Covid Rash: Identification, Treatment, When to Seek Medical Help - Healthline

COVID-19 is the disease caused by the novel coronavirus. While many people who become sick with COVID-19 experience a mild or moderate illness, some can develop serious symptoms that require hospitalization.

According to data from the Centers for Disease Control and Prevention (CDC), there have been over 33 million confirmed cases of COVID-19 in the United States. Since COVID-19 vaccines have been rolled out, the rate of new cases is trending downward.

The most common symptoms of COVID-19 are fatigue, fever, and cough. However, some people may experience less common symptoms. One of these is rash.

Below, we explore what COVID-19 rashes look like, how they can be treated, and when it's important to see a doctor.

Some individuals with COVID-19 may develop a rash. While skin symptoms have been reported in adults and children, most available research centers on adults.

A 2020 meta-analysis of 2,261 people with COVID-19 estimated that the prevalence of skin symptoms was about 1 percent. However, according to a 2021 review, the exact incidence of rash in COVID-19 remains unknown.

Some general symptoms associated with many COVID-19 rashes include:

  • Skin discoloration: Rashes are typically discolored in comparison to neighboring skin. On light skin, a rash may look red, pink, or purple. On dark skin, it may appear purple, ashy grey, or dark brown.
  • Swelling: The affected area may appear swollen or puffy compared to surrounding skin.
  • Itching: Many, but not all, types of COVID-19 rash may itch.

When do rashes appear and how long do they last?

When exactly the rash occurs during COVID-19 can vary. In some instances, it may appear at COVID-19 symptom onset, while in others, it may happen several days after other symptoms have developed.

According to information from the American Academy of Dermatology, COVID-19 rash can last 2 to 12 days. On average, most people have a rash for 8 days. However, rashes impacting the toes may last 10 to 14 days.

The exact appearance of COVID-19 rashes can vary by individual. While some infectious diseases, such as chickenpox and measles, cause a very distinctive rash, a rash due to COVID-19 can take many forms:

  • Hives: COVID-19 rash can appear as itchy patches or wheals that resemble hives. These most often affect the limbs and torso.
  • Macules and papules: In some cases, a COVID-19 rash can consist of itchy spots that may either be flat or raised. This type of rash often impacts the torso.
  • Rash with blisters: This type of COVID-19 rash can appear with blisters that may look similar to chickenpox. It's most often been observed on the torso and may itch.
  • Lace-like pattern: Some COVID-19 rashes can have rings of skin discoloration that form a lace or net-like pattern. This kind of COVID-19 rash typically affects the legs.
  • Pinpoint spots: This type of COVID-19 rash consists of dark pinpoint spots. The legs are the most commonly impacted area.
  • Toe rash: Also referred to as "COVID toes," this type of rash causes discolored patches and swelling of one or more toes. The affected area may be painful, itchy, or have a burning sensation. Toe rashes appear to be more common in young adults.

Pictures of rashes associated with COVID-19

Below are some examples of what COVID-19 rash can look like.

Researchers don't understand why some people with COVID-19 get a rash and others do not. They also don't know what exactly causes the rash to occur. Some possible mechanisms include:

  • direct infection of skin tissues by the novel coronavirus
  • immune system activity
  • the effects of increased blood clotting (hypercoagulability) that can sometimes happen in COVID-19

It's also possible that different types of COVID-19 rash will happen through different mechanisms. Researchers are working to find out more.

It's also possible to get a rash after receiving your COVID-19 vaccine. Let's look at this in a little more detail.

Allergic reaction

Some people may have an allergic reaction to the COVID-19 vaccine. If this happens, you may notice a rash or hives after you get your vaccine.

Allergic reactions to the COVID-19 vaccine can be classified as either non-severe or severe:

  • Non-severe: Non-severe allergic reactions happen within 4 hours of vaccination. They may include signs such as hives, swelling, and wheezing.
  • Severe: This type of reaction is called anaphylaxis. It typically happens in the minutes after vaccination and can include hives, swelling of the face and throat, and dizziness or fainting.

Delayed rash at the injection site

Some individuals may get a rash at the site of their injection. You may see this referred to as "COVID arm."

This type of rash is most often associated with the Moderna COVID-19 vaccine and typically happens after the first dose. However, it can also occur after the second dose or after both doses.

Delayed rashes at the injection site typically appear about a week after vaccination and last about 4 days. This rash can be large and include symptoms like:

  • redness
  • swelling
  • warmth
  • itching
  • pain

This type of reaction isn't harmful. If you have a delayed rash at the injection site, the CDC recommends that you still receive your second vaccine dose, if applicable. However, you may want to receive it in your other arm.

If you develop an unexplained rash, it's a good rule of thumb to talk with a doctor. COVID-19 rashes may appear very similar to rashes caused by other medical conditions that need treatment.

The only way to be sure if your rash is due to COVID-19 is to get a COVID-19 test.

Most rashes that happen with COVID-19 will go away in about a week. Meanwhile, you can help treat a COVID-19 rash at home by doing the following:

  • Applying a cool compress: Placing a cool compress onto the affected area may help to ease swelling or itching.
  • Trying an oatmeal bath: Indulging in an oatmeal bath can potentially work to soothe irritated skin.
  • Using over-the-counter (OTC) topicals: OTC topical products may help to alleviate itching or swelling associated with some types of COVID-19 rash. Some examples to look into include hydrocortisone cream or calamine lotion.
  • Taking OTC antihistamines: OTC antihistamines may help to reduce symptoms associated with hive-like COVID-19 rash.
  • Avoiding scratching: It may be tempting to pick at or scratch a rash, particularly if it's itchy. Try to avoid doing this, as it can increase the risk of infection, scarring, or skin pigmentation changes.

Your doctor may also prescribe a prescription medication to help with a COVID-19 rash. These may include corticosteroids in a topical or oral formulation.

The symptoms of COVID-19 can come on between 2 and 14 days after exposure to the novel coronavirus. Three of the most common COVID-19 symptoms are:

Other symptoms that can occur include:

If you come down with any of the above symptoms and are concerned that you may have COVID-19, seek a COVID-19 test. After getting your test, be sure to isolate at home until you receive your result.

Whether or not it's due to COVID-19, it's important to seek medical attention for any rash that:

  • happens along with any of the following symptoms:
  • covers a large area of your body
  • appears suddenly and begins to spread quickly

If your rash is due to COVID-19, seek immediate medical attention or call 911 if you develop any of the following serious symptoms:

Rash is one of the less common symptoms of COVID-19. It can take on many forms, including hives, macules, papules, or a toe rash. It's unknown what exactly causes COVID-19 rashes to occur.

You can also get a rash after being vaccinated for COVID-19. This can happen due to an allergic reaction or a delayed reaction at the injection site.

Generally, most COVID-19 rashes go away in about a week. You can care for them at home by applying a cool compress, using OTC topical products, and resisting the urge to scratch.

Contact a doctor if you develop an unexplained rash, particularly if it's painful, has blisters, or covers a large area. If you have COVID-19, seek emergency care if you have symptoms like trouble breathing or persistent chest pain.

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