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The most common causes of skin rashes

Skin rashes can be caused by a variety of factors and vary based on the season, genetics and environmental or work exposures. David Harvey, M.D., a Piedmont dermatologist, explains the most common causes of skin rashes, how to treat them and how to prevent skin conditions in the future.

The most common types of skin rashes

Atopic dermatitis (eczema) and psoriasis are two common skin ailments that are part genetic and part environmentally related,” says Dr. Harvey. “Atopic dermatitis flares can be exacerbated with stress, cold weather and exposures to things like fragrance, nickel, solvents and wool. Psoriasis can similarly flare with stress, infections—particularly strep—and high-fat diets.”

Approximately 10% of people in the United States have atopic dermatitis. The condition isn’t contagious and can occur in people of all ages. Symptoms can include dry, itchy, painful rashes.

About 2% of people in the United States have psoriasis. Psoriasis isn’t contagious and tends to run in families. The condition causes plaques (patches of thick, raised skin) to form on the body. A thin, dry, silvery-white coating called a scale can cover the plaques.

Rashes can also be caused by exposure to poison ivy, poison sumac or poison oak.

How to treat skin rashes

If you have a rash:

  • Don’t scratch. Scratching can worsen your rash and lead to an infection.

  • Try an over-the-counter anti-itch cream, oatmeal bath or cool compress.

  • Use fragrance-free lotion or cream to seal in moisture after showering, bathing or washing your hands. Look for products that are eczema-friendly. If you’re tempted to scratch, apply moisturizer.

  • Don’t take hot showers or baths. Keep baths and showers as brief as possible.

Skin rashes are notoriously difficult to cure, but they can be controlled in most instances.

“Different skin rashes need different approaches. In the atopic dermatitis and psoriasis illustrations above, if the rash is limited, a prescription for a topical corticosteroid may be all that is required,” says Dr. Harvey. “For more severe cases in which the rash encompasses a lot of body surface area, systematic treatments with biologic medications or immunosuppressants may be needed. For rashes like poison ivy, an oral steroid like prednisone may be needed.”

You may need skin allergy testing to determine if an allergic reaction is causing your skin to flare up. It’s possible to develop an allergy to an ingredient you’ve used for years.

How to prevent skin rashes

  • Be aware of your environment. “If you’re working outside or in the garden, it’s important to know what poison ivy, sumac or oak looks like,” says Dr. Harvey. “If insects are around, watch for ant hill mounds, bee nests or chiggers. Wear long pants and sleeves if needed.”

  • Protect your skin barrier. If you are prone to atopic dermatitis (eczema), use moisturizers to maintain and protect your skin barrier.

  • Be mindful of chemical exposure. If you’re handling solvents, harsh cleaning products or paint, he recommends using protective gloves to prevent hand dermatitis.

  • Wash your clothes before wearing them. New clothes can sometimes contain dyes or chemical residues that can cause rashes.

When to seek medical attention for a skin rash

While it can be normal for skin to occasionally be red or irritated (such as from poison ivy exposure, a harsh skin care product, an insect bite or a sunburn), a non-resolving rash that causes persistent pain or itch warrants a trip to your dermatologist or primary care provider.

“Rashes can bleed or become infected,” says Dr. Harvey. “Warmth, swelling, redness or foul-smelling drainage in a rash may be an indicator that treatment with an antibiotic is needed. If a rash is spreading despite over-the-counter topical creams, it likely is a more serious condition that needs prompt evaluation by a health care provider.”

You should seek medical care if the rash:

  • Develops suddenly and spreads quickly

  • Blisters

  • Covers a large portion of your body

  • Is accompanied by a fever

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