Pustular Rash

A pustular rash is a particular area of the skin which is affected by pustular lesions. These rashes can cover a small part of the skin or may expand to cover a wider area, such as an entire limb or the whole torso.

What is a pustular rash?

Pustules are spots or pimples which are filled with fluid. In some cases, pustules may be filled with clear fluid and look like blisters, whereas others may be filled with a white, cream or yellow fluid, more akin to pus.

When a pustular rash forms, groups of these pustules are clustered together on the skin. As well as being characterized by numerous pustular lesions, this type of rash may also feature skin redness and skin irritation.

What are the symptoms of a pustular rash?

A pustular rash can vary in severity and may cause a wide range of symptoms. Common accompanying symptoms to a pustular rash may include:

  • Skin irritation
  • Redness
  • Itching
  • Fluid leaking from the pustules
  • Increased risk of infection

As pustules form, the skin can take on an irritated and angry appearance. Whilst the pustules themselves may cause itching, the skin around the pustular rash may also feel itchy or uncomfortable. Often, when pimples or spots fill with fluid, it’s because the body is trying to fight an infection. When this happens, it can increase the itchiness and may feel particularly uncomfortable for the patient, even though the body is protecting itself in the long-term.

If the pustules burst or leak, fluid is likely to be released on to the skin. In some instances, this fluid may appear to be clear, whilst other pustules may contain a thick, white, cream or yellow pus. If a pustule bursts, an open sore is left and bacteria can easily enter the patient’s system. Similarly, if a pustule leaks fluid, an opening in the skin is left and bacteria could enter the patient’s body through a tiny break in the skin.

This can increase the patient’s risk of contracting a secondary infection so it’s important that action is taken quickly. Whilst pustular rashes should always be assessed by a medical professional, it’s important to access assistance if the skin becomes broken. Pre-emptive action may be able to prevent a secondary infection from taking hold and could help to prevent the patient from developing additional symptoms.

Furthermore, if patients experience the following symptoms in conjunction with a pustular rash, urgent medical treatment may be required:

  • Fever
  • Muscle weakness
  • Difficulty breathing
  • Chills

If a pustular rash is accompanied by the above symptoms, it may be indicative of a serious medical problem and it’s important that patients seek medical help quickly. Whilst minor pustular rashes are unlikely to cause these types of symptoms, more severe pustular rashes can cause significant pain and discomfort, and should be treated by a medical professional immediately.

What causes a pustular rash?

A pustular rash can be caused by various types of conditions, including:

  • Acne Vulgaris
  • Folliculitis
  • Pustular psoriasis
  • Pustular dermatosis

As pustular rashes can be caused by so many different conditions, physicians will often take into account the patient’s age, weight, medical history and accompanying symptoms before making a diagnosis.

Acne Vulgaris is, perhaps, the most common form of a pustular rash. Affecting millions of people each year, acne can cause a pustular rash to develop on the face, back, shoulders and/or chest. Often affecting various layers of skin, pustules can form in addition to nodules, cysts, whiteheads and blackheads.

Alternatively, folliculitis is responsible for a significant number of pustular rashes. Occurring when the patient’s hair follicles become inflamed, folliculitis is typically caused by a fungal or bacterial infection. Although the condition can cause skin irritation and discomfort, folliculitis usually responds well to treatment and the patient’s pustular rash can be resolved fairly quickly.

Pustular psoriasis may occur alongside other forms of psoriasis and is usually characterized by large, white pustules. These may develop on one specific part of the body or they may cover the body completely, although the face is not usually affected.

Similarly, pustular dermatosis can take various forms and may affect different layers of the skin. Subcorneal pustular dermatosis causes pus-filled blisters to form below the top layer of skin, for example, and may give the outer layer of skin a bulging or uneven appearance. Alternatively, erosive pustular dermatosis is more common in patients with sun-damaged skin and can cause erosions in the skin, as well as crusting and scabbing.

Whilst relatively minor health problems can cause a pustular rash to occur, more serious medical conditions can also cause this type of rash to develop. For example, patients with sepsis may present with a pustular rash. Due to this, patients who develop this type of rash should seek urgent medical advice. By assessing any other symptoms the patient has, physicians can determine exactly what is causing the pustular rash.

Can a pustular rash be treated?

Although pustular rashes can often be resolved, the appropriate treatment will depend on the cause of the rash.

In many cases, treating a pustular rash may be a two-step process, which involves:

  • Identifying the underlying cause of the rash
  • Minimizing the symptoms of the rash itself

If the rash is being caused by an underlying condition, it will only be fully resolved once this condition has been diagnosed and treated. If the patient is diagnosed with hormonal acne, for example, their symptoms may fully disappear once hormonal treatment has commenced. Alternatively, if a systemic infection is causing the rash, intravenous antibacterial or antifungal medications may be used to resolve the infection and, therefore, the rash.

Similarly, oral and topical antibiotics or antifungal medications may be used to resolve skin conditions which cause pustular rashes. If bacteria within the skin’s pores is contributing to the formation of pustules, this type of treatment can resolve the rash fairly quickly and help to minimize the patient’s symptoms.

However, the symptoms of a pustular rash must also be addressed, regardless of the underlying cause. As well as causing the patient discomfort and pain, a pustular rash may present certain risks, so it’s important that it is resolved as quickly as possible.

If the pustules are open or leaking, physicians will be keen to protect the patient from developing a subsequent infection. In serious cases, physicians may attempt to clean the patient’s wounds and remove bacteria from the open sores. Alternatively, topical treatments may be used to minimize the risk of additional infections developing.

In addition to this, patients may be given various forms of treatment designed to manage their symptoms. These may include:

  • Painkillers
  • Antihistamines
  • Steroids

If necessary, oral painkillers may be prescribed as these can help to minimize the patient’s pain and discomfort. Anti-inflammatory painkillers are often suitable for patients with a pustular rash, as they can help to reduce inflammation, as well as treating the patient’s pain.

Depending on the cause of the patient’s rash, antihistamines may also be a viable form of treatment. These inhibit the body’s histamine response and can reduce symptoms, such as itching and irritation. If the patient is struggling not to scratch the affected area, antihistamines can help to reduce itching and ensure that the patient does not damage their skin or spread infection by scratching the rash.

Some patients may also benefit from steroid medications when a pustular rash is present. As steroids help to reduce inflammation, they can minimize many of the symptoms associated with a pustular rash. As well as helping to prevent additional pustules from forming due to ongoing inflammation, steroids can be used to reduce skin irritation, redness and discomfort.

Can a pustular rash be prevented?

As pustular rashes can develop for a variety of reasons, it can be difficult to prevent them completely. Furthermore, pustular rashes may appear over a matter of minutes or hours, and patients may have little warning that their skin is about to react in this way. Due to this, it can be difficult to take preventative steps when it comes to this type of condition.

However, if patients notice any changes to their skin, they should seek medical help in a timely manner. By doing so, patients may be able to prevent a relatively minor skin problem from becoming more serious and could, therefore, prevent a pustular rash from forming.