Rashes

A rash is any type of irritated skin. It can be red, inflamed, itchy, or painful. The rash might consist of raised bumps on the skin. Sometimes the bumps are filled with pus.^1,2

Some rashes are caused by a minor irritation or contact with an allergen. For example, soap, household cleaning products, or even jewelry may irritate your skin. Some rashes may be linked to a more serious allergic reaction, such as to a specific medicine or seafood. Serious allergic reactions can be life-threatening and need immediate medical attention.¹

Other rashes can be caused by a:¹

• Fungal infection
• Virus
• Bacteria

More than 90 percent of people living with HIV will develop a skin rash at some point. A minor irritant may have caused the rash. But the rash might be a sign that you have a more serious infection or need to switch medicines. Seek medical help to be sure.^2,3

Rashes and acute HIV infection

An acute phase of HIV infection can occur within a few days of exposure to the virus or up to 6 weeks after exposure. Symptoms can include a fever, sore throat, and swollen lymph nodes. Many people mistake these symptoms for the flu. But another symptom of HIV infection may be a rash.^2,4

Both the rash and flu-like symptoms are caused by the body’s immune system reacting to the virus. The symptoms typically last about 2 weeks, although they may stay for several months.^2,4

Rash as a side effect of HIV medicine

Medicines can cause a rash as a side effect, and HIV medicines are no exception. Usually, these types of rashes are not serious and will go away by themselves within a few days or a week, but check with your healthcare provider to be sure.^2,3

In rare cases, a rash can be a sign of hypersensitivity to an HIV medicine. This can be life-threatening. In cases of hypersensitivity, the rash is usually accompanied by more serious symptoms such as:²

• Dizziness
• Feeling faint
• Problems breathing

Stevens-Johnson syndrome is another rare but serious reaction to HIV medicines. A person with this syndrome can develop:²

• A rash
• Flu-like symptoms
• Painful blisters anywhere on their body

People taking HIV medicines who have any of these symptoms should seek medical treatment immediately.²

Other rashes tied to HIV

Skin conditions are common in people with HIV infection. Some rashes are called opportunistic. They appear when the body’s immune system is lowered and take advantage of the body’s inability to fight back. Other rashes can take hold when the body’s immune system is overactive because a course of medicine is working.^3,5

Herpes viruses

People living with HIV are at risk from several types of the herpes virus. Herpes simplex is the virus that causes sores around the mouth or genitals. Herpes zoster causes shingles, which often form a painful rash on the torso. Antiviral medicines can treat both types.⁵

Kaposi sarcoma

Kaposi sarcoma is a type of cancer. It usually occurs only in advanced stages of HIV infection and is an indicator of AIDS. Brown, purple, or red marks (areas of damage called lesions) appear on the skin. Antiretroviral therapy (ART) helps to reduce the risk of Kaposi sarcoma. ART, chemotherapy, and radiation therapy are used to treat it.⁵

Molluscum contagiosum

This viral skin infection is marked by bumps on the skin. They can be pink or skin- colored. The condition is very contagious and is transmitted via touch. Medical treatment is the only way to make the bumps disappear. Laser, liquid nitrogen, or topical (applied to the skin) cream might be used.⁵

Photodermatitis

Photodermatitis causes the skin to darken after sun exposure. It often affects people of color and people with HIV. It can be a side effect of some ART medicines. Switching medicines may help, as will taking extra steps to protect the skin when outdoors.⁵

Prurigo nodularis

Itchy, crusty lumps on the skin are a symptom of this condition. It is more common in people of color and in people with more advanced levels of HIV infection. ART and steroid creams can help.⁵

Thrush

Thrush is a common fungal infection. It forms a thick white coating on the tongue or inside the cheeks. Medicines and mouthwashes can help to treat it, although it often reoccurs.⁵

How are rashes treated?

The treatment of a rash depends on its cause. Some rashes will go away on their own without needing any treatment. Others may require specific medicine. Those caused by a virus will require antiviral medicines. Fungal infections can be treated by antifungal medicines. Topical steroid creams and lotions can also help to ease any itch or dryness.^1-3,5

Prevention of rashes

People living with HIV can benefit from ART. This involves a combination of medicines to help strengthen the immune system. Maintaining a healthy immune system can, in turn, lessen the risk of certain infections and potentially help prevent rashes.^4,5