Red splotches on the skin can be caused by hives, eczema, heat rash, an allergic reaction, or stress. Seek urgent care if you have swelling or trouble breathing.
Common causes
- Hives (urticaria): raised, itchy welts from allergies, infections or stress.
- Eczema (atopic dermatitis).
- Heat rash.
- Allergic contact dermatitis.
- Viral rashes, such as roseola or measles.
- Rosacea or sunburn.
- Stress and flushing.
- Medication reactions.
Home care
Cool compress, antihistamines and fragrance-free moisturizer. Avoid triggers.
Seek emergency care
If splotches come with swelling of the lips or face, trouble breathing or dizziness. That could be anaphylaxis.
See a doctor if
Rash lasts more than a week, spreads, blisters or comes with fever.
Patch test
A doctor can identify allergens.
Why splotchy red skin appears
Red splotches happen when blood vessels widen or the skin becomes inflamed. They may be flat or raised, itchy or painless, and appear on the face, neck, chest or limbs. The cause ranges from heat or emotion to allergies and infections.
Common causes
- Emotional flushing and stress: red blotches on the neck and chest, which fade within minutes.
- Heat, exercise, alcohol and spicy food.
- Allergic reactions to food, medicine, plants or insect bites, including hives (urticaria), which are raised welts that move around.
- Contact dermatitis from soaps, detergents, nickel or poison ivy.
- Eczema (atopic dermatitis), which causes dry red itchy patches and affects about 7% of US adults and 11% of children.
- Rosacea, with persistent facial redness.
- Psoriasis: thick red plaques with silvery scales.
- Viral rashes such as measles, chickenpox and fifth disease.
- Heat rash, ringworm and shingles.
- Drug eruptions, such as from antibiotics.
- Autoimmune diseases such as lupus, which can cause a butterfly rash on the face.
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Home care
- Avoid scratching and known triggers.
- Use fragrance free moisturizer and gentle cleansers.
- Apply a cool compress or 1% hydrocortisone cream for itchy areas.
- Take an oral antihistamine for hives.
- Wear loose, breathable clothes and keep cool.
- Stop using new products you suspect.
Seek emergency care
Call 911 for a rash with swelling of the lips, face or tongue, trouble breathing, wheezing, dizziness or fainting, which suggest anaphylaxis. Also seek urgent help for a rash that spreads fast with fever and purple spots that do not fade when pressed, which can signal meningitis or sepsis.
See a doctor if
The rash lasts more than 2 weeks, covers large areas, blisters, is painful, is spreading, comes with fever or joint pain, or follows a new medication.
Patch test
Dermatologists use patch testing to identify contact allergies. Patches with small amounts of allergens are placed on the back for 48 hours and read at 72 to 96 hours.
Skin conditions behind red patches
Hives (urticaria) affect about 20 percent of people at some point, appear as raised itchy welts that move around and fade within 24 hours, and are often triggered by foods, medicines, infections or heat. Eczema (atopic dermatitis) affects about 10 percent of Americans and causes dry, itchy red patches in skin folds. Rosacea causes facial redness and flushing in an estimated 16 million Americans. Contact dermatitis follows exposure to nickel, fragrances, latex or poison ivy. Heat rash, sunburn and viral rashes such as measles and fifth disease are other causes. Emotional stress and exercise can cause blotchy red patches on the neck and chest for some people because of dilated blood vessels. A rash with swelling of lips or tongue, trouble breathing or dizziness needs emergency care because it can be anaphylaxis.
Based on data from the American Academy of Dermatology and the NIH
