The rashes you get often change as you age. Before you try home treatments, understand what's behind the break-out.
by Featured Provider Tyler Olson on Tuesday, September 22, 2020
You can get a rash at any age and from almost anything. An itchy sweater. A hot summer’s day. Even something that never touched your skin.
Your skin is the largest organ in your body. And there are a number of things that can cause it to break out in blotches, bumps, blisters, scales, spots or just general redness.
Rashes are the most common skin problems for adults.
A rash isn’t a specific diagnosis. It’s just any noticeable change in the texture or color of your skin. Most skin rashes clear up as quickly as they come. They might be small and appear easy to treat. But before you consider applying a little lotion to relieve the itch, you should understand exactly what kind of rash you have.
Luckily, the most common types of skin rashes in adults are ones you can typically wait out, treat with over-the-counter medications or resolve with the help of your primary care provider. Tyler Olson, MD, a Family Medicine physician at The Iowa Clinic in Johnston, helps clear up concerns about the rashes you’re most likely to develop in adulthood.
Talk to your doctor to end the itching and relieve the redness
Most people associate eczema with itchy children but you can get it as an adult, too. It’s the most common skin rash, affecting more than 31 million Americans. Eczema is evident by its itchy, red, inflamed patches of skin in light skin tones. It looks brown, purple, gray or ashen in darker skin tones.
Eczema is not something you can catch from someone else. Instead, it’s a skin response triggered by your immune system and due to genetic and environmental factors. But it can be a chronic skin condition. Atopic dermatitis is a chronic, inflammatory type of eczema that can start in childhood but reappear in adulthood. It flares up in response to stress, weather changes, poor sleep and irritating fabrics or products. Avoiding these triggers is the first step of treatment but gentle skincare, a daily moisturizer and healthy sleep habits go a long way.
2. Contact Dermatitis
The most likely source of this rash is an allergic reaction where your skin comes into contact with an irritant. You may have had a brush with poison ivy, leaving behind a line-shaped or streaking rash. Nickel and rubber are lesser known yet common causes of contact dermatitis. But you could be allergic to anything from a certain type of fabric to a chemical in your laundry detergent.
Allergic contact dermatitis typically takes a few days to show up, so it’s not always easy to identify the source. You may get itchy, red or swollen skin, and can develop blisters near the site of contact. The best remedy is to avoid the allergen or irritant altogether. You can also apply a topical hydrocortisone cream or take an oral antihistamine to ease the itching.
“One of the most common, but unexpected, causes of contact dermatitis is actually a common medication: Neomycin, found in triple-antibiotic cream,” Dr. Olson says. “Up to one in 10 patients have this type of reaction to topical neomycin.”
While most rashes are caused by viral infections, they can result from bacterial infections too. Cellulitis is the most common skin rash brought on by bacteria, says Dr. Olson. If you experience the redness, swelling and pain it causes, you need to see your provider.
Left untreated, cellulitis can cause serious tissue damage and spread to deeper tissues like the muscles and bones. Or, more concerningly, it can cause a bloodstream infection called sepsis. Fortunately, that rarely happens because cellulitis is treatable with antibiotics.
It’s not always clear how the bacteria that causes cellulitis enters your body, but it is known to enter through breaks in the skin. Cleaning and caring for any wounds, cuts, scrapes or blisters helps prevent cellulitis and other bacterial skin infections from forming.
If you had chickenpox as a kid, you’re more likely to get this painful rash after you turn 50 (although it still pops up from time to time in teens and young adults). Shingles and chickenpox come from the same virus. It stays in your body even after the chickenpox rash is gone and can be reactivated in adulthood, commonly during times of stress.
Although shingles come from the same virus as chickenpox, the resulting rash is very different. A shingles rash is characterized by its containment to one side of the face or torso. The groups of small, clear blisters aren’t itchy. They’re painful. And the pain can last for weeks and months after the rash is gone, a condition called post-herpetic neuralgia.
“This is a condition you should probably see your doctor about, especially if the rash involves the face, as it can affect vision or hearing in rare cases,” Dr. Olson advises. “If you see your doctor right away, there are often medications that can be prescribed to help limit pain and spread of the rash.”
About one in three people will get shingles in their lifetime. But just like chickenpox, there’s an effective vaccine. You can prevent a shingles outbreak by getting vaccinated at your local primary care clinic after you turn 50.
5. Pityriasis Rosea
Pityriasis rosea is a lesser known but relatively common rash that may be the result of a virus. It starts out as a large, pink or red oval. After a couple of days — or even a couple of weeks — it spreads out with smaller, scaly patches forming on your chest or back. The shape of the rash ends up looking like an evergreen, giving pityriasis rosea its nickname, “Christmas tree rash.”
You’re more likely to get pityriasis rosea in the spring or fall as a young adult, before you hit your mid-30s. It’s not contagious or permanent. It typically resolves on its own, but that can take up to 12 weeks. In the meantime, you can practice good skin hygiene, take oral antihistamines and apply topical anti-itch creams to keep from scratching.
More than 16 million people have rosacea, the skin disease that results in a red, rosy face. You may also get visible blood vessels and small, red, fluid-filled bumps on your face. A rosacea rash can appear on your cheeks, forehead, chin and tip of your nose, giving you a flush appearance.
Rosacea typically affects people with fair skin between the ages of 30 and 50. The rash comes and goes. It can disappear for years, only to erupt again. Over time, your skin may not return to its original color once rosacea goes into remission, leaving you with a pink or red skin tone.
“Mild rosacea can often be treated by avoiding triggers such as makeup, foods that make you flush or excess sun exposure,” Dr. Olson says. “If the rash persists, there are antibacterial washes, topical creams and prescription medications. If rosacea symptoms are really persistent, there are procedures and additional medications you can get from a dermatologist.”
Get help if your rash spreads or presents other symptoms.
While many skin rashes are not aesthetically appealing, most aren’t life-threatening. Your rash may resolve on its own. And you can usually help it along with a little lotion or topical treatment.
Some rashes can get out of control or be a sign of something more, like an infection or serious allergic reaction. Dr. Olson advises that if your rash shows any of these signs, you need to seek medical treatment:
- Fever – Drug reactions and serious infections from measles or bacteria can cause fevers. Any time you have both a rash and a fever, you should schedule a same-day appointment with your primary care provider.
- Rapid spread – Skin rashes that come on suddenly usually signal an allergic reaction or serious infection. Call your primary care provider. If you have breathing difficulties, call 9-1-1.
- Blistering – Many rashes blister, where bumps turn into fluid-filled pockets. Avoid scratching or popping them. If the blisters are near your eyes or mouth, it’s best to see your provider sooner than later.
- Infection – The reason you don’t want to scratch blisters is because you could spread an infection. If you notice yellow or green fluid, swelling, crusting, red streaks or warm skin, your rash may be infected.
- Pain – Outside of shingles and cellulitis, most rashes don’t cause significant pain. If your rash hurts, you should call your provider or head to Urgent Care.
Your skin is an important diagnostic tool — one of the few that you have at your disposal. Whenever you notice a skin rash or just any spot of concern, it’s worth a call to your primary care provider. They can help you quickly relieve your rash and get you well on your way to recovery — or refer you to a dermatologist, if necessary.