Effective Treatments 101 for Rash

Rashes may be a symptom of certain fungal, bacterial, or viral infections as well. If you have a rash that does not improve or go away within a few days, you should consult a doctor.

In general, most noninfectious rashes are usually treated symptomatically and often with cortisone creams or pills. Infection-associated rashes are frequently treated by addressing the underlying infection. Some treatments, such as oatmeal baths, may help control the itching of both infectious and noninfectious rashes.

Infectious Rashes

• Fungal

  • Tinea or ringworm infections of the skin, hair, and nails are treated by topical and/or oral antifungal medications like terbinafine.
  • Candida infections (yeast) are treated with topical antifungal medications like clotrimazole (Lotrimin AF, Alevazol, Desenex) and sometimes with oral antifungal drugs like fluconazole (Diflucan). Nystatin will not treat ringworm, nor will griseofulvin treat yeast.
  • Atypical fungal infections, including cryptococcosis, aspergillosis, and histoplasmosis, are generally treated with an oral or intravenous course of special antifungal medications.

• Viral

  • Herpes infections are usually treated with oral or intravenous antiviral medications, including acyclovir (Zovirax), famciclovir (Famvir), valacyclovir (Valtrex), ganciclovir (Cytovene), and cidofovir (Vistide). Depending on the severity of the individual infection and factors relating to the patient’s immune system, specific antiviral treatment may not be required or more aggressive treatment may be recommended.
  • Vaccination is an effective prevention measure to help ward off infections with the herpes zoster virus, which causes chickenpox and shingles.
  • There is no currently vaccine available for herpes simplex.
  • HIV infections are treated with a special combination of antiviral medications designed specifically for this virus.
  • Most other viral infections are self-limited and often may clear even without any treatment.

• Bacterial

  • Staphylococcus infections are typically treated with dicloxacillin and cephalosporin antibiotics. Topical treatment may include mupirocin cream or ointment (Bactroban).
  • A resistant form of Staphylococcus called methicillin-resistant Staphylococcus aureus (MRSA) is treated based upon specific antibiotic testing. Common antibiotics for treatment of MRSA infections include doxycycline (Vibramycin, Oracea, Adoxa, Atridox, Acticlate, Doryx), sulfamethoxazole-trimethoprim (Bactrim, Septra), and vancomycin (Vancocin).
  • Streptococcus infections are typically treated with oral or injectable antibiotics, including penicillin and erythromycin (Eryc, Ery-Tab, E.E.S, EryPed, PCE).
  • Pseudomonas infections are treated with oral or intravenous antibiotics, including ciprofloxacin (Cipro, Cipro XR, Proquin XR) or ofloxacin (Floxin).

• Noninfectious Rashes

  • Treatment of a rash due to a drug allergy includes stopping the responsible drug. Sometimes, a short course of oral steroids may be required in severe cases to help clear the rash. A rash may persist for days or weeks after discontinuing the offending drug.
  • Therapy for contact allergic dermatitis includes withdrawal of the offending topical agent and use of topical steroid creams like clobetasol (Cormax, Embeline, Temovate, Olux, Clobex) or hydrocortisone cream.
  • Treatment for eczema or atopic dermatitis includes a wide variety of skin-care measures, including lubrication and topical steroids, as well as oral antihistamines like diphenhydramine (Benadryl) for itching. Nonsedating antihistamines, while effective for hives, do not work as well for common eczema.
  • Hypersensitivity or allergic dermatitis from poison oak and poison ivy is treated by washing off the plant’s oily resin from the skin, clothing, and objects like golf clubs or shoes and applying steroid creams to the rash two to three times a day. Severe cases may require oral steroids like prednisone. The rash may last for another two to three weeks after a single exposure and will usually have a delay in onset of two to four days.
  • Irritant dermatitis is treated by skin lubrication, avoidance of harsh soaps and chemicals, use of petrolatum (Vaseline), and topical steroids like hydrocortisone.
  • Autoimmune conditions such as lupus (SLE) are treated by addressing the overactive immune reaction. Often oral and topical steroids are used to help control symptoms. Additional medications include hydroxychloroquine or immune-suppressing medications such as azathioprine (Imuran, Azasan) or mycophenolate mofetil (CellCept).