A rash can be an early symptom of HIV, but HIV can also increase the risk of developing different types of rashes.
People who develop a rash and believe they may have had exposure to HIV should seek medical advice. If an HIV infection is present, treatment can help manage it effectively.
HIV transmits from one person to another when bodily fluids come into contact with each other. These include blood, semen, rectal and vaginal fluids, and breast milk.
Exposure to HIV can happen if a person has sex or shares needles with someone who has the virus.
No single rash is specific to HIV. As HIV involves changes in the immune system, it can trigger a variety of skin reactions.
However, the rash that occurs at the early stage usually involves flushed, discolored, or reddish, flat blemishes that do not itch, according to one source.
A rash can be an early sign of HIV, occurring as a result of seroconversion. This is the acute, or early stage of HIV, which occurs within 1–2 weeks of exposure to the virus.
During the seroconversion or acute HIV stage, the body produces antibodies to the virus. Between half and 80–90% of all people with HIV experience flu-like symptoms at this stage and some people may develop a rash.
Sometimes, a rash is the only symptom of HIV, but because HIV impacts the immune system, there are often other symptoms, too.
Early symptoms of an HIV infection that can occur alongside a rash include:
- muscle aches
- night sweats
- sore throat
- generally feeling unwell
- a fever
- swollen lymph nodes
- mouth ulcers
According to the Centers for Disease Control and Prevention (CDC), these symptoms may appear 2–4 weeks after exposure and last between a few days and several weeks.
Anyone who experiences these symptoms after possible exposure to HIV should seek advice about testing.
If a rash occurs as a symptom of the acute stage of HIV, it will usually go away as the immune system produces antibodies to HIV.
After this, however, if a person is not taking medications to control HIV, they may have a higher chance of developing further rashes and skin problems. This is because HIV leads to a weakened immune system.
When the immune system is compromised, it becomes easier for viruses, fungi, bacteria, parasites, and other causes to trigger a rash.
Conditions that may appear with skin symptoms include:
- Molluscum ecthyma
- furuncles and carbuncles
- verrucae, warts, and papules
- non-melanoma skin cancer
- seborrheic dermatitis
- bullous impetigo
- drug reactions
In some cases, treatment for HIV can trigger an allergic skin reaction.
The following images here show some ways in which HIV may affect the skin.
A rash that appears during seroconversion will usually disappear without intervention, but other types of rash may occur later.
HIV-related rashes vary greatly. The chance of developing a rash will depend on factors such as:
- overall health
- use of antiretroviral drugs
- access to medical care
- exposure to contagious skin conditions
Chronic skin conditions
In time, other rashes can develop due to chronic conditions, such as herpes and psoriasis. These are long-term conditions that do not go away completely, although the symptoms may improve or disappear for a while.
The severity of each outbreak varies but depends partly on the immune function. Some medications, such as antiviral drugs for herpes, can reduce the severity of each outbreak.
Acute skin conditions
Rashes that result from an infection will go away with appropriate treatment.
However, due to HIV’s impact on the immune system, infections can become more likely. A previous rash may return, or a new one may appear.
Drugs for treating HIV can sometimes trigger a rash. Anyone who believes they have a rash due to their medication should speak to a member of their healthcare team. It is often possible to switch to another drug.
It is essential to speak to a doctor before changing or discontinuing treatment.
Taking antiviral medication keeps viral levels low and reduce HIV’s impact on the immune system. Many people can now live a healthy life with HIV, but it is essential to follow the treatment plan.
Prompt testing and early treatment are effective at stopping the progress of HIV, and early treatment for a rash can help prevent complications.
Anyone who develops a rash or flu-like symptoms should seek medical advice if they think they have come into contact with HIV.
They can undergo a test for HIV. If the result is positive, a healthcare team can help them develop a treatment plan that will help them stay healthy.
With current medication, it is possible to reduce the level of virus in the body to undetectable levels. The risk of diseases and infections falls and a person cannot transmit HIV to another person. In other words, undetectable = untransmittable.
The CDC provide a locator to help people locate HIV testing and prevention services in their area.
People who already have a diagnosis of HIV should see a doctor if a new rash develops or an existing rash gets worse.
Emergency medical attention may be necessary if:
- a rash spreads quickly
- there are swollen lymph nodes or a fever
- other symptoms are present, such as nausea and vomiting
- a rash
- flu-like symptoms, including a fever
- painful blisters
If anyone experiences these symptoms or other symptoms that may indicate a hypersensitivity or allergy — such as dizziness and breathing difficulty — they should seek urgent medical attention.
HIV undermines the immune system, making it harder for the body to fight infections. Even a minor infection can become life threatening without treatment.
Early testing and treatment for HIV can help a person live a healthy life and reduce the risk of developing HIV-associated infections and other conditions.
If anyone thinks they have come into contact with HIV, they should ask about a test, especially if they develop a rash and other symptoms within the following few weeks after exposure.