Skin rash

What is a skin rash?

A skin rash is a term used to describe a change in your skin’s colour or texture. Rashes are very common and can appear on any part of the body. Some flare up quickly and disappear after a few hours, while others may cause more persistent or recurring problems.

What are the different kinds of rash?

To help you identify and familiarise yourself with skin rash types, we’ve listed some of the most common causes and what symptoms to look out for.

Bacterial skin rash

Just like viruses, bacterial infections may cause a skin rash that doesn’t affect your general health. Our skin has lots of bacteria on it and most cause no harm. But these rashes can also be a sign of a more serious illness and so need to be checked out.

• Impetigo

Impetigo is very common and usually starts with small red spots that rapidly become itchy blisters. These blisters can burst and leave crusty, brown/yellow (‘honey crusting’) patches. The rash tends to occur around your nose or mouth. Impetigo spreads very easily, for example in a swimming pool. Keep the sores, blisters and dry patches clean and dry. It is important to see a doctor if you think you or your child has impetigo as antibiotic treatment can speed up the recovery time and reduce complications.

• Scarlet fever

Scarlet fever often starts with a sore throat and red ‘strawberry’ bumps on your tongue. A widespread rash then appears on your body of tiny red/pink spots and makes your skin feel rough like sandpaper. Other common symptoms include a stomach ache, nausea and vomiting. This infection mostly affects young children and is treated with antibiotics. It is very contagious.

• Erysipelas

Erysipelas is a skin infection affecting the upper layers of the skin. The rash often occurs on the legs or near damaged skin. It often starts with nausea and vomiting, tender lymph nodes and sometimes a high temperature. The infection can be treated with antibiotics.

• Cellulitis

Cellulitis is a very common bacterial skin infection that looks like areas of red, painful and hot skin. It usually only occurs on one part of the body and can be associated with temperatures, chills and feeling unwell. It is important to see a doctor quickly as, left without antibiotics, the cellulitis can become serious.

• Folliculitis

Folliculitis is inflammation of the hair follicle which can occur either due to infection, irritation or injury. Frequent shaving, hot tubs or other medical conditions can predispose to getting folliculitis. The rash appears as one or more sore small boils around the hair follicle. Antiseptic cleaners or antibiotics can help resolve the condition.

Fungal skin rash

Fungi can cause infections of the skin, nails, mouth and genital area. Fungal skin infections cause redness of the skin and rashes that can itch, sting or flake. Yeast fungi that are normally present on or inside your body may multiply out of control and cause an infection. Skin rashes may also be caused by external fungi, such as the dermatophytes that cause foot and nail fungus, or the zoonotic fungi that can be transmitted between animals and humans.

• Athlete’s foot 

The symptoms of athlete’s foot include itchy white patches or scales between your toes, blisters and cracked skin. Athlete’s foot will usually disappear if you keep your feet clean and dry, avoid tight footwear and by wearing shoes in public places e.g. swimming pools. However, over-the-counter medicines and prescription creams and tablets can also help. 

• Fungal nail infection

A fungal nail infection typically affects your toenails. The nail becomes discoloured, thick and spongy. Sometimes the nail will lift and scaling develops under the nail. Mild infections will sometimes be successfully treated with nail lacquer but often lengthy courses of antifungal medications are needed to get rid of the fungus. 

• Intertrigo

This infection causes an itchy and sometimes flaky rash where your skin rubs together or traps moisture. You can get a fungal rash in your armpits, under your breasts, or between your buttocks (fungi multiply in warm and moist places). The rash may clear up if you keep the skin clean and dry, but antifungal creams can be purchased from the pharmacy (e.g. canesten) or prescribed to treat the infection. 

• Ringworm

Ringworm is a ring-shaped rash with flaky edges. Children can be infected by pets such as dogs, cats, guinea pigs and rabbits. The infection can also be passed between people, for example during contact sport. Ringworm is mainly treated by over-the-counter antifungal medicine but it can be helpful to wear loose clothing and keep your skin clean and dry.

• Pityriasis versicolor

Pityriasis versicolor is a fungal infection that causes patches of skin to become scaly. The patches may be brown, pink or paler than the surrounding skin and, on some occasions, are mildly itchy. The rash often develops on the chest, back, or other areas with sebaceous glands. Humidity, sweat, heat, rich moisturisers and oily skin will make you especially prone to infection. The infection can be treated with antifungal medicines either in a shampoo, gel or tablet form.

Viral rash

Viral skin rashes are less likely to make you feel unwell as they are usually localised (like a cold sore). However, a rash may also be one of many symptoms caused by a viral infection. They can be different sizes and shapes and some can be itchy.

Children commonly develop a rash if they develop a viral infection but it is important to check that the rash is not caused by a serious infection such as meningitis. If your child has a rash make sure you do the ‘glass test’. Press the glass over the rash. If the rash remains (known as a non-blanching rash) then please seek urgent medical help. 

A viral infection can be spread in different ways, including close physical contact. There are many viruses that can cause rashes including measles and rubella.

• Herpes simplex

Herpes causes sores or blisters to form, but you can also carry the herpes simplex virus (HSV) without showing any symptoms. One type of HSV virus causes cold sores mainly in and around the mouth – and the other type causes genital herpes. After the first infection with HSV, the virus remains in the nerves where it can cause ‘attacks’ from time to time. These attacks can sometimes be triggered by other infections, like a cold, hormonal changes, stress or injury to the area. Cold sores can be treated with over-the-counter medicine, but treatment for genital herpes usually requires a prescription.

• Warts

Warts are small, round (‘cauliflower-like’) lumps that form on the skin and may feel sore and itchy. Warts that occur on the sole of the foot are called verrucas. They are caused by the human papillomavirus (HPV). There are lots of HPV variations but only some can infect the skin. They tend to have a hard edge and a softer centre, sometimes with tiny black spots. These black spots are not the virus (they are too small to see) but small blood vessels. Warts usually disappear by themselves, but this may take a long time. You can also treat them with over-the-counter medication. 

• Shingles

Shingles is caused by the herpes zoster virus. Anyone who has had chickenpox can develop shingles. It is caused by the reactivation of the virus which remains dormant after the initial chickenpox infection so it is more common in adults. The first sign of shingles is a painful, tingling feeling followed by a rash of blisters occurring in blotches on one side of your body. A high temperature, headache, dizziness and fatigue are other common symptoms. While the blisters usually clear up after 2-4 weeks, the pain can linger for much longer.

• Covid skin rash

There is a wide range of Covid symptoms, including a high temperature, a new, continuous cough, and changes to your sense of taste and smell. Another recognised coronavirus symptom is a skin-coloured or purple rash, which can be found on your hands and feet (sometimes called ‘Covid toes’). This usually disappears in a matter of days.

Contact dermatitis

Contact dermatitis causes the skin to become itchy, blistered, dry and cracked. This reaction is usually triggered by an irritant or allergen within a few hours or days. As well as avoiding whatever triggered the dermatitis, you may also be advised to use an emollient moisturiser or a steroid cream.

Insect bites

Insects and other tiny creatures can cause temporary skin rashes by piercing, biting or burning the skin. Redness, swelling and itching are common skin reactions. If you are allergic to an insect bite or sting, you may experience a stronger reaction that needs urgent medical attention.

• Wasps, mosquitoes and other insects

Insect bites may cause pain, redness, swelling and itching. The symptoms usually disappear in one or two days – and over-the-counter medicine can alleviate your symptoms in the meantime. 

• Ticks

Ticks are commonly found in high grass and woodlands. Tick bites themselves are painless and most bites are harmless. However, some ticks carry the Borrelia bacteria that can lead to Lyme disease. The most obvious symptom of Lyme disease is a circular red rash (often described as looking like a ‘target’)  around the tick bite. The majority of people infected with Lyme disease in Europe experience this rash. You may also develop flu-like symptoms. Lyme disease is treated with antibiotics and it is important to treat this early

• Lice and fleas

Head lice, pubic lice and bedbugs may irritate your skin and cause itching. These symptoms can be treated with over-the-counter medication and hygiene measures like thoroughly cleaning your bed linen.

• Mites and scabies

Mites can be found in the fur of pets and cause an itchy rash. 

Scabies is a skin disease caused by a tiny parasite that burrows under your skin. It can also cause itching (which is typically worse at night), lumps, blisters or eczema-like rashes. Your symptoms can be treated with over-the-counter medicines and by thoroughly cleaning your towels and bedlinen.

Eczema

Eczema is a very common skin rash that makes your skin red, itchy and flaky. It is a chronic disease and is characterised by episodes of flare and more settled periods. Atopic eczema is common among children and young people. The main treatment for eczema is moisturising creams (emollients) and sometimes hydrocortisone creams (corticosteroids).

Cancer skin rash

Sometimes cancer can cause itching. This can be due to dry skin, infections, allergies, jaundice or medications being used to treat the cancer. This can be very distressing, but there are several options for treating and managing these symptoms, such as medication. 

Dry skin rash

Dry skin, especially common in winter, can cause a rash that appears cracked, dry and, in severe cases, inflamed. Frequent scratching of dry skin can also lead to skin rashes like dermatitis or eczema when the skin becomes red in addition to dry and scaly. Any part of the body can be affected but the lower legs are common sites. It's important to use emollients regularly to keep the skin hydrated. It may also help to reduce the amount you are washing, keep showers short with lukewarm water and avoid soap. 

What causes skin rashes?

A skin rash is often caused by an allergic reaction or sometimes an insect bite, or they could be a result of a viral infection. Rashes can also be caused by chronic skin conditions like eczema or psoriasis.

In some cases, a skin rash is a sign of a more serious condition, and will need medical treatment. If you’re concerned about a skin rash, it does not go away, or you have other symptoms too, always speak to a doctor for medical advice.

What causes skin rash and itching?

A skin rash that comes with itchy skin has lots of different causes. Possible causes include skin reactions to heat, allergens or hives; long-term conditions like eczema or psoriasis, fungal skin infections like ringworm or athlete’s foot and insects living on the skin such as scabies. 

Itchy skin is not usually a sign of anything serious and will usually pass on its own. You can often manage it yourself by following the guidance below or using a cream, lotion or antihistamine medication recommended by a doctor.

Best skin rash treatments

Rashes come in many different forms and develop for lots of reasons. It’s really important to speak with a doctor if you are unsure as to what the rash is so that you get the right treatment for you. They can also recommend a suitable brand of over-the-counter products.

For mild skin rashes or regular flare-ups there are some lifestyle measures that can be preventative, speed up recovery and ease some of the discomfort:

• Use mild soap and moisturisers rather than scented (often advertised for sensitive skin)

• Stick to the same cosmetic products if you know you’re prone to skin rashes

• Wash your skin with warm water, rather than hot

• Pat the area of skin dry instead of rubbing

• Avoid scratching the skin to reduce your risk of infection

• Calamine can also be calming for the skin and relieve some skin rashes

• If the skin rash causes mild pain, paracetamol or ibuprofen may be useful, but these are not a long-term solution and will not treat the cause

When to worry about skin rash in adults

If you’re uncertain about the cause of your rash or if you’re worried about your symptoms, it’s best to speak to a doctor. 

Always seek medical help for persistent skin reactions and rashes that are not helped by self-care and over-the-counter treatment. It’s also important to get medical help if you have signs of diseases that require infection tracing such as measles or rubella.

Visit the emergency department if you have a rash (particularly one that doesn't disappear under pressure) and feel severely unwell or have a high temperature. Call 999 or visit the emergency department if you experience a sudden allergic reaction that may be a sign of anaphylactic shock – this is a potentially life-threatening condition.