Rash

A rash is a change in the skin's appearance that can involve color, texture, or both. Rashes are very common and can have many causes, ranging from minor skin irritations to signs of serious medical conditions. The appearance, location, and associated symptoms help determine the cause.

Most rashes are not serious and resolve on their own or with simple treatment. However, some rashes can indicate serious conditions requiring immediate medical attention. Understanding when a rash is concerning is important.

Rashes can appear in many ways:

Appearance:

• Red patches: Areas of redness
• Bumps: Raised areas
• Blisters: Fluid-filled bumps
• Scales: Flaky, dry skin
• Pustules: Pus-filled bumps
• Hives: Raised, itchy welts

Characteristics:

• Itchy: Common with many rashes
• Painful: Some rashes are painful
• Burning: May feel like burning
• Warm: Skin may feel warm
• Swollen: Area may be swollen

Location:

• Can occur anywhere on body
• May be localized or widespread
• May follow a pattern
• Location can help identify cause

Associated Symptoms (may accompany rash):

• Fever
• Fatigue
• Joint pain
• Difficulty breathing
• Swelling
• Other symptoms

Call Emergency Services (112 in Sweden) if:

• Rash with difficulty breathing
• Rash with swelling of face, lips, or throat
• Rash covering large area of body
• Rash with high fever
• Rash with signs of infection (increasing redness, pus, warmth)
• Rash that doesn't fade when pressed (meningitis sign)
• Rash with severe pain

For mild rashes:

1. Avoid Irritants:

   • Stop using new products
   • Avoid known allergens
   • Use gentle, fragrance-free products
   • Avoid harsh soaps

2. Cool Compresses:

   • Apply cool, wet cloth
   • Helps reduce itching and inflammation
   • Don't use ice directly
   • Apply for 15-20 minutes

3. Moisturize:

   • Use gentle, fragrance-free moisturizer
   • Apply after bathing
   • Helps with dry, irritated skin
   • Avoid products with irritants

4. Over-the-Counter Treatments (if appropriate):

   • Hydrocortisone cream: For itching and inflammation
   • Antihistamines: For allergic rashes
   • Calamine lotion: For itching
   • Follow instructions
   • Don't use on face without doctor approval

5. Don't Scratch:

   • Can cause infection
   • Can make rash worse
   • Can cause scarring
   • Keep nails short
   • Use anti-itch treatments

6. Identify and Avoid Triggers:

   • New products (soaps, lotions, detergents)
   • Foods
   • Medications
   • Environmental factors
   • Keep diary if needed

• Rash with difficulty breathing
• Rash with swelling of face, lips, or throat
• Rash covering large area
• Rash with high fever
• Rash that doesn't fade when pressed
• Severe symptoms

• Rash not improving with self-care
• Rash spreading
• Rash with fever
• Rash with pain
• Rash with other concerning symptoms
• Recurrent rashes
• Questions about rash

• Mild, localized rash
• Known cause (mild irritation, etc.)
• Responding to self-care
• No other concerning symptoms
• Not spreading

Evaluating a rash may involve:

1. Medical History and Physical Exam:

   • Description of rash
   • When it started
   • What makes it better/worse
   • Recent exposures
   • Physical examination

2. Skin Tests (if allergy suspected):

   • Patch testing
   • Allergy testing
   • Other tests

3. Blood Tests (if infection or systemic cause suspected):

   • Complete blood count
   • Other tests as needed

4. Skin Biopsy (if needed):

   • Small sample of skin
   • Examined under microscope
   • Helps diagnose certain conditions

5. Other Tests (if indicated):

   • Cultures (if infection suspected)
   • Other specialized tests

Treatment depends on the cause:

Allergic Rashes:

• Avoid allergen
• Antihistamines
• Topical steroids
• Usually resolves when allergen removed

Infectious Rashes:

• Antibiotics if bacterial
• Antiviral if viral
• Antifungal if fungal
• Supportive care

Inflammatory Rashes:

• Topical steroids
• Other anti-inflammatory medications
• Moisturizers
• Other treatments

Other Causes:

• Treat underlying condition
• Medications as needed
• Lifestyle modifications
• Other treatments

Prevent rashes by:

• Avoid Known Allergens: If you know what causes your rashes
• Use Gentle Products: Fragrance-free, hypoallergenic
• Protect Skin: From irritants and sun
• Practice Good Hygiene: But don't over-wash
• Moisturize: Keep skin healthy
• Avoid Harsh Products: That can irritate skin

Rashes can result from:

Allergic Reactions:

• Immune system reacts to allergen
• Releases histamine and other chemicals
• Causes inflammation and rash
• Can be immediate or delayed

Infections:

• Bacteria, viruses, or fungi
• Cause inflammation
• Body's immune response
• Rash appears

Irritation:

• Direct damage to skin
• Harsh products, friction
• Causes inflammation
• Rash develops

Medical Conditions:

• Autoimmune diseases
• Other medical conditions
• Various mechanisms
• Rash as symptom

Other Causes:

• Medications
• Heat
• Stress
• Other factors

• Very common
• Often from infections or allergies
• May need different treatments
• Watch for serious causes
• May spread easily

• May have different causes
• Skin more sensitive
• May need different treatments
• Higher risk of complications
• May take longer to heal

Seek medical care if the rash is severe, spreading, accompanied by fever or other symptoms, doesn't improve with self-care, or if you're concerned. Also seek immediate care if it's with difficulty breathing or swelling.

Hydrocortisone can help with many rashes, but it's not appropriate for all. Don't use on face without doctor approval, and don't use on infected skin. When in doubt, check with a healthcare provider.

It depends on the cause. Some resolve in days, others may take weeks. If a rash persists more than a few weeks or is getting worse, see a healthcare provider.

Yes, stress can trigger or worsen some rashes, especially conditions like eczema or psoriasis. Stress management may help.

For most rashes, a primary care provider can help. Consider a dermatologist if the rash is severe, not responding to treatment, recurrent, or if you need specialized care.