An HIV rash is an early symptom of human immunodeficiency virus (HIV), an infection that weakens the body's immune system. An HIV rash can be itchy or painful. It generally appears red in people with lighter skin tones or dark brown, purple, or red in people with darker skin tones.

A rash caused by acute HIV infection typically lasts several days to weeks. It's important to see a healthcare provider if you develop a rash and may have been exposed to HIV. The sooner you are diagnosed and begin treatment, the better the outcomes.

What Is an HIV Rash?

A rash that develops as a result of HIV appears as irritated skin that can be itchy, red, and painful. An HIV rash can appear dark brown, purple, or red in people with darker skin tones.

Not everyone with HIV will develop a rash, but it commonly occurs with the infection. One of the most common possible causes is acute HIV, the earliest stage of the infection.

HIV also weakens the immune system, making you more susceptible to infections that cause a rash. You might also develop a rash as a side effect of medications that treat HIV.

Other HIV Symptoms

A rash caused by acute HIV infection may appear along with other flu-like symptoms, such as:

  • Fatigue

  • Fever and chills

  • Mouth ulcers

  • Muscle aches

  • Night sweats

  • Sore throat

  • Swollen lymph glands

These early HIV symptoms typically develop two to four weeks after infection. It's also important to know that you might not experience any symptoms even if you have the infection.

Types and Causes

One of the common symptoms that comes with acute HIV infection can be a rash. Rashes could also result from other infections, HIV medicines, or unrelated medications.

Acute HIV infection
A rash may develop due to the body's immune response to acute HIV infection, the earliest stage in which the body produces HIV antibodies.

Other infections
The immune cells within the skin may react to germs that include bacteria, fungi, and viruses. HIV can make you more susceptible to other infections if it progresses untreated.

Other possible causes of rash include:

  • Herpesviruses: Can cause oral or genital herpes and shingles, with painful blistering rashes.

  • Kaposi sarcoma: A type of cancer linked to AIDS that causes brown, purple, or red lesions.

  • Molluscum contagiosum: Produces painless bumps that spread more quickly in people with HIV.

  • Syphilis: An untreated sexually transmitted infection that may cause a rash on the hands and feet.

Medication
Some HIV medicines can cause a rash. This type of rash is usually mild and goes away within days to weeks. A healthcare provider can adjust treatment if necessary—never stop medication without medical advice.

How To Treat an HIV Rash

Treatment depends on the cause of the rash. The primary treatment for all people with HIV is antiretroviral therapy (ART). ART involves medicines that control the virus.

A healthcare provider may prescribe three medications or a combination pill at the start of treatment. In some cases, HIV medicine injections every two months may be an option if viral load is undetectable, there’s no treatment failure history, and no allergies to the drugs.

Other supportive treatments for rash may include moisturizers, lotions, baths, cortisone creams, or antihistamines. A provider will also check for other causes such as infections, sunburns, or stress.

When To Contact a Healthcare Provider

Skin irritation often clears up easily, but a rash can also signal a serious medical condition.

Seek medical attention if you develop:

  • A blistering rash

  • A rash that spreads quickly

  • A rash with fever

  • A full-body rash

  • An infected or painful rash

Also watch for signs of severe allergic reactions to HIV medicines, such as dizziness, breathing difficulties, or painful blisters. In rare cases, Stevens-Johnson syndrome, a life-threatening reaction, can occur.

A Quick Review

An HIV rash may be an early sign of infection. Depending on skin tone, it can appear red, dark brown, or purple, and usually clears within days to weeks. HIV can also cause rashes from secondary infections or medication side effects.

If you develop an unexplained rash, consult a healthcare provider promptly for proper diagnosis and treatment.