HIV and Rash
Key Points
- A rash is an area of skin that is itchy, red, bumpy, or painful.
- A rash can be an early sign of HIV, a side effect of HIV medicines, or a symptom of another infection.
- Most HIV-related rashes aren’t serious, but some can be life-threatening. Always tell your health care provider if you develop a new rash.
Why would you get a rash if you have HIV?
A rash is an area of skin that is irritated, itchy, red, bumpy, or painful. If you have HIV, there are three main reasons you might develop a rash:
Early (Acute) HIV
A rash can be one of the first symptoms you notice after being exposed to HIV. A rash may develop as your body tries to fight the virus. This rash often looks like small, flat, red areas with tiny bumps.
Other infections
HIV can weaken your immune system, especially if you aren’t taking HIV medicines. This makes it easier to get opportunistic infections that cause rashes or changes to your skin, including herpes viruses and molluscum contagiosum.
HIV Medicines
Certain HIV medicines can cause a rash that usually appears when you first start them. Examples of HIV medicines that may cause a rash include—
- Abacavir (ABC): A rash with abacavir can be part of a serious allergic reaction but can usually be prevented by specialized testing.
- Darunavir (DRV): Can cause a darker rash (usually red or purple) weeks or months after starting treatment.
- Efavirenz (EFV): Often causes a pinkish rash in the first two weeks after starting treatment.
A rash caused by HIV medicine is typically not serious and goes away in several days to weeks. However, it may be necessary to switch to another HIV medicine if a rash develops and won’t go away, or if other symptoms like fever, blisters, joint pain, or fatigue also occur.
If you are taking HIV medicine, tell your health care provider if you develop a rash. In rare cases, a rash caused by an HIV medicine can be a sign of a serious condition. Never stop taking your HIV medication without talking to your health care provider.
When should you worry about a rash if you have HIV?
Although most rashes go away on their own, two conditions require immediate medical help.
This serious allergic reaction is most common with ABC. If you take ABC and get a rash plus symptoms like difficulty breathing, dizziness, nausea, vomiting, or lightheadedness, call your health care provider right away. A severe hypersensitivity reaction can require immediate medical attention.
Stevens-Johnson Syndrome (SJS)
SJS is another rare but serious reaction to some HIV medicines. SJS may cause symptoms such as rash, painful blisters, skin peeling, and fever or other flu-like symptoms. If you have symptoms of SJS, get medical help immediately. SJS can be life-threatening.
How are HIV-related skin rashes treated?
If you develop a rash from HIV or HIV medicines, it should be treated based on the underlying cause. If you don’t have HIV, were recently exposed, and have since developed a rash, see your health care provider immediately. HIV medicines can help support your immune system and control the virus, which helps to improve skin conditions caused by HIV.
If your rash is caused by an HIV medicine, your health care provider may recommend switching to another medicine. Always talk to your health care provider if you have concerns about a rash that could be caused by HIV or an HIV medicine. Never stop taking your HIV medicines without talking to your doctor.
This fact sheet is based on information from the following sources:
From the HIV clinical practice guidelines at Clinicalinfo.HIV.gov:
- Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV:
From MedlinePlus:
From the United States Food and Drug Administration:
Also see the HIV Source collection of HIV links and resources.