Rash, Age 12 and Older
Healthy skin provides a barrier between the inside of the body and the outside environment. A rash means some change has affected the skin.
Rashes are generally caused by skin irritation, which can have many causes. A rash is generally a minor problem that may go away with home treatment. In some cases a rash does not go away or the skin may become so irritated that medical care is needed.
In adults and older children, rashes are often caused by contact with a substance that irritates the skin (contact dermatitis). The rash usually starts within 48 hours after contact with the irritating substance. Contact dermatitis may cause mild redness of the skin or a rash of small red bumps. A more severe reaction may cause swelling, redness, and larger blisters. The location of the rash may give you a clue about the cause.
Contact dermatitis does not always occur the first time you are in contact to the irritating substance (allergen). After you have had a reaction to the substance, a rash can occur in response to even very small amounts of the substance. Contact dermatitis is not serious, but it is often very itchy. Common causes of contact dermatitis include:
- Poisonous plants, such as poison ivy, oak, or sumac.
- Soaps, detergents, shampoos, perfumes, cosmetics, or lotions.
- Jewelry or fabrics.
- New tools, toys, appliances, or other objects.
- Latex. Allergy to natural rubber latex affects people who are exposed to rubber products on a regular basis, especially health care workers, rubber industry workers, and people who have had multiple surgeries. Latex allergies can cause a severe reaction.
Rashes may occur with viral infections, such as herpes zoster; fungal infections, such as a yeast infection (Candida albicans); bacterial infections, such as impetigo; and sexually transmitted diseases (STDs). Rashes may also occur as a symptom of a more serious disease, such as liver disease, kidney disease, or some types of cancer.
Rashes may also appear after exposure to an insect or a parasite, such as the scabies mite. You may develop a rash when you travel to a rural area or go hiking or camping in the woods.
A rash may be a sign of a chronic skin problem, such as acne, eczema, psoriasis, or seborrheic dermatitis. Other causes of rash include dry, cold weather; extremely hot weather (heat rash); and emotional stress. Emotions such as frustration or embarrassment may lead to an itchy rash.
The need for medical treatment often depends on what other symptoms are present. A rash that occurs with other symptoms, such as shortness of breath or fever, may mean another problem, such as a serious allergic reaction or infection.
A very rare and serious type of generalized red rash is toxic epidermal necrolysis (TEN). This rash may cause the skin to peel away, leaving large areas of tissue that weep or ooze fluid like a severe burn. If this type of rash occurs, you need to see a doctor. TEN may occur after the use of some medicines.
Use the Check Your Symptoms section to decide if and when you should see a doctor.
Most rashes will go away without medical treatment. Home treatment can often relieve pain and itching until the rash goes away.
If you have come in contact with a substance such as poison ivy, oak, or sumac, immediately wash the area with large amounts of water.
Once a rash has developed, leave it alone as much as possible.
- Use soap and water sparingly.
- Leave the rash exposed to the air whenever possible.
- Do not scratch the rash.
If you have a rash, you should not be in contact with children or pregnant women. Most viral illnesses that cause a rash are contagious, especially if a fever is present.
Relief from itching
- Keep the itchy area cool and moist. Put cloths soaked in ice water on the rash a few times a day. Too much wetting and drying will dry the skin, which can increase itching.
- Keep cool and stay out of the sun. Heat makes itching worse.
- Try an oatmeal bath to help relieve itching. Wrap 1 cup of oatmeal in a cotton cloth or sock and boil as you would to cook it. Allow it to cool to room temperature, and use it as a sponge and bathe in cool water without soap. You may also buy a product at the store, such as Aveeno Colloidal Oatmeal bath.
- Avoid scratching as much as possible. Scratching leads to more scratching. Cut nails short or wear cotton gloves at night to prevent scratching.
- Wear cotton clothing. Do not wear wool and synthetic fabrics next to your skin.
- Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay, and use as little soap as possible. Do not use deodorant soaps.
- Wash your clothes with a mild soap, such as CheerFree or Ecover, rather than a detergent. Rinse twice to remove all traces of the soap. Do not use strong detergents.
- Do not let the skin become too dry, which may make itching worse. See the topic Dry Skin and Itching for additional home treatment.
- Take several breaks during the day to do a relaxation exercise, particularly before going to bed if stress appears to cause your itching or make it worse. Sit or lie down, and try to clear your mind. Concentrate on relaxing every muscle in your body, starting with your toes and going up to your head. For more information, see the topic Stress Management.
Nonprescription medicines for itching
Carefully read and follow all label directions on the medicine bottle or box.
- Try calamine lotion for a rash caused by contact dermatitis, such as poison ivy or poison oak rashes.
- For severe itching, apply 1% hydrocortisone cream 4 times a day until the itch is gone.
- Try an oral antihistamine to help the scratch-itch cycle. Examples include chlorpheniramine maleate, such as Chlor-Trimeton, and diphenhydramine, such as Benadryl. Oral antihistamines are helpful when itching and discomfort are preventing you from doing normal activities, such as work and sleep. Antihistamines may cause drowsiness. Do not drive or operate any type of equipment if you are taking any of these medicines. And don't give antihistamines to your child unless you've checked with the doctor first.
|Try a nonprescription medicine to help treat your fever or pain:|
Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
|Be sure to follow these safety tips when you use a nonprescription medicine:|
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:
- A rash does not go away or gets worse even with home treatment.
- Symptoms become so bad that you are very uncomfortable.
- Other symptoms, such as a fever, feeling ill, or signs of infection, are severe or become worse.
- A rash lasts longer than 2 weeks.
- A rash that has been diagnosed lasts longer than 2 weeks or is not following the expected course.
- Symptoms become more severe or happen more often.
If you have a known allergy, avoid contact with the substance that causes the allergy.
Treat your skin gently:
- Do not bathe too much. Soap and water dries your skin of the essential oils that hold in moisture.
- Do not scratch your skin or rub it roughly with towels.
- Avoid exposure to chemicals that may irritate the skin, such as rubbing alcohol, soaps, detergents, or solvents.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- What is the history of your rash, including:
- When did the rash start?
- Where did the rash start?
- Has the rash spread?
- Has the rash changed?
- Have you been in contact with anything that may have caused the rash?
- Have you been around anyone recently who has a similar rash?
- Has anything made the rash better or worse?
- Have you had this rash before? If yes:
- What were the circumstances?
- When did you last have it?
- How was it treated?
- How long did it last?
- What other symptoms have you had? Symptoms may include itching, burning, stinging, tingling, numbness, pain, or tenderness to the touch.
- Have you used a new food, medicine, or product, such as cosmetics, cleaning agents, detergents, soaps, chemicals, fabrics, lotions, or nonprescription medicines?
- Have you been exposed to poisonous plants. such as poison ivy, oak, or sumac?
- Have you had any other health problems during the past 3 months?
- Have you recently traveled to a rural area or to another country?
- Have you been under an unusual amount of stress at home, work, or both?
- Does anyone in your family have a skin disorder or an allergy? If so, to what?
- What home treatment measures have you tried? Did they help?
- What nonprescription medicines have you tried? Did they help?
- Do you have any health risks?
|Author||Jan Nissl, RN, BS|
|Editor||Susan Van Houten, RN, BSN, MBA|
|Associate Editor||Tracy Landauer|
|Primary Medical Reviewer||William M. Green, MD - Emergency Medicine|
|Primary Medical Reviewer||Martin Gabica, MD - Family Medicine|
|Specialist Medical Reviewer||Alexander H. Murray, MD, FRCPC - Dermatology|
|Specialist Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Last Updated||August 1, 2008|
Last Updated: August 1, 2008