What happens if I already have a skin condition?

Most people with skin conditions are no more at risk of catching COVID than anyone else. Stress and worry can make some skin problems worse. It is important to continue to treat your skin condition. If you are concerned about your skin condition, or your medications, then contact your GP surgery or Dermatology Team for advice.

Can COVID affect my skin?

Skin conditions are very common in normal times, with around half of people having a skin problem every year. Many skin problems have been seen in people with COVID but there are some that occur more frequently, which include:

“COVID Digits” are tender swellings on the fingers and toes which may be purple in those with lighter skin or a slightly darker appearance/brown/black in those with darker skin. They look like chilblains and are more common in younger people. They usually appear sometime after the onset of the infection and may last up for more than 12 weeks. The areas heal slowly after COVID has gone away, with peeling of the skin. Painkillers such as paracetamol may be helpful.

Sores or ulcers in the lips and mouth can occur in COVID. This usually settles within 2 weeks. This may be helped by antiseptic mouthwashes.

A very itchy widespread rash with tiny lumps and blisters like prickly heat can occur in COVID, either during the infection or weeks afterwards. This can last for weeks after the infection settles. If troublesome, treatment with moisturisers (emollients) and topical steroid creams can help.

COVID can trigger a very itchy widespread rash called urticaria. This is sometimes called nettle-rash or hives and appears suddenly as smooth raised areas (‘wheals’) on the skin which can come and go quite quickly over hours. This can come up early in the COVID infection but can last for months afterwards. Antihistamine tablets from a chemist can help with the itch. If the rash affects the face, causing swelling of the lips or tongue, then advice from NHS 111 should be sought. If the swelling is causing breathing problems, then urgent advice is needed.

A rash on the trunk (body) called pityriasis rosea, which can be triggered by other viruses, has been seen in COVID. This starts with a single, large red patch, followed a few days later by many smaller red/darker patches on the trunk, which are not usually too itchy. In darker skin, the patches can be darker, brown or black. This rash goes away by itself after several months without treatment. If troublesome, moisturisers and topical steroid creams can be helpful.

Many viruses, including COVID, produce a slightly itchy widespread rash called a viral exanthem. This can be lumpy and flat, red in people with lighter skin and brown/black in darker skin. It usually heals after a week or so with peeling of the skin, like that seen after a sunburn. Moisturisers and topical steroid creams can help with the itch.

Most rashes that occur with COVID settle down without treatment, however, the following two rashes require urgent medical attention:

A viral widespread rash is also seen in a rare and more severe condition in children called PIMS (paediatric inflammatory multisystem syndrome). Children with this rash will be poorly with a high fever and may have other symptoms, such as tiredness, swollen hands and feet, headache, red eyes, aches and pains, diarrhoea and vomiting.
Purple (or darker/brown/black), tender lumpy areas anywhere on the skin called purpura can occur in COVID. These areas are due to bleeding in the skin, and do not change colour when they are pressed. If purpura appears suddenly in somebody with a fever, then seek urgent medical advice from NHS 111 as this can be a sign of other serious conditions like meningitis or sepsis.

My skin condition affects my hands – are there any special measures I should take when washing my hands?

To help stop the spread of COVID, it is important to follow government guidance and wash your hands frequently and follow the social-distancing rules.

People with skin conditions may find handwashing difficult as this may make dry skin worse. However, it is important to follow the government’s COVID guidance on this:

Wash hands using soap and water. This is not ideal for people with dry and cracked skin but follow the advice as much as you can.
Dry your hands after washing by patting, not rubbing.
Moisturisers are helpful to treat hand dermatitis. They should be applied after handwashing and applied often throughout the day and when the skin feels dry.
Moisturisers can be used instead of soap when showering or bathing. They do not kill the COVID virus like soap but can help reduce dry skin problems when bathing. Some people apply moisturiser before the shower or bath.
Overnight moisturising helps some people. Apply plenty of moisturiser just before bedtime, then put on clean cotton gloves overnight.
When you are not washing your hands, but the hands come into contact with water or detergents, (e.g. when washing up dishes, shampooing hair, cleaning surfaces with wipes), wear gloves (e.g. nitrile gloves from a chemist or online) to protect your skin.

What should I do if my hand eczema or dermatitis is getting worse despite following this advice?

A pharmacist at your chemist may be able to recommend different moisturisers. These should be applied often, every hour or so if needed. They may also recommend a mild- or moderate-strength steroid cream or ointment (such as clobetasone or hydrocortisone) which can be bought over the counter and applied once daily for up to a week.

If your hand eczema/dermatitis is getting worse, or you suspect an infection (e.g. if your skin is oozing or there are yellow crusts), you may need to speak to your GP. You may need prescription treatments to reduce the inflammation or treat the infection.

My face mask is causing skin problems, what should I do?

There are several types of skin problems that have been reported relating to face masks.

Acne produces pus spots under face masks, triggered by the build-up of sweat and oil. This can be minimised by cleansing daily, using an oil-free moisturiser, washing cloth face masks regularly, avoiding heavy make-up and removing your mask whenever it is safe to do so. A pharmacist at your chemist may be able to advise on a treatment, or you may need to see a doctor or nurse at your GP surgery for prescribed medications.
Rosacea under face masks produces pus spots, multiple tiny lumps and skin discolouration which may be red, purple, or brown, depending on your skin colour. This often needs prescribed treatment from your GP or nurse.
Eczema under masks may become worse due to irritation, allergy, or reactions to skin yeast. This may be helped by moisturisers but may also need prescribed treatment.

Medication

It is important that you continue taking medication that has been prescribed to you for your skin condition. Stopping this could make your overall condition much worse. If you have any concerns or queries about your medication, then please speak to your local pharmacist, GP or dermatologist. If you are unable to pick up your medications, your local surgery or pharmacist can organise a delivery for you.

If you need to be admitted to hospital, please remember to take an up-to-date list of your medication with you.

Many people with skin conditions take medications that act on the immune system. It is not yet known for sure whether these medications increase or decrease the risk of infection and severity of COVID. Research is continuing so more information will become available. Do not stop or reduce treatment unless a doctor or nurse advises it.

Medications given for your skin condition should not prevent you from having any of the three approved COVID vaccines that are being offered at present.

If you have symptoms of COVID, then you should discuss with your doctor or nurse whether you should continue with your medications. Do not stop your medication without medical advice.

If you do decide with your doctor or nurse to stop or reduce some medication, then there should also be advice on when to restart treatment.

Hospital appointments

Hospitals have had to postpone many non-urgent appointments and planned procedures due to the COVID outbreak. These decisions have been in line with national guidance, and you will be offered another appointment when it is safe to do so.

Patients should be contacted by their local Dermatology teams if their appointment has been affected.

Some of the appointments may go ahead and be offered as face-to-face appointments, or they may be held via telephone or video.

If you are unsure about what has happened to your appointment, or your condition has worsened and you need to be seen, then please contact your local hospital switchboard or ring the number on the appointment letter.

It is important to remember that you should not attend face-to-face appointments if you have any symptoms of COVID or have suffered with sickness or diarrhoea in the last 48 hours.