An unusual skin condition named “covid toes” appeared during the COVID-19 pandemic. It involves inflammation of the small blood vessels in the toes, and sometimes the fingers. This response is not indicative of a severe infection. The condition can appear at any age but has been more frequently noted in children, teenagers, and young adults.
Symptoms and Appearance
The primary indicators of covid toes are visible changes to the skin on one or more toes. Individuals may notice swelling and a change in color, with the skin appearing bright red before gradually shifting to a purple or bruised-looking hue. On darker skin tones, the condition can present as a purplish discoloration or brownish-purple spots. The affected areas can also look shiny and develop a texture different from the surrounding skin.
The condition is often accompanied by physical sensations. The toes may feel tender to the touch, and individuals frequently report an itching or burning feeling. In some instances, the swelling can lead to the formation of blisters, small bumps, or even areas of rough, dry skin. While many people experience no discomfort and only notice the discoloration, others may find the toes to be painful.
The Connection to COVID-19
The development of covid toes is linked to the body’s immune response to the SARS-CoV-2 virus, considered a delayed reaction from the immune system. This response involves an overproduction of specific proteins called type I interferons. While effective against the virus, these interferons can also provoke inflammation that may damage the small blood vessels in the body’s extremities, like the toes.
This condition frequently appears in people who have mild or no other symptoms of COVID-19, and it often emerges one to four weeks after the initial infection. Because of this timing, a person might test negative for an active COVID-19 infection by the time the toe lesions appear, as the virus may have already been cleared from their system.
The presentation of covid toes bears a strong resemblance to a pre-existing condition known as pernio, or chilblains, which is triggered by exposure to cold, damp conditions. In the case of covid toes, however, the viral infection is believed to be the trigger for this specific type of vascular inflammation, rather than environmental temperatures.
Management and When to Seek Medical Advice
For most individuals, covid toes resolve on their own without specific medical intervention, within a few weeks to a couple of months. At-home care can help manage any discomfort. Keeping the feet warm can improve circulation to the affected areas, and applying an over-the-counter hydrocortisone cream can help alleviate itching and reduce inflammation. It is important to handle the affected skin gently and wear comfortable footwear that does not constrict the toes.
While the condition is not a cause for alarm, there are specific circumstances when consulting a doctor is recommended. If the pain becomes severe and is not manageable with at-home care, medical advice should be sought. Any signs of a secondary infection, such as the presence of pus or increasing redness, warrant a visit to a healthcare provider. A doctor should also be consulted if the sores or blisters show no signs of healing over time.