A rash can be an early symptom of HIV, but HIV can also increase the risk of developing different types of rashes. The rash may be discolored and include mild itchiness.

People who develop a rash and believe they may have had exposure to HIV should seek medical advice. If an HIV infection is present, treatment can help manage it effectively.

HIV transmits from one person to another when bodily fluids come into contact with each other. These include blood, semen, rectal and vaginal fluids, and breast milk.

Exposure to HIV can happen if a person has sex or shares needles with someone who has the virus.

In this article, find out what an HIV rash looks like, what causes rashes linked to HIV, and what to do if they happen.

The following images here show some ways in which HIV may affect the skin.

No single rash is specific to HIV. As HIV involves changes in the immune system, it can trigger a variety of skin reactions.

However, the rash that occurs at the early stage usually appears flushed, discolored, or reddish in people with fair skin, or dark purplish in people with dark skin. The blemishes are flat, and there may be mild itchiness.

A rash can be an early sign of HIV, occurring as a result of seroconversion. This is the acute, or early stage, of HIV, which usually occurs 2–4 weeks after exposure to the virus.

During the seroconversion or acute HIV stage, the body produces antibodies to the virus. Between 50-90% of all people with HIV experience flu-like symptoms at this stage, and some people may develop a rash.

Sometimes, a rash is the only symptom of HIV, but because HIV impacts the immune system, there are often other symptoms, too.

Early symptoms of an HIV infection that can occur alongside a rash include:

According to the Centers for Disease Control and Prevention (CDC), these symptoms may appear 2–4 weeks after exposure and last between a few days and several weeks.

Anyone who experiences these symptoms after possible exposure to HIV should seek advice about testing.

If a rash occurs as a symptom of the acute stage of HIV, it will usually go away as the immune system produces antibodies to HIV.

After this, however, if a person is not taking medications to control HIV, they may have a higher chance of developing further rashes and skin problems. This is because HIV leads to a weakened immune system.

When the immune system is compromised, it becomes easier for viruses, fungi, bacteria, parasites, and other causes to trigger a rash.

Conditions that may appear with skin symptoms include:

In some cases, treatment for HIV can trigger an allergic skin reaction.

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A rash that appears during seroconversion will usually disappear without intervention, but other types of rash may occur later.

HIV-related rashes vary greatly. The chance of developing a rash will depend on factors such as:

  • overall health
  • use of antiretroviral drugs
  • access to medical care
  • exposure to contagious skin conditions

Chronic skin conditions

In time, other rashes can develop due to conditions, such as herpes and psoriasis. People with these conditions have symptoms that often improve or disappear for a while but then return.

The severity of each outbreak varies but depends partly on the immune function. Some medications, such as antiviral drugs for herpes, can reduce the severity of each outbreak.

Acute skin conditions

Rashes that result from an infection will go away with appropriate treatment.

However, due to HIV’s impact on the immune system, infections can become more likely. A previous rash may return, or a new one may appear.

Medication-related rashes

Drugs for treating HIV can sometimes trigger a rash. Anyone who believes they have a rash due to their medication should speak to a member of their healthcare team. It is often possible to switch to another drug.

It is essential to speak to a doctor before changing or discontinuing treatment.

Taking antiviral medication keeps viral levels low and reduces HIV’s impact on the immune system. Many people can now live a healthy life with HIV, but it is essential to follow the treatment plan.

Learn more here about living with HIV.

Prompt testing and early treatment are effective at stopping the progress of HIV, and early treatment for a rash can help prevent complications.

Testing

Anyone who develops a rash or flu-like symptoms should seek medical advice if they think they have come into contact with HIV.

They can undergo a test for HIV. If the result is positive, a healthcare team can help them develop a treatment plan that will help them stay healthy.

With current medication, it is possible to reduce the level of virus in the body to undetectable levels. The risk of diseases and infections falls, and a person cannot transmit HIV to another person. In other words, undetectable = untransmittable.

The CDC provides a locator to help people locate HIV testing services in their area.

Rash treatment

People who already have a diagnosis of HIV should see a doctor if a new rash develops or an existing rash gets worse.

Emergency medical attention may be necessary if:

Drug reactions

In rare cases, HIV medications can trigger a serious hypersensitivity reaction known as Stevens-Johnson syndrome.

Symptoms include:

  • a rash
  • flu-like symptoms, including a fever
  • painful blisters

If anyone experiences these symptoms or other symptoms that may indicate a hypersensitivity or allergy — such as dizziness and breathing difficulty — they should seek urgent medical attention.

How to identify HIV rash?

An HIV rash typically emerges during the acute phase of infection and may be itchy, painful, and accompanied by flu-like symptoms such as fever and swollen lymph nodes.

It usually appears flushed, discolored, or reddish in people with fair skin, or dark purplish in people with dark skin.

However, the presence of a rash alone does not provide a definitive diagnosis of HIV. Early testing is crucial for prompt management if HIV infection is confirmed.

What can be mistaken for HIV?

HIV can be mistaken for the following:

Where do HIV lesions first appear?

Generally speaking, HIV lesions can appear on the face, chest, abdomen, arms, and legs.

What does your skin look like when you have HIV?

Skin appearance in people with HIV varies widely, with no specific indicator unique to the virus.

Some may develop rashes during acute infection, while others might experience opportunistic infections like fungal, bacterial, or viral skin conditions due to a weakened immune system. Drug reactions and skin disorders are also possible.

Consulting a healthcare professional for proper evaluation and testing is crucial if a person is concerned about skin health or HIV status.

The rash that appears in the early stage of HIV typically manifests as flushed, discolored, or reddish in individuals with fair skin, and dark purplish in those with dark skin.

A rash may also occur due to HIV medications or other infections.

Early testing and treatment for HIV can help a person live a healthy life and reduce the risk of developing HIV-associated infections and other conditions.

If anyone thinks they have come into contact with HIV, they should ask about a test, especially if they develop a rash and other symptoms within the following few weeks after exposure.