Exanthema
Definition
The term skin rash (exanthema) refers to a long-lasting or receding change in individual areas of the skin. Various triggers cause skin irritation, which is accompanied by redness, itching and/or burning. In most cases, a rash on the face indicates inflammatory processes of the facial skin.
This inflammatory reaction can be triggered by various causes. In particular, infections or allergic reactions are often responsible for the rash on the face. A large number of germs, such as bacteria or fungi, can also trigger strong reactions of the facial skin and put a lot of strain on the affected person.
The rash on the face is usually manifested by red, blotchy spots and is often accompanied by severe itching. In addition, the inflammatory processes can lead to pus-filled blisters or swelling of the face. The aesthetic effects are particularly stressful for patients suffering from facial rashes.
Apart from the obvious, namely that a rash on the face is easy to see, the fact that scar tissue easily develops, especially on the face, is also a decisive factor. There can be many different causes for the development of rashes on the face. Especially in the warm seasons, many patients experience a so-called “heat rash”, small heat spots appear on the face, neck and other parts of the body.
The reason for the development of the rash is the fact that the affected body parts are exposed to excessive heat for a long period of time in warm temperatures. In addition, the skin surface is stressed by sweat particles. The typical skin rash of a “heat rash” manifests itself by severe itching, which is further aggravated by excessive scratching.
In some cases, eczema leads to the appearance of rashes on the face. Eczema is also a small local inflammation of the skin surface caused by environmental influences, cosmetic products or allergens. Eczema can also occur as a result of diabetes.
Another cause of facial rash is the so-called contact dermatitis. Contact dermatitis typically develops on the face and chest, but its effects can also be seen in other parts of the body. Irritants such as pollen, animal hair, various chemicals and foods in particular trigger such a rash on the face.
In contact dermatitis, in addition to the appearance of the typical rash, severe itching and the formation of small blisters can also occur. “Hives” (synonyms: urticaria or hives) represent an allergic reaction to stimuli, viral infections, insect bites or severe temperature changes. Especially in the area of the facial skin, red rashes and blotchy skin areas develop, which in most cases are accompanied by itching and a burning sensation.
In addition, rashes on the face can be triggered or intensified by herpes viruses or acne diseases. More about the risk of infection: Is my rash contagious? Even too intensive care in the form of rich creams and ointments can irritate the skin and restrict its normal function.
This usually manifests itself in the form of a rash around the mouth, so-called perioral dermatitis. During pregnancy, numerous changes of the skin in the facial area can occur. (see: Skin changes during pregnancy) On the one hand, the skin of a pregnant woman has more moisture.
This can have pleasant effects, such as the disappearance of small wrinkles. But it can also be so pronounced that the face looks swollen and existing red spots stand out more strongly. This should not be counteracted by reducing the water consumption, as this is of utmost importance for a pregnancy without complications.
Rather, it may be helpful to take more rest breaks and, if necessary, to use toning face creams. In addition, the so-called chloasma can occur. Colloquially the term “pregnancy mask” is used for this.
These are pigment spots in the face and neck area, which are due to the increased production of the tanning hormone melanin. In fair-skinned people, these spots appear darker, whereas in dark-skinned people they appear lighter than the rest of the skin. If these are perceived as disturbing, sun exposure should be reduced and sunscreen should be used.
After birth, however, these spots usually disappear by themselves.During pregnancy, acne can also reappear, although it may not have existed since adolescence. This is due to the increased production of sebum, the normal skin oil that is supposed to keep the skin supple. However, this often causes the pores to clog, which leads to the development of pimples.
It is helpful here to always clean the skin carefully and this if possible with oil-free products. Medicines against acne should be avoided, if necessary an acne cream can be used, but only in consultation with the treating doctor. Acne also usually disappears by itself after birth.
Due to the increased hormone levels during pregnancy, the skin as a whole becomes more sensitive and can spontaneously overreact to previously non-harmful substances. Skin rash and itching, for example, are to be expected in such a reaction. The trigger should therefore be identified and avoided for the duration of the pregnancy if possible.
Then the symptoms usually subside on their own within a few days. However, if this is not the case and the symptoms persist over a longer period of time, the doctor should be consulted in order to detect more serious complications at an early stage and treat them if necessary. Most HIV patients complain of a severe skin rash, which is often localized in the facial area.
In medical terms, this is known as an HIV exanthema. Affected persons complain about small spots on the nodules, which itch at least in the early stages of the infection. Because of the external appearance of this rash, it is also called a maculopapular rash.
A few days later, however, the skin changes recede and the itching disappears. In rare cases, there may be open spots in the oral mucosa, which can be associated with very severe pain. Like many other medications, antibiotics can also lead to skin rashes.
The most common are rashes after taking antibiotics from the penicillin group. About 10 percent of patients taking the antibiotic Ampicillin get a rash. This is usually a very itchy rash that can spread throughout the entire body and usually occurs up to a week after taking the drug.
It usually develops patchy and slightly raised skin lesions that are very similar to those of measles. More rare are wheals, blisters or even bleeding into the skin. In the acute phase, it is of course important to stop the medication that is causing the problem as quickly as possible and to alleviate the symptoms by cooling and applying creams or gels to combat the itching.
After stopping the triggering medication, the rash usually disappears on its own after one to two weeks and usually leaves no traces. In the context of a therapy with tetracyclines it should be noted that a so-called phototoxicity can occur. This means that this substance reacts in conjunction with sunlight and can cause redness and swelling in the light-exposed areas.
For this reason, adequate sun protection must be ensured when taking antibiotics from this group. An allergy that manifests itself through a rash on the face can have completely harmless causes and does not necessarily have to refer to a more serious problem. Allergenic substances can be food, during spring and summer time often pollen, but also chemical substances such as nickel or clove oil.
These substances can either act directly on the skin (through the mere contact of skin and substance, for example in earrings with nickel) and thus cause the allergy and subsequently the rash on the face, or they can enter the body itself (for example through inhalation, swallowing or injection) and then cause an allergy with skin irritation. Allergic reactions of the immediate type immediately cause a rash on the face. Typical of an immediate reaction is itching or burning of the rash and redness of the skin.
If the allergy is of the late type, itchy blisters appear only after hours and are sharply defined. Drugs can also be used as triggers for an allergy with a rash on the face. Before taking the medicine, it is therefore advisable to study the package insert carefully and if a rash appears during the period of use, the attending physician must be informed about the medication.
Only then can he correctly diagnose and treat an allergy. In acute allergic reactions, whether of the immediate or the late type, the rash on the face occurs most frequently in the form of the well-known hives. Itchy, red, fluid-filled wheals form on the face.In case of an allergy, the body releases the messenger substance histamine to fight the intruders.
The histamine ensures that the permeability of the blood vessels increases. This allows more fluid to escape from the bloodstream and collect under the skin. Fluid accumulations in the dermis cause wheals (the dermis is one of the various layers of skin that every person has.
It lies under the epidermis, the uppermost layer of skin that we can touch). Sunlight is one of the most common triggers for allergies, which cause a rash on the face. Direct exposure to sunlight in combination with the sebum film on the skin secreted by the sebaceous glands can cause a rash on the face.
This is because the face is exposed to constant sun exposure. Any form of rash should be clarified by a dermatologist (skin specialist), even if no symptoms are noticeable. Not every rash on the face caused by an allergy necessarily itches. A completely symptom-free course is also conceivable.
All articles in this series:
