We often think of COVID-19 as a viral disease. causes respiratory symptomssuch as congestion, sore throat and cough. But like a surprising number of other viruses, coronavirus can cause annoying, itchy, and even painful skin rashes.

Dr., a dermatologist at Brigham and Women’s Hospital and assistant professor of dermatology at Harvard Medical School, told TODAY.com. When you see a rash as part of a virus, you’re not seeing the virus getting directly into your skin, says Andrew Walls. .

Instead, what you usually see is “the virus highly activating your immune system as it fights the virus,” he explains. While not a common COVID symptom, a rash is another symptom of your body’s overall immune response to the virus.

Viral rashes are also not specific to COVID-19; Other viral diseases such as measles, varicella And hand, foot and mouth disease often contains rash.

Yale School of Medicine dermatology professor Dr. A rash associated with a viral infection is sometimes called a viral exanthema, Jeffery Gehlhausen tells TODAY.com. And this term covers the entire category of well-known skin conditions. “This (connection) is something we’ve known for centuries, to be honest,” Gehlhausen says.

So, if you develop a rash as a symptom of COVID-19, you’re definitely not the first. Here’s what to expect and when to talk to your doctor.

COVID skin rashes

Hives

Hives, also called urticariaIt may be related to allergies. But they also occur after a viral infection, including COVID-19.

This condition may appear as raised, itchy red, pink, or flesh-colored bumps. They can occur in isolated patches or large clusters. These can appear almost anywhere on your body, including your back, chest, legs and face, Walls says.

Hives also “move around your body a little bit,” Walls says. You may experience hives for a few days, but the hives patch can move from area to area, he adds.

When hives are associated with a virus, they tend to appear toward the end of your infection, Walls says. The timing usually goes something like this: Someone is feeling quite sick and develops a fever. Then, when the fever subsides and they seem to turn a corner, the rash begins to appear, Walls says.

Gehlhausen says hives alone, or even in combination with COVID-19, aren’t necessarily alarming. If your hives need treatment, the first-line option is antihistamines, he explains.

Morbilliform rash (measles-like)

A typical viral rash is a rash of smooth, raised pink spots that can collect into larger spots, Walls says. The rash tends to start on the chest or back. It then spreads to the extremities within a few days. (Some people only cover a small area of ​​their body, while others have very large areas of rash.)

Walls says the rash will then peak and “kind of fade away and peel off, almost like a sunburn.” For some, the rash is completely asymptomatic. But for others, he adds, it’s too itchy.

A specific type of viral exanthem that dermatologists are seeing in COVID is morbilliform rash, which means measles-like rash. measles rash tends to look like small raised bumps As TODAY.com previously explained, these rashes eventually turn into larger rashes that can affect a large part of the body and gradually disappear.

Coxsackie-like rash

Dermatologists have also seen COVID-related rashes that resemble the following: Caused by Coxsackie virusIt is also known as hand-foot-mouth disease.

“These are fixed, small, painful, sometimes itchy, oval blisters that develop on the hands, feet, and inside the mouth,” Walls explains, “mostly without much rash elsewhere.”

But Walls adds that this is “an unusual skin manifestation for COVID.”

More recently, some strains of the Coxsackie virus cause “more unusual rashes that can affect a larger body surface area,” Gehlhausen says. In other cases, he adds, the rash can also affect less common areas, such as appearing only on the buttocks.

“Obviously, COVID has evolved over time,” Gehlhausen says, “and as a result you can see different distributions of rashes.”

COVID toes

“You may remember many conversations about”COVID toes“It’s early in the pandemic. But experts say it’s not something dermatologists are seeing a lot of these days.

Walls explains that Chilblains (the technical term for COVID toes) is a skin condition that appears to be uniquely linked to COVID and not other viruses. “It’s sometimes been linked to autoimmune diseases… and that’s associated with exposure to cold” he adds.

This condition causes small areas of skin on the feet and hands to become swollen, itchy, and painful. Mayo Clinic he says. Affected areas may also swell and temporarily change color.

Experts speaking to TODAY.com say they don’t see Covid-19 toes very often these days. This could be because people stopped reporting it, the virus mutated and no longer caused problems, or it could be because there was never a connection to begin with.

For now, “researchers are still looking at whether swollen, discolored toes are caused by COVID-19.” American Academy of Dermatology he says. “It is possible for Covid-19 toes to develop when a person’s immune system reacts to the virus that causes COVID-19.”

vasculitis

Vasculitis is an autoimmune condition caused by inflammation of blood vessels and can appear as a rash.

Walls says experts are seeing some cases of vasculitis with COVID-19, particularly small cell vasculitis, which is the “least devastating” version of the condition.

We know that SARS-CoV-2 can affect the cardiovascular system and increase the chance of blood clotsTherefore, it is not surprising that we see vascular eruptions in some patients, says Gehlhausen. Vasculitis-type rashes usually occur in people with more serious infections, he says.

Walls says small cell vasculitis is linked to many other conditions, including bacterial infections (even strep throat) as well as antibiotics and other medications. “There are many things that trigger small vessel vasculitis in people,” he explains.

Fortunately, this condition usually appears as a single episode that goes away on its own. But Walls says some people have cases that last for months or reoccur over time.

Can COVID trigger or exacerbate other skin problems?

In addition to causing skin rashes, COVID-19 infections can also aggravate or trigger the recurrence of pre-existing skin problems.

Experts say this includes chronic skin conditions like psoriasis and eczema. Interestingly, these symptoms can also flare up after the COVID-19 vaccine, says Gehlhausen.

Diseases, including COVID, are also known to trigger conditions such as: shingles Cold sores and cold sores are due to HSV (herpes simplex virus), Walls says. It could be not getting enough sleep, stress in your personal or professional life, or another illness like COVID. These conditions “like to reactivate when something else has already tired you out,” he explains.

COVID skin rashes in children

Children may experience skin rashes due to viral infections, including COVID-19. Walls explains that children are actually “a little more prone to these viral skin reactions than adults.”

“Children who experience these viruses for the first time will be more prone to catching these things,” Gehlhausen explains. For example, dermatologists say that many children have a viral infection as well as various hive-like rashes, such as urticaria multiforme.

When to see a doctor for COVID skin rashes?

“If you have rashes and COVID, it would definitely be helpful to go see your primary care doctor and discuss it with them,” says Gehlhausen.

However, if you have one of the more common rashes, such as hives or a measles-like rash, they’re not necessarily “something scary or concerning,” he adds. “These are just the types of rashes that we know are associated with Covid-19, so it doesn’t lead us to manage the virus differently.”

And if it’s milder, you can treat it at home with over-the-counter antihistamines or pain medications.

If your rash is severe, covers a large area of ​​your body, or is particularly painful or itchy. Be sure to consult a doctor or dermatologistWalls says. They may prescribe medications such as topical antihistamines or steroids to help your skin heal.

The other related scenario is that you feel very bad in general along with the rash. For example, if you have a severe headache, high fever, difficulty breathing, and a rash appears, Walls recommends contacting a healthcare professional.

This article was first published on: TODAY.com