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Medical Author:

Nili N. Alai, MD, FAAD

Nili N. Alai, MD, FAAD

Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In general, most noninfectious rashes are usually treated symptomatically and often with cortisone creams and/or pills. Infection-associated rashes are frequently treated by addressing the underlying infection.

Infectious rashes

• Fungal



• Tinea or ringworm infections of the skin, hair, and nails are treated by topical and or oral antifungal medications like terbinafine.



• Candida infections ("yeast") are treated with topical antifungal medications like clotrimazole and sometimes with oral antifungal drugs like fluconazole.



• Atypical fungal infections including cryptococcosis, aspergillosis, and histoplasmosis are generally treated with an oral or intravenous course of special antifungal medications.



• Viral



• Herpes infections are usually treated with oral or intravenous antiviral medications, including acyclovir, famciclovir, valacyclovir, ganciclovir, and cidofovir. Depending on the severity of the individual infection, specific antiviral treatment may not be required.



• Vaccination is an effective prevention measure to help ward off infections with the herpes zoster virus, which causes chickenpox and shingles.



• There is no currently vaccine available for herpes simplex.



• HIV infections are treated with a special combination of antiviral medications designed specifically for this virus.



• Many other viral infections are self-limited and often may clear even without any treatment.



• Bacterial



• Staphylococcus infections are typically treated with penicillin and cephalosporin antibiotics. Topical treatment may include mupirocen cream or ointment.



• A resistant form of Staphylococcus called methicillin-resistant Staphylococcus aureus (MRSA) is treated based upon specific antibiotic testing. Common antibiotics for treatment of MRSA infections include doxycycline, sulfamethoxazole-trimethoprim, and vancomycin.



• Streptococcus infections are typically treated with oral or injectable antibiotics, including penicillin and erythromycin.



• Pseudomonas infections are treated with oral or intravenous antibiotics, including ciprofloxacin or ofloxacin.

Noninfectious rashes

• Treatment of a rash due to a drug allergy includes stopping the responsible drug. Sometimes, a short course of oral steroids may be required in severe cases to help clear the rash.



• Therapy for contact allergic dermatitis includes withdrawal of the offending topical agent and use of topical steroids creams like clobetasol or hydrocortisone cream.



• Treatment for eczema or atopic dermatitis includes a wide variety of skin-care measures, including lubrication and topical steroids, as well as oral antihistamines like diphenhydramine (Benadryl) for itching.



• Hypersensitivity or allergic dermatitis from poison oak and poison ivy is treated by washing off the plant's oily resin from the skin, clothing, and objects like golf clubs or shoes and applying steroid creams to the rash two to three times a day. Severe cases may require oral steroids like prednisone.



• Irritant dermatitis is treated by skin lubrication, avoidance of harsh soaps and chemicals, use of petrolatum (Vaseline), and topical steroids like hydrocortisone.



• Autoimmune conditions such as lupus (SLE) are treated by addressing the overactive immune reaction. Often oral and topical steroids are used to help control symptoms. Additional medications include hydroxychloroquine.

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