People have been reporting skin rashes after Covid infections ever since the pandemic first began – but how do you know what it means?
There is no single Covid rash, after all, and the NHS simply lists “rashes” as one of the symptoms that the infection has triggered long Covid.
Doctors and scientists are still finding out exactly how Covid affects our bodies, but here is the current understanding about the difference between an immune response and a sign you may have long Covid.
Why would you develop a rash with an active Covid infection?
Once the virus enters the body, it is detected by immune cells in our respiratory tract, activating the rest of the immune system.
This can be exaggerated in some people, triggering skin sensitivity and reactivity. This can cause a break out in a rash for some people who test positive.
Healthline suggests that there is a possibility a rash could emerge due to increased blood clotting which can occur with Covid, although scientists are still looking into how exactly the Covid rash works.
It is one of the less common symptoms of Covid. The Zoe Covid Symptom Study app suggests 9% of Covid positive app users reported a rash. For 21% of respondents, rashes were the only sign of infection (along with a positive nasal swab).
Most people feel fatigue, develop a fever, a cough or a runny rose instead.
According to the AADA, any Covid-related rash could last two to 12 days, although toe rashes may stretch on to 14 days.
The British Association of Dermatologists also put together a list of images of potential Covid-related rashes with the Zoe Covid Study app showing the range of reactions your skin may have to the virus.
This rash could itch, look patchy, look like blisters or pinpoints, large patches, small patches, lace-like patterns and be flat or raised.
It could even be a toe rash – like the infamous Covid toe which resembles chilblains – skin discolouration, hives or swelling.
But why would you get a rash after Covid?
For some people, a skin reaction does not occur until after the infection has subsided.
But, confusingly, this red, irritated skin is not necessarily caused by the virus.
“The skin rash, or ‘covid toes’ as some people have started to call it is not directly caused by the virus. It is one of the results of an over-active immune system, leading to an allergic type rash in some and a vasculitis-like rash in others,” according to founder of Skin Aesthetics and emergency medic Dr Qian Xu.
What if it is a sign of long Covid?
Dr Xu pointed out that Long Covid can fall into two main categories.
One is the mast-cell activation syndrome, which is a hyper-allergic state where the body produces an allergic reaction to anything.
However, this will trigger other issues to which will indicate a sign of long Covid. This could be anything from feeling sick, a high temperature, sore throats, joint pain, depression to shortness of breath or “brain fog”.
Then, there’s fatigue predominant type, where exhaustion continues for weeks after an infection.
What to do if you aren’t sure about a rash
Dr Xu said: “It is vital to get the correct diagnosis for your skin rash before starting any treatment. If the rash is driven by something systemic, then just using topical skincare would not be enough to control it, and there is a chance that it could make things worse.
“If you think you may have long Covid and the skin issues have started after Covid, it would be worth you attending a long Covid clinic to get necessary guidance.”
She also recommended using just simple moisturisers if your skin is dry, itchy or irritated, and steering clear of serums or scrubs.