8 Types of Rashes That Can Be a Sign of COVID-19

Although rare, skin rashes and other changes may be a sign of COVID-19. Research has found that some people develop a COVID rash in response to high inflammation in the body. 

A study published in 2021 found that skin rashes might be less common than other signs of COVID-19. Still, the researchers point out that people can easily recognize skin changes, which may help detect the virus. Read on to learn how to identify some of the most common COVID-19 rashes.

What Causes a COVID-19 Rash?

Skin rashes are a rare symptom of COVID-19. Still, "[i]t's not unique that a virus would give you a skin rash," Mona Gohara, MD, a medical and surgical dermatologist based in Connecticut, told Health.

There's a lack of research on how and why COVID-19 rashes occur. Some evidence suggests a few theories.

For example, research has found that a high number of angiotensin-converting enzyme 2 (ACE2) receptors in the skin may cause rashes. ACE2 is a protein by which SARS-CoV-2, the virus that causes COVID-19, enters your body. A high density of ACE2 receptors in your skin may trigger a skin rash.

Other theories suggest that SARS-COV-2 in the tiny blood vessels supplying your skin may activate the release of cytokines, or proteins that regulate inflammation. High inflammation may cause a rash and itchy bumps, among other skin changes.

Types of COVID-19 Rashes

The authors of the 2021 study found a possible link between a positive COVID-19 test result and skin rashes. 

The researchers found that, among 336,847 people, 8.8% of those who tested positive reported skin-related changes. A rash was the only symptom for nearly 21% of people who tested positive for COVID-19, and 17% had skin changes before other symptoms developed.

The authors worked with the British Association of Dermatologists (BAD) to create a catalog of images of the most common skin manifestations of COVID‐19. Here are the main categories of possible skin changes to help you identify what a COVID-19 rash might look like.

COVID Toes

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COVID toes resemble chilblains, or pernio, a skin condition that typically occurs after exposure to cold weather.

You may develop purple or red sores on your toes. Some people may notice sores on their fingers. The top layer of your skin may peel away as COVID toes heal. You may notice scaly patches where the sores were.

COVID toes may happen months after the initial infection, Veronique Bataille, MD, Ph.D. and Mario Falchi, PhD, two of the authors of the 2021 study, told Health. COVID toes are more common in young people who may not have had symptoms, said Dr. Bataille and Falchi. 

COVID Hives (or Urticarial)

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COVID hives, or urticaria, appear suddenly and, over hours, quickly come and go. Hives are usually itchy and can affect any body part, including the face. 

According to the BAD, COVID hives can appear early on and last long after you fully recover from COVID-19.

Neck Eczema

Neck eczema can appear during or after COVID-19 infection and typically lasts for an extended period. The rash is usually itchy and can extend to the part of the chest exposed to sunlight. Generally, eczema may look pink on lighter skin or dark brown, gray, or purple on darker skin.

You do not have to have a history of eczema for neck eczema to develop, said Dr. Bataille. Most people included in the 2021 survey had no history of skin conditions.

Oral Rash

With oral rash, the inside of your mouth and lips may feel sore. As the rash subsides, your lips may become dry and scaly.

Vesicular and Papular Rash

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Vesicles are fluid-filled bumps, while papular lesions are raised, solid bumps. Vesicular and papular rashes are typically itchy.

These rashes can pop up anywhere on your body, but they usually develop on:

• Backs of your feet and hands
• Elbows
• Knees

Sometimes, vesicular and papular rashes are not so easy to identify. For example, the rashes may appear as tiny bumps all over your skin.

In people with COVID-19, vesicular and papular rashes can last long after the contagious stage is over. These rashes can appear many weeks after the onset of the infection.

Pityriasis Rosea

Pityriasis rosea, or a "herald patch," usually begins as a large circular or oval spot on your abdomen, back, or chest. Small spots later appear on your torso and arms. The spots often look like a Christmas tree in shape.

Pityriasis rosea may last several months before clearing.

Purpuric or Vasculitic Rashes

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Purpuric or vasculitic rashes appear as deep, purple or red spots and may cause bruise-like patches. Damage to your tiny blood vessels causes bleeding into your skin. As a result, purplish discoloration appears on your skin.

Viral Exanthem

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Viral exanthem is a common, widespread rash that occurs with viral infections, such as COVID-19. The rash is typically symmetrical, with multiple reddish blotches or bumps all over the body. Viral exanthem may appear alongside other symptoms of a viral illness, such as cough and fever.

How To Treat a COVID-19 Rash 

Some COVID-19 rashes go away on their own without treatment, such as COVID toes. If you have itching or pain, you can apply an over-the-counter (OTC) hydrocortisone cream to the affected area.

Other treatments for COVID-19 rashes depend on the type of skin changes you have and may include anticoagulants, antihistamines, or corticosteroids. Those medicines work by reducing inflammation in your body, which may reduce the appearance of skin rashes. Some of those treatments are available in oral or topical forms. 

"Your dermatologist can help you with your skin by suggesting treatments for any painful lesions, but stay safe and call them or arrange a visit virtually," Mary Stevenson, MD, a dermatologic surgeon at NYU Langone Health, told Health. Let a dermatologist know if you have COVID-19 symptoms or have tested positive. 

When To See a Healthcare Provider

COVID-19 rashes have no long-term effects, with most clearing up on their own, said Dr. Bataille and Falchi. Still, you may want to consult a dermatologist if at-home treatments fail or your COVID-19 rash worsens.

"For some, the rashes are quite recurrent and can come and go for weeks and months," said Dr. Bataille and Falchi. "Some of the rashes can be very itchy and affect sleep, so there may be a need for a prescription from a [a healthcare provider]."

In rare cases, a skin rash that develops days to weeks after COVID-19 infection is a multisystem inflammatory syndrome (MIS) symptom. MIS is a severe condition in which inflammation affects your brain, gut, heart, and skin.

Seek medical attention right away if you develop a skin rash alongside other MIS symptoms like:

• Bloodshot eyes
• Diarrhea
• Low blood pressure, which may make you feel dizzy or lightheaded
• Stomach pain
• Vomiting

A Quick Review

Skin rashes and other changes are rare symptoms of COVID-19. Being able to identify different types of COVID-19 rashes may help detect the virus and keep it from spreading.

Consider taking a test if you develop a skin rash or other COVID-19 symptoms. If you test positive, the Centers for Disease Control and Prevention (CDC) advises isolating for five days and wearing a high-quality mask through day 10.

Seek immediate medical attention if you develop worsening or severe symptoms like blue lips or skin and trouble breathing.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.