How to Identify and Manage an HIV Rash

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Learn what HIV rash looks like and how to take care of it at home

Co-authored by Dale Prokupek, MD

Last Updated: March 18, 2024 Approved

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A skin rash is a common symptom of HIV infections. It is an early indication in most cases and occurs within two to three weeks after you have contracted the virus. However, skin rashes can be caused by other, less dangerous factors too, like an allergic reaction or a skin issue. When in doubt, you should go see your doctor and get tested for HIV. This will ensure you receive the correct treatment for your condition.

Identifying HIV Rash Symptoms

HIV rash usually looks like red or dark purple blotches on your skin, but its appearance can vary from person to person. Check your shoulders, upper body, face, and hands for HIV rash. Severe cases may also cause nausea, fever, or muscle pain.

Part 1

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Recognizing the Symptoms of an HIV Rash

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1
Check for a rash that is red, slightly raised, and very itchy.^{[1]
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Dale Prokupek, MD. Internist. Personal interview. 16 April 2020.} HIV rash usually causes blotches and spots on the skin, red for people with fair skin and dark purplish for people with dark skin.
- The severity of the rash varies from patient to patient. Some get a very severe rash that covers a large area, while others only have a minor rash.
- If the HIV rash is the result of antiviral medications, the rash will appear as raised reddish lesions that cover your whole body. These rashes are called “drug eruptions”.
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Note if the rash appears on your shoulders, chest, face, upper body, and hands. This is usually where the HIV rash shows up on your body. However, the rash tends to disappear by itself within a few weeks. Some people mistake it for an allergic reaction or eczema.
- HIV rash is not transmittable, so there is no risk of spreading HIV via this rash.
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Pay attention to other symptoms that may occur when you have HIV rash. These include:^{[2]
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- Nausea and vomiting
- Mouth sores
- Fever^{[3]
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  Dale Prokupek, MD. Internist. Personal interview. 16 April 2020.}
- Diarrhea
- Muscle pain
- Cramps and body aches
- Enlargement of your glands
- Blurred or hazy vision
- Loss of appetite
- Joint pain
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Be aware of the causes of HIV rash. This rash occurs due to the fall in the number of white blood cells (WBC) in your body. HIV rash can occur at any stage of infection but generally, you notice it two to threes weeks after you have contracted the virus. This phase is called seroconversion, which is when the infection becomes detectable via a blood test. Some people may skip this phase and develop HIV rash in the later stages of having the virus.
- HIV rash can also be caused by an adverse reaction to anti-HIV medicines. Drugs like Amprenavir, abacavir, and nevirapine can cause HIV skin rashes.
- During the third phase of HIV infection, you can develop skin rashes due to dermatitis. This type of HIV rash appears pink or reddish and are itchy. It can last from one to three years and is usually found on your groin, underarms, chest, face, and back areas.
- You can also get HIV rashes if you have Herpes and are HIV-positive.

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Getting Medical Care

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1
Get an HIV test if you have a mild rash. If you have not already been tested for HIV, your doctor should perform a blood test to check if you have the virus. If you are negative, your doctor will then determine if your rash is from an allergic reaction to food or other factors. You may also have a skin issue like eczema.
- If you are HIV positive, your doctor will likely prescribe anti-HIV medication and treatment.
- If you are already on anti-HIV medication and the rash is mild, your doctor will tell you to continue taking the medication as the rash should go away after one to two weeks.
- To reduce the rash, especially the itching, your doctor may prescribe an antihistamine, such as Benadryl or Atarax, or a corticosteroid-based cream.^{[4]
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Your severe rash may also appear along with other symptoms of the virus, such as fever, nausea or vomiting, muscle pain, and mouth sores.^{[5]
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Dale Prokupek, MD. Internist. Personal interview. 16 April 2020.} If you haven’t already been tested for the HIV, your doctor should perform a blood test to check if you have HIV. Based on the results of your blood test, your doctor will then prescribe anti-HIV medication and treatment.
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Consult a doctor if the symptoms worsen, especially after you take your medication. You may develop hypersensitivity to certain medications and your HIV symptoms, including your HIV rash, may get worse. Your doctor should advise you to stop taking the medication and provide alternative medications you can take. The hypersensitivity symptoms usually disappear in 24-48 hours. There are three main classes of anti-HIV drugs that can cause skin rashes:
- NNRTIs
- NRTIs
- PIs
- NNRTIs, such as nevirapine (Viramune) are the most common cause of medication skin rashes. Abacavir (Ziagen) is an NRTI drug that can cause skin rashes. PIs like amprenavir (Agenerase) and tipranavir (Aptivus) can also cause rashes.
If your doctor advises you to stop a certain medicine due to hypersensitivity or an allergic reaction, do not take it again. By taking it again, you run the risk of causing an even more severe reaction that could progress and make your condition much worse.
People with HIV have an increased incidence of bacterial infection due to abnormalities in immune cell function. Staphylococcus aureus (MRSA) is prevalent among those who are HIV-positive,^{[6]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} which may lead to impetigo, inflamed hair follicles, boils, cellulitis, abscesses, and ulcerations.^{[7]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} If you have HIV, you may want your doctor to test for MRSA.

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Treating the Rash at Home

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Your doctor may prescribe anti allergy creams or medication to help with any discomfort or itching. You can also buy over-the-counter antihistamine cream to help with these symptoms. Apply the cream as directed on the package.
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Avoid direct sunlight or extreme cold. These are both triggering factors for HIV rashes, and can make your HIV rash worse.^{[8]
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- If you are going to go outside, apply sunscreen to your body to protect your skin or wear long sleeves and pants.
- Wear a coat and warm clothing when going outside to avoid exposing your skin to extreme cold.
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Take cold water baths and showers. Hot water will irritate your rash. Skip the hot baths or showers and go for a cold water bath or sponge bath to soothe your skin.^{[9]
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- You can use lukewarm water and pat, rather than rub, at your skin in the shower or the bath. Apply an all natural moisturizer to your skin to help it heal, such as creams that contain coconut oil or aloe vera, as soon as you get out of the bath or shower. The top layer of your skin is like a sponge, so applying moisturizer once you have stimulated your pores will trap water inside your skin and prevent dryness.
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Switch to mild soap or herbal body wash. Chemical based soap can irritate your skin and cause dryness and itching. Look for mild soap, such as baby soap, or herbal body wash at your local drugstore.^{[10]
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- Avoid products that contain chemicals such as Petrolatum; Methyl-, Propyl-, Butyl-, Ethylparaben; and Propylene Glycol. These are all synthetic ingredients that can irritate your skin or cause an allergic reaction.
- You can also make your own herbal body wash with natural moisturizers like olive oil, aloe vera, and almond oil.
- Be sure to apply all natural moisturizer right after your bath or shower and throughout the day to keep your skin hydrated.
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Wear soft cotton clothing. Clothing made of synthetic or non breathable fibers can cause you to sweat and make your skin more irritated.
- Tight clothing can also rub against your skin and worsen the HIV rash.
Let the anti-HIV medication prescribed by your doctor run its course. It will improve your t-cell count and can treat symptoms like HIV rash, as long as you are not having an allergic reaction to the medicine.

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Question

Is it possible to get a rash from body spray if I am HIV positive?

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

Sure, but this might not be an HIV rash. This might be an atopic dermatitis. HIV rashes are usually blotchy and purple.

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Question

It is possible for someone with H.S.V. to test positive for HIV?

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

Yes, HSV does not protect against HIV. They are separate viruses and infect the body differently.

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