Common Skin Rashes

Not usually serious, but sometimes painful Your skin is surprisingly resistant t
o a wide variety of assaults, but it's still susceptible to various invaders. Vi
ruses, parasites, fungi, heat and medications can all cause skin rashes and erup
tions. Though not life-threatening, rashes are often bothersome, uncomfortable o
r even painful. Some, such as heat rash and swimmers' itch, clear up on their ow
n. Others, including rosacea and drug rashes, require medical treatment. Here ar
e common skin rashes, their causes and when you might need to see your doctor.
1. Atopic dermatitis This form of dermatitis, commonly referred to as eczema, is
a chronic condition that causes itchy, inflamed skin. Most often, it occurs in
the folds of the elbows, backs of the knees or the front of the neck. It tends t
o flare periodically and then subside for a time, even up to several years. The
exact cause of this skin disorder is unknown, but it may result from a malfuncti
on in the body's immune system. Even mild cases of atopic dermatitis can be extr
emely itchy. Self-care measures, such as avoiding soaps or other irritants and a
pplying creams or ointments, can help. See your doctor if your symptoms distract
you from your daily routines or prevent you from sleeping.
2. Christmas tree rash (pityriasis rosea) Named for its sweeping presentation, t
he Christmas tree rash is a fine, scaly rash that ranges in color from pink to t
an. It often starts as one larger spot at the spine or the midline of the back o
r front of the body (herald patch) and spreads outward. The rash, which may be c
aused by a virus, is usually only mildly itchy and may flake or peel. This skin
condition is common in teenagers and young adults and occurs more frequently in
the fall and spring. It usually resolves without treatment in four to six weeks
but can last up to 12 weeks. Contact your doctor if the rash is uncomfortable or
painful.
Contact dermatitis Contact with an irritant or allergen causes this form of derm
atitis. Irritant contact dermatitis (A) produces red, dry itchy patches usually
on the hands, fingers and face. Common irritants include soap, detergents and sk
in-cleaning products. Allergic contact dermatitis (B) produces a red rash, bumps
and sometimes blisters. Common allergens include rubber, metals such as nickel,
costume jewelry, perfume, cosmetics, hair dyes and weeds such as poison ivy.
If you can identify and avoid the offending agent, the inflammation usually reso
lves without treatment in two to three weeks. See your doctor if your symptoms c
ontinue beyond that time frame or if the rash is uncomfortable or painful.
3. Drug rash Any medication can produce a drug rash — an allergic reaction to a me
dication. But the most common culprits include antibiotics, anti-seizure medicat
ions and diuretics. The rash usually starts within two weeks of taking a new med
ication and begins as discrete red spots that spread, covering large areas of th
e body. A drug rash could be a part of a more serious and potentially life-threa
tening allergic reaction. Contact your doctor promptly if you experience a rash
after taking a medication. He or she can determine a treatment option that likel
y includes an alternative medication. A drug rash usually resolves one to three
weeks after discontinuing the medication.
4. Heat rash (miliaria) Miliaria rubra (A), one type of heat rash, appears as re
d clusters of small blister-like bumps that can produce a stinging-like sensatio
n. Miliaria crystallina (B), on the other hand, appears as clear, fluid-filled b
umps that produce no other signs or symptoms. Caused by active sweat glands, hea
t rash usually develops on the neck, upper chest, groin, under the breasts and i
n elbow creases. This rash isn't serious. It often resolves with proper self-car
e methods, such as keeping the affected areas cool and dry, avoiding tight, rest
rictive clothes, and not using heavy ointments or creams when you expect heavy p
erspiration.
5. Intertrigo In most cases, intertrigo occurs in warm, moist areas where skin r
ubs or presses together, such as under the arms, in the groin area, between abdo
minal folds or under the breasts (as seen in the image). Moisture, bacteria or f
ungi can cause intertrigo, which is usually red and painful. In severe cases, th
e skin may crack and bleed. This condition often resolves with proper self-care
methods, such as keeping the affected areas dry and avoiding tight, restrictive
clothes. See your doctor if the inflammation moves beyond the skin fold or if th
e affected area is painful.
6. Lichen planus Typically, this rash appears as rows of itchy, flat-topped bump
s (lesions) on the arms and legs. It can also involve the scalp or the mucous me
mbranes that line the mouth, nose, vagina and anus. In some cases, lichen planus
results from an allergic reaction to a medication or from chronic hepatitis. Bu
t in most cases, doctors are unable to identify a cause. Lichen planus occurs mo
st often in middle-age and isn't usually serious. The rash can last months or ev
en years and may reappear after it goes away. When present in the mouth, it's im
portant to see your doctor to reduce your symptoms and to speed the healing of t
he lesions. Though rare, long-term lichen planus in the mouth can result in the
development of skin cancer.
7. Psoriasis With psoriasis, the life cycle of skin cells speeds up, resulting i
n a rapid buildup of rough, dead skin cells. These skin cells accumulate, formin
g thick silvery scales and itchy, dry, red patches that are sometimes painful. T
he inflammation — which usually affects the knees, elbows, trunk and scalp — tends t
o flare periodically and then subside for a time. Psoriasis almost always return
s, however. Psoriasis may occur in combination with arthritis. For some people,
this chronic condition is a mild nuisance. For others, it's totally disabling. T
alk to your doctor if your skin condition moves beyond the nuisance stage and ca
uses you discomfort and pain, if it makes performing routine tasks difficult, or
if you're concerned about the appearance of your skin.
8. Ringworm of the body (tinea corporis) Despite its name, ringworm isn't caused
by a worm but rather a fungus. It appears as itchy, red, scaly, slightly raised
, expanding rings on the trunk of the body, face, groin or thigh fold. The ring
grows outward as the infection spreads, and the center area becomes less activel
y infected. Ringworm is contagious and spreads several ways, including from skin
-to-skin contact or contact with a contaminated object such as unwashed clothing
. It can also spread from animal to person. This infection may resolve without t
reatment within four weeks, but it usually requires a prescription medication to
clear up. If you experience swelling, drainage, fever or excessive redness, see
your doctor immediately.
9. Rosacea Though rosacea can look like acne, it's actually a chronic, inflammat
ory skin condition of adults. It causes redness in the face and produces small,
red, pus-filled bumps or pustules. Rosacea mainly affects those between the ages
of 30 and 60, especially people with lightly pigmented skin. The cause of rosac
ea is unknown, but researchers believe it's likely due to a combination of genet
ic and environmental factors. For most people, rosacea is cyclic, meaning it ten
ds to flare up periodically, lessen in intensity, and then flare up again. Thoug
h it doesn't have a cure, treatments can control and reduce the signs and sympto
ms. If you experience persistent redness of your face, see your doctor for a dia
gnosis and proper treatment.
10. Shingles (herpes zoster) Herpes zoster, more commonly known as shingles, dev
elops when the virus that causes chicken pox (varicella zoster) reactivates afte
r lying dormant within the nerve cells. As this virus reactivates, pain or tingl
ing starts in a limited area, usually only on one side of the body or face. Subs
equently, a rash with small blisters appears. These blisters break, leaving behi
nd superficial ulcers that dry and form crusts. Shingles usually resolves in two
 to three weeks without treatment. For people over 60, the discomfort of shingle
s can take many weeks to even months to resolve. Contact your doctor if your sym
ptoms continue beyond that time frame or if the condition remains uncomfortable
or painful.
11. Swimmer's itch Parasites in contaminated water can enter the superficial lay
ers of exposed skin — skin not covered by a swimsuit, wet suit or waders. The orga
nisms soon die and cause a skin reaction called swimmers' itch. Initially, the r
eaction is mild and consists of redness of the affected skin followed by itchy,
red, raised areas. On subsequent exposures to the organisms, the reaction can be
more severe and persistent, sometimes causing blisters. Swimmers' itch isn't se
rious and usually resolves without medical treatment within one week. See your d
octor if the rash doesn't clear up in this time frame or if you're uncomfortable
or in pain.