How to Treat an Mpox Rash

A rash is not necessarily the first symptom of mpox (formerly known as monkeypox), but it is one of the most common.

The symptoms of mpox can include fever, headache, muscle aches, swollen lymph nodes, chills, and exhaustion. Some people get a rash on their face and other body parts about one to three days later, which may manifest as bumps, open sores, and fluid-filled blisters or pimples.

Rashes caused by mpox can go through several stages—from pimples and blisters to scabs. As they are healing, the rashes can be itchy and even hurt. So how can you alleviate these symptoms, and when is treatment necessary?

"In some people—not all—the rash can be painful," Elizabeth Gilliams, MD, MS, an instructor of medicine with expertise in infectious diseases at Johns Hopkins Medicine, told Verywell. "This would be the main situation when treatment is considered."

If you have an mpox rash, here's what experts want you to know about treating your symptoms and making sure you don't spread the infection to others.

Protect Your Rash—But Not With Bandages

While you're recovering at home, you need to take care of the lesions. That means keeping them clean and infection-free.

You aren't required to cover the lesions when you are isolated and alone during your recovery. But Luis Ostrosky, MD, an infectious disease specialist at Memorial Hermann Hospital, of the University of Texas Health Science Center at Houston (UTHealth), told Verywell that if you have to leave the house and be around people, any lesions and rashes should be covered with clothing like long sleeves, pants, or gloves.

Don't put bandages or Band-Aids on the lesions. They interfere with the healing process by creating a moist environment, damaging nearby skin, promoting cross-contamination, or even causing more severe lesions or rashes.

Don't Scratch

Gilliams said that mpox patients with rashes or lesions need to avoid scratching, which can allow the lesion to spread to areas where the skin is damaged or sensitive, like around the eyes.

“Anything that disrupts the skin barrier—including picking scabs or popping lesions—from healing should be avoided if possible,” said Gilliams. “Scratching can open up a sore and put it at risk for bacterial infection.” 

Scratching can increase your risk of transmitting mpox to others, too.

"You risk the possibility of transmission, albeit from your fingers, after scratching a rash and having scabs or fluid trapped within your fingernail," Donald Alcendor, PhD, an associate professor in the department of microbiology, immunology, and physiology at Meharry Medical College, told Verywell. "Scratching also brings the complication of secondary bacterial infection."

Treatments for Mpox Rashes 

The U.S. Food and Drug Administration (FDA) has not authorized or approved a specific treatment for mpox. However, there are some ways to ease mpox symptoms, including a rash.

TPOXX

According to Gilliams, one potential treatment for mpox rashes is taking an antiviral called tecovirimat (TPOXX). The medication is provided by the Centers for Disease Control and Prevention National Stockpile.

While TPOXX is not FDA-approved for infections like mpox, the CDC states that since it has a  “non-research expanded access Investigational New Drug (EA-IND)” protocol, the drug can be used for primary or early treatment of mpox in adults and children.

According to Ostrosky, most mpox rashes simply need to run their course.

"We focus on keeping the lesions clean to avoid secondary bacterial infection," he said.

However, Ostroksy said that TPOXX can be used for more "aggressive rashes in sensitive regions like the eye" or for people with compromised immune systems.

Over-the-Counter (OTC) Treatment

If you have an mpox rash and don't need to take a prescription antiviral, but you're still looking for a way to deal with the painful or itchy rash, there are a few over-the-counter (OTC) treatments that might help:

• Topical steroid creams or gels 
• Ointments (like Vaseline or Aquaphor)
• Topical numbing medications (like lidocaine)

"Some providers also recommend antibacterial ointments, but those should be used with caution as more people may be allergic to certain ointments," Ostroksy said.

For mild pain, he said that anti-inflammatory medications like ibuprofen can help.

OTC antihistamines, acetaminophen, or soaking in a sitz bath may help alleviate symptoms, too.

Treating Symptoms, Not Disease

Topical creams, ointments, and oral medications are only meant to help reduce pain, itchiness, or redness from an mpox rash—they do not treat the disease.

"You’re just trying to alleviate a symptom, meaning you’re trying to reduce inflammation at the site," Alcendor said. "[These products] reduce the pain and the itch, but the disease will still go on." 

Should Everyone Worry About Mpox Rashes?

"It's important to take a step back and understand the risk of monkeypox to the general population remains low," said Gilliams. "And the current cases are being driven by intimate or sexual contact. There has not been substantial transmission during day-to-day activities, like going to the grocery stores, or going to pick up takeout."

But that's not to say mpox should be taken lightly.

"Monkeypox is extremely contagious, and touching monkeypox lesions is the most efficient way to transmit the disease," Ostrosky said.

If you have mpox and get any lesions, scabs, or rashes, experts say that it's important that you avoid other people.

Until you're no longer contagious, the best thing to do is stay at home, unless you need to seek emergency care or see your provider.