HIV is transmitted from person to person when bodily fluids like blood, semen, vaginal fluids, rectal fluids, and breast milk come into contact with each other. You can get HIV during unprotected sex or when you share needles with an infected person.
This article explores four types of rashes commonly seen in people with HIV and what can be done to treat them.
What Is an HIV Rash?This photo contains content that some people may find graphic or disturbing.See PhotoU.S. National Library of Medicine / National Institutes of HealthThis is a type of rash that occurs when the immune system reacts to the presence of HIV. This type of HIV rash usually starts two to six weeks after exposure to the virus.A rash occurs in around half of early HIV cases.The rash is described asmaculopapular, meaning there are flat, reddened patches on the skin (macules) covered with small, raised bumps (papules).In people with darker skin, the rash may be a deep, purple color.While many diseases can cause this type of rash, an “HIV rash” will generally affect the upper part of the body. There may also be ulcers in the mouth or on the genitals. The rash can be itchy or painful. Flu-like symptoms are also common, such as:Fever and chillsMuscle achesNight sweatsSwollen lymph nodesSore throatFeeling very fatigued or unwellTheearly symptoms of HIVincluding the HIV rash will usually go away within one to two weeks.If the rash is severe, the doctor may prescribe an over-the-counterhydrocortisone creamto help relieve the itching and swelling.When to See a Healthcare ProviderIf you think you have been exposed to HIV and you develop a rash either on its own or along with flu-like symptoms, see your healthcare provider right away to get an HIV test.Once HIV is confirmed with anHIV test,antiretroviral therapyshould be started immediately to control the virus and prevent the condition from progressing. HIV causes a compromised immune system, which can put you at increased risk of developing a rash from sources such as viruses, bacteria, or fungi.How Long Does It Take to Show Symptoms of HIV?
What Is an HIV Rash?
This photo contains content that some people may find graphic or disturbing.See PhotoU.S. National Library of Medicine / National Institutes of Health
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
U.S. National Library of Medicine / National Institutes of Health
This is a type of rash that occurs when the immune system reacts to the presence of HIV. This type of HIV rash usually starts two to six weeks after exposure to the virus.A rash occurs in around half of early HIV cases.
The rash is described asmaculopapular, meaning there are flat, reddened patches on the skin (macules) covered with small, raised bumps (papules).In people with darker skin, the rash may be a deep, purple color.
While many diseases can cause this type of rash, an “HIV rash” will generally affect the upper part of the body. There may also be ulcers in the mouth or on the genitals. The rash can be itchy or painful. Flu-like symptoms are also common, such as:
Theearly symptoms of HIVincluding the HIV rash will usually go away within one to two weeks.If the rash is severe, the doctor may prescribe an over-the-counterhydrocortisone creamto help relieve the itching and swelling.
When to See a Healthcare ProviderIf you think you have been exposed to HIV and you develop a rash either on its own or along with flu-like symptoms, see your healthcare provider right away to get an HIV test.
When to See a Healthcare Provider
If you think you have been exposed to HIV and you develop a rash either on its own or along with flu-like symptoms, see your healthcare provider right away to get an HIV test.
Once HIV is confirmed with anHIV test,antiretroviral therapyshould be started immediately to control the virus and prevent the condition from progressing. HIV causes a compromised immune system, which can put you at increased risk of developing a rash from sources such as viruses, bacteria, or fungi.
How Long Does It Take to Show Symptoms of HIV?
Seborrheic DermatitisThis photo contains content that some people may find graphic or disturbing.See PhotoAmras 666Seborrheic dermatitisis one of the most common causes of an HIV rash. It affects over 80% of people with advanced HIV infection but can even affect those whose immune systems are only moderately impaired.Seborrheic dermatitiscauses inflammation of the scalp, face, torso, and upper back. It most often affects oily parts of the skin, causing redness and yellowish scales. Although the cause is unknown in people with HIV, the condition is not contagious.In severe cases, seborrheic dermatitis can cause scaly pimples around the face and behind the ears. The nose, eyebrows, chest, upper back, armpits, and inside of the ear may also be affected.Topical steroidsmay be used for severe cases. People with HIV who are not yet on antiretroviral therapy should be started immediately to preserve or restore the immune system.Uncommon Signs and Symptoms of HIV
Seborrheic Dermatitis
This photo contains content that some people may find graphic or disturbing.See PhotoAmras 666
Seborrheic dermatitisis one of the most common causes of an HIV rash. It affects over 80% of people with advanced HIV infection but can even affect those whose immune systems are only moderately impaired.
Seborrheic dermatitiscauses inflammation of the scalp, face, torso, and upper back. It most often affects oily parts of the skin, causing redness and yellowish scales. Although the cause is unknown in people with HIV, the condition is not contagious.
In severe cases, seborrheic dermatitis can cause scaly pimples around the face and behind the ears. The nose, eyebrows, chest, upper back, armpits, and inside of the ear may also be affected.
Topical steroidsmay be used for severe cases. People with HIV who are not yet on antiretroviral therapy should be started immediately to preserve or restore the immune system.
Uncommon Signs and Symptoms of HIV
Herpes zoster (shingles).Photograph © Fisle, 2007
Medication-Related Rashes
This photo contains content that some people may find graphic or disturbing.See PhotoU.S. National Library of Medicine
Antiretroviral drugsand other drugs that treatHIV-related infectionscan sometimes trigger a rash. The rash tends to appear one to two weeks after the start of treatment. Some have been known to develop within one to two days.
The rash is most commonlymorbilliform, meaningmeasles-like, and made up of flat or slightly raised red, circular, or oval patches. It usually affects the torso before spreading to the arms, legs, and neck.
Ziagen (abacavir) and Viramune (nevirapine) are two antiretroviral drugs commonly linked to drug hypersensitivity reactions.
If you develop a rash after you start a new medication, talk to your healthcare provider. You may need to discontinue the use of the drug.
Antihistaminesmay be prescribed to reduce redness and swelling. In severe cases, emergency care may be needed if there is trouble breathing, swelling, or other signs of a severe allergic reaction calledanaphylaxis.
Life Expectancy for People Living With HIV
Stevens-Johnson Syndrome
Stevens-Johnson syndrome (SJS)is a potentially life-threatening drug reaction that causes the top layer of skin to detach from the lower layer.
Round lesions about an inch wide will then start to appear on the face, trunk, limbs, and soles of the feet. The lesions grow together quickly and form blisters that erupt, peel, ooze, and crust over. If left untreated, the massive loss of skin and fluid can cause sepsis, shock, and death.
Viramune (nevirapine) is one HIV drug commonly linked to SJS.Ziagen (abacavir) andsulfa antibioticscan also trigger a reaction.
The drug is stopped once symptoms of SJS appear. Emergency care is essential and may include antibiotics, intravenous (IV) fluids, and treatments to prevent eye damage.
In severe cases, recovery time can sometimes take months. The risk of death from SJS is roughly 10%.
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HIV Rash Treatment
Treatment for an HIV rash depends on what’s causing it. A rash that develops in the early stages of HIV may be treated with hydrocortisone cream to relieve itching. Antiretroviral treatment can help prevent the development of other types of rashes.
You should discuss any rash with your healthcare provider. They may be able to provide treatments or recommend a medication change that can help resolve your symptoms.
Call 911 or seek emergency care if you have a rash along withsigns and symptoms of anaphylaxis, including:
Summary
Depending on the cause, the rash may be managed with steroids, antibiotics, or antihistamines. If the rash is the result of a drug reaction, HIV treatment is almost invariably stopped.
10 SourcesVerywell 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.Altman K, Vanness E, Westergard RP.Cutaneous manifestations of human immunodeficiency virus: a clinical update.Curr Infect Dis Rep.2015;17(3):464. doi:10.1007/s11908-015-0464-yMatsumoto S, Murata Y, Tomoda Y.Acute HIV infection in a 39-year-old man.CMAJ. 2022;194(45):E1541. doi:10.1503/cmaj.220656Cowan EA, McGowen JP, Fine SM, et al.Box 1: acute retroviral syndrome (a). In:Diagnosis and Management of Acute HIV [Internet].Borda LJ, Wikramanayake TC.Seborrheic dermatitis and dandruff: a comprehensive review.J Clin Investig Dermatol.2015;3(2). doi:10.13188/2373-1044.1000019Motswaledi HM.Common dermatological conditions in the HIV patient.S Afr Fam Pract. 2019;6(sup1):S19-S24. doi:10.1080/20786190.2019.1610234Yunihstuti E, Widhani A, Karjadi TH.Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management.Asia Pac Allergy.2014;4(1):54-67. doi:10.5415/apallergy.2014.4.1.54Fakoya AOJ, Omenyi P, Anthony P, Anthony F, Etti P, Otohinoyi DA, Olunu E.Stevens - Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci. 2018;6(4):730-738. doi:10.3889/oamjms.2018.148National Library of Medicine.Stevens-Johnson syndrome/toxic epidermal necrolysis.du Toit JD, Kotze K, van der Westhuizen HM, Gaunt TL.Nevirapine-induced Stevens-Johnson syndrome in children living with HIV in South Africa.South Afr J HIV Med. 2021;22(1):1182. doi:10.4102/sajhivmed.v22i1.1182National Library of Medicine.Anaphylaxis.
10 Sources
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.Altman K, Vanness E, Westergard RP.Cutaneous manifestations of human immunodeficiency virus: a clinical update.Curr Infect Dis Rep.2015;17(3):464. doi:10.1007/s11908-015-0464-yMatsumoto S, Murata Y, Tomoda Y.Acute HIV infection in a 39-year-old man.CMAJ. 2022;194(45):E1541. doi:10.1503/cmaj.220656Cowan EA, McGowen JP, Fine SM, et al.Box 1: acute retroviral syndrome (a). In:Diagnosis and Management of Acute HIV [Internet].Borda LJ, Wikramanayake TC.Seborrheic dermatitis and dandruff: a comprehensive review.J Clin Investig Dermatol.2015;3(2). doi:10.13188/2373-1044.1000019Motswaledi HM.Common dermatological conditions in the HIV patient.S Afr Fam Pract. 2019;6(sup1):S19-S24. doi:10.1080/20786190.2019.1610234Yunihstuti E, Widhani A, Karjadi TH.Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management.Asia Pac Allergy.2014;4(1):54-67. doi:10.5415/apallergy.2014.4.1.54Fakoya AOJ, Omenyi P, Anthony P, Anthony F, Etti P, Otohinoyi DA, Olunu E.Stevens - Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci. 2018;6(4):730-738. doi:10.3889/oamjms.2018.148National Library of Medicine.Stevens-Johnson syndrome/toxic epidermal necrolysis.du Toit JD, Kotze K, van der Westhuizen HM, Gaunt TL.Nevirapine-induced Stevens-Johnson syndrome in children living with HIV in South Africa.South Afr J HIV Med. 2021;22(1):1182. doi:10.4102/sajhivmed.v22i1.1182National Library of Medicine.Anaphylaxis.
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.
Altman K, Vanness E, Westergard RP.Cutaneous manifestations of human immunodeficiency virus: a clinical update.Curr Infect Dis Rep.2015;17(3):464. doi:10.1007/s11908-015-0464-yMatsumoto S, Murata Y, Tomoda Y.Acute HIV infection in a 39-year-old man.CMAJ. 2022;194(45):E1541. doi:10.1503/cmaj.220656Cowan EA, McGowen JP, Fine SM, et al.Box 1: acute retroviral syndrome (a). In:Diagnosis and Management of Acute HIV [Internet].Borda LJ, Wikramanayake TC.Seborrheic dermatitis and dandruff: a comprehensive review.J Clin Investig Dermatol.2015;3(2). doi:10.13188/2373-1044.1000019Motswaledi HM.Common dermatological conditions in the HIV patient.S Afr Fam Pract. 2019;6(sup1):S19-S24. doi:10.1080/20786190.2019.1610234Yunihstuti E, Widhani A, Karjadi TH.Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management.Asia Pac Allergy.2014;4(1):54-67. doi:10.5415/apallergy.2014.4.1.54Fakoya AOJ, Omenyi P, Anthony P, Anthony F, Etti P, Otohinoyi DA, Olunu E.Stevens - Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci. 2018;6(4):730-738. doi:10.3889/oamjms.2018.148National Library of Medicine.Stevens-Johnson syndrome/toxic epidermal necrolysis.du Toit JD, Kotze K, van der Westhuizen HM, Gaunt TL.Nevirapine-induced Stevens-Johnson syndrome in children living with HIV in South Africa.South Afr J HIV Med. 2021;22(1):1182. doi:10.4102/sajhivmed.v22i1.1182National Library of Medicine.Anaphylaxis.
Altman K, Vanness E, Westergard RP.Cutaneous manifestations of human immunodeficiency virus: a clinical update.Curr Infect Dis Rep.2015;17(3):464. doi:10.1007/s11908-015-0464-y
Matsumoto S, Murata Y, Tomoda Y.Acute HIV infection in a 39-year-old man.CMAJ. 2022;194(45):E1541. doi:10.1503/cmaj.220656
Cowan EA, McGowen JP, Fine SM, et al.Box 1: acute retroviral syndrome (a). In:Diagnosis and Management of Acute HIV [Internet].
Borda LJ, Wikramanayake TC.Seborrheic dermatitis and dandruff: a comprehensive review.J Clin Investig Dermatol.2015;3(2). doi:10.13188/2373-1044.1000019
Motswaledi HM.Common dermatological conditions in the HIV patient.S Afr Fam Pract. 2019;6(sup1):S19-S24. doi:10.1080/20786190.2019.1610234
Yunihstuti E, Widhani A, Karjadi TH.Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management.Asia Pac Allergy.2014;4(1):54-67. doi:10.5415/apallergy.2014.4.1.54
Fakoya AOJ, Omenyi P, Anthony P, Anthony F, Etti P, Otohinoyi DA, Olunu E.Stevens - Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci. 2018;6(4):730-738. doi:10.3889/oamjms.2018.148
National Library of Medicine.Stevens-Johnson syndrome/toxic epidermal necrolysis.
du Toit JD, Kotze K, van der Westhuizen HM, Gaunt TL.Nevirapine-induced Stevens-Johnson syndrome in children living with HIV in South Africa.South Afr J HIV Med. 2021;22(1):1182. doi:10.4102/sajhivmed.v22i1.1182
National Library of Medicine.Anaphylaxis.
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