For many people newly infected with HIV, a rash is one of the earliest symptoms. A wide range of illnesses, infections, and allergic reactions can irritate the skin, however, so a rash alone is never sufficient to diagnose HIV.
People who develop a rash and believe that they may have been exposed HIV should see the doctor. People are at risk of exposure through sex with someone whose HIV status is unknown, sharing needles, or a blood transfusion, for example.
There is no single rash that is specific to people who have HIV. This is because when a person develops HIV, changes in their immune system can trigger a number of skin reactions.
Because HIV reduces the immune system’s ability to fight off infections, people with the disease are at risk from a range of skin infections and rashes.
Sometimes a rash is the only symptom. However, because an HIV rash usually signals an issue with the immune system, other symptoms are common. The symptoms that can accompany an HIV rash include:
- flu-like symptoms, such as muscle aches, chills, or a general feeling of illness
- fever, particularly if the rash is due to a skin infection
- swollen lymph nodes
Some people may experience mobility issues. Cellulitis, for example, can cause swelling that makes movement painful.
HIV-related rashes vary greatly. The specific outlook depends on the type of rash, as well as individual factors, such as overall health, use of antiretroviral drugs, access to medical care, and exposure to contagious skin conditions.
The rash associated with seroconversion, which occurs shortly after infection, usually disappears on its own.
Rashes due to chronic conditions, such as herpes and psoriasis, tend to come and go. The severity of each outbreak varies, but is partly dependent on immune function. Some medications, such as antiviral drugs for herpes, can reduce the severity of each outbreak.
Rashes caused by infections will go away with proper treatment. However, because HIV steadily weakens the immune system, an infectious rash may return. Cellulitis in particular tends to recur. People with HIV who have had one infectious rash may also later develop a different infectious rash.
Prompt HIV testing is an important weapon in the fight against HIV. Early diagnosis enables effective treatment, and can potentially lead to a longer life.
People who develop a rash or flu-like symptoms should see their doctors if they may have been exposed to HIV. Anyone can contract HIV after exposure to infected blood, semen, vaginal fluids, or breast milk.
Some risk factors for HIV infection include:
- a recent blood transfusion
- use of needles to inject drugs, particularly among people who share needles
- high-risk sex, including non-monogamous sex, unprotected sex, including vaginal and anal sex
- sex with a new partner if that partner’s HIV status is unknown
- a child breastfeeding from an HIV-positive woman
- breastfeeding a child with HIV
People who are already HIV-positive should see a doctor if a new rash develops or an existing rash gets worse. Because HIV undermines the immune system, allowing infections to more quickly spread, even a minor infection can become life threatening if left untreated.
Rashes that quickly spread, that are accompanied by swollen lymph nodes or a fever, or that produce symptoms, such as exhaustion or vomiting may need emergency medical treatment.