An HIV Information & Educational Resource Site

Skin Rash
or, "What should I do if I have skin problems or my medications are making me break out and itch?"

Side effects from medications are pretty common, but fortunately they are generally pretty mild and can be remedied with relatively easy treatments.  As medicine makes progress in the treatment of HIV and AIDS, the newer medications are generally easier to take and less sickening than some of the older treatments.  Additionally as more and more treatments are found, it becomes easier and easier to find treatments that suit all patients much better.

See below for skin rashes and itching skin.  The most important thing to do about side effects is to report them to your healthcare provider promptly and completely.  If your healthcare provider is aware of your symptoms and problems, your provider can provide recommendations about treatments and changes in your treatment that can decrease or even eliminate the symptoms that you are dealing with.  Please note that the information below should not come before the advice of your healthcare provider because only that person knows all of your medications and all of your conditions.

Skin Rash
Possible Causes
HIV Drugs
atovaquone (Mepron)
AIDS-related illness
"HIV dermatitis"
disseminated varicella
Other drugs
almost any drug can cause a rash
penicillin, amoxicillin, ampicillin
staph skin disease (folliculitis)
toxic shock syndrome
Rocky Mountain Spotted Fever
chicken pox
connective tissue disease
adhesives for medication patches
Explanation and Possible Solutions
Important:  As one can see from the list of possible causes to the left, there are many serious causes of skin rash that must be considered besides medications especially infections.  It is critical that all skin rashes and especially a skin rash that persists and/or worsens should be reported to your healthcare provider promptly.

Important:  Do not stop any medications that you think may be causing the skin rash until you have spoken with your healthcare provider.  If you absolutely MUST stop a suspected antiretroviral medication, stop all of your antiretroviral medications at the same time.  Do not stop just the suspected medication or you might lose the effectiveness of the remaining drugs.  This warning does not apply to medications that are not antiretrovirals.

The most important aspect of skin rash is to diagnose and treat the cause, preferably by eliminating the cause of the rash (e.g., switch sulfamethoxazole/trimethoprim for dapsone or treating the infection).  However, in some cases, it is safe and/or necessary to continue a medication that is causing a rash. 

It may be safe to continue a particular medication if the following conditions are met:

1.  The rash is mild.  This means not particularly troublesome, not covering the entire body, and not particularly cosmetically an issue.
2.  The rash is not getting worse, even slowly.
3.  The mouth, throat, eyes, and rectum are not involved.
4.  There are no associated symptoms such as fever, cough, diarrhea, weakness, difficulty breathing, or bleeding.

If the conditions above are met, you may get benefits from the following:

1.  Take an antihistamine such as loratidine (Claritin) or diphenhydramine (Benadryl) on a regular basis.
2.  Apply a moisturizing lotion with or without a cortisone-like component (e.g. Lubradem, Sarna, etc.)
3.  Avoid hot bathes and showers.  Use only warm or cool water as hot water makes itching worse.
4.  Avoid scratching.  Scratching damages the skin and makes it more likely for you to get infections on top of the rash.  Scratching can also make the itching worse.
5.  Consider oatmeal or Aveeno soaks in the bathtub.
6.  If you are allergic to adhesives or the glue in skin patches, consider asking your healthcare provider for a nasal steroid inhaler.  To use the inhaler, puff the medication onto the skin before you apply the patch, let it dry, and then apply the patch.


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