Although not seen in every infected person, COVID-19 can affect the skin as well. These symptoms, also called the cutaneous manifestations of COVID-19, may vary with people.
Unlike the rash caused by other viral infections (such as rubella, measles, herpes, and chickenpox), rash due to COVID-19 can present in various ways, such as:
- Bumps
- A measles-like or morbilliform rash
- Patchy rash
- Fluid-filled bumps or blisters (resembling chickenpox)
- Lace-like or net-like patterns (retiform rashes)
- Pus-filled rashes
- Petechiae (small pin-point sized rashes)
- Papules (round, tiny, which measures less than 1 cm, raised rashes)
- Itchy rashes
- Pernio or chilblain-like rashes (seen as red to violet papules mainly on the elbows, toes, outer sides of feet, fingers)
- Necrosis or gangrene formation
When the skin manifestations of COVID-19 mainly affect the toes or fingers or both, the condition is called COVID toes, which may present as discoloration (red to violet) and swelling of the toes and fingers. It may be associated with pain, pus formation, and itching at the affected sites.
Multisystem inflammatory syndrome in children (MIS-C) is a rare but life-threatening manifestation of COVID-19. MIS-C results due to an overreaction (overstimulation) of the immune system against the coronavirus. It is mainly seen in children and teens who had COVID-19.
MIS-C may present with symptoms such as:
- Skin rash
- Bloodshot or red eyes
- Persistent fever
- Abdominal pain
- Swelling over the hands, feet, and tongue
- Discoloration of the hands and feet
- Swollen neck glands
- Excessive drowsiness
- Nausea and vomiting
- Diarrhea
- Confusion
MIS-C can be potentially fatal if not timely managed. If a child exhibits any of these symptoms, contact the doctor right away.
Who is at risk of the skin symptoms of COVID-19?
It is not clear who is likely to get the skin manifestations of COVID-19. About 0.2 to 20.4 percent of COVID-19 patients may show cutaneous signs.
- The factors influencing the appearance of skin manifestations are not well-understood.
- They may occur independently of the disease severity.
- Certain skin manifestations, however, may be more common in children, teens, and young adults.
The symptoms may appear any time during the disease with many individuals being affected at the start of the disease or during recovery. There have been cases of COVID-19 skin symptoms in some newborns of women who had COVID-19 during pregnancy.
How long do the COVID-19 skin symptoms last?
The time taken for COVID-19 skin symptoms to go away varies depending on the symptoms, their severity, and the sites affected.
- Most skin symptoms may go away within a week or two, whereas some may last for months.
- COVID-19 skin rash may subside within 2 to 12 days. Most patients report recovery within eight days.
- COVID toes may improve in 7 to 14 days although some may have persistent symptoms for weeks or months.
The skin manifestations of COVID-19 may be caused by some underlying health condition (other than COVID-19) or may result due to a reaction to COVID-19 treatment. They could be caused by secondary infections, including fungal infections. Thus, a person should report skin manifestations to the doctor if they see any skin-related symptoms.
Most COVID-19 cutaneous lesions do not require treatment. Topical hydrocortisone or antihistamines may be advised to reduce symptoms, such as pain, itching, and swelling.
Health Solutions From Our Sponsors
American Academy of Dermatology Association. Covid Toes, Rashes: How the Coronavirus Can Affect Your Skin. https://www.aad.org/public/diseases/coronavirus/covid-toes
Feldman SR, Freeman EE. COVID-19: Cutaneous manifestations and issues related to dermatologic care. UpToDate. https://www.uptodate.com/contents/covid-19-cutaneous-manifestations-and-issues-related-to-dermatologic-care
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