A symptom of toxic shock syndrome (TSS) is a distinctive rash. As TSS can be life threatening, anyone who thinks that they may have a TSS rash should seek emergency medical care.

Toxic shock syndrome (TSS) is a rare but serious infection. It causes flu-like symptoms, low blood pressure, and a distinctive rash.

This article explains how to tell whether a rash is due to TSS. It also discusses the symptoms and causes of TSS, how doctors diagnose and treat it, and other possible causes of the rash.

TSS can cause a rash that resembles sunburn and covers large areas of the body, including the palms of the hands and the soles of the feet. If TSS is the cause of a person’s rash, they will also experience other symptoms.

TSS is an acute infection that causes low blood pressure and severe flu-like symptoms, such as a high fever and muscle aches. TSS develops rapidly and requires immediate medical attention.

If a person believes that they or a loved one has TSS, they should seek immediate medical attention.

People can call 911 or go to the nearest hospital or healthcare clinic for an evaluation.

TSS is a rare but severe medical condition that is most commonly due to the Staphylococcus aureus bacterium.

TSS occurs when S. aureus bacteria secrete toxins, called superantigens, into the bloodstream.

The Streptococcus pyogenes bacterium, which people sometimes refer to as group A Streptococcus (GAS), also produces superantigens.

A GAS infection can result in a condition called streptococcal toxic shock syndrome or toxic shock-like syndrome (TSLS).

TSS and TSLS cause similar symptoms. Without treatment, these infections can spread throughout the body, affecting multiple organ systems.

The symptoms of TSS can include:

People with TSS can develop a sunburn-like rash that covers large parts of the body.

The rash usually appears a few hours after TSS symptoms begin. Similar to a sunburn, a TSS rash eventually leads to skin peeling and scaling. In people with lighter skin, the rash will be red, but it might be less visible in people with darker skin.

According to the National Institutes of Health (NIH), people rarely develop a rash with TSLS.

TSS symptoms develop rapidly. Without appropriate treatment, TSS can progress into a serious, potentially life threatening condition.

People may experience the following complications within 24–48 hours of the initial TSS symptoms:

  • extremely low blood pressure
  • faster-than-normal heartbeat
  • rapid breathing
  • kidney or liver failure

TSS occurs when bacteria enter the body through an open wound or sore. Historically, people have associated it with the use of super-absorbent tampons.

Although TSS primarily affects young adult females, it also occurs in males and nonmenstruating females.

Risk factors for TSS include:

  • skin wounds, burns, or open sores
  • soft tissue infections
  • postsurgical infections
  • recent childbirth, pregnancy loss, or abortion
  • using diaphragms or contraceptive sponges

A sunburn-like rash is a characteristic symptom of TSS. However, TSS is a rare medical condition, affecting an estimated 1 out of 30,000 people worldwide. Most rashes have causes other than TSS.

Other possible causes of a rash include:


A sunburn is an inflammatory skin reaction that results from overexposure to UV rays from the sun.

The symptoms usually include painful or swollen skin, which can become very red in people with lighter skin. Peeling and flaking of the skin may follow the initial symptoms.

Sunburns typically heal on their own. However, the following treatments can help speed up the healing process and reduce uncomfortable symptoms:

  • taking cool baths or showers to relieve pain
  • applying aloe vera to soothe and moisturize the affected skin
  • keeping blisters clean and dry while they heal
  • taking ibuprofen or aspirin to reduce swelling and relieve pain

Contact dermatitis

Contact dermatitis refers to an allergic skin reaction that develops when the skin comes into contact with an irritant. An itchy rash appears on areas of the skin with exposure to the irritant.

People can treat and manage the symptoms of contact dermatitis by:

  • avoiding known allergens and irritants, such as latex, poison ivy, and nickel
  • applying a cool compress to the affected skin
  • using over-the-counter (OTC) anti-itch ointments
  • taking OTC allergy medication, such as diphenhydramine (Benadryl) or cetirizine (Zyrtec)
  • keeping the skin hydrated with a fragrance-free moisturizer

Severe forms of contact dermatitis may require prescription-strength creams or ointments. Topical treatments containing corticosteroids can help reduce redness or discoloration and inflammation.

Heat rash

Heat rash, or miliaria, is a skin rash that occurs when sweat becomes trapped inside blocked sweat glands. A heat rash causes discolored, inflamed skin. Small bumps or blisters may form in the affected area.

Heat rash usually develops in skin folds and areas where the skin rubs against other skin, such as the neck, breasts, and inner thighs.

Avoiding hot environments and keeping the skin cool can help reduce mild heat rash symptoms. More severe forms of heat rash may require OTC treatments, such as calamine lotion.


Rosacea is a chronic skin condition that causes patches of discolored skin and small, fluid filled bumps. People with rosacea may also experience flushing and swelling in the following areas:

  • nose
  • cheeks
  • forehead
  • chin
  • eyes
  • ears
  • chest
  • back

There is currently no cure for rosacea, but avoiding triggers can help reduce symptoms. Common rosacea triggers include:

  • sun exposure
  • heat
  • wind
  • exercise
  • alcohol
  • stress
  • certain medicines
  • cosmetics and hair care products


Cellulitis is another type of skin infection that Staphylococcus and Streptococcus bacteria cause. People with cellulitis may notice flushed, swollen skin that is warm or painful to the touch.

Other symptoms of cellulitis include:

  • peeling skin
  • pitted skin
  • blisters
  • fever
  • chills

According to the Centers for Disease Control and Prevention (CDC), cellulitis most commonly affects the legs and feet but can occur anywhere on the body.

Doctors can treat cellulitis with antibiotics. Without treatment, cellulitis can lead to infections of the:

  • blood
  • bones
  • joints
  • lining of the heart or heart valves

People with TSS require immediate medical treatment.

The treatment for TSS usually involves an intravenous (IV) antibiotic that helps fight the bacterial infection. Antibiotic treatment will usually last 1–2 weeks.

Depending on the severity of the infection and a person’s symptoms, doctors may recommend the following supportive treatments:

  • IV fluids
  • electrolyte replacement therapy
  • medication to increase blood pressure

Toxic shock syndrome is a serious bacterial infection that develops rapidly and requires immediate medical attention.

TSS often causes severe flu-like symptoms, such as high fever, muscle aches, and chills. Severe TSS can also cause extremely low blood pressure.

A sunburn-like rash is a characteristic sign of TSS. The rash develops within a few hours of TSS symptoms first appearing. Large portions of the skin may start peeling or flaking.

People who develop TSS symptoms with or without the rash should either call an ambulance or go to the nearest emergency room.

Without treatment, TSS can cause potentially life threatening complications, such as kidney or liver failure.