Key TakeawaysCOVID-19 “long-haulers” can experience skin symptoms, like hives and “COVID toes,” which can last for months, new research has found.The severity of a COVID-19 case is associated with different types of skin symptoms.Experts are still learning about the disease, but they believe inflammation is at play in some skin conditions, like COVID toes.Other viruses and diseases cause skin symptoms, too, like measles and chickenpox, but symptoms usually go away once a patient has recovered.
Key Takeaways
COVID-19 “long-haulers” can experience skin symptoms, like hives and “COVID toes,” which can last for months, new research has found.The severity of a COVID-19 case is associated with different types of skin symptoms.Experts are still learning about the disease, but they believe inflammation is at play in some skin conditions, like COVID toes.Other viruses and diseases cause skin symptoms, too, like measles and chickenpox, but symptoms usually go away once a patient has recovered.
Patients with ongoing symptoms of COVID-19 say things like fatigue, headaches, and difficulties breathing are common in the weeks after being infected. These “long-haulers,” or people with “long-COVID,” also experience skin symptoms—some of which can last for several months, according to new research presented at the 29th European Academy of Dermatology and Venereology (EADV) Congress in October and November.
Data entered into a global registry of nearly 1,000 patients across 39 countries showed that COVID-19 long-hauler patients continue to experience skin-related symptoms long after their initial infection has cleared. The wide-raging symptoms include:
“There are many different types of skin manifestations of COVID-19, which is very interesting,” Esther Freeman, MD, PHD, the principal investigator of the International COVID-19 Dermatology Registry and director of Global Health Dermatology at the Massachusetts General Hospital, tells Verywell.
“It’s actually hard to think of another virus that causes so many different types of skin findings.”
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Why COVID-19 Causes Skin Symptoms
Experts are learning more about COVID-19 and its symptoms, both short-term and long-term, every day. When it comes to the skin symptoms long-haulers are experiencing, Freeman says there’s likely multiple factors at play.
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The skin symptoms that seem to be linked to inflammation include COVID toes, or pernio/chilblains. Based on her research findings, Freeman says COVID toes are mostly associated with milder cases of the disease; only 16% of patients in the registry with this skin symptom were hospitalized, she says. This can be interpreted as meaning that COVID toes are “a reaction to the way your immune system is handling the virus.”
Freeman’s registry found that 100% of patients with retiform purpura were hospitalized. Blood clots are one of the mostsevere and dangerous manifestationsof COVID-19.
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Susanne R. Gulliver, BA, MPH, a senior epidemiologist and research and operations manager at NewLab Clinical Research Inc. in St. John’s, Newfoundland and Labrador, tells Verywell that many other viruses or diseases can also cause skin symptoms, as seen withmeaslesand chickenpox.
The measles virus, for example,causes fever and flu-like symptomsand spreads throughout the body. As antibodies fight the virus, damage to the walls of tiny blood vessels occurs, which leads to rash.
“We also see [skin symptoms] withguttate psoriasis, which is a type of psoriasis that tends to be the precursor with a lot of patients with a strep infection,” Gulliver says. “A lot of these diseases are dysregulation of the immune system.”
Why Do Skin Symptoms Last So Long?
Long-haulers or people experiencing long-term symptoms from COVID-19 are still being studied. Experts need to better understand what the disease does to the body, and why it can cause such a range of ongoing conditions.
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In Freeman’s research, data showed that different symptoms lasted various amounts of time. Rash-like morbilliform lasted a median of seven days, and urticarial (hives) lasted a median of four days in COVID-19 patients. Papulosquamous eruptions lasted a median of 20 days, but one COVID-19 long-hauler had the symptom for 70 days.
COVID toes lasted about two weeks in patients, but six patients in the registry had symptoms lasting at least 60 days. Two had COVID toes for more than 130 days.
Usually with other viruses or diseases, like measles, skin symptoms clear once “the disease goes into remission and the lesions heal,” Gulliver says.
But with COVID-19, the longer-lasting symptoms are still puzzling to experts. “Recovering” from COVID-19 is not clear-cut, as people with long-COVID have shown, Freeman says. Someone with symptoms eight weeks after contracting the virus may no longer be in their acute phase of infection, she says, but that doesn’t mean they are back to “normal.”
What This Means For YouPeople with long-COVID can experience long-term skin symptoms of the disease, including COVID toes or rash, for days or months. Different skin conditions depend on the severity of the disease; COVID toes is associated with milder cases. Researchers are still unsure exactly why some patients develop skin symptoms, but believe inflammation plays a role in certain reactions.
What This Means For You
People with long-COVID can experience long-term skin symptoms of the disease, including COVID toes or rash, for days or months. Different skin conditions depend on the severity of the disease; COVID toes is associated with milder cases. Researchers are still unsure exactly why some patients develop skin symptoms, but believe inflammation plays a role in certain reactions.
This is evident with the various symptoms long-haulers experience, including longer-standing cardiac complications, neurological effects, and chronic fatigue, Freeman says.
“With COVID toes, we’re seeing this kind of persistent inflammation,” she says. “It certainly begs the question of why do some patients seem to have these really long-standing, persistent inflammatory effects? My suspicion is that it’s not a direct viral effectthatmany months out; clearly the virus has triggered some other process in the body that’s continuing.”
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.
1 SourceVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.European Academy of Dermatology and Venereology.New analysis reveals “long-hauler” COVID-19 patients with prolonged skin symptoms. Eureka Alert.
1 Source
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.European Academy of Dermatology and Venereology.New analysis reveals “long-hauler” COVID-19 patients with prolonged skin symptoms. Eureka Alert.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
European Academy of Dermatology and Venereology.New analysis reveals “long-hauler” COVID-19 patients with prolonged skin symptoms. Eureka Alert.
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