white lace (on the mucus membranes such as the mouth or vagina)
- Lichen planus sores in the mouth can cause difficulty eating
Symptoms of pityriasis rosea affect the back, neck, chest, abdomen, upper arms, and legs and include:
- Starts with a large, round or oval patch of scaly, pink area of skin followed by smaller, intensely itchy, inflamed, scaly, or reddened patches
- May appear as pink or salmon-colored spots on fair-skinned individuals, and red-brown color or darker than the skin on darker-skinned individuals
- Spots may be spread out in a "fir tree" or "Christmas tree" pattern on the back
- In children, spots may occur on the face and scalp
Symptoms of shingles commonly affect the trunk (chest, abdomen, and back) but can affect any part of the body and include:
- Usually starts with unusual sensations such as itching, burning, or tingling feelings in an area of skin on one side of the body
- Within one to two days, a rash of blisters appears on one side of the body in a band-like pattern
- Within three to four days, shingles blisters can become open sores (ulcers)
- Pain that is described as sharp, stabbing, or burning
- May begin several days before the rash
- May be severe
- Other symptoms that may accompany the rash of shingles include:
What Causes Skin Rash?
The cause of skin rash depends on the type of rash.
Eczema (atopic dermatitis)
- The cause of atopic eczema is unknown but genetics are believed to play a role and the condition often affects people with a family history of allergies
- Triggers for eczema flares include stress, anxiety, skin irritants (including soaps, skin care products, detergents, perfumes or cosmetics, dust, sand, secondhand smoke, or some fabrics), allergens, sweating, rapid temperature changes, climate, and cold or dry environments
Granuloma annulare
- The cause is unknown
Lichen planus
- It is believed to be an autoimmune condition, but the cause is unknown
- Hepatitis B or hepatitis C may trigger lichen planus (lichenoid reaction)
- Allergies to medications to treat high blood pressure, heart disease, and arthritis, may cause a lichen planus-type rash
Pityriasis rosea
- The cause is unknown
- It may be caused by a virus since the rash resembles some viral illnesses
Shingles
- Caused by varicella-zoster virus (the same virus that causes chickenpox)
How Is Skin Rash Diagnosed?
Skin rashes are diagnosed with a history and physical examination of the skin.
Tests may be used to determine the type of rash and/or the cause:
- Skin biopsy
- Skin scraping
- Blood tests
What Is the Treatment for Skin Rash?
Treatment for skin rashes depends on the type of rash.
Treatment for eczema (atopic dermatitis) includes:
- Fragrance-free moisturizers that contain ingredients such as ceramides, glycerin, and mineral oil
- Over-the-counter (OTC) creams and ointments that contain hydrocortisone (Cortizone-10, Cort-Aid, Dermarest Eczema, Neosporin Eczema) to help relieve itching, swelling, and redness
- Prescription-strength cortisone creams, pills, and shots, may be indicated for severe cases
- Topical immunomodulators (TIMs) such as pimecrolimus (Elidel) and tacrolimus (Protopic) can help prevent flare-ups in mild-to-moderate eczema
- Crisaborole (Eucrisa) ointment may be used for mild to moderate psoriasis
- Dupilumab (Dupixent) helps treat itch in patients with moderate to severe atopic dermatitis
- Antibiotics to treat infected skin
- Antihistamines to help relieve itching
- Phototherapy
Granuloma annulare does not always need treatment, except for cosmetic reasons, and the rash will usually go away on its own over time. If granuloma annulare symptoms or appearance are bothersome, treatment includes:
- Steroid creams or ointments for rash
- Freezing lesions with liquid nitrogen
- Injection of steroids directly into the rings of bumps
- Ultraviolet light therapy for severe cases
- Oral steroids for severe cases
Treatment for lichen planus includes:
- Antihistamines such as diphenhydramine (Benadryl) to treat itching
- Topical steroid ointments, creams, or gels
- Steroid injections, prednisone, or other drugs that suppress your immune system for more severe cases
- Retinoids
- Calcineurin inhibitors such as pimecrolimus (Elidel) and tacrolimus (Protopic)
- Anesthetic medicines to numb the skin and ease pain, especially for sores on the mouth or genitals
- Phototherapy
In mild cases, pityriasis rosea may not need to be treated and many cases will go away on its own. When treatment for pityriasis rosea is indicated, it may include:
- Oatmeal bath in lukewarm (not hot) water to soothe skin
- Keep the body cool
- Use fragrance-free moisturizer
- Oral antihistamines such as diphenhydramine (Benadryl) to treat itching
- Over-the-counter topical anti-itch medications
- Prescription steroids to soothe itching
- Exposure to sunlight or ultraviolet light may help sores heal faster
Treatment for shingles includes:
- Antiviral medications: acyclovir (Zovirax), famciclovir (Famvir), alacyclovir (Valtrex)
- Antibiotics, if the rash becomes infected
- Pain-relieviers
- Anti-seizure medications for postherpetic neuralgia pain: gabapentin (Neurontin) and pregabalin (Lyrica)
- Tricyclic antidepressants for postherpetic neuralgia pain: amitriptyline, desipramine, and nortriptyline
- Capsaicin cream (Zostrix) for postherpetic neuralgia
- Topical anesthetics: lidocaine (Xylocaine gel or Lidoderm skin patch)
- Prescription pain medications (opioids)
- Steroid injections
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