Rashes can occur during or after a cold, stemming from various causes. These skin manifestations might result from a viral infection, the body’s immune reaction, medication side effects, or other factors. Understanding their origins helps determine when medical attention is appropriate.
Viral Rashes Associated with Cold-Like Symptoms
Several viruses can cause both cold-like symptoms and a characteristic rash. Measles, for instance, typically begins with a high temperature, runny nose, cough, and red, watery eyes before a rash appears a few days later. The measles rash consists of red-brown spots that start on the face and behind the ears, then spread across the body, sometimes forming blotchy patches.
Rubella, sometimes called German measles, presents with cold-like symptoms like a cough and runny nose, along with a red-pink rash of small spots. This rash usually starts behind the ears and on the face, then spreads to the neck, body, arms, and legs, often lasting three to five days. Roseola, common in young children, is caused by human herpesviruses 6 and 7 (HHV-6/7) and features a high fever for three to five days, sometimes with cold-like symptoms, followed by a pinkish-red rash once the fever subsides. The rash appears on the chest, stomach, and back before spreading and is not itchy.
Fifth Disease, caused by parvovirus B19, begins with mild cold-like symptoms such as a low fever, headache, and a stuffy or runny nose. A few days later, a distinctive bright red rash appears on the cheeks, often described as a “slapped cheek” appearance. This is followed by a lacy, net-like rash on the trunk, arms, and legs that can last for one to three weeks. Enteroviruses, including coxsackieviruses and echoviruses, can also cause cold-like symptoms, fever, and various skin rashes, such as those seen in hand, foot, and mouth disease. Some enteroviruses can cause a generalized, non-itchy rash or sores inside the mouth.
Other Reasons for Rashes During a Cold
Rashes appearing during a cold are not always a direct symptom of the cold virus itself; they can arise from other factors. Allergic reactions are a common cause, potentially triggered by medications taken for cold symptoms, such as ibuprofen, or antibiotics if a secondary bacterial infection is present. These reactions can manifest as a widespread rash. Environmental allergens can also contribute, leading to both respiratory symptoms and skin reactions.
The body’s general immune response to an infection can result in a non-specific rash. When the immune system activates to fight off a cold virus, the resulting inflammation can lead to skin irritation or a blotchy, itchy rash. This type of rash might appear towards the end of the infection as the body heals. Continuous nose blowing during a cold can irritate the skin around the nostrils, leading to localized redness or chapping. Changes in hygiene practices during illness or exposure to dry air can also contribute to skin irritation.
Secondary bacterial infections can also cause rashes during or after a cold. When the immune system is busy fighting a viral infection, the skin may become more vulnerable to bacterial invaders. Conditions like impetigo, characterized by honey-crusted lesions, can develop around the nose and mouth, especially in children, and may require antibiotic treatment. Other bacterial infections, such as scarlet fever, are caused by Streptococcus bacteria and present with a rash, often accompanied by a sore throat and fever.
When to Seek Medical Attention
Seek medical attention if a rash accompanied by cold-like symptoms exhibits certain characteristics or severe signs. A rapidly spreading, painful, or blistering rash requires medical attention, especially if blisters appear around the eyes, mouth, or genitals. Rashes that look purpuric, resembling tiny bruises, or those that do not fade when pressed, can indicate a serious condition.
Immediate medical care is advised if the rash is accompanied by difficulty breathing, swelling of the face or lips, or signs of anaphylaxis, such as a racing heart rate or lightheadedness. A high fever that persists or does not respond to medication, particularly when combined with a rash, also requires a doctor’s visit. Other concerning symptoms include severe lethargy, signs of dehydration, a stiff neck, or a severe headache. If a rash appears suddenly and makes an individual feel very sick, or if the rash seems infected with pus, warmth, or red streaks, consult a healthcare provider.