Can you tell a harmless rash from the fatal or contagious? Pharmacist shares vital clues and when to seek immediate help

IF your skin breaks out in lumps or bumps, you’ll often be tempted to dismiss it as a harmless rash.

In many cases, it will be just that.

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Changes to your skin can provide vital clues about any underlying health conditions

But a pharmacist has warned Brits not to overlook changes to their skin, as they could be vital clues to a life-threatening condition.

From a subtle discolouration to a change in texture or feel, skin can serve as a silent messenger of the first signs of an underlying health condition. 

George Sandhu, deputy pharmacy superintendent from Well Pharmacy, said: “Whether you’re curious about a pimple, dry patch or discolouration, your skin can act as a barometer for your general wellbeing.

“Skin is a major organ, capable of revealing not just cosmetic but also potentially life-threatening conditions – it’s not something to take lightly.

Read more on skin conditions

“Through observation, we can identify changes that may signify deeper health issues.”

From shingles to eczema or sepsis – below are ten well-known conditions that affect the skin.

1. Shingles

How to spot it: Red blotchy skin, which turns into itchy blisters, that ooze fluid.

Shingles can cause red and itchy patches of skin which turn into blisters

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Shingles can cause red and itchy patches of skin which turn into blistersCredit: NHS
The rash can be red, but this can be harder to see on brown and black skin

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The rash can be red, but this can be harder to see on brown and black skinCredit: NHS

Shingles is an infection that causes a painful rash.

The first signs of shingles can be:

  • A tingling or painful feeling in an area of skin
  • A headache or feeling generally unwell

The rash will usually appear within a few days of these first symptoms – usually on the chest and belly, but it can appear anywhere on your body including on your face, eyes and genitals.  

You can tell if it’s a shingles rash if it appears on one side of your body only – if both sides are affected, it’s unlikely to be shingles.

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Blotches will pop up on your skin, becoming itchy blisters that ooze fluid. They should dry and out scab within a few days.

 In rare cases shingles can cause pain without a rash.

You can’t spread shingles to others, but people could catch chickenpox from you if they have not had chickenpox before or have not had the chickenpox vaccine, as both illnesses are caused by the chickenpox virus.

The NHS suggests avoiding pregnant mothers who have not had chickenpox before and people with a weakened immune system – like someone having chemotherapy and new-born babies.

If you have shingles symptoms, you can pop into a pharmacy for diagnosis and treatment under the new Pharmacy First service.

The shingles vaccine helps reduce your risk of the illness and is available on the NHS for:

  • People who turned 65 on or after September 1, 2023
  • People aged 70 to 79 who have not yet been vaccinated
  • People aged 50 and over with a severely weakened immune system

2. Impetigo

How to spot it: It starts as itchy, red sores or blisters. Once healed a crusty, yellow or “honey-coloured” scab forms over the sore.

Impetigo causes sores or blisters that can look like cornflakes stuck to your skin

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Impetigo causes sores or blisters that can look like cornflakes stuck to your skinCredit: NHS

Impetigo is a very contagious skin infection, but not usually serious. It often gets better in seven to 10 days if you get treatment.

Conditions start with red sores or blisters, which quickly burst and leave crusty golden-brown patches.

The NHS says the patches can look like cornflakes stuck to the skin and can be painful.

Impetigo can easily spread to other parts of your body or to other people until it stops being contagious – this is generally 48 hours after the infected person starts using prescribed hydrogen peroxide cream or antibiotics or when the patches dry out and crust over.  

Pharmacy First allows pharmacists in England to provide advice and treatments for impetigo, though you can also see a GP about the condition.

3. Atopic eczema

How to spot it: Patches of itchy, dry, cracked and sore skin that is red, weepy, crusty, itchy or flaky.

Eczema can cause the skin to become itchy, dry and cracked

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Eczema can cause the skin to become itchy, dry and crackedCredit: © DermNet New Zealand

Atopic eczema – sometime called atopic dermatitis – is one of the most common forms of eczema, a condition that causes the skin to become itchy, dry and cracked.   

The skin condition leaves a sufferer scratching, sometimes feeling like they cannot stop.

Some only have small patches of dry skin – this’ll often be on the hands for adults or inside of the elbows, backs of the knees and the face and scalp in children.

But others may experience have inflamed skin all over their body.   

4. Sepsis

How to spot it: Blue, grey, pale or blotchy skin, which can also appear on lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet.

Sepsis can cause your skin to look mottle and blueish

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Sepsis can cause your skin to look mottle and blueish

Sepsis is a life-threatening reaction to an infection, where the immune system  overreacts and starts to damage the body’s tissues and organs.

If you’re displaying signs of sepsis, you need to get hospital treatment right away, as it could turn into septic shock if not treated early, resulting in organ failure and even death.

Aside from blue, grey, pale or mottled skin, a rash that doesn’t fade when you roll a glass over it – the same as meningitis – can signify sepsis.

Other symptoms can include a fast heart rate, low blood pressure, fever, nausea and vomiting, clammy skin, confusion and diarrhoea.

Go to A&E if you or your child are exhibiting these symptoms.

5. Staph infections

How to spot it: A painful red lump or bump on the skin.

Staph infections can result in boils or abscesses

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Staph infections can result in boils or abscessesCredit: NHS/Supplied

Staph infections are caused by bacteria called staphylococcus.   

Symptoms include:

  • A painful red lump or bump on the skin
  • Hot, red or swollen skin
  • Sore, crusts, blistering
  • Red or sore eyelids

The infection tends to go away on its own but can sometimes need antibiotics.

The bacteria that cause staph infections live harmlessly on many people’s skin, often in the nose, armpits, groin and buttocks.

They usually only cause an infection if they get into the skin – for example, through a bite or cut.

The NHS says the bacteria can spread through close skin contact, sharing towels and toothbrushes and less common, through droplets in coughs and sneezes.

You should see a GP if you think you have a staph infection and it’s getting worse or spreading quickly, it lasts more than a weak or you have a weakened immune system.

6. MRSA

How to spot: A red and swollen patch of skin, which leaks pus or liquid and is warm to touch.

MRSA can cause skin to redden, feel warm and leak fluid or pus

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MRSA can cause skin to redden, feel warm and leak fluid or pusCredit: NHS/Supplied

MRSA is a type of bacteria that usually lives harmlessly on the skin, but if it gets inside the body, it can cause a serious infection that needs immediate treatment with antibiotics.   

If you get an MRSA infection under your skin, you may have an area of skin that:

  • Is painful and swollen
  • Feels warm when you touch it
  • Leaks pus or liquid
  • Looks red – though this may be harder to see on brown or black skin

You should ask for an urgent GP appointment if you have a wound that’s painful, red, swollen or warm, as these could be symptoms of an MRSA infection.

The infection can spread to your blood, lungs, or other parts of your body, causing symptoms that include high temperature, difficulty breathing, chills, dizziness and confusion.  

Call 999 or go to A&E if you have any of these symptoms.

7. Pityriasis versicolor

How to spot it: Patches of skin that may be darker or lighter than your normal skin colour – discolouration may be red, brown or pink

Pityriasis versicolor causes patches of skin to change colour

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Pityriasis versicolor causes patches of skin to change colourCredit: NHS/Supplied
On brown or black skin, the patches tend to be paler than the surrounding skin

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On brown or black skin, the patches tend to be paler than the surrounding skinCredit: NHS/Supplied

Pityriasis versicolor is a common fungal skin infection that causes patches of skin to change colour.

On white skin, the patches are usually pink, red or pale brown. You may notice the patches do not tan in the sun.

On brown or black skin, the patches tend to be paler than the surrounding skin.

The patches usually appear on the chest, upper back, upper arms, neck or tummy.

You should see a GP if patches of your skin have changed colour.

8. Meningitis

How to spot it: A rash which starts with small, red pinpricks before spreading quickly and turning into red or purple blotches.

Mengitis causes a rash that doesn't fade when you roll a glass over it

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Mengitis causes a rash that doesn’t fade when you roll a glass over itCredit: Meningitis Research Foundation

Meningitis is an infection of the protective membranes that surround the brain and spinal cord – called the meninges – which can be very serious if not treated quickly.

It can affect anyone, but is most common in babies, young children, teenagers and young adults.

With the effects of meningitis developing suddenly it is important to be aware of symptoms.

It can cause a rash that doesn’t fade when you roll a glass over it. But the rash does not always appear, so it’s important to know other signs of the life-threatening disease.

Other symptoms to be aware of include:

  • A high temperature
  • Being sick
  • Headaches
  • A stiff neck
  • Dislike to bright lights
  • Drowsiness
  • Seizures

Call 999 for an ambulance or go to your nearest A&E immediately if you think you or someone you look after could have meningitis.

9. Cellulitis

How to spot it: Red, hot and painful skin

Cellulitis can cause swelling in your fingers, the back of your hand or near your toes

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Cellulitis can cause swelling in your fingers, the back of your hand or near your toesCredit: NHS/Supplied
It can also affect your eye, which can be serious

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It can also affect your eye, which can be seriousCredit: NHS/Supplied

Cellulitis is a skin infection that’s treated with antibiotics. It can be serious if it’s not treated quickly, with complications including a blood clot or infection of the bone joint.

The condition makes skin feel painful, hot and swollen. Skin may also be blistered, and your glands can also get painful and swollen.

Cellulitis is caused by a number of bacteria. The bacteria gets into the body through a wound, whether it be an ulcer, tattoo or insect bite.

Cellulitis generally affects the legs and feet.

10. Molluscum contagiosum

How to spot it: Raised and dome-shaped spots with a shiny white dimple in the middle.

Molluscum contagiosum causes dome-shaped spots with a shiny white dimple in the middle

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Molluscum contagiosum causes dome-shaped spots with a shiny white dimple in the middleCredit: NHS/Supplied

Molluscum contagiosum is an infection that causes spots on the skin, which is usually harmless and rarely needs treatment.

The spots tend to be about 2 to 5mm wide and usually appear together. They are raised and dome-shaped with a shiny white dimple in the middle.

Children with the infection often get spots on their body and in or around folds of skin, while adults may get them in the lower tummy area and groin if it’s spread through sexual contact.

The spots should clear up within 18 months without needing treatment.

The condition is usually passed on by direct skin to skin contact, however the chance of passing it on to other people during normal activities is so small that normal day-to- day activities can continue. 

When a skin rash requires you to see a doctor or call 999

MOST of the time, rashes in babies and children aren’t anything too serious.

But if you little one’s rash is accompanied by any of the following symptoms, they need urgent medical help and you must call 999 or take them to A&E immediately:

  • A stiff neck
  • Bothered by light
  • Confusion
  • A high temperature
  • Difficulty breathing (e.g. grunting noises, tummy sucking under their ribs, breathlessness etc.)
  • A rash that looks like small bruises under the skin and does not fade when you press a glass against it
  • Pale, blue, grey or blotchy skin, lips or tongue

Source: NHS

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