We’ve all had them – those pesky skin rashes that seem to pop up out of nowhere. Often accompanied by itching or irritation, skin rashes are one of the most common health problems.

Sometimes skin rashes are caused by outside factors. Allergens, irritants, and things our skin comes in contact with can cause a rash.

However, the skin can also be a window to what’s happening internally in the body. And in these instances, skin rashes can be a sign of a more systemic problem.

Our board certified dermatologist in Hagerstown and Martinsburg describes a dozen common rashes we see among our patients.

1 – Atopic Dermatitis (Eczema)

One of the most common types of skin rash is atopic dermatitis, otherwise known as eczema. This rash often occurs in people with a family or personal history of atopy (asthma, seasonal allergies, or hay fever). It can occur at any age and is common in both children and adults. For some, it can clear up for a period of time and then reappear later. In some cases, it may reappear even years later.

Atopic dermatitis, or eczema, is a rash that can be located anywhere on the body but is more common in the flexural regions. (The medical terms for these regions are the popliteal fossa and antecubital fossa. Think of them as the underside of the elbow or knee.)

Atopic dermatitis, or eczema, is a very itchy rash that presents in various ways on different people. It is often red, scaly patches on the skin. It may also have small, red bumps that produce a fluid and then crust over. It can be accompanied with dry skin.

The itching that accompanies eczema, or atopic dermatitis, can be more severe at night.  It can make the skin raw, inflamed, or swollen.

People with this skin rash should use mild soaps and moisturizers as harsh products can cause flare ups. Treatment options vary but generally dermatologists begin with a topical steroid. If initial treatment is unsuccessful, different topical medicines may be used in conjunction with oral medicines and light treatments.

2 – Psoriasis

Psoriasis is a skin rash that peaks in patients in their 20-30s or 50-60s. This rash can occur anywhere on the body but is more common on the elbows, knees, or scalp. It is considered a long-term condition that while not curable, can be made better through treatment.

Thought to be an immune system problem, psoriasis looks like thick, silvery, scaled plagues. It’s not usually as itchy as atopic dermatitis, although it can become painful. Certain things like stress, illness, a skin injury, or weather can precipitate psoriasis.

People with psoriasis can develop psoriatic arthritis. This inflammatory condition causes joint pain and stiffness as well as swelling.

Patients should be aware a link has been found between inflammation caused by psoriasis and inflammation in heart valves that cause heart attacks. Mentioning your psoriasis diagnoses to your primary care physician and following good heart health guidelines is recommended.

Dermatologists treat psoriasis with topical steroids. If the condition does not improve with initial treatment, light treatments and oral medicines may also be used.

3 – Contact Dermatitis

Another common rash is that caused by contact dermatitis. This type of rash can be a reaction to things like poison ivy, poison oak or poison sumac. However, it can also be caused by over-the-counter products like Neosporin or additives in skin care products. Common metals like nickel can by culprits as well, as can dyes and perfumes in soaps and laundry detergents.

Contact dermatitis is an extremely itchy, swollen rash that can sometimes blister and ooze. It is confined to the area that came in contact with the allergen that caused it.

The most obvious way to treat contact dermatitis is to stop it before it begins by avoiding the allergens. That’s not always possible, especially when patients are unsure what causes the reaction for them in the first place. In these cases, allergy testing is recommended.,

Additional treatment for contact dermatitis includes topical steroids.  Oral steroids can be prescribed depending upon severity.

4 – Fungal Infections (Tinea Infections)

Fungal infections, known medically as tinea infections, are other common sources of skin rashes. Athlete’s foot, nail infections, and jock itch are all types of tinea infections. These rashes are sometimes referred to as ringworm because it forms a ring on the body.

Tinea infections can be scaly and red, with a leading edge of scale. It can be located anywhere on the body but tends to be in areas that get hot and humid, like between the toes or in the groin.

Unlike some other skin rashes, tinea infections are contagious. It can be transferred in skin to skin contact. This characteristic makes it common in contact sports like wrestling.

In addition to being transferred from person to person, tinea infections can be contacted through infected objects like towels, clothing or combs. It can also be transmitted from infected animals or even in the soil. Signs of infection are generally detected anywhere from several days to a few weeks after transmission.

Tinea infections are diagnosed by a dermatologist taking a scraping or small biopsy of the infected area. The condition is treated by anti-fungal medication. Treatment may need to be repeated as curing tinea is often initially difficult.

5 – Tinea Versicolor (Yeast Skin Infections)

Tinea versicolor, also known as yeast infections, are skin rashes that are circular to oval reddish brown patches. It is typically seen on the torso. This skin condition is not usually itchy, nor is it contagious. It’s most prevalent in older adolescents or young adults.

Tinea versicolor occurs more frequently in hot, humid weather. This is because excessive sweating or oily skin can trigger the natural yeast that is on your skin to replicate. That replication causes the skin rash associated with the condition.

Treatment for Tinea versicolor involves topical anti-fungal and anti-yeast medications.

6 – Drug Eruptions

Sometimes a new medication, or even a mediation someone has been on for a longer period of time, can cause a skin rash. This condition is known as a drug eruption rash.

Drug eruptions can mimic many different skin conditions as they can take on multiple forms. Sometimes the rash can be combined with systemic symptoms, like fever, fatigue, increased liver enzymes, or decreased kidney functioning. Patients often tend to feel ill in addition to experiencing a rash.

Most drug eruptions occur within the first several weeks to 3 months after starting a new medication. The condition can occur with prescription medications, over-the-counter drugs, or herbal supplements.

Treatment for drug eruptions depends on the severity of the rash and other symptoms. Dermatologists and other physicians recommend discontinuing use of the offending medication if possible. Then topical steroids are utilized if the reaction is not severe. Oral steroids or hospitalization for fluid support and additional treatment may be recommended for severe drug eruptions.

7 – Impetigo

Impetigo is a contagious skin infection that causes a red, often circular skin rash.  The infection is superficial, remaining on the outer layer of skin. This rash often produces yellow crusting that can sometimes blister. It is most likely to appear around the nose or mouth or on the hands or feet. It often enters the body through a sore or insect bite.

Impetigo can spread to other parts of the body though touch, towels, or clothing. It can be itchy or painful, although usually mildly so.

Impetigo is more common in young children or infants than adults. It’s caused by bacteria, most commonly staphylococci or streptococcus. It’s commonly spread through skin-to-skin contact. It is often passed in childcare settings or through sports that involve contact.

Impetigo is typically not dangerous, although it should be treated with oral antibiotics to clear the rash and prevent spreading.

8 – Stasis Dermatitis

Stasis dermatitis is an itchy, red, sometimes scaly rash on the lower extremities. It’s usually seen on both legs, but can appear on just one leg. Usually the area will become swollen first, and then the rash appears.

Stasis dermatitis is typically seen in older adults where leg swelling has occurred. It’s common in people with congestive heart failure or who are on medicines associated with the condition.

Stasis dermatitis is treated by first managing the edema. Keeping the legs elevated or wearing compression stockings can aid in doing this. Topical steroid treatment follows to help with the affected skin.

Following or in conjunction with dermatologic care, primary care management is often necessary with recurring or persistent cases of stasis dermatitis. Primary care physicians can prescribe diuretics and assist with medication adjustments to help alleviate the symptoms..

9 – Cellulitis

Cellulitis is a swollen, red rash that is localized to one area of the body, often the lower leg. The affected skin is painful and usually warm to the touch. The infection involves deeper tissue than impetigo and is associated with systemic symptoms like fever and chills.

Cellulitis is more commonly seen in adults, although it can occur at any age. It is bacterial in nature. The condition often begins in an area where surgery recently occurred, a scratch, a cut, or an insect bite. It can also enter the body where dermatitis is present or in dry, cracked skin.

Cellulitis should be treated immediately as complications may occur, some of which are serious. If untreated, the infection may spread to the lymph nodes or bloodstream. Treatment involves oral antibiotics or intravenous antibiotics if the infection is severe.

10 – Scabies

Scabies is a dermatologic condition that presents as an extremely itchy skin rash. Itching may be more severe at night. The rash has a pimple-like appearance and can be scaly or blustery.

Scabies is usually located in the finger webs or waistband. It can also be located in the bends of elbows, wrists and knees. In very young children, it may appear on the head, neck, face, palms, or soles of the feet.

Scabies is a contagious condition caused by a mite that burrows in the skin. The rash produced by the mites occurs 4 to 6 weeks following infestation.  It’s often diagnosed when a rash has spread throughout a household. A skin scraping performed by a dermatologist can confirm the diagnosis.

A anti-parasitic prescription medication called permethrin is most often used to treat scabies. Medicines generally clear the infestation quickly, although itching may persist for several weeks after treatment.

11 – Viral Eruptions

Viruses may also sometimes cause skin rashes. For example, in children, hand, foot, and mouth disease or chickenpox are common viral skin infections. In adults, one of the most common viral skin rashes is shingles. In some cases, streptococcus or other viruses may cause a skin rash as well.

Viral skin rashes have differing presentations according to the virus that causes them. Some are itchy or painful, while others are not. Many pediatric viral rashes are diagnosed by primary care physicians as patients are seen for the other symptoms. These symptoms can include sore throat, fever, chills, fatigue, and additional flu-like symptoms.

Treatment for viral skin conditions often involves waiting for the virus to run its course. The skin rash will generally clear as the virus leaves the body. Mild soaps and moisturizers, as well as mild detergents can help alleviate any discomfort. Topical steroids may also be prescribed in some cases.

In addition to treatment, prevention of viral skin rashes is also recommended. Varicella (chickenpox) vaccines and shingles vaccines can help prevent the viruses that cause some viral skin rashes.

12 – Lyme disease

Lyme disease can produce a skin rash that’s caused by a tick bite. The rash produced from the bite can aid in early diagnosis of the disease, although the rash is not always present. When the rash does occur, it looks like an expanding, non-scaly red ring on the skin where the bite occurred. When the rash does not occur, diagnosis and treatment can be delayed.

Lyme disease can occur at any age and in any region where black legged ticks live. The rash can be associated with symptoms like fever, chills, and fatigue. It should be treated as soon as possible to avoid complications that can be life-long, like joint pain, cardiac issues, and nervous system damage.

Treatment of early Lyme disease begins with doxycycline, an antibiotic that kills the bacteria caused by the tick bite. If Lyme disease has gone undiagnosed or untreated, neurologic Lyme disease, Lyme carditis, or Lyme arthritis may develop. In these cases, primary care physicians or medical specialists can provide additional treatment options.

At the Center for Dermatology in Hagerstown and Martinsburg, we treat all skin rashes. Please contact our office if we can help diagnosis and treat your skin rash.

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