HIV Skin Rashes: Symptoms, Causes, And Treatment Options

Skin changes are common in people who are HIV-positive, and rashes are one of the opportunistic infections that can occur due to a weakened immune system. A rash can be an early symptom of HIV. It is also a common reaction to HIV medications. Though it may sometimes go away within some days, it can sometimes recur and even prove fatal. Early testing and timely treatment along with monitoring the viral load, are effective ways to stop the progress of an HIV rash and prevent transmission.

In this article, we discuss the causes of HIV rash and the treatment options available, along with strategies for preventing the condition and addressing stigma. You will also find out why these rashes can be life-threatening. Keep reading to know more

What Is HIV Rash?

HIV infection involves changes in the immune system that trigger various skin reactions, leading to skin rashes. Dr. Kire Stojkovski, a practicing medical doctor, says, “HIV rash is a type of skin infection which appears a few weeks after a person is infected with HIV.” HIV rash is of different types and can develop on any part of the body, including the face, abdomen, arms, or legs.

HIV rash can initially manifest in different forms. Understanding how to identify them can help you choose the right course of treatment. Learn more in the next section.

Types Of HIV Rash

The types of HIV rash include (1):

• Maculopapular Rash: Is a flat and discolored area of the skin with a small raised bump (2).
• Eosinophilic Folliculitis: Occurs as small red or pus-filled bumps, often on the shoulders, trunk, arms, neck, and forehead.
• Papular Pruritic Rash: Is characterized by itching papules on the arms, legs, face, and trunk.
• Xerotic Eczema: Is marked by severe dryness and itchiness.
• Prurigo Nodularis: Causes itchy, raised lesions on both sides of the arms and legs, and is typically found on the outer parts of the limbs.
• Seborrheic Dermatitis: Occurs during the early stages of the disease in areas where there is an abundance of sebaceous glands, including the sides of the nose and the chest.

Often these rashes could be mistaken for a symptom of another infection. So, it is better to know about HIV rash to identify it. Read on to learn more about it.

What Does HIV Rash Look Like?

HIV rash can be reddish, blemished, itchy, or painful. In the early stages of infection, the rash looks flushed, discolored, and reddish with flat blemishes and does not itch. It usually appears as a flat red area covered with small bumps.

Quick Tip

HIV rashes are classified as the maculopapular type. This means they are flat or slightly raised, discolored patches of skin (macules) covered with tiny papules.

While HIV rashes can sometimes mimic other skin conditions like eczema or psoriasis, there are key differences that set them apart. Other conditions that may be confused with HIV rashes include:

• Allergic Reactions: Unlike HIV rashes, allergic reactions tend to improve with antihistamines.
• Eczema: Eczema rashes typically worsen in dry conditions or under stress, which distinguish them from HIV-related rashes.
• Heat Rash: It is usually localized to areas where sweat builds up and clears up with cooling and drying the area.
• Psoriasis: Psoriasis tends to appear on the elbows, knees, and scalp, which differs from the distribution of HIV rashes.

It is important to consult with a healthcare professional for an accurate diagnosis, especially if you are experiencing persistent or unusual skin changes.

HIV rash can be an early symptom of the infection and may be accompanied by other symptoms. Keep reading to find out more.

Symptoms Of HIV Rash

If you have a rash and suspect an HIV infection, look out for the following symptoms (1):

•  Night sweats
•  Fever
•  Chills
•  Muscle aches
•  Fatigue
•  Sore throat
•  Swollen lymph nodes
•  Mouth ulcers

These symptoms may last for a few days or several weeks (3).

However, these symptoms can also be of other infections or side effects of certain medications. So, it is important to consult a doctor for a proper diagnosis.

It is important to pay close attention to your body and recognize the signs of an HIV rash. If you notice any of these symptoms, especially when combined with other potential HIV indicators, consult a healthcare professional immediately. Early detection and treatment can make a significant difference in managing HIV and improving your overall well-being.

Read on to learn more about the types and causes of HIV rash.

Causes Of HIV Skin Rash

The main causes for HIV skin rash are:

•  Acute HIV Infection: A rash is one of the symptoms during the early stages of infection. It usually goes away as the immune system produces antibodies. However, if the person is not taking proper medications, it may recur due to a weakened immune system (4).

•  HIV Medicines: Dr. Stojkovski says, “The HIV rash may be due to side effects of using antiretroviral drugsⁱ  A class of medications used to treat HIV patients to prevent the virus from replicating and spreading inside the body and stop further harm. (ARVs). The drugs that treat HIV infection may cause hypersensitivity. Earlier, around 50% of people taking HIV antiretroviral therapy used to get rashes (5). These rashes go away in several days without treatment. But, you may need to consult your doctor to know if it is necessary to switch to another medicine.”

•  Other Infections: HIV weakens your immune system, leading to a higher risk of fungal and viral infections, which cause rashes. These infections may involve chronic skin conditions like psoriasisⁱ  A chronic skin condition where skin cells multiply rapidly and become thick, scaly, and itchy, resulting in severe inflammation. , dermatitisⁱ  A common skin inflammation where the skin becomes itchy, dry, and inflamed, and may even become oozy and cause blisters in some cases. , tineaⁱ  A group of harmless diseases caused by a fungus that affects the groin, scalp, feet, and the areas beneath the breasts. , eczemaⁱ  A chronic, non-contagious condition characterized by dry, itchy, and inflamed skin that typically affects young children. , or herpesⁱ  A skin condition caused by the herpes virus that usually causes painful blisters and sores but can be asymptomatic too at times. (6). In fact, HIV can make you susceptible to contracting other viruses, like herpes simplex virus, which may cause rashes on the skin. Therefore, watch out for signs of herpes on the skin and consult a doctor.

Did You Know?

About 80% of patients with advanced HIV are affected by seborrheic dermatitis rashes due to the weakened immune system (9).

Compounding Factors

Beyond the direct impact of HIV on the immune system, other factors can contribute to the severity of HIV rashes. These compounding factors include:

• Emotional and psychological stress
• Hormonal changes
• Exposure to irritants or allergens in the environment

You can take proactive steps to minimize the impact of HIV rashes by understanding these factors. This may involve reducing stress levels, adopting healthy lifestyle habits, and avoiding irritants that trigger your skin.

There are several treatment options available for HIV rash. Learn more about them in the next section.

HIV Rash – Treatment Options

Skin issues that develop due to HIV can be treated. A doctor can prescribe you medicines based on the cause of the rash. Over-the-counter drugs such as hydrocortisone cream or Benadryl may help reduce itching and rash size. If you have more serious symptoms, consult a healthcare professional immediately.

You may also need to make some lifestyle changes to alleviate the symptoms. For example, Dr. Stojkovski says, “Avoiding excess sunlight can help reduce the rash. Heat tends to make the condition worse. Therefore, avoid exposing oneself to heat.” Hot showers and baths can also make the rash worse.

Additionally, consuming a nutritious diet provides essential nutrients that support skin function. You should also drink adequate water to prevent dryness and irritation.

Chronic stress can negatively impact the immune system and exacerbate skin conditions. Incorporating stress management techniques, such as relaxation exercises, meditation, or yoga, may help promote skin health.

People with HIV may also experience allergic reactions more often. Therefore, always conduct a patch test before you start using any new shampoo, soap, or other skin care or hair care product.

Beau Newham, a blogger, shares his experience about being diagnosed as HIV positive. He recounts how terrified he was listening to sudden stories of hospitalizations, late diagnosis, and complicated co-infections. He adds, “We now have the tools and the knowledge to completely change the story of HIV in every part of the world, but the pace is far too slow, and the distribution far too uneven. Both these narratives are true, with treatment HIV is now a manageable chronic disease, and in 2019 large numbers young people are still dying HIV related deaths (i).”

Prompt testing and timely treatment are effective ways to reduce the progress of HIV rash. Continue reading to find out how HIV rash can turn severe.

Severity Of HIV Rash

In most cases, the HIV rash is harmless and goes away in a few days. However, it may turn severe and be fatal too. A hypersensitivity reaction to HIV medicine is a potentially serious condition. The symptoms include difficulty breathing, dizziness, or lightheadedness. If the case is severe, it may become life-threatening and require immediate medical attention (4), (7).

Stevens-Johnson syndrome (SJS) is one such life-threatening hypersensitivity reaction. It is seen in less than 0.5% of patients. Its symptoms include fever, flu-like symptoms, rash, and painful blisters and the CD4 count also decreases (4). Within 1 to 3 days, a red or purplish rash forms, and then the skin begins to blister and peel, leading to “raw” areas of the skin that are painful (5).  If you notice any of these symptoms after an HIV treatment, you must seek medical help immediately.

In the case of Stevens-Johnson Syndrome (SJS), the affected person is moved to an intensive care unit. The treatment for this condition is similar to that of major burns, including wound care, pain control, fluids and electrolytes, nutritional supplements, temperature control, and monitoring for secondary infections (8).
Now, let’s answer the most important question.

When Should You See A Doctor?

If you develop a rash or flu-like symptoms after coming in contact with a person who is HIV-positive, you must seek medical advice and undergo an HIV test. In addition, people with HIV must seek immediate medical help if a new rash develops or existing ones get worse.

Seek immediate medical attention if you experience symptoms like:

•  Nausea and vomiting.
•  Swollen lymph nodes or fever.
•  Painful blisters with a red or purplish rash.
•  Quickly spreading rash.
•  Dizziness and breathing difficulty.

These could be symptoms of hypersensitivity or Stevens-Johnson Syndrome.

Infographic: HIV Skin Rash: Causes & Treatments

Most HIV-positive individuals eventually develop an HIV rash. A rash is frequently the body’s response to a virus, but it can also be an allergic reaction or a sign of another infection. Moreover, these skin patches tend to be painful and itchy. The infographic below provides information about the causes and treatments of an HIV skin rash. Take a look.

Illustration: StyleCraze Design Team

Frequently Asked Questions

How often do you get rashes with HIV?

You observe rashes in most patients with HIV. Due to a weakened immune system, HIV patients are susceptible to skin infections and rashes.

How fast does HIV rash develop?

You may observe an HIV-related skin rash within two months of contracting the virus.

Can other conditions cause rashes similar to HIV rashes?

Yes, rashes caused by skin disorders like eczema or psoriasis, fungal infections, or allergic reactions might seem similar to HIV rashes.

Can HIV rashes be a symptom of early or acute HIV infection?

Yes, HIV rashes may be a symptom of early or acute HIV infection. HIV tampers with the body’s immune system, therefore it might trigger skin infections in the form of rashes.

Illustration: HIV Skin Rashes: Symptoms Causes And Treatment Options

Image: Dall·E/StyleCraze Design Team

Unsure about HIV rash and its patterns? Gain clarity in this informative video that delves into its nature and behavior. Check it out!

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Dr. Schwarzburg MD

 

Dr. Schwarzburg is a leading authority in the field of minimally invasive cosmetic and laser medicine in New York City. He is an Ivy League school graduate with 7 years of experience in cosmetic dermatology and regenerative medicine.

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Anjali is an associate editor at StyleCraze. She specializes in hairstyles and hair and skin care and has written over 200 articles in these domains. She has 7 years of experience, and her philosophy about hair and skin care is simple: if you love and care for it, it will be healthy.

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Monomita has a graduate degree in mass communication and video production from St. Anthony's College, Shillong, and a master’s degree in journalism and mass communication from the Royal Global University, Guwahati. She is also a certified skincare coach with a keen interest in skin, hair, tattoos, nail art, and lifestyle trends.

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