While most people exposed to COVID-19 watch for symptoms like a dry cough, loss of taste, and difficulty breathing, many overlook its impact on the skin. Although less common, the coronavirus disease can produce skin symptoms like red bumps, hives, water blisters, and rashes.
Fortunately, most of these clinical features dissipate over time with the right care. If you want to protect your skin from a COVID-19 outbreak, this guide will tell you what signs to look out for and how to treat them.
The impact of COVID-19 on the skin
Here are some cutaneous manifestations you might experience after becoming infected with COVID-19.
COVID digits (or COVID toes) refer to the swelling of extremities and may appear as bruising or darkening. Sometimes, the skin around your nails will peel.
Generally, COVID toes last about 12 weeks and are the most common cutaneous manifestation. During this time, you can relieve pain from these skin lesions through paracetamol. Contact your healthcare provider immediately if you experience extreme redness or notice the rash spreading rapidly.
When the body is under immense stress, it can cause unusual symptoms like COVID nails, a mild disease that changes your body in the following ways:
- Mees’ lines: These horizontal white lines appear across the fingernails and toenails because of abnormal protein production.
- Beau’s lines: These horizontal indentations occur at the base of the nails due to a temporary halt in nail growth from stress.
Though these acral lesions are commonly referred to as COVID nails, only 1-2% of COVID patients experience them.
Sores and ulcers
Sores and ulcers often appear around the lips or inside the mouth and last an average of two weeks. Studies found that lesions in the oral mucosa were common in hospitalized patients in particular.
You can combat these issues using antiseptic mouthwash or medication. While usually mild, you will want to consult your pharmacist if these sores and ulcers last more than three weeks, keep reoccurring, or become enlarged or painful.
Also known as vesicular eruptions, water blisters are fluid-filled sacs that often appear on the hands. They are more common in middle-aged patients and last about 10 days.
Contrary to popular belief, it isn’t always recommended to pop a water blister. These vascular skin symptoms often heal without the help of any medication.
Because vesicular lesions are not a common cutaneous finding in young adults, you will want to seek a tertiary care hospital immediately if you are 30 or below.
When you contract COVID-19, the body may shut down unnecessary activity, such as hair growth. That said, people with high iron levels often recover quickly.
In severe cases of COVID-19, older patients might develop livedo or a fishing-net-looking red and blue pattern on the skin. These cutaneous lesions often occur due to blockages in the blood vessels as part of the body’s defensive response to the virus.
Fortunately, these skin manifestations disappear without treatment unless you suffer from an underlying condition.
Herpes simplex virus and varicella-zoster virus
Further research has determined that indications of HSV-1 and VZV were more common in patients who had already contracted COVID-19. However, the skin disease was more common in patients with more severe effects, such as acute respiratory distress syndrome and viremia. Still, research remains young, and the prognostic implications of COVID-caused HSV/VZV are limited.
Lesional skin biopsies have shown that clinical and histopathological features like viral exanthems happen after contracting COVID-19. In some cases, viral exanthem might even be one of the first cutaneous signs of COVID-19. A more in-depth systematic review also posed a possible correlation between vascular lesions and neurological symptoms like headaches.
Are rashes a sign of COVID-19?
Rashes are occasionally a sign of COVID-19. While some individuals who develop COVID-19 may experience an itchy rash due to the virus, a 2021 review stated that the exact incidence of these symptoms remains unknown.
In addition, skin issues after COVID are not the most common. In fact, most patients don’t experience cutaneous manifestations related to COVID.
However, it’s possible to experience skin manifestations like discoloration, swelling, and itching. Skin manifestations are also more common in patients suffering from severe disease.
If you are concerned about skin findings, your best bet is to get a COVID test, as there is no indication that rashes are an early diagnostic clue to SARS-COV 2.
What does a COVID rash look like?
How COVID-inflicted skin conditions look may vary across individuals. Here are a few common systemic symptoms to look out for:
- Hives: These red, itchy patches resemble hives and can appear on the limbs and torso.
- Pinpoint spots: These dark spots appear on the legs.
- Macules and papules: Some itchy spots can appear flat or raised on the torso.
- Urticaria: Urticarial lesions are itchy red welts that appear all over the body.
While most COVID-related rashes go away independently, these two skin conditions require immediate medical attention:
- Pediatric inflammatory multisystem syndrome (PIMS): Children affected by COVID-19 might develop PIMS, an inflammatory rash coupled with symptoms like a high fever, swollen limbs, aches and pains, cold sweats, diarrhoea, headaches, and fatigue.
- Purpura: This vesicular rash may appear purple, dark brown, or black due to internal bleeding. You may develop a severe septicemia infection if you experience these cutaneous lesions with a high fever.
Causes of COVID-related rashes
The reasons why some people get rashes while others don’t remain unknown to researchers. However, experts predict these rashes might occur for the following reasons:
- Slow immune response or compromised immune system
- Increased blood clotting (hypercoagulability)
- Directly infected skin tissues
- ‘Complement’ response leading to damaged blood vessels seen in chilblain-like lesions
In addition, younger patients might experience multi-system inflammatory syndrome in children (MIS-C) , a severe complication that causes body parts to break out or become inflamed. MIS-C can manifest as a rash, redness in the extremities, or dry and cracked lips.
Children who develop MIS-C should get intensive care unit admission immediately.
How long does a COVID-19 rash last?
How long a COVID-19 rash lasts will depend on the rash you develop. On average, most individuals have a rash for eight days. However, a rash can disappear as quickly as two days or as long as 12 days.
Meanwhile, COVID toes last 10 to 14 days.
Can you get COVID rashes if you are vaccinated?
Yes, you can still get COVID rashes even after being vaccinated. Skin symptoms can occur after receiving the COVID-19 vaccine and are either mild or severe.
Mild allergic reactions can occur within four hours of receiving your vaccine and manifest as hives, swelling, or wheezing. Severe or anaphylactic reactions occur immediately after receiving your vaccines and can cause hives, throat closure, or dizziness.
You might also develop a rash around the injection site, commonly known as the ‘COVID arm’. This skin condition most often occurs with the Moderna vaccine. You might notice redness, swelling, warmth, pain, and itching for about four days.
The best ways to treat COVID-related rashes
The best way to treat COVID-related rashes will depend on your doctor’s advice. While many COVID-related rashes disappear independently, other symptoms may require additional treatment. For example, some rashes may require the same treatments as other skin diseases like HS, atopic dermatitis, and VZV.
Below are a few ways to treat mild symptoms at home:
- Oatmeal baths: Colloidal oatmeal has anti-inflammatory properties that help reduce itching and swelling. In addition, starches in oatmeal increase moisture, battling dryness and flakiness in the skin.
- Topical creams and ointments: You can use topical corticosteroids or calamine lotion to alleviate swelling and itching in the area.
- Antihistamines: Over-the-counter antihistamines can also suppress itching and rashes.
- Cool compresses: Applying ice to the affected area can decrease swelling and inflammation by restricting blood circulation.
- Personal protective equipment: While wearing personal protective equipment like masks won’t treat existing cutaneous manifestations, they can prevent future ones. Protect yourself by wearing the appropriate mask type in public.
- Other preventive measures: Masking up isn’t the only way to prevent future outbreaks due to COVID-19. You can get a skin biopsy to rule out other skin diseases that may exacerbate the effects of SARS-COV-2.
When to see a doctor
Rashes associated with COVID-19 don’t always require a doctor’s attention. In most cases, treating mild cases can be easily done at home with the help of systemic corticosteroids, DIY remedies, and basic relief.
However, there are some cases in which you should call your doctor for severe cutaneous manifestations. Seek medical attention if the following symptoms coincide with your rash:
- High fever
- Other signs of infection
- Rapid spreading all over the body
- Difficulty breathing
- Bluing of the lips, nails, and skin
- Trouble sleeping or staying awake
The bottom line
Though dermatological manifestations from COVID-19 are not very common, it’s best to be aware of them and know how best to alleviate these symptoms.
A coronavirus infection can cause dermatologic manifestations in hives, blisters, rashes, and swelling, but they typically subside independently. Generally, most of these cutaneous manifestations disappear within a week, though this recovery period may vary.
If these skin manifestations begin to spread rapidly, become painful, or cause other symptoms, consult with your general physician.
For more information on Post-COVID skin problems and any other related symptoms, talk to us. Discover how you can overcome Post-COVID effects and lead a healthy life.