How to Identify 10 Common Skin Rashes

A rash is an area of irritated or swollen skin that can be itchy, red, and painful and may involve blisters, bumps, or areas of raw skin. Rashes are symptoms of conditions that can come about in response to an allergy, toxin, infection, or larger systemic disease.

The appearance of a rash can range from an almost incidental swelling of tissues to an outbreak of painful eruptive sores. Some outbreaks may be localized, while others can be generalized. Rashes can sometimes be tough to distinguish—even for a trained eye.

Broadly speaking, a rash can be classified as either infectious or non-infectious, and there are many different types and possible causes. 

Here are 10 of the most common rashes and how they can be identified.

Hives (Urticaria)

Urticaria; rash on arm
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There are times when an allergy or infection will cause the immune system to release a substance called histamine into the bloodstream. When this happens, tiny blood vessels in the skin expand and leak fluid into the outermost layer, called the epidermis. This results in raised, red bumps or welts, a skin condition recognized as hives (urticaria).

Hives are transient. They typically last for less than 24 hours and often go away within minutes or hours, but may appear in new areas as well.

Hives may:

  • Look spongy or like bug bites
  • Appear as red, raised areas of inflammation with no distinct border
  • Whiten (blanch) when you press them
  • Affect large areas of skin
  • Be intensely itchy 

Angioedema, may also be present. It is a closely related condition in which swelling occurs in deeper tissue layers (typically around the eyes, lips, and face).

Hives can also develop in response to hot or cold temperatures, excessive perspiration, and stress. While hives will usually go away on their own, antihistamines may be used to relieve itching and inflammation.

Impetigo

Impetigo rash beneath a mans lower lip

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Impetigo is a common infection of the skin caused by either streptococcal or staphylococcal bacteria. Impetigo occurs most commonly on the face or limbs and is characterized by the following features:

  • The eruption of red sores that leak clear fluid or pus
  • Formation of a honey-colored crust

The bacteria typically enter the body through broken or abraded skin such as a cut, scrape, burn, or insect bite. Children often develop impetigo after a cold when the skin around their noses becomes raw from using tissues, providing easy access for bacteria. 

A less common form of impetigo, called bullous impetigo, is characterized by the development of large blisters known as bullae. This form is more commonly seen in young children.

While the honey-colored crust is usually the tell-tale sign of impetigo, a bacterial culture may be needed to confirm the diagnosis. Although impetigo may cause minor itchiness, it is generally not painful (unlike shingles or other types of eruptive lesions).

As a bacterial infection, impetigo is typically treated with antibiotics.

Shingles

Herpes Zoster (Shingles)
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Shingles (herpes zoster) is a painful rash caused by a reactivation of the varicella virus, the same virus that causes chickenpox. The lifetime risk of developing shingles can run anywhere from 20% to 30%, particularly in high-risk groups, such as people with compromised immune systems. 

Shingles typically occurs later in life and symptoms generally present in two phases:

  • Pre-eruptive stage: Shingles often begins with a dull, localized ache and an increased sensitivity to touch.
  • Eruptive stage: Soon after, a cluster of tiny, painful blisters will appear, many of which will burst and scab over. (Shingles is contagious during this blistering phase.)

Shingles almost invariably occurs on only one side of the body and is limited to an area of skin supplied by a single spinal nerve, also known as a dermatome.

Shingles is also characterized by pain, the severity of which can range from prickly, persistent discomfort to deep, excruciating pain.

In some people, shingles can cause long-term (and sometimes) permanent nerve pain known as postherpetic neuralgia. This is especially true in older adults and those who leave the condition untreated.

It is important to see a doctor as soon as you recognize the characteristic rash of fluid-filled blisters. Early treatment with antiviral drugs such as Zovirax (acyclovir) can shorten the duration of an outbreak and prevent the spread of the rash to vulnerable parts of the body, including the eyes.

A highly effective shingles vaccine known as Shingrix (recombinant zoster vaccine) was approved by the U.S. Food and Drug Administration (FDA) in October 2017. Vaccination is recommended for all adults 50 and older.

Athlete's Foot (Tinea Pedis)

Athlete's foot

 ussaquarius / Getty Images

Athlete's foot (tinea pedis) is a common fungal infection. The characteristic symptoms of athlete's foot include:

  • A red rash, primarily between the toes or on the soles of the feet
  • Discomfort ranging from mild itchiness and flaking to painful blisters with breaks in the skin

Athlete's foot can occur between the toes (referred to as interdigital tinea pedis), develop mainly on the soles (scaly, moccasin-type tinea pedis), or cause a blister-like outbreak (acute vesicular tinea pedis).

Athlete's foot is easily spread in moist, unhygienic environments, such as spas and locker room floors, and is typically treated with topical antifungals.

Because it is so common, athlete's foot is usually recognized by appearance alone. However, other conditions such as plaque psoriasis and pityriasis can cause similar symptoms and may need to be investigated if the rash does not respond to antifungal treatment.

Ringworm (Tinea Corporis)

Skin infected with ringworm

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Ringworm (tinea corporis) is a common fungal infection that, despite its name, is in no way related to worms. Symptoms of ringworm may include:

  • Round rash with raised, red edges
  • Flaking and peeling
  • Itchiness
  • Skin cracking
  • Hair loss in the affected area

Ringworm is not inherently painful. It can appear anywhere on the body but is mostly seen on the trunk, arms, and legs.

Tinea capitis is a related fungal infection that involves the scalp.

Ringworm is highly contagious and easily spread through skin-to-skin contact with a lesion. It can also be passed through contaminated surfaces or everyday objects such as clothing, towels, and bedding.

Ringworm is typically diagnosed based on its appearance.

It is important to note that other rashes can also present with ring-shaped lesions, including pityriasis rosea and granuloma annulare or those associated with sarcoidosis and lupus.

Once diagnosed, ringworm can be effectively treated with oral or topical antifungal medications.

Psoriasis

Psoriasis (plaque type)

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Psoriasis is an autoimmune skin disorder that is chronic and inflammatory. It can be triggered by stress, medications, infection, skin injury, and environmental triggers like the sun. Around 1% to 8% of the global population is affected by this skin condition.

Psoriasis occurs when the immune system inappropriately attacks its own skin cells, triggering inflammation and the hyperproduction of cells. The rash is formed when new skin cells are produced faster than the old ones can be shed.

Plaque psoriasis is the most common form of psoriasis. Symptoms include:

  • Red patches of skin covered with thick, silvery scales
  • Itching, burning, and/or soreness
  • Skin flaking
  • Cracked, dry skin that can bleed when scratched

Plaque psoriasis is most commonly seen on the elbows and knees, as well as the scalp. Other types of psoriasis include pustular psoriasis (characterized by pus-filled lesions) and guttate psoriasis (seen mainly in children).

Psoriasis can often be diagnosed by its appearance but occasionally requires a skin biopsy for confirmation. Because there are no blood tests that can definitively diagnose psoriasis, it may be necessary to rule out other similar skin conditions, such as seborrheic dermatitis, lichen planus, pityriasis, or squamous cell skin cancer.

The treatment varies by the severity of the outbreak and may include topical steroids, immunosuppressants, and UV light therapy. Psoriasis can sometimes resolve spontaneously without treatment and recur just as suddenly.

Pityriasis Rosea

Pityriasis Rosea
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Pityriasis rosea is a common, benign rash that often starts as a single large spot (called a "herald patch") on the chest, abdomen, or back. This is soon followed by the appearance of other smaller patches or bumps, often in a pine tree-like pattern.

A pityriasis rosea rash is typically red, scaly, and sometimes itchy. It often has a ring-like appearance similar to ringworm in the early stages. Those affected often feel unwell for a day or two prior to the onset of skin symptoms.

Pityriasis is also commonly seen on the upper arms and upper legs but rarely on the face (except in children). Pityriasis can progress over the course of days or weeks.

Pityriasis rosea is not well understood but is believed to be caused by a virus. There are no tests to diagnose the condition, so a doctor must rely on a physical exam. That said, if the symptoms are severe, tests may be performed to rule out other causes, including guttate psoriasis, lichen planus, and tinea versicolor.

While treatment is typically not indicated for pityriasis rosea, a topical steroid or antihistamine may be used if the rash is especially itchy.

Scabies

Red papules on the skin due to scabies

DR P. MARAZZI/SCIENCE PHOTO LIBRARY / Getty Images

Scabies is a contagious skin condition caused by a tiny mite that burrows its way beneath the skin. Like head lice, it can spread quickly through schools and nursing homes and is easily passed between family members. 

Symptoms of scabies include:

  • Rash that causes tiny bumps, often in a linear track-like pattern
  • Itching, often severe (particularly at night)
  • Skin crusting (most commonly associated with crusted scabies)
  • Bleeding and sores due to scratching

Scabies most often develops on the wrists, elbow, buttocks, waist, armpits, penis, and between the fingers.

Scabies can mimic other skin conditions, such as folliculitis. To make a definitive diagnosis, a doctor will need to scrape the affected skin and examine it under a microscope for evidence of infestation.

The treatment of scabies involves the use of 5% permethrin cream or lotion, often in tandem with oral histamines or topical steroids to treat the rash.

Herpes Simplex

Herpes simplex on/around a woman's mouth

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Herpes simplex is a viral infection caused by either herpes simplex virus type 1 (HSV-1), the type commonly associated with cold sores, or herpes simplex type 2 (HSV-2), the type most commonly linked to genital herpes.

Herpes is characterized by the formation of open and sometimes painful ulcers. An outbreak initially presents with tingling and redness that later progresses to the formation of blistering lesions. The lesions can sometimes merge into larger open, weeping sores.

A herpes outbreak can be painful and sometimes severe. Fever and swollen lymph nodes may accompany or precede the onset of skin symptoms.

Herpes can be transmitted through contact with a sore or bodily fluids from an infected individual. Transmission can even occur when there are no visible lesions.

Once infected, you can experience a relapse of symptoms at any time (although the first outbreak tends to be the worst). While cold sores and genital herpes may be diagnosed by appearance alone, it is possible for HSV-2 to cause a cold sore if transmitted through oral sex. Similarly, HSV-1 can cause genital lesions.

Herpes simplex can be differentiated from herpes zoster based on the area the lesions appear on the body. Primary syphilis and chancroid can also be distinguished from HSV, as they usually only cause single sores. If there is any doubt as to the cause of the sore, a simple test called polymerase chain reaction (PCR) can be used to confirm the presence of viral DNA.

Herpes simplex can be treated with antiviral drugs such as Zovirax (acyclovir) or Valtrex (valacyclovir). There are currently no vaccines that protect against herpes simplex.

Eczema

Woman scratching eczema (atopic dermatitis) on her neck

Aniao Studio / Getty Images

Eczema, also known as atopic dermatitis, is an inflammatory skin condition that can affect people of all ages but occurs more frequently in children.

The most common symptoms of eczema are:

  • A red, itchy rash
  • Dry, rough, or scaly skin
  • Small, fluid-filled blisters
  • Cracked or broken areas of skin
  • Oozing, weeping, or crusting

Although the exact cause of eczema is unknown, it’s believed to be the result of genetic and environmental factors. Doctors can diagnose eczema based on its physical appearance and whether the symptoms meet specific diagnostic criteria.

The diagnosis of eczema typically requires the exclusion of all other possible causes. Other tests, such as a patch test, may be ordered to rule out skin conditions like contact dermatitis.

There is no cure for eczema, but there are treatments that can help manage it. Mild eczema can often be controlled with emollient-rich moisturizers and over-the-counter hydrocortisone creams. Moderate to severe cases may require prescription drugs.

Eczema can be difficult to manage, so many patients find the need to try different treatment options or even change their treatment regimen over time.

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