Skin manifestations, or “breakouts,” have been observed in individuals with COVID-19, appearing as various rashes, lesions, and inflammation. These skin changes can range in appearance and severity, sometimes emerging before or alongside more common COVID-19 symptoms. This article explores the reported connections between COVID-19 and these diverse skin issues, providing insights into their characteristics, potential causes, and general management strategies.
Common Skin Manifestations
COVID-19 has been linked to several types of skin manifestations, each with distinct appearances. One recognized type is “COVID toes,” or chilblain-like lesions, presenting as red, purple, or swollen digits on the toes and sometimes fingers. They can be painful or itchy, often seen in younger individuals, sometimes appearing late in the infection or as a post-COVID symptom.
Another common manifestation is maculopapular rashes, flat or raised red spots resembling measles or drug rashes. These often appear on the trunk and can be itchy, usually developing within the first few days of infection. Urticaria, or hives, are itchy, raised welts that can appear anywhere on the body and may emerge quickly and then disappear.
Vesicular eruptions are small, fluid-filled blisters, similar to chickenpox lesions. These can be localized or widespread, sometimes appearing before other COVID-19 symptoms. Less commonly, livedo reticularis or racemosa may occur, a purplish, net-like skin discoloration. This pattern suggests blood vessel involvement and is more frequently associated with severe COVID-19 cases.
Why COVID-19 May Affect Skin
Skin manifestations associated with COVID-19 arise from several biological mechanisms. A primary factor is the immune system’s response to the SARS-CoV-2 virus, which can lead to widespread inflammation. The body’s fight against the virus can trigger an excessive inflammatory response, sometimes involving a “cytokine storm,” where immune signaling molecules called cytokines are released in large quantities, affecting skin cells and blood vessels.
The virus may also directly impact blood vessels. COVID-19 can affect their lining, potentially leading to microclots or impaired circulation. This vascular involvement can manifest as skin discoloration or lesions, such as COVID toes or livedo reticularis, where reduced blood flow causes visible skin changes.
While less common, the virus may directly infect skin cells, as skin tissues express ACE2 receptors. However, the immune system’s overactivation and vascular effects are more widely cited as primary contributors to COVID-19-related skin issues. General illness, stress, and changes in daily routines during infection can also indirectly influence skin health.
Managing Skin Changes
For individuals experiencing skin changes related to COVID-19, several practical approaches can help manage discomfort. Over-the-counter remedies provide symptomatic relief. Antihistamines may reduce itching from rashes like hives, while moisturizing lotions soothe dry or irritated skin. Applying cool compresses to affected areas also alleviate swelling and discomfort.
Gentle skin care practices are important. Using mild, fragrance-free cleansers and avoiding harsh soaps prevents further irritation. Wearing loose-fitting clothing reduces friction and allows the skin to breathe. Keeping the skin cool may also provide comfort, as excessive heat can exacerbate itching and inflammation.
Beyond topical care, supporting overall body health contributes to skin recovery. Staying hydrated and maintaining a balanced diet provides essential nutrients for skin health. Adequate rest is also important, as the body’s healing processes are supported during recuperation.
When to Seek Medical Advice
While many COVID-19-related skin changes resolve on their own, certain signs warrant consulting a healthcare professional. Seek medical advice if skin lesions are widespread, intensely painful, or severely itchy. The presence of blistering, which could indicate a more serious reaction, also requires evaluation.
Signs of a possible infection in skin lesions, such as increased redness, warmth, swelling, or pus, should prompt a medical consultation. If skin issues are accompanied by other concerning systemic symptoms of COVID-19, including difficulty breathing, chest pain, or confusion, immediate medical attention is necessary.
Persistent rashes that do not improve or worsen after a few days, even with home care, should be assessed by a doctor. When uncertain about the cause or severity of any new or unusual skin changes, contacting a healthcare provider is always appropriate to ensure proper diagnosis and management.