Skin Manifestations Seen in COVID-19 Patients

The COVID-19 pandemic has affected almost every way of life, from how people travel to how kids play together. Even as the Omicron variant sweeps across the country, most health experts are still learning about the effects and symptoms of this virus.

Dr. Praveen Buddiga, the founder of BUDDIGA Family Allergy | Skin | Immunology and BUDDIGA Skin Aesthetics Med Spa, is a leading immunology expert and specializes in understanding allergies and the body’s negative reactions that can result in symptoms like distressed skin and inflamed sinuses. Throughout the pandemic, he has been approached by patients who have experienced skin manifestations because of the virus despite the fact that few people know that COVID-19 can affect your skin – and what the long-term effects are. Here are a few of the most common skin problems that arise as a result of the virus and how doctors like Dr. Buddiga are working to treat them.

Symptoms Change With Each New Variant

Before diving into the different skin manifestations seen in COVID-19 patents, it’s important to remember that this virus is always evolving. The first cases of COVID-19 were the alpha variant. Since then, the United States has seen severe waves of the Delta and Omicron variants, and each of these variants has its own symptoms and level of aggression.

The evolving nature of the virus means that skin conditions may be more common in some variants over others. Additionally, different bodies react to the virus in unique ways. While one patient might have mild symptoms, another patient might have a severe reaction with long-term skin manifestations.

The following is not a diagnosis but rather a discussion; the only way to reduce your chances of developing skin conditions because of COVID-19 is to get vaccinated if you can and to follow the CDC’s guidelines for social distancing and mask-wearing.

COVID Patients Can Develop Hives

When your body perceives a threat, it reacts in any way possible to defeat the invader. This is why spring can be so frustrating for people with pollen allergies– their itchy eyes and runny nose are the body’s way of fighting the perceived threat. As the COVID-19 virus starts to attack the body, it can respond by developing different skin conditions. It’s possible that you may develop Urticaria, otherwise known as hives.

Urticaria rashes can develop at the onset of COVID symptoms and can last through the duration of the illness. They look like raised welts on the skin, which can spread quickly and become itchy. Some people develop hives on their lips and eyelids, which can be painful and impact their ability to function.

Hives can be treated with antihistamines. If a patient develops hives near the mouth or lips, it’s important to make sure they can still breathe. If there are signs that they’re struggling to breathe or that their airway is being impacted, it’s critical that they receive immediate medical attention.

Maculopapular Rashes are the Most Common

One of the most common ways for COVID-19 to affect the skin is with a maculopapular rash. This occurs when there are flat skin patches and raised bumps.

For the “macule,” part of the rash, your skin may redden and could become itchy. The redness could be hard to see if your skin is dark.
For the “papule,” your skin starts to develop raised bumps, like goosebumps that remain and become swollen.

A maculopapular rash caused by COVID-19 can start anywhere on the body and spread throughout your abdomen, back, limbs, and face.

Researchers noticed that maculopapular rashes started to form early on in the illness. This was a sign that the body was trying to fight the novel coronavirus. Maculopapular rashes were most common in people with moderate to severe responses to the diseases. However, everyone’s skin is different, and rashes could still form in mild cases.

Oftentimes, there is no specific treatment for a maculopapular rash that is caused by a virus. Instead of treating the rash, the doctor treats the virus and, as patients start to recover from COVID-19, their rash symptoms fade away.

Some Patients Report Having “COVID Toe”

In early 2020, most people were still learning how to identify signs of COVID-19. It was during this time that doctors reported changes to the toes of patients who were infected with the virus. The toes turn reddish-purple and start to swell. They can become sensitive to the touch. COVID toe is caused by inflamed blood vessels and can actually be a good sign.

“[It is] a sign that your body is mounting a good immune response to the SARS-CoV2 virus,” says Dr. Ginette Okoye, chair of the department of dermatology at Howard University. Okoye reports that many signs of COVID toe occur in patients with mild symptoms.

Not much is known about COVID toe. In late 2021, there were rumors that Aaron Rodgers, quarterback for the Green Bay Packers, developed the condition when he was sick. However, he stated that it was a foot fracture that was unrelated to the coronavirus.

Patients who experience this can apply hydrocortisone cream to the affected area to prevent itching or pain. If the condition persists or becomes significantly uncomfortable, make an appointment with Dr. Buddiga. COVID toe can last a few weeks up to a few months, depending on the patient.

COVID Can Cause Your Body to Shed Its Hair

Because the symptoms of COVID-19 are so varied, some people are mistaking a normal bodily response to illness as a symptom of coronavirus. For example, many people noticed increased hair loss directly after they experienced COVID-19. This caused the American Academy of Dermatology Association to step in and explain the body’s reaction to the virus.

A few months after a major illness, you may experience high levels of hair shedding. This is called telogen effluvium. With a mild case, you may notice more hair in your brush. In a severe case, your hair may come out in clumps. This is because your body underwent physical stress that resulted in shutting down certain normal processes.

Even if you haven’t experienced COVID, you may notice more hair shedding as a result of stress. Your body is so focused on your stress and anxiety that it doesn’t have the energy to keep up with your hair.

Hair shedding can occur two or three months after your COVID-19 symptoms end. It usually lasts for a few months before normal hair growth will return. The shedding is mostly temporary. If you experience a rash on your scalp, burning, or itching in your hairline, make an appointment with Dr. Buddiga as this likely isn’t telogen effluvium and may be a sign of another immunological condition

If you have experienced increased shedding recently, learn more about the Hydrafacial™ Keravive™ treatments offered at BUDDIGA Skin Aesthetics Med Spa to give you stronger, healthier hair.

Prolonged Mask-Wearing can Cause “Maskne”

Not all skin manifestations are caused by catching the coronavirus itself. Many frontline workers started to notice skin irritation at the start of the pandemic when they began wearing masks all day. Nurses, grocery store workers, teachers, and other essential employees needed to wear masks for eight to twelve hours at a time and were left with sensitive skin and breakouts.

Dr. Anna Lien-Lun at Johns Hopkins uses the term “maskne,” (mask + acne) to describe skin conditions caused by wearing a mask. Wearing a mask can worsen existing dermatological issues or cause new problems for your delicate facial skin. Fortunately, there are a few ways to reduce the impact of mask-wearing, so you can stay safe while protecting your skin.

• Opt for soft cotton or polyester-blend masks instead of scratchy paper face coverings.
• Wear your mask properly, so it fits snuggly on your face. This will prevent chafing.
• Keep your mask clean so you aren’t wearing face coverings that have dirt and bacteria on them.
• If you need to wear a mask for long periods of time, avoid other irritants like cosmetics (this also prevents makeup smudging).
• Practice a healthy skincare routine. Wash your face with water and mild soap and use a daily moisturizer. This also applies to dry skin on your hands caused by too-much hand washing and sanitizer.

If your maskne persists and you need to keep wearing face coverings for long periods of time, talk to Dr. Buddiga. He can create a treatment plan so your skin stays healthy and you stay safe.

Talk to Dr. Buddiga if You Experience Any Skin Conditions

If you have developed a rash because of the Coronavirus or because of another cause, contact Dr. Buddiga. He has seen all different types of skin conditions and can help you treat any visual or physical discomfort you may have. Even if you haven’t caught the virus, Dr. Buddiga can help you prevent “maskne” and keep your skin healthy and reduce signs of irritation and aging. Request a consultation today so you can make optimize the health of your skin through the pandemic and beyond.