A rash is a noticeable change in the texture or color of the skin. The skin may become scaly, bumpy, itchy, or irritated. Rash is not a specific diagnosis instead it refers to any sort of inflammation and/or discoloration that distorts the skin’s normal appearance. Common rashes include eczema, poison ivy, hives, and athlete’s foot. lnfections that cause rashes may be fungal, bacterial, parasitic, or viral. Over-the-counter products may be helpful treatments for many skin rashes. Rashes lasting more than a few days that are unexplained should be given immediate medical attention.
Skin Rash Identification
Skin rashes can occur from a variety of factors, including infections, heat, allergens, immune system disorders and medications. These include:
Christmas tree rash (pityriasis rosea): Christmas tree rash (pityriasis rosea) is a fine, itchy, scaly rash that usually appears first as a single patch on the chest, abdomen or back. After this first appearance (herald patch), the rash may spread as small patches to other parts of the back, chest and neck. The rash may form a pattern on the back that resembles the outline of a Christmas tree. Pityriasis rosea usually goes away without treatment in 4 to 10 weeks, but it can last months. Medicated lotions may lessen itchiness and speed the disappearance of the rash. Often, though, no treatment is required.
Atopic dermatitis: One of the most common skin disorders that cause a rash is atopic dermatitis, also known as eczema. Atopic dermatitis is an ongoing chronic condition that makes skin red and itchy. Most often it appears as patches on the hands, feet, ankles, neck, upper body and limbs. It tends to flare up periodically and then subside for a time. At-home interventions, such as avoiding harsher soaps and detergents or other irritants and applying creams or lotions, can lessen symptoms and reduce the risk of flare-ups. Medicated anti-itch creams or ointments also can lessen symptoms.
Contact dermatitis: Contact dermatitis is a rash caused by direct contact with or an allergic reaction to certain substances. lrritant contact dermatitis (A) usually produces a dry, scaly, non-itchy rash. Many substances, such as cleaning products or industrial chemicals, that you come into contact with cause this condition. The irritant will cause a rash on anyone exposed to it, but some people’s skin may be more easily affected. Allergic contact dermatitis (B) produces a very itchy, red rash with bumps and sometimes blisters. Common allergy-causing agents (allergens) are latex rubber, nickel and poison ivy. Allergic contact dermatitis develops after initial exposure to the allergen. To treat the rash, try to figure out what caused it and avoid that substance. One can also apply medicated cream to help improve symptoms.
Drug rash: A rash may occur as a side effect of taking a drug or as an allergic reaction to it. A drug rash may be caused by many different medications, including antibiotics and water pills (diuretics). Some drugs are more likelyto produce a rash if the skin is exposed to sunlight. A drug rash, which usually starts within the first week of taking a new medication, often begins as red spots. The spots spread and merge, covering large areas of the body. lf one stops taking the drug that caused the rash, it will usually clear up in days to weeks. Rarely, a drug rash is part of a more serious, potentially life-threatening allergic reaction that affects the respiratory system and other organs. These severe reactions require emergency care.
Heat rash (miliaria): Heat rash (miliaria) occurs when the flow of sweat is obstructed, usually due to hot, humid weather or overdressing. Prickly heat (miliaria rubra, A) is a type of heat rash that appears as clusters of small, red bumps that produce a pricking or stinging sensation. Miliaria crystalline (B) appears as clear, fluid-filled bumps that generally produce no other signs or symptoms. Heat rash isn’t serious and usually resolves when the affected area cools. Cool compresses or a cool bath might help. One can prevent heat rash by wearing loose, lightweight clothing and avoiding excessive heat and humidity.
Intertrigo: Intertrigo is inflammation caused by skin-to-skin friction, most often in warm, moist areas of the body, such as the groin, between folds of skin on the abdomen, under the breasts, under the arms or between toes. The affected skin may be sensitive or painful, and severe cases can result in oozing sores, cracked skin or bleeding’ lntertrigo usually clears up if one is able to find a way to keep the affected areas as clean and dry as possible. Try wearing loosefitting clothing and using powder to reduce skin-to-skin friction in affected areas. weight loss may be helpful as well. sometimes, a bacterial or fungal infection can develop at the site of the intertrigo. lf this happens, one may need a medication to healthe skin.
Lichen planus: Lichen planus is an inflammatory condition that can affect the skin and mucous membranes. on the skin, it usually appears as purplish, often itchy, flat-topped bumps (lesions). ln the mouth, vagina and other areas covered by a mucous membrane, lichen planus forms lacy white patches. The condition may develop gradually over a couple of months. After that, it rarely worsens, but it may persist for months or years. One can usually control mild lichen planus symptoms on the skin, such as stinging and itching, by applying cool compresses or aloe vera gel. More-severe symptoms may require drug treatment. Lesions on mucous membranes tend to take longer to heal and often recur.
Psoriasis: Psoriasis is the rapid buildup of rough, scaly skin that occurs when the life cycle of skin cells rapidly increases. The accumulation of dead skin cells results in thick, silvery scales and itchy, dry, inflamed patches that are sometimes painful. The condition tends to flare up periodically and then subside for a time. For some people, psoriasis is a mild nuisance. For others, it can be disabling, affecting extensive areas of skin for long periods and often occurring with a distinct type of arthritis (psoriatic arthritis). Topical medications and light therapy may help reduce signs and symptoms of the skin lesions.
Ringworm of the body (tinea corporis): Ringworm of the body (tinea corporis) is a fungal infection that appears as itchy, red, scaly, slightly raised, expanding rings on the body. The ring grows outward as the infection spreads, and the center area becomes less actively infected. Ringworm is contagious. One can catch the infection through skin-to-skin contact with an infected person or animal or by coming into close contact with contaminated objects, such as unwashed clothing or bedding. Treatment usually requires prescription antifungal medication. A tinea infection in the groin is called jock itch (tinea cruris), and a tinea infection of the foot is called athlete’s foot (tinea pedis).
Rosacea: Rosacea is a chronic, long-term skin condition of adults that causes redness in the face and may produce small red or pus-filled bumps. Most people experience occasional flare-ups, usually in response to factors that increase blood flow to the surface of the skin. Triggers vary from person to person. Possible triggers include certain foods, skin products, extreme temperatures, alcohol consumption, emotional stress and sun exposure. Rosacea has no cure, but treatments may control or reduce signs and symptoms.
Shingles (herpes zoster): Shingles (herpes zoster) is a painful, blistering condition caused by the chickenpox (varicella-zoster) virus. If anyone ever had chickenpox, the virus remains inactive in nerve tissue. Years later, the virus may reactivate, causing shingles. A shingles outbreak may start with vaguely uncomfortable sensations, itching or pain with no obvious external cause. Within several days, clusters of small blisters; similar to the chickenpox rash which appears in a defined area on one side of the body. Over a few more days, the blisters break, leaving behind ulcers that dry and form crusts. Within about four weeks, the crusts fall ofl and the pain and itching usually go away. Antiviral drugs may lessen the pain or decrease the likelihood of persistent pain after the rash has healed. A shingles vaccine is recommended for most people age 60 or over.
Seborrheic dermatitis: Seborrheic dermatitis is the single most common rash affecting adults. It produces a red scaling often itchy eruption that characteristically affects the scalp, forehead, brows, cheeks, and external ears. ln infants, it may involve and scalp and diaper area.
Swimmer’s itch (cercarial dermatitis): Swimmer’s itch (cercarial dermatitis) is a burning or itchy rash caused by an allergic reaction to a waterborne parasite that burrows into the top layer of skin. The parasites soon die, but it’ll leave rash that produces tiny bumps or blisters. Because swimmer’s itch is an allergic reaction, repeated exposure to infected water can increase a person’s sensitivity and result in worse symptoms with each subsequent exposure. Swimmer’s itch isn’t serious and usually clears up on its own within a week. At-home remedies include soothing lotions, lukewarm baths with colloidal oatmeal or baking soda may ease the itchiness.
Signs and symptoms that may be associated with rashes include blister formation, scaling, skin ulceration, skin discoloration, itching and bumps on skin.
Most rashes will go away without medical treatment. Home treatment can often relieve pain and itching until the rash goes away. If there is contact with a substance such as poison ivy, oak or sumac, immediately wash the area with large amounts of water. After a rash has developed, leave it alone as much as possible, use soap and water sparingly, leave the rash exposed to the air whenever possible and do not scratch the rash.
If one has a rash, Avoid contact with children or pregnant women. Most viral illnesses that cause a rash are contagious, especially if a fever is present.
Steps to get relief from itching:
- Keep the itchy area cool and moist. Put cloths soaked in ice water on the rash a few times a day. Too much wetting and drying will dry the skin, which can increase itching.
- Keep cool, and stay out of the sun. Heat makes itching worse.
- Add a handful of oatmeal (ground to a powder) to bath. Or try an oatmeal bath product, such as Aveeno.
- Avoid scratching as much as possible. Scratching leads to more scratching. Cut nails short or wear cotton gloves at night to prevent scratching.
- Wear cotton clothing. Do not wear wool and synthetic fabrics next to your skin.
- Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay, and use as little soap as possible. Do not use deodorant soaps.
- Wash the clothes with a mild soap, such as CheerFree or Ecover, rather than a detergent. Rinse twice to remove all traces of the soap. Do not use strong detergents.
- Do not let the skin become too dry, which may make itching worse.
- Take several breaks during the day to do a relaxation exercise, particularly before going to bed if stress appears to cause the itching or make it worse. Managing stress by relaxing every muscle in the body, starting with the toes and going up to the head. This may help the symptoms.
Symptoms to watch for during home treatment
Call the doctor
- If any of the following occur during home treatment such as a fever, feeling ill, or signs of infection, are severe or become worse.
- A rash lasts longer than 2 weeks.
- Symptoms become more severe or happen more often.
Nonprescription medicines for itching
Carefully read and follow all label directions on the medicine bottle or box.
Try calamine lotion for a rash caused by contact dermatitis, such as poison ivy or poison oak rashes.
For severe itching from contact dermatitis, apply hydrocortisone cream 4 times a day until the itch is gone. Do not use this cream on a fungal rash, because this can make the rash worse.
Try an oral antistamine to help the scratch-itch cycle. Examples include chlorpheniramine maleate, such as Chlor-Trimeton, and diphenhydramine such as Benadryl. Oral antihistamines are helpful when itching and discomfort are preventing one from doing normal activities, such as work and sleep. Antihistamines may cause drowsiness. Do not drive or operate any type of equipment if taking any of these medicines. And don’t give antihistamines to a child unless checked with the doctor first.