As COVID-19 cases alternately surge and wane around the world, health officials continually update what we know about how the virus affects people.

One of the more unusual symptoms reported so far is a painful red rash that spreads across the toes.

Quickly dubbed “COVID toes,” the condition seems to affect younger people more than older ones — and it often appears when there are no other symptoms of COVID-19 present.

Here’s what we know about this mysterious skin finding.

“COVID toes” closely resemble an inflammatory condition called pernio, in which one or more toes turn red, swell up, and sometimes blister.

Over the course of several days, the redness may darken to a purplish color. Sometimes the blisters resemble a skin reaction to cold called chilblains, and they can spread to the rest of the foot.

Your fingers may also be affected with the same swelling, discoloration, and blistering. Sometimes the swelling looks like a small bulb on the toe, and in other cases it causes whitish sores.

People who have had COVID toes report that the condition can be itchy and is painful enough to keep them from wearing shoes.

COVID toes affects only a small percentage of people with COVID-19. In one small Italian study, researchers reported that nearly 20 percent of those with COVID-19 experienced lesions or red patches of the toes and feet.

Early studies from China reported only 0.2 percent of people with COVID-19 presented with any skin symptoms.

However, in April 2020 reports of COVID toes and other skin conditions were significant enough for both Spain and the United States to launch registries to collect information about the number of people experiencing COVID toes and other skin symptoms associated with COVID-19.

One of the most unusual aspects of this condition is that people have had COVID toes without testing positive for the coronavirus, and without experiencing any of the other symptoms of the viral infection.

Research indicates some people have reported that the toe condition appeared several weeks after they had mild viral symptoms.

At this point, doctors think COVID toes are associated with the virus but may not be caused by it. The inflammation may be part of an immune response to the infection.

If lesions and swelling suddenly develop on your fingers or toes, consult your primary care physician or dermatologist to make sure it isn’t a different skin condition that needs a specific course of treatment.

In most COVID toe cases, researchers say no treatment is necessary at all, as the skin eruptions resolve on their own within in a few weeks.

Skin symptom FAQs

If I have this symptom, should I self-quarantine?

According to the information currently available from the Centers for Disease Control and Prevention (CDC), symptoms can appear 2 to 14 days after you have been exposed to the coronavirus. Researchers aren’t yet certain when you may be most contagious.

Can you get COVID-19 from touching someone’s toes?

Being close enough to someone to touch their toes could put you within range to contract the coronavirus by breathing it in. The CDC reports that the coronavirus has been found in blood, stool, urine, and respiratory fluids — but respiratory fluids appear to be the only source of live, transmissible virus particles.

If my toes suddenly swell and turn red, should I get tested for COVID-19?

Although the CDC and the WHO haven’t listed the toe rash on the official list of major symptoms, researchers recommend that you get tested if you have this skin symptom. It’s possible that people with skin symptoms are contagious, so it’s important to know what precautions you should take to prevent the virus from spreading. To find out more about when to get tested, see this article.

If I have one of these skin conditions, should I go to the emergency room?

Unless you have severe symptoms like a high fever, confusion, or shortness of breath, it’s better to contact your local health department or your doctor to see where you should be tested for COVID-19. If you haven’t already contracted the coronavirus, you could come into contact with it in an emergency room.

Viral infections often cause skin issues. Researchers around the world have documented a number of skin manifestations on patients being treated for COVID-19.

But it can sometimes be hard to determine whether a rash is a symptom of the infection, part of an immune response, or a reaction to one of the drugs being used to treat the patient.

Some of the skin findings involving patients being treated for COVID-19 include:

  • Hives. Some people get a raised, red rash that looks like welts. Hives can appear on the trunk or on limbs, and they can be itchy.
  • Morbilliform rash. Some people have widespread raised red speckles on various parts of the body.
  • Chickenpox-like rash. Researchers in Italy reported that 22 patients has small, fluid-filled eruptions across the skin that resemble the chickenpox rash.
  • Livedo reticularis. This skin symptom shows up as purple or red mottled skin. Livedo reticularis looks as though a vivid net has been cast over parts of the body.
  • Petechiae. The red bumps of petechiae are actually tiny blood vessels that burst underneath the skin.
  • Multisystem inflammatory syndrome (MIS-C). Health officials are finding that some children with COVID-19 experience MIS-C, which is similar to Kawasaki disease. One of the indicators of MIS-C is a widespread rash. Other symptoms of the syndrome include fever, swelling of hands and feet, inflamed mouth, throat, and lips, plus swollen glands in the neck.

The CDC regularly updates its list of COVID-19 symptoms. Currently, you should be watching for these symptoms:

  • fever or chills
  • sore throat
  • cough
  • trouble breathing
  • tiredness or fatigue
  • body aches, including headache
  • sudden loss of taste or smell
  • stuffy or runny nose
  • nausea
  • vomiting
  • diarrhea
How to reduce your risk of getting COVID-19

Here’s what CDC recommends you do to protect yourself from contracting the coronavirus:

  • Wash your hands thoroughly and often.
  • Keep a safe distance from other people (at least 6 feet).
  • Wear a cloth face mask or covering when you’re out in public.
  • Clean the frequently touched surfaces in your home every day.
  • Pay attention to any symptoms you may have.

The outlook varies according to other COVID-19 symptoms a person may have.

In some people, the COVID toe rash is the only symptom, and it goes away on its own in a matter of weeks.

In other people, the rash accompanies more severe symptoms and may take much longer to resolve.

“COVID toes” refers to a painful red swelling on one or more of the toes that is associated with COVID-19. The rash may be itchy and may include blisters that may darken over time. The rash may appear on the heels and fingers as well.

For many people with COVID toes, there are no other symptoms of infection. For some, the toe rash happens along with more common respiratory symptoms.

If your toes suddenly swell and form blisters, it’s a good idea to talk to your doctor and get tested for COVID-19, since you may be contagious or at risk for developing other symptoms of the illness.

The good news is that for most people, this uncomfortable condition will resolve on its own in a few weeks.