WHAT’S THAT RASH?

It’s red, unsightly, uncomfortable and a mystery. Here’s how to tell a patch of psoriasis from a bout of eczema

It’s red, uncomfortable and a mystery.

SHAM DHANJI HAS SENSITIVE

SKIN. So when she developed a small, painful rash on her thigh, she didn’t think too much about it.

A few weeks later, Dhanji noticed a bump in her groin, near the hip. She panicked. “I was emotional, feeling run down, had a random rash and now this lump. I burst into tears, I thought I had cancer,” she says.

At the hospital the next day, a nurse immediately diagnosed Dhanji with something she never would have guessed: shingles. “You had shingles,” the nurse clarified. “This is the end of it.” The bump, she explained, was an inflamed lymph node, which often follows the condition’s telltale blistery rash.

Luckily, Dhanji’s outbreak cleared up without complications. But the next time you find yourself facing your own mystery rash, check this rundown of six common ones.

Psoriasis

WHAT IT’S LIKE Psoriasis consists of red, scaly plaques that can be itchy andpainful. It is often found on the scalp, as well as the outside of the elbows and knees, and usually starts between age ten and 30. “It’s a stubborn disease so people have it their whole lives,” says dermatologist Paul Cohen. WHAT CAUSES IT This rash is the result of the immune system attacking the skin’s cells and creating new ones too quickly, which then build up into the plaques. There’s no one single cause, but the condition runs in families. Stress, obesity, smoking and having many infections (particularly strep throat) increase your risk. HOW TO TREAT IT The first step is topical steroids, used for a week or two at a time. For ongoing treatment, people use a synthetic form of vitamin D, medicated shampoos and retinoids. Exposure to sunlight also helps, as does moisturising well. More serious cases can use oral medications that suppress the immune system, and phototherapy done in a doctor’s surgery with a special light. POSSIBLE RED FLAG Serious cases can involve the joints, a condition called psoriatic arthritis. Also, psoriasis increases your chances of having some other diseases, including type 2 diabetes, cardiovascular disease and autoimmune conditions such as Crohn’s disase – all of which are, like psoriasis, linked to inflammation.

Hives

WHAT IT’S LIKE Hives are itchy, raised welts that often have a red ring around them. They disappear after about a day, only to show up later in a different location. They come in two forms: acute, which lasts six weeks or less, and chronic. WHAT CAUSES IT Hives are often the result of the body releasing histamine as part of an allergic reaction to drugs, food or some other irritant. They can also appear after a viral illness, as a side effect of your immune system revving up to battle the disease. “There are a number of potential triggers,” says dermatologist Katie Beleznay. In most cases, she adds, the specific origin is never determined. HOW TO TREAT IT Over-the-counter antihistamines are the first line of defence. If that doesn’t work, ask a doctor if you should use a stronger antihistamine or oral prednisone, an anti-inflammatory medication. POSSIBLE RED FLAG Rarely, people suffer from ongoing outbreaks of hives almost daily for six weeks or more, a condition called chronic idiopathic urticaria (CIU). Its treatment is the same as for regular hives, but in some cases, it can also be a sign of thyroid disease or cancer.

Eczema

WHAT IT’S LIKE Eczema presents as patches of red, scaly skin that are extremely itchy, especially at

night. These rashes often appear on the inside of your elbows and knees. If it’s more serious, the skin might blister or look thickened and white. WHAT CAUSES IT Eczema is the result of having a weakened skin barrier, which can lead to inflammation and an overreaction from your immune system. Most people are born with it, and your genes are partly to blame. “You’re more predisposed to eczema if you have a family history of asthma, hay fever or the condition itself,” says dermatologist Lisa Kellett. Some research also suggests that it might be a reaction to pollution, or to not being exposed to enough germs in childhood. HOW TO TREAT IT Apply a thick, hypoallergenic moisturiser to affected areas immediately after a bath or shower and at night. More serious f lare-ups will need topical prescription steroid creams or non- steroid immunosuppressant creams. Those with stubborn eczema might also try phototherapy, which uses UVB light to help calm your immune system and reduce itchiness. POSSIBLE RED FLAG Rarely, what looks like eczema is actually skin cancer. “The difference with skin cancer is that it doesn’t go away if you use a steroid,” says Kellett.

Contact Dermatitis

WHAT IT’S LIKE Contact dermatitis is a variation of eczema, and it looks similar – red, itchy patches on your skin. But unlike that chronic condition, this rash is a reaction to something specific and appears only where the offending object has made direct contact. WHAT CAUSES IT Common culprits are poison ivy, face cream, jewellery or fragrances. You can also develop a new intolerance to something you’ve used for a long time, such as your regular antibiotic ointment. If the cause is not clear, your dermatologist can do a patch test, putting small amounts of suspected substances on your skin to see if you react. HOW TO TREAT IT It can be treated with topical steroids, or a stronger oral one, to calm down your immune system and stop the reaction. POSSIBLE RED FLAG Like eczema, the red and scaly presentation of contact dermatitis could be confused for skin cancer, which is another reason to visit your doctor if you’re not sure what caused it.

Rosacea

WHAT IT’S LIKE As rosacea is a dilation of the blood vessels in your cheeks and nose, it often presents as red, sensitive skin in those places. Another form of the condition also includes bumps that resemble acne. For some people, the skin on their nose thickens, making it seem larger. WHAT CAUSES IT We don’t know what brings rosacea on, but you’re more likely to have it if others in your family do, too. You’re also prone to

acquire the condition if you have sun-damaged skin. “Rosacea usually begins around the age of 35 and gets worse with time,” says Kellett. People often find their flare-ups come after eating or drinking specific things. HOW TO TREAT IT For many, preventing activation of rosacea is as simple as avoiding triggers – but that can be a serious test of willpower. “Those are often the good things in life,” says Beleznay, citing coffee, spicy foods and alcohol as common aggravators. Some women find that makeup is enough to cover up the cosmetic impact of the condition, while others use prescription creams or laser or light therapy to reduce redness. For those whose rosacea includes bumps, topical creams or oral antibiotics often get rid of them. POSSIBLE RED FLAG Rarely, what looks like rosacea can be confused for the butterfly rash that’s a symptom of lupus, a serious autoimmune disease. The butterfly rash is named as such because of the shape it makes on the nose and both cheeks.

Shingles

WHAT IT’S LIKE Shingles often starts out as a tingly, numb or bruised feeling in a small area, most commonly on the abdomen. A few days later, a painful rash with blisters appears over those places. As the condition follows the path of a nerve, the rash eventually presents as a stripe that lasts from two to six weeks. WHAT CAUSES IT: This one’s easy: chicken pox. Even once you have fully recovered from that virus, your body never totally beats it; it simply lies dormant in your nerve cells, where, decades later, it can re-erupt as shingles. You’re more likely to get them if you’re immunocompromised or over 50. Although some people choose to get the vaccine for shingles at that age, it will remain effective when the body becomes more vulnerable overall. HOW TO TREAT IT: If you suspect you have shingles, see your doctor immediately. “You have to go right away because studies show that people do much better if the antiviral pills are started within 72 hours of the rash onset,” says Cohen. Additionally, sufferers are often given medication, like a local anaesthetic or codeine, to help control the pain. POSSIBLE RED FLAG: The real worry is that for some people, if it is not contained quickly, the virus can lead to longer-term pain lasting over three months and in some cases over a year. If the rash appears on the face, it can even cause blindness.

ALTHOUGH DHANJI WAS fortunate not to suffer complications from her untreated shingles, she still learned an important lesson: “Even if you’re super busy, sometimes you have to take that break to get checked out,” she says. “It’s so important to know what you’re dealing with.”