Rashes

A rash is a change in the skin's colour, feel, or appearance. Most rashes are harmless and go on their own, but some are warning signs. In India, two patterns are especially important: fungal (tinea) rashes that have become widespread and often treatment-resistant, and allergic drug rashes that can progress into life-threatening reactions.

Common types

• Fungal (tinea) — ring-shaped, itchy, scaly patches; groin, inner thigh, under the breast, feet. Spreads in the household via towels, clothes, unwashed cotton.
• Contact dermatitis — red, itchy, well-defined patch where something touched the skin (nickel, cosmetics, henna, detergents, rubber, plants, cement workers' hand dermatitis).
• Atopic eczema — dry, itchy, flexural (elbows, knees, wrists, face in babies).
• Prickly heat (miliaria) — tiny itchy bumps in hot, humid weather, especially under clothing.
• Urticaria (hives) — itchy, raised wheals that appear and disappear within hours.
• Drug rashes — generalised red rash or hives starting days after a new medicine.
• Viral rashes — measles, rubella, chickenpox, dengue, hand-foot-mouth, mpox.

The fungal-rash problem in India

• Over-the-counter "itch creams" (clobetasol combinations sold without prescription) are driving a widespread epidemic of atypical, resistant tinea in India.
• These creams briefly relieve itching but thin the skin, spread the infection, and make it harder to treat.
• See a doctor for persistent ringworm — it usually needs a course of oral antifungal, not just a cream.
• Wash and change clothes daily during infection, dry skin fully, treat the whole household if multiple members are affected.

Red flags — see a doctor urgently

• Rash with fever — especially petechiae (pinpoint purple spots that don't blanch), stiff neck, or confusion (meningococcal sepsis suspicion).
• Rash with facial, lip, tongue, or throat swelling, breathing difficulty, or wheeze — go to emergency, dial 112.
• Peeling skin, blisters, mouth or eye sores after a new medicine — may be Stevens–Johnson syndrome / TEN. Stop the drug and go to hospital immediately.
• Rash in a newborn or in pregnancy (possible rubella, chickenpox, mpox) — tell the doctor.
• Purple bruise-like patches in a young child (possible HSP or sepsis).