Tips on Five Common Rash-Causing Skin Conditions

By Derek V. Chan, MD, PhD

None of us remembers our first case of contact dermatitis – diaper rash, that is. But it likely wasn’t our last rash. Life is full of triggers that can cause rashes. Some may be so common and transitory that we don’t consider them medical problems. Others, though, may be very serious. It’s important to be aware of when to see a doctor.

The term “rash” refers to any change in skin color, texture, or appearance. Rashes are often reddish due to inflammation, such as with hives or contact dermatitis. But rashes can also present as scaly or thickened skin, such as with atopic dermatitis, psoriasis, or rosacea.

The number of different rashes – and the fact that their signs and symptoms often overlap – can be confusing. So can the terminology, with words like “eczema” used as a catch-all phrase for different itchy conditions. ‘Contact dermatitis” and “atopic dermatitis” may both be referred to as “eczema.” But they have distinct underlying causes, symptoms, and treatments.

The complex conditions underlying some chronic rashes – such as atopic dermatitis, rosacea, and psoriasis – remain under research. That said, there seems to be an intersection of genetics, immune response, and a trigger of some sort, for example, in the environment or due to disease.

In all cases, I emphasize supportive skin care: Regardless of the rash, we’re going to benefit from gentle cleansing, regular moisturizing, and sun protection.

For specific rashes, I suggest the following tips for dealing with five common skin rashes:

1. Hives:

   These red itchy welts – medical name ‘urticaria’ – may appear and fade within hours and typically last less than 24 hours. Or they may be chronic, hanging around and regularly reoccurring – in which case you should see a doctor to find out why. Allergy testing may uncover a food trigger, for example. Or medical evaluation may reveal an underlying condition – for example a thyroid problem. Antihistamines are often used to manage symptoms.

2. Contact dermatitis:

   As the name suggests, this red, itchy, irritating rash is caused by contact with something in the environment. There are two types: allergic and irritant. With allergic contact dermatitis, doctors will investigate patients’ exposure history and do testing. Irritant contact dermatitis can require a change in routine – for example, in the case of a bartender who may need protection from repeated exposure to water or detergent during the workday. In addition to avoidance of the trigger, use of topical corticosteroids can help manage symptoms until they clear.

3. Atopic dermatitis:

   Atopic dermatitis is not an allergic reaction. It typically starts before the age of five, showing up on infants as dry, scaly, very itchy patches, often on the face. In young children, the patches tend to develop in elbow and knee creases. About half the time, the condition continues through adulthood, with periods of flare and remission. The support of an experienced dermatologist can be vital in avoiding triggers and controlling symptoms through a regimen that may include topical as well as systemic medications and, in some cases, light therapy. 

4. Rosacea:

   Early identification is important because rosacea is progressive. There are actually four types, causing facial redness, skin thickening, acne-like inflammation, and eye problems. A dermatologist’s early diagnosis can help prevent permanent skin discoloration, serious eye problems, and, in the case of thickening skin, the need for surgery. Dermatologists will customize a treatment plan that limits triggers and controls symptoms.

5. Psoriasis:

   The scaly appearance of most psoriasis is due to the body’s skin cell production kicking into overdrive, causing excess surface skin cells – or “plaques”. Psoriasis needs attention: In addition to having irritated, itchy skin, some patients also develop psoriatic arthritis, which requires early intervention to prevent long term joint damage. Psoriasis also can occur alongside other serious illnesses, such as diabetes. Management may involve topical and systemic treatments and include light therapy.

In life, rashes are all but inevitable. Your dermatologist can help ensure that when they occur, they get the treatment they require.

Derek V. Chan, MD, PhD, board certified dermatologist with particular interests in psoriasis, cutaneous neoplasms, and lasers/cosmetic dermatology.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.