Overview

Rash in teens and adults: Overview

Healthy skin provides a barrier between the inside of the body and the outside environment. A rash means that some change has affected the skin.

In many cases, rashes are caused by skin irritation, which can have many causes. A rash is often a minor problem that may go away with home treatment. But sometimes a rash doesn't go away, or the skin may get so irritated that medical care is needed.

In adults and older children, rashes are often caused by contact with a substance that irritates the skin (contact dermatitis). Contact dermatitis may cause mild redness of the skin or a rash of small red bumps. A more severe reaction may cause swelling, redness, and larger blisters. The location of the rash may give you a clue about the cause.

Contact dermatitis doesn't always occur the first time you are in contact with the irritating substance (allergen). After you've had a reaction to the substance, a rash can occur in response to even very small amounts of the substance. Contact dermatitis isn't serious, but it's often very itchy. Common causes include:

• Poisonous plants, such as poison ivy, oak, or sumac.
• Soaps, detergents, shampoos, perfumes, cosmetics, or lotions.
• Jewelry or fabrics.
• New tools, toys, appliances, or other objects.
• Latex. Allergy to natural rubber latex affects people who are exposed to rubber products on a regular basis. It's often seen in health care workers, rubber industry workers, and people who've had multiple surgeries. Latex allergies can cause a severe reaction.

Rashes may occur with:

• Viral infections, such as herpes zoster.
• Fungal infections, such as a yeast infection (Candida albicans).
• Bacterial infections, such as impetigo.
• Sexually transmitted infections (STIs).

Rashes may also occur as a symptom of a more serious disease, such as liver disease, kidney disease, or some types of cancer.

Rashes may appear after exposure to an insect or a parasite, such as the scabies mite. You may get a rash when you travel to a rural area or go hiking or camping in the woods.

A rash may be a sign of a chronic skin problem, such as acne, eczema, psoriasis, or seborrheic dermatitis. Other causes of rashes include dry, cold weather; extremely hot weather (heat rash); and emotional stress.

Some medicines can cause a rash as a side effect. A very rare and serious type of generalized (whole-body) red rash called toxic epidermal necrolysis (TEN). TEN can cause the skin to peel away, leaving large areas of tissue that weep or ooze fluid like a severe burn. TEN may occur after the use of some medicines. If this type of rash occurs, you need to see a doctor.

The need for medical treatment often depends on what other symptoms you have. A rash that occurs with other symptoms, such as shortness of breath or fever, may mean another problem, such as a serious allergic reaction or infection.

Self-Care

Most rashes will go away without medical treatment. Home treatment can often relieve pain and itching until the rash goes away.

After a rash appears, leave it alone as much as you can.

• Use soap and water sparingly.
• Leave the rash exposed to the air when you can.
• Don't scratch the rash.

But if you have come in contact with a substance such as poison ivy, oak, or sumac, wash the area with a lot of water right away. If you can, use liquid dish soap or a mild soap and very warm running water.

If you have a rash, you should not be in contact with children or anyone who is pregnant. Most viral illnesses that cause a rash are contagious, especially if you also have a fever.

Relief from itching

Try these tips to help relieve itching from a rash.

• Keep the itchy area cool and moist.

  Put cloths soaked in ice water on the rash a few times a day. Too much wetting and drying will dry the skin, which can increase itching.

• Keep cool, and stay out of the sun.

  Heat makes itching worse.

• Add a handful of oatmeal (ground to a powder) to your bath.

  Or you can try an oatmeal bath product, such as Aveeno.

• Avoid scratching as much as you can.

  Scratching leads to more scratching. Cut nails short or wear cotton gloves at night to prevent scratching.

• Wear cotton clothing.

  Don't wear wool and synthetic fabrics next to your skin.

• Use gentle soaps on your skin.

  Examples are Basis, Cetaphil, Dove, and Oil of Olay. Use as little soap as you can. Don't use deodorant soaps.

• Wash your clothes with a mild soap, rather than a detergent.

  Try using ones like CheerFree or Ecover. Rinse twice to remove all traces of the soap. Don't use strong detergents.

• Don't let the skin get too dry.

  Dry skin may make itching worse.

• Try nonprescription medicines for itching.

  Carefully read and follow all label directions on the medicine bottle or box.

  • Try calamine lotion for a rash caused by contact dermatitis, such as poison ivy or poison oak rashes.
  • For severe itching from contact dermatitis, apply hydrocortisone cream 4 times a day until the itch is gone. But don't use this cream on a fungal rash, because it can make the rash worse.
  • If itching affects your sleep, ask your doctor if you can take an antihistamine that might reduce itching and make you sleepy, such as diphenhydramine (Benadryl). Be safe with medicines. Read and follow all instructions on the label.
• Take breaks.

  Take several breaks during the day to do a relaxation exercise if stress appears to cause your itching or make it worse. In particular, do it before you go to bed. Sit or lie down, and try to clear your mind. Manage your stress by relaxing every muscle in your body, starting with your toes and going up to your head. Doing this may help your symptoms.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse signs of infection, such as warmth, redness, swelling, pus, or a fever.
• Symptoms occur more often or are more severe.

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