Side Effects of HIV Medicines

HIV and Rash

Last Reviewed: September 4, 2024

Key Points

  • A rash is an irritated or swollen area of skin that may be itchy, red, bumpy, and painful. 
  • A rash may be an early symptom of HIV infection. In people who already have HIV, a rash can develop due to secondary infections or interactions with medicines, including some HIV medicines.
  • A rash caused by an HIV medicine is typically not serious and resolves in several days to weeks without treatment. However, it may be necessary to switch HIV medicines if a rash doesn’t go away on its own.
  • If you have HIV and get a rash, tell your health care provider immediately. Even a minor rash can be a sign of a serious condition that requires immediate medical attention. 

Why do people with HIV develop a rash?

A rash is an irritated or swollen area of skin that may be itchy, red, bumpy, and painful. Possible causes of a rash in people with HIV include:

Acute HIV 
A rash may be an early symptom of HIV infection. During the earliest stages of HIV, a rash can develop as the body fights off the virus, weakening the immune system.

Other infections
Without treatment, HIV gradually destroys the immune system. Damage to the immune system increases the risk of other infections such as herpesviruses and molluscum contagiosum that cause rashes and skin conditions. While a rash may be directly related to HIV, it can also be a symptom of many other infections. 

Medicines 
Many medicines, including some HIV medicines, can cause a rash. Examples of HIV medicines that may cause a rash include efavirenz (EFV) and darunavir (DRV). 

Rashes from EFV often appear in the first two weeks of treatment as pink or red-colored patches with or without raised bumps. In contrast, rashes from DRV often occur weeks to months after starting treatment and are typically darker (red or purple) and more likely to blister or peel.

A rash caused by HIV medicine is typically not serious and goes away in several days to weeks without treatment. 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 have 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 doctor.

What are serious rash-related conditions?

A rash can be a sign of a hypersensitivity reaction, which is a potentially serious allergic reaction to a medicine. In addition to a rash, signs of a hypersensitivity reaction can include difficulty breathing, dizziness, or lightheadedness. A severe hypersensitivity reaction can require immediate medical attention.

Stevens-Johnson syndrome (SJS) is a rare but serious hypersensitivity reaction reported with the use of some HIV medicines, including nevirapine (NVP). SJS may cause symptoms such as fever, rash, painful blisters, and other flu-like symptoms. 

Given the severity of SJS, people taking HIV medicine should know about this condition. If you have symptoms of SJS, get medical help immediately. SJS can be life-threatening.

How are HIV-related skin rashes treated?

Treatment of HIV-related skin rashes depends on the cause. If you think you have been exposed to HIV and developed a rash, see your health care provider immediately. HIV medicines can help restore the immune system and reduce viral load, leading to significant improvement in HIV-related skin conditions.

If your rash is caused by an HIV medicine, switching to another medicine should help the rash go away. Otherwise, consult with your health care provider if you have concerns about any rash or rash related to an HIV medicine. Never stop taking your HIV medications without talking to your doctor.