Common skin rashes which are noninfectious

Common skin rashes can be divided into 2 main groups such as; Infectious skin rashes and non-infectious skin rashes. Noninfectious skin rashes which are commonly seen are; Eczema, psoriasis, contact dermatitis, drug rash, Hives (Urticaria), pityriasis rosea (Christmas tree rash) and Heat rash (Miliaria).

• Eczema (Atopic dermatitis)

Eczema (Atopic dermatitis) comes under chronic common skin rashes seen in children but also in adults. It is a long term disease and tends to have exacerbations (flares) and remissions (healed stage). Eczema can run in families and may associate with Hay fever and Asthma.

Eczema can be dry or wet. When it is dry there are red patches, thickened due to scratching. The area becomes scaly sometimes cracked and associated with dry skin. In wet eczema, there is oozing from lesions with crusting. There is a possibility of infection. The lesions are raw and angry looking. There is intense itching in eczema where sometimes your sleep can get disturbed.

Eczema usually starts in childhood and may continue to have flare-ups on and off throughout life. Continuous and habitual scratching can lead to thick, leathery and discolored lesions.

Treatment

There is no cure for eczema however it can be controlled, but the disease can go in to complete remission anytime.

• Moisturize your skin well with a good emollient regularly, especially to damp skin after a bath.
• Avoid strong soaps and detergents which can worsen eczema
• Apply over the counter medications like 1% Hydrocortisone cream or prescribed creams or ointments such as Betamethasone or Mometasone over the lesions once or twice a day
• Avoid scratching to prevent damage to skin and subsequent infection
• Use an OTC antihistamine to prevent itching

Ex: Cetirizine, Fexofenadine, Chlorpheniramine or Loratadine

• Identify and avoid the triggers which can cause flares like excessive sweating, strong soaps, and detergents, pollen, certain foods, smoking, dust, stress etc.

• Psoriasis

Psoriasis also comes under chronic common skin rashes which can appear on and off in a person’s lifetime. Skin cells are formed at a faster rate than they are shed. These skin cells accumulate as thick scales or plaques on skin surface. The lesions are dry and itchy. The rash is red or purplish in color with silvery scales. Itching can be mild to severe. As the skin is very dry, there can be a burning or stinging sensation.

There is a genetic predisposition to psoriasis and also a disturbance in the immune system. Certain triggers like excessive stress, smoking, sunburn and various infections can cause exacerbations. Psoriasis can associate with arthritis (Inflamed, painful, swollen joints) commonly in fingers and knees. The nails, scalp, and eyes can get affected too.

There are severe forms like pustular psoriasis where tiny blisters appear which are filled with pus and Erythrodermic psoriasis where the whole body appears red and peeling (Exfoliative dermatitis) with itching and severe burning sensation. Both these conditions are severe but luckily not common.

Home remedies and treatment

• Avoid injury to skin as it can cause new lesions over those sites due to Koebner phenomenon. (Which means the rash appear in trauma sites)
• Avoid stress
• If you are a smoker – quit
• Moisturize skin well with a good emollient 2-3 times a day

It is best to seek medical treatment in psoriasis early. Compliance with treatment is very important for proper control of the disease.

There are many treatment options like:

• Topical applications – steroid creams, retinoids, Vitamin D analogs, Salicylic acid – there are well-combined products which are effective, which will be prescribed to you by your doctor.
• Systemic medications – Methotrexate, Cyclosporin which are taken orally with frequent monitoring for side effects.

Frequent follow up is necessary to prevent the appearance of new lesions.

• Contact dermatitis

Contact dermatitis comes under common skin rashes, is an itchy red rash caused by contact with a substance which is allergic to certain individuals. Many substances are commonly found to cause allergic reactions such as; plants (poison ivy), jewelry, watches, perfumed spray, some cosmetics, some soaps and detergents, shoe straps etc. The rash commonly develops soon after contact with the substance. Itching will be followed by the red rash. It may be dry or scaly, but can be wet and oozing in some.

Scratching can cause skin damage and may lead to infection. Some people may develop severe allergic reactions with blistering, leading to oozing and crusting. If infected, the person feels pain and severe burning sensation.

Treatment and relief –

• Identify the trigger substance and avoid it
• Apply hydrocortisone cream (found over the counter)
• If itching is unbearable use an OTC antihistamine like fexofenadine, being cautious of the dose and frequency of administration.
• Cold compresses to soothe the area

Drug rash

Drug rash arises within 14 days of taking a new medication. It begins as discrete red spots which spread to cover large areas of the body. It is an allergic reaction to a certain drug in that particular individual. The rash is red with bumps, hives and sometimes blisters. It may cause itching and pain. Peeling can occur later.

Most drug rashes resolve once the offending drug is withdrawn. If it is mild apply calamine lotion to soothe the area and take an OTC antihistamine like fexofenadine or cetirizine. If the drug rash is severe seek help. Injectable drugs like epinephrine and corticosteroids will be used as treatment if the drug rash is severe and widespread.

• Hives (Urticaria)

Urticaria or hives can occur anywhere in the body, commonly face, arms, legs, and back. They are itchy, red or skin-colored bumps with a surrounding red halo.

Hives may occur due to the allergic reaction to certain foods (peanuts, seafood, pineapple), medications (such as anti-epileptics, certain antibiotics), some cosmetics, detergents, pollen, excessive sun exposure and insect bites.  Although hives are quite a common hypersensitivity to the allergens occur in certain individuals only.

You can apply calamine lotion to soothe the area and take an OTC antihistamine to reduce itching. 1% hydrocortisone can be applied over the lesions at night.

• Pitiriasis rosea (Christmas tree rash)

Pitiriasis rosea starts as a herald patch which is a large, oval or circular spot on your abdomen, back or chest. The herald patch is followed by smaller red spots which sweep out from the middle of your body resembling a Christmas tree. It is a red, itchy rash.

It spontaneously recovers within 2-3 months.

Home remedies and treatment

• Shower with lukewarm water
• Exposure to natural sunlight may help to fade the rash
• Apply calamine lotion, a moisturizer or 1% hydrocortisone cream (found over the counter) to soothe the rash
• Take an OTC antihistamine like cetirizine or Loritidine
• If the rash is not recovering your doctor may prescribe a short course of steroids

It is common in 10 -35 year age group.

Heat rash (Miliaria)

Heat Rash is characterized by tiny, red or white raised dots or lumps on the skin which can be very itching and irritable. Although it is commonly seen in babies, it can affect children and adults too. It is also called “Prickly heat”, because of the warm and prickly feeling. Sweat glands in the skin produce sweat or perspiration which comes out to the skin surface through pores or sweat ducts. When these pores are blocked, sweat is trapped under the skin.

It is common during warm and humid weather conditions (summer months) and in people living in tropical countries. Heat rash will spontaneously recover with time, especially once the weather conditions are reversed.

Heat rash is mainly seen over chest, neck, and shoulders in babies. In children and adults mainly neck, chest, and back get involved.

Home remedies and treatment

• Cool your skin by frequent cold water baths
• Use fans or air conditioner to prevent sweating
• Avoid heat exposure – firefighters, factory workers, lab workers, out-door workers get occupational exposure to hot, humid conditions. They should cool off their bodies as much as possible during non-working hours.
• If heat rash is widespread use soft cotton, loose clothes to avoid friction with skin.

There are several OTC products available in the market to treat heat rash. Such as;

• Calamine lotion to soothe the rash
• Lotions or Creams containing Zinc oxide and menthol – for the soothing effect
• Products which contain Anhydrous Lanolin – This prevents blocking of sweat ducts
• If the rash is associated with inflammation and redness – apply a mild steroid like 1% Hydrocortisone cream, which is available over the counter.
• If itching is difficult to bear can take an oral antihistamine

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