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Dermatologist explains what the monkeypox rash looks like


Most rashes that dermatologists are seeing at this time are not caused by monkeypox

Still, it’s important for you to be aware of monkeypox and get medical care if you develop a new rash with an unknown cause.

Dermatologist examining rash on patient’s face

As reported cases of monkeypox grow, more patients are reaching out to their dermatologist about a new rash or bump on their skin. That’s a good thing.

The Centers for Disease Control and Prevention (CDC) now recommends that you "seek medical care immediately if you develop a new, unexplained skin rash or lesions on any part of the body." Just be sure to call ahead before going to a medical office. Monkeypox is contagious.

Here’s what else it can be helpful to know about monkeypox.

What is monkeypox?

Monkeypox is a contagious disease caused by a virus. This virus has been infecting humans since 1970, primarily in Africa, where outbreaks have occurred.

In the United States and Europe, where cases are now being reported, monkeypox outbreaks have been rare.

What are the signs and symptoms of monkeypox?

During past outbreaks, monkeypox started with a fever and often flu-like symptoms. A rash followed. The rash typically started on the face and spread to many areas of the body. People usually had between 10 and 150 pox-like bumps on their skin. Some people developed more than 200 bumps.

"This time, monkeypox looks different," says board-certified dermatologist Esther E. Freeman, MD, PhD, FAAD, Director, Global Health Dermatology, Massachusetts General Hospital, Harvard Medical School; Associate Director, Center for Global Health, Massachusetts General Hospital; and a member of the American Academy of Dermatology’s Monkeypox Task Force.

With this new outbreak, it's more common for people who get monkeypox to develop fewer bumps on their skin. They may not have a fever or flu-like symptoms.

What does the monkeypox rash look like?

"During this particular outbreak, we’re seeing that the rash may start in the groin, genital region, or around the anus – and sometimes stay in the spot that it started instead of spreading," says Dr. Freeman.

People may have only 1 or 2 bumps on their skin. These bumps can look like a blister, pus-filled bump, or open sore.

Even with a few bumps, the rash can be painful. Some people seek medical treatment for the painful rash.

Monkeypox causes pox-like bumps on the skin

In 2022, people may develop a few bumps instead of hundreds.

Monkeypox rash on patient’s hand

How do dermatologists know monkeypox is causing a rash?

"While the monkeypox rash can be mistaken for chickenpox, shingles, or herpes, there are differences between these rashes," says Dr. Freeman. By looking at the pattern on the skin and where the rash appears, a board-certified dermatologist can narrow down which disease is causing the rash.

If monkeypox is a likely cause, your dermatologist will swab the rash and send the swab to a lab. At the lab, a test known as a PCR (polymerase chain reaction) test will be performed. The results from the PCR test will indicate whether the swab contains the monkeypox virus.

How long does monkeypox last?

Most people have monkeypox for 2 to 4 weeks. That’s the amount of time it takes for the disease to run its course.

Until the bumps go away, a person who has monkeypox is contagious and can spread the virus to others.

How do you get monkeypox?

You develop monkeypox through close contact with an infected person or animal. Here’s how this happens:

An infected person: If someone has monkeypox, you can catch it if you:

  • Touch the rash or scabs or have intimate contact. This is the most common way to spread monkeypox.

  • Have prolonged face-to-face contact, as the virus can spread through respiratory droplets. This seems uncommon.

  • Touch an object that an infected person has used like unwashed clothing or bedding.

An infected animal: Animals infected with monkeypox are found in central or western Africa, where this virus is endemic (there all the time). Most of the infected animals are wild rodents like rope squirrels and dormice.

You can get monkeypox from an animal infected with the virus if you:

  • Are bit or scratched by the animal

  • Handle an infected animal (even a dead one)

  • Eat an infected animal

  • Use a product like a cream or powder made from an infected animal

Smallpox vaccine helps prevent monkeypox

If you have been vaccinated against smallpox, you have less risk of developing monkeypox.

The smallpox vaccine is approximately 85% effective in preventing monkeypox. However, many people, especially those under age 50, have not received this vaccine. The last routine smallpox vaccines were given in the United States in 1972 because smallpox had been eradicated (eliminated).

What should I do if I have symptoms of monkeypox?

If you have symptoms of monkeypox, call your doctor. Tell the person answering the phone that you have symptoms. Your doctor can determine what you should do.

The CDC is telling people, "If possible, call ahead before going to a health care facility"

If you are not able to call ahead, tell a staff member as soon as you arrive that you are concerned about monkeypox.

Dermatologist uses video call to check on sick patient with monkeypox symptoms

Dr. Freeman notes, "Not every new rash is monkeypox. However, if you do think you have monkeypox, it’s important to see your doctor quickly. Patients who delay getting medical attention may be diagnosed later when fewer treatment options are available. Waiting also means that you can expose more people to the virus, so family and others may develop monkeypox."

How is monkeypox treated?

People at risk of developing severe disease may receive treatment. Some antiviral medications are being used to treat people when the PCR test shows that they have monkeypox. There is currently no specific treatment approved by the U.S. Food and Drug Administration (FDA) for monkeypox.

Monkeypox is rare

As monkeypox is making its way around the world, it can seem like any new rash on your skin could be monkeypox. It’s important to remember that monkeypox is rare. Few people in the United States have developed this disease.

Still, some people are getting monkeypox. If you have a rash or bump on your skin and you don’t know what caused it, contact your board-certified dermatologist.

To find a board-certified dermatologist near you, go to Find a Dermatologist.


Images
Images 1, 3: Getty Images

Image 2: Used with permission of the Centers for Disease Control and Prevention (CDC). This image is also available on the CDC website, and use of this image does not constitute endorsement or recommendation by the U.S. Government, Department of Health and Human Services, or Centers for Disease Control and Prevention.

References
American Academy of Dermatology, Recognizing monkeypox.” Page last updated June 1, 2022. Last accessed June 1, 2022.

Centers for Disease Control and Prevention (CDC):

World Health Organization. “Monkeypox: Key facts.” Page last updated May 19, 2022. Last accessed June 6, 2022.


Written by:
Paula Ludmann, MS

Reviewed by:
Terrence A. Cronin, MD, FAAD
Esther Ellen Freeman, MD, PhD, FAAD
George J. Hruza, MD, MBA, FAAD
Toby A. Maurer, MD, FAAD
Jon Klint Peebles, MD, FAAD
Adrian O. Rodriguez, MD, FAAD
Misha Rosenbach, MD, FAAD

Last updated: 6/22/22

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