My Skin, My Health

Rashes are abnormal changes in skin color or texture. They usually result from skin inflammation, which can have many causes.

There are many types of rashes, including;

Eczema (also called atopic dermatitis)
Granuloma annulare
Lichen planus
Pityriasis rosea
Shingles

Skin rashes can occur because of a variety of factors including heat, infections, medications and environment stimulants. Here is a rundown of the most common types of skin rashes

Atopic Dermatitis

Also known as Eczema, atopic dermatitis is a common skin disease in children. It is rare for adults to develop atopic dermatitis. According to the American Academy of Dermatology, 90% of people get atopic dermatitis before the age of 5. About 50% of people who get atopic dermatitis during childhood continue to have milder signs as an adult. If a child gets atopic dermatitis, it will show as dry and scaly patches, often located on the scalp, forehead, and face. This type of rash is extremely itchy, but scratching can lead to a skin infection. While treatment for atopic dermatitis cannot cure it, it can control it. Your local Forefront Dermatologist will work with you to create a treatment plan that often includes medicine, skincare, and lifestyle changes.

Contact Dermatitis

Another type of dermatitis is allergic contact dermatitis. Contact dermatitis occurs when you come in contact with something that causes a reaction in the form of a rash. Common causes of contact dermatitis include poison ivy, nickel, and rubber. Symptoms of contact dermatitis rarely appear on contact; it may take a few days for your skin to react. Signs of contact dermatitis include itchy, red, swollen skin, and oftentimes fluid-filled blisters. For mild reactions, avoiding the allergen allows the rash to clear. For severe cases, please see your local Forefront Dermatologist for help.

Shingles

The interesting fact about shingles is that anyone who has ever had chickenpox is susceptible to getting shingles. After chickenpox clears, the shingles virus stays in the body. If that virus is ever reactivated, the result is shingles. Unlike chickenpox where itching is common, pain is the common symptom with shingles. A shingles rash typically appears in groups of clear blisters and typically last 2 to 3 weeks. Shingles is most common in older adults. For individuals over the age of 50, there is a vaccine available that reduces the risk of developing shingles by 51 percent.

Swimmer’s Itch

Common in spring and summer is a swimmer’s itch. Swimmer’s itch, also known as cercarial dermatitis, is a rash that occurs after swimming in freshwater lakes or ponds. The rash is caused by an inflammatory reaction to microscopic parasites that originated with waterfowl. These parasites are released into the water when the bird lands in the water. Swimmer’s itch typically appears as reddish pimples or small blisters, with the skin usually feeling tingly, burning or itchy. Swimmer’s itch is not contagious and can be easily treated with corticosteroid creams. If itching is severe, please see your local Forefront Dermatologist for a treatment plan.

Pityriasis Rosea

Pityriasis rosea, also known as the Christmas tree rash, most often occurs in the spring and fall. This common skin disease causes patches on the skin, typically starting with a larger patch, the mother “herald” patch, and spreading as smaller patches, daughter patches. Pityriasis rosea is typically seen in adolescents and young adults and is uncommon for those over 60 years old. The cause of pityriasis rosea is still unknown, but research shows it is not caused by an allergy, fungi or bacteria. It usually goes away without treatment, but rashes can last 6 to 8 weeks. If itching becomes unbearable, schedule an appointment with your local Forefront Dermatologist for a treatment plan.

Symptoms of Skin Rash

Symptoms of skin rashes depend on the condition and can be identified by some hallmark characteristics.

Symptoms of eczema (atopic dermatitis) most often affect the hands, elbows, and "bending" areas such as the inside of the elbows and back of the knees and include:

Itching
Skin redness
Flaking skin
Dry, scaly, or crusted skin that can become thick and leathery from scratching
Small, fluid-filled blisters that may ooze when scratched
Infection of the areas of broken skin
Plugged hair follicles that cause small bumps, usually on the face, upper arms, and thighs
Darkening of the skin around the eyes

How Is Skin Rash Diagnosed?

Skin rashes are diagnosed with a history and physical examination of the skin. Tests may be used to determine the type of rash and/or the cause:

Skin biopsy
Skin scraping
Blood tests

Treatment for Skin Rash

Treatment for skin rashes depends on the type of rash.

Treatment for eczema (atopic dermatitis) includes:

Fragrance-free moisturizers that contain ingredients such as ceramides, glycerin, and mineral oil
Over-the-counter (OTC) creams and ointments that contain hydrocortisone (Cortizone-10, Cort-Aid, Dermarest Eczema, Neosporin Eczema) to help relieve itching, swelling, and redness
Prescription-strength cortisone creams, pills, and shots, may be indicated for severe cases
Topical immunomodulators (TIMs) such as pimecrolimus (Elidel) and tacrolimus (Protopic) can help prevent flare-ups in mild-to-moderate eczema
Crisaborole (Eucrisa) ointment may be used for mild to moderate psoriasis
Dupilumab (Dupixent) helps treat itch in patients with moderate to severe atopic dermatitis
Antibiotics to treat infected skin
Antihistamines to help relieve itching
Phototherapy

Granuloma annulare does not always need treatment, except for cosmetic reasons, and the rash will usually go away on its own over time. If granuloma annulare symptoms or appearance are bothersome, treatment includes:

Steroid creams or ointments for rash
Freezing lesions with liquid nitrogen
Injection of steroids directly into the rings of bumps
Ultraviolet light therapy for severe cases
Oral steroids for severe cases

Treatment for lichen planus includes:

Antihistamines such as diphenhydramine (Benadryl) to treat itching
Topical steroid ointments, creams, or gels
Steroid injections, prednisone, or other drugs that suppress your immune system for more severe cases
Retinoids
Calcineurin inhibitors such as pimecrolimus (Elidel) and tacrolimus (Protopic)
Anesthetic medicines to numb the skin and ease pain, especially for sores on the mouth or genitals
Phototherapy

In mild cases, pityriasis rosea may not need to be treated and many cases will go away on its own. When treatment for pityriasis rosea is indicated, it may include:

Oatmeal bath in lukewarm (not hot) water to soothe skin
Keep the body cool
Use fragrance-free moisturizer
Oral antihistamines such as diphenhydramine (Benadryl) to treat itching
Over-the-counter topical anti-itch medications
Prescription steroids to soothe itching
Exposure to sunlight or ultraviolet light may help sores heal faster

Treatment for shingles includes:

Antiviral medications: acyclovir (Zovirax), famciclovir (Famvir), alacyclovir (Valtrex)
Antibiotics, if the rash becomes infected
Pain-relieviers
Anti-seizure medications for postherpetic neuralgia pain: gabapentin (Neurontin) and pregabalin (Lyrica)
Tricyclic antidepressants for postherpetic neuralgia pain: amitriptyline, desipramine, and nortriptyline
Capsaicin cream (Zostrix) for postherpetic neuralgia
Topical anesthetics: lidocaine (Xylocaine gel or Lidoderm skin patch)
Prescription pain medications (opioids)
Steroid injections

Easy Home Remedies for Rashes

Cold compress

One of the fastest and easiest ways to stop the pain and itch of a rash is to apply cold. Whether you choose a cold compress, cool showers, or damp cloth, cold water can bring immediate relief and can help stop swelling, ease itching, and slow the progression of a rash.

Consider making or purchasing fabric bags stuffed with ice. They freeze well, and they can be heated for other uses.

Cold limits blood flow to an inflamed area. When you apply ice or cold water to a rash, it can help reduce swelling and inflammation and can stop itching almost immediately. For rashes that cover more of the body or that affect an area that is difficult to cover with an ice pack, a cool bath or shower may provide relief.

Oatmeal bath

Oats (avena sativa) have been used for centuries to treat many skin conditions, from eczema to burns. The U.S. Food and Drug Administration (FDA) approved the use of oatmeal in suspension (colloidal oatmeal) as a skin protectant in 2003. Today there are many over-the-counter skin products containing oatmeal.

Colloidal oatmeal dissolved in a bath can relieve itchiness. Commercial brands of oatmeal bath, like Aveeno, come in ready-to-use packets, measured for a single bath. Or you can very finely grind regular oatmeal in a food processor or blender and add 1 cup to bathwater.

The oatmeal works as an anti-inflammatory and anti-oxidant to relieve skin itchiness, dryness, and roughness.

Aloe vera (fresh)

The aloe vera plant has been used for centuries as an aid to health and skin care. You may be familiar with its use to promote the healing of small cuts in the kitchen.

In addition to wound healing, aloe has been used as an anti-inflammatory, antimicrobial, antiviral, and antioxidant. Although it’s widely used, much of the evidence for its effectiveness is anecdotal, and more studies are needed. Aloe contains vitamin B-12; calcium; magnesium; zinc; vitamins A, C, E; and essential fatty acids. It also contains enzymes, carbohydrates, and sterols, which are thought to contribute to its anti-inflammatory effects.

Coconut oil

Coconut oil, extracted from the meat and milk of coconuts, has been used for centuries in tropical countries as a cooking oil and skin moisturizer. It’s high in saturated fats and has antiseptic and anti-inflammatory properties.

People allergic to coconut should test it first on one spot on the inner arm. If no reaction occurs within 24 hours, it should be safe to use. Discontinue use if irritation develops.

The medium-chain fatty acids in virgin coconut oil are thought to have antibacterial, antiviral, anti-inflammatory, and healing properties. A monoglyceride formed from lauric acid in coconut oil has been found to be an antibacterial. Lauric acid makes up about half the fat content of coconut oil.

Tea tree oil

The tea tree (Melaleuca alternifolia) is native to Australia where it was originally used by the aboriginal people as an antiseptic and anti-inflammatory. It’s an essential oil that is steam-distilled from the plant.

Tea tree oil is potent and can be irritating if it touches the skin without dilution in a cream or oil.

Baking soda

Baking soda (sodium bicarbonate) is an old household remedy for itchy skin — rashes, poison ivy, or bug bites.

The chemical makeup of baking soda acts as a buffer, keeping solutions in stable acid-alkali balance. For this reason, baking soda may sooth your skin, putting the skin’s pH into balance.

Indigo naturalis

Indigo naturalis is a dark-blue powder made from a dried Chinese herb (Qing Dai).

There are risks when using any herbal remedy, including a lack of standards in purity and dosing, potential interactions with prescribed medications, and the danger of damaging organs such as the liver or kidneys.

Apple cider vinegar

Apple cider vinegar is a centuries-old remedy for skin and other ailments. It’s known to have antimicrobial properties as well. There’s plenty of anecdotal evidence for its use, but only a limited number of scientific studies.

Epsom salts (or Dead Sea salts)

Epsom salts (magnesium sulfate) have traditionally been used in a warm bath to soothe muscle aches and pains. But soaking in Epsom salts or magnesium- and mineral-rich Dead Sea salts may also help relieve itching and scaling.

Magnesium salts have been found to improve the skin barrier function, help the skin retain moisture, and reduce inflammation. Bathing in the Dead Sea has been used for centuries to heal skin ailments.

Plant oils

Many different plant oils can be used effectively to moisturize itchy skin. These include:

olive oil
safflower seed oil
argan oil
jojoba
chamomile

Each oil has different compounds and different effects on the skin.

In general, oils act to reduce inflammation and create a protective skin barrier.

Olive oil. This oil is known to reduce inflammation and help in wound healing. It contains oleic acid and smaller amounts of other fatty acids, plus 200 different chemical compounds.
Safflower seed. An anti-inflammatory, safflower seed oil is 70 percent polyunsaturated linoleic acid. Two of its ingredients have shown anti-inflammatory properties: luteolin and glucopyranoside.
Argan oil. Research suggests that, with daily use, this oil improves skin elasticity and hydration. It’s composed mostly of mono-unsaturated fatty acids and contains polyphenols, tocopherols, sterols, squalene, and triterpene alcohols. It also promotes softening and helps delivery of topical drugs.
Jojoba oil. An anti-inflammatory that also helps repair the skin barrier in dermatitis, jojoba oil is found in many cosmetics. It also helps you absorb topical drugs.
Chamomile oil. This herb is a traditional remedy for calming skin. You may be familiar with it as a relaxing herbal tea. But used topically, it has three ingredients (azulene, bisabolol, and farnesene) that produce anti-inflammatory or antihistamine effects. A 2010 study showed that chamomile in oil form decreased scratching and lowered histamine activity in mice who had atopic dermatitis.

12 signs you need to seek medical care for your rash

Sometimes, a rash is a sign something serious is going on with your body. It’s a good idea to keep an eye on any rash you develop and watch for these signs. Seek medical care if any of them develop.

You have a fever
The rash is spreading
The rash area hurts
The rash came on suddenly
The rash is beginning to blister
You see signs of infection in the rash
You have difficulty breathing
The rash looks like large purple patches
Bruises are forming in or around the rash
The rash is in a circle shape
You’ve had the rash for longer than a week
The rash is causing you discomfort or concern

It’s a good idea to get any rash that is causing you to feel significant discomfort or concern checked out by a dermatologist or other healthcare professional. While it might be simple contact dermatitis, it’s still a good idea to consult a doctor.