A skin rash is a change in the color and/or texture of the skin. It can result from many different factors, including allergic reactions, friction, exposure to heat and moisture, infections, medications and contact with chemicals or other irritants.

In some cases, a patient will come into contact with an irritant or allergen that causes the skin to react. In other cases, an underlying medical condition – such as infection, infestation with parasites or disease – causes a rash to form on the surface of the skin. Skin rashes usually involve reddened skin that may be inflamed with blisters, bumps or pimples. They are sometimes itchy and may flake, scale, peel or weep fluid. Some may be painful or cause a stinging sensation. In severe cases, the rash may crack or bleed.

A skin rash is a change in the color and/or texture of the skin on any part of the body. It can have many causes, including allergic reactions, friction, exposure to heat and moisture, infections, fungus, parasites, medications and contact with chemicals or other irritants.

A basic skin rash is known as dermatitis. This term simply means inflammation of the skin. Rashes can be caused by many different factors. In some cases, a patient will come into contact with an irritant or allergen that causes the skin to react. This is known as contact dermatitis, and it can be sparked by substances such as detergents, soaps, fabrics, clothing, rubber, solvents and jewelry.

In other cases, a patient may have an underlying medical condition that causes a rash to form on the skin's surface. Examples include infections, infestation with parasites and diseases such as:

• Fifth disease. Viral disease occurring mainly in early childhood and characterized by fever and a rosy-red rash on the cheeks that often spreads to the trunk and limbs.
  
  
• Hand, foot and mouth disease. A common and highly contagious viral infection that most often occurs in children. The condition is characterized by fever and the development of painful red sores in the throat, mouth and tongue. A rash may also appear on the palms of the hands and the soles of the feet, and may spread to the buttocks. The associated blisters are painful and very contagious.
  
  
• Juvenile arthritis. Chronic arthritis that begins in childhood and is marked by swelling, tenderness, and pain in one or more joints. Fever may also occur, and be accompanied by a rash.
  
  
• Kawasaki disease. An acute disease of young children characterized by a rash, swollen lymph nodes and fever.
  
  
• Lupus erythematosus. A chronic, inflammatory autoimmune disorder that affects the skin, joints, kidneys and other organs. A "butterfly" rash may appear over the cheeks, the bridge of the nose and other areas exposed to sunlight.

In the past, illnesses like chickenpox, measles, roseola and rubella were common causes of skin rashes in children. However, there has been a dramatic drop in the incidence of these diseases since children began to receive vaccinations against them.

Skin rashes usually involve reddened skin that may be inflamed with blisters, bumps or pimples. They are sometimes itchy and may flake, scale, peel or weep fluid. Some may be painful or cause a stinging sensation. In severe cases, the rash may crack or bleed.

Although most rashes will subside without causing any complications, skin rashes can become infected. In addition, severe rashes can result in permanent scarring.

There are many different types of skin rashes. Certain rashes are typically experienced during childhood, such as cradle cap and diaper rash. Some of the more common rashes for all ages include:

• Pityriasis rosea (Christmas tree rash). A fine, scaly rash that ranges in color from pink to tan. It often starts as a larger spot (herald rash) at the spine or midline of either the front or back of the body and spreads outward. The rash is characterized by mild itching, flaking and peeling. It usually resolves without treatment, but can last from four to 16 weeks. Ultraviolet light may help resolve the rash quicker. The origin of the rash is unknown, but it may be caused by a virus.
  
  
• Drug rashes. Any medication can cause an allergic reaction that manifests as a skin rash. The most common sources of drug rashes include antibiotics, anti-seizure medications and diuretics (increase urine production). An ingredient called neomycin – found in many antibiotic creams, ointments, lotions, ear drops and eye drops – may cause a rash in some people. In most patients, drug rashes begin within two weeks of beginning to take the medication. It starts as discrete red spots that spread and cover large areas of the body. Drug rashes can sometimes indicate a serious or potentially life-threatening allergy. They usually disappear within three weeks of ceasing to take a medication.
  
  
• Eczema. An itchy, noncontagious inflammation of the skin. In most cases, eczema begins as intense itching, followed by a rash that is patchy and made up of dry, flaky lesions that appears over reddened and inflamed areas. The rash most often affects the face, arms and legs as well as the creases of the hands and feet. Often used interchangeably with the term “dermatitis,” eczema appears in many different varieties, including atopic dermatitis, contact dermatitis, seborrheic dermatitis, perioral dermatitis and dyshidrotic dermatitis.
  
• Heat rash (prickly heat). Rash that often appears in hot and humid conditions and is caused by temporarily blocked active sweat glands. It usually affects the neck, the upper chest, the groin, under the breasts and the elbow creases. Miliaria rubra appears as red clusters of small blister-like bumps that cause a stinging sensation, whereas miliaria crystallina appears as clear, fluid-filled bumps that do not produce other symptoms. Heat rash usually resolves if the area is kept cool and dry.
  
  
• Hives (urticaria). A skin disorder in which itchy bumps of varying sizes appear suddenly anywhere on the body. These skin eruptions form when blood plasma leaks out of small blood vessels in the skin, usually as a result of the release of a chemical called histamine.
  
  

  

• Intertrigo. Occurs in warm, moist areas where the skin rubs or presses together, such as under the arms, in the groin area, between folds in the abdomen or under the breasts. Moisture, bacteria or fungi cause intertrigo, which is often red and painful. In severe cases, the skin may crack and bleed. Intertrigo usually resolves when patients keep the affected area dry and avoid tight, restrictive clothes.
  
  
• Lichen planus. A rash that appears as rows of itchy, flat-topped lesions. The lesions, which are red to purple in color, often appear on the arms and legs. It may also affect the scalp or mucous membranes lining the mouth, nose, vagina or anus. In most cases, the cause of this rash cannot be determined, although it sometimes stems from an allergic reaction to a medication or from chronic hepatitis (a liver disease). The rash can last for months or even years before disappearing, and may recur later. It is not contagious.
  
  
• Psoriasis. A common skin disease related to the immune system. Psoriasis is marked by raised, inflamed lesions that join together to form patches with distinct borders. The lesions are covered with flaky scales due to the rapid turnover of cells in the epidermis. It is not contagious, but is related to family history. It may be minor or serious and may cycle through remissions and flares. Psoriasis tends to affect the knees, elbows, trunk and scalp.
  
  
• Ringworm. A rash caused by a fungus that appears as itchy, red, raised and expanding rings. It tends to appear on the trunk, face, groin or thigh fold and grows outward as the infection spreads. Ringworm is contracted from pets, soil or other humans through skin-to-skin contact. It usually requires prescription medication before it clears.
  
  
• Rosacea. A chronic skin condition that leads to redness, inflammation and acne-like bumps on the nose, forehead, cheeks, chin and sometimes the eyes. Because it resembles acne, rosacea is sometimes called acne rosacea or adult acne. The cause of rosacea is unknown, but several factors have been identified that trigger flare-ups, including spicy floods, alcohol, sunlight, caffeine, menopause, certain medications (e.g., vasodilators) and stress. Rosacea is a progressive condition, which means that it gets worse over time. It can be inherited and is more common in fair-skinned people.
  
  
• Shingles (herpes zoster). A viral infection caused by the varicella-zoster virus (VZV), the same virus that causes chicken pox. After a person has had chicken pox, VZV remains in a dormant state in nerve roots for the rest of a person’s life. VZV may reactivate years later in the form of a painful rash known as shingles. It usually affects just one side of the body and resolves within two or three weeks without treatment.
  
  
• Swimmer itch. A patchy, red rash caused when the skin comes into contact with water contaminated with parasites. This causes a mild reaction in which the skin becomes red and appears as raised, itchy areas, sometimes resembling small pimples or blisters. The skin may also tingle or burn. In most cases, only skin not covered by swimsuits, wet suits or waders is affected. Swimmer itch often appears within 48 hours of exposure to the water and may last up to a week.

Skin rashes can often be identified through a visual examination by a dermatologist or other healthcare professional. In some cases, a skin biopsy or other test (e.g., blood test, urine test) may be necessary to determine the exact nature of a rash. Details from a medical history can also aid diagnosis.

Treatment options vary significantly depending on the type of rash. Some rashes clear on their own over time. Patients can take several steps to relieve symptoms associated with the rash until it clears. These include:

• Avoid scrubbing skin. This causes further irritation.
  
  
• Do not apply cosmetic lotions or ointments to a rash.
  
  
• Use minimal amounts of soap. Gentle cleansers are better.
  
  
• Use warm (not hot) water for cleaning.
  
  
• Pat dry. Rubbing with a towel will further irritate the skin.
  
  
• If possible, expose the affected area to the air. This will help speed healing.
  
  
• Use calamine lotion for rashes caused by poison ivy, oak or sumac.
  
  
• Use oatmeal baths to soothe itchiness.

Persistent rashes should be brought to the attention of a dermatologist or other healthcare professional. Some skin rashes may require special creams, medications or shampoos before the rash clears. Treatment options for various rashes include:

• Antibiotics. Topical or oral antibiotics may be used to treat skin rashes caused by underlying bacterial infections. The entire course of prescribed antibiotics should be taken, even if symptoms improve, to prevent recurrence.
  
  
• Antihistamines. Oral antihistamines block the release of histamines into the body. Histamines cause the symptoms – including some skin rashes – that occur during an allergic reaction or other immune system responses. Topical antihistamines can also help prevent the itching that may accompany some rashes. Older antihistamines used to cause drowsiness, but there are newer ones on the market that cause little or no drowsiness.
  
  

  

• Corticosteroid medications. These potent medications help lessen inflammation. However, they should be carefully used, as they can cause thin skin or rosacea. In most cases, a topical corticosteroid will be used. If the rash covers a large portion of the skin or is severe, a physician may prescribe corticosteroid pills or injections. A patient is usually tapered off the medication gradually over a two-week period to prevent the recurrence of the rash.
  
  
• Phototherapy. Some skin rashes – such as those resulting from psoriasis – can be treated by exposing the patient in controlled circumstances to ultraviolet light waves over a period of time.

Individuals with skin rashes should also consult a dermatologist when signs of infection (e.g., streaks of redness, swelling, tenderness) develop or when existing symptoms worsen.

Some skin rashes cannot be prevented, such as those that result from an underlying illness or disease. However, in other cases, people can lower the risk of developing rashes by taking several steps, including:

• Avoidance of allergens or irritants. Rashes are often caused by exposure to allergens and irritants. Avoiding these triggers can dramatically reduce the risk of developing a rash. Talk to a physician about allergy testing and other ways to identify potential allergens and irritants.
  
  
• Frequent hand washing. This can help prevent spreading viruses that cause rashes such as roseola (rose–colored skin rash associated with measles, syphilis or scarlet fever); hand, foot and mouth disease (contagious infection caused by coxsackievirus), and fifth disease.
  
  
• Stress reduction. Stress aggravates many rashes, including atopic dermatitis, psoriasis and seborrheic dermatitis. Patients with these conditions may benefit from learning stress management techniques, such as yoga and meditation.
  
  
• Vaccinations. Adhering to the recommended vaccination schedule for childhood illnesses – such as the varicella vaccine for chickenpox and MMR immunization for measles, mumps and rubella – can reduce the risk of contracting these diseases and their associated skin rashes. In some cases, however, the vaccinations can trigger reactions that result in skin rashes.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to skin rashes:

1. Do my symptoms indicate that I have a skin rash?
   
   
2. What type of skin rash do I have?
   
   
3. Is my rash contagious?
   
   
4. Is my rash likely to spread to other parts of my body?
   
   
5. What may have caused my skin rash?
   
   
6. What are my treatment options?
   
   
7. How long will it take my rash to clear up?
   
   
8. Am I likely to develop skin rashes again in the future?
   
   
9. How can I prevent skin rashes from forming?
   
   
10. Under what circumstances should I bring a rash to your attention?