Fibromyalgia Rash: Effective Relief Strategies for Skin Symptoms

Are you concerned that a persistent rash may be related to fibromyalgia? Often manifesting as red, itchy patches, a rash associated with fibromyalgia can be both annoying and distressing.

This article delves into the relationship between fibromyalgia and rashes. We'll guide you through the symptoms that may indicate a connection to your condition and introduce you to treatment strategies designed to alleviate discomfort and enhance your daily wellbeing.

Understanding skin symptoms in fibromyalgia

Fibromyalgia is primarily identified by widespread pain and fatigue. It does not typically include a rash as a symptom, but fibro can present with a wide range of symptoms, including skin ailments.

Even though a rash alone is not a determinant for a fibromyalgia diagnosis, the American College of Rheumatology (ACR)¹ does consider rashes and itching in its diagnostic criteria. Research also indicates that people with fibromyalgia are more likely to experience certain skin issues, compared to those without the condition. These include:

1. Hyperhidrosis: characterized by excessive sweating, this condition can lead to soft, cracked, or scaly skin, which can increase your risk of secondary infections through the broken skin. In one study, nearly a third of people with fibromyalgia also experienced hyperhidrosis.²
2. Lichen simplex chronicus: this condition features itchy rashes with thickened, leather-like skin, resulting from a continuous itch-scratch cycle. It is considered one of the more common skin issues for people with fibromyalgia.³

Rashes in fibromyalgia, when they do occur, are typically red, raised, or bumpy and may be exacerbated by dry skin, leading to increased itchiness. You might also have skin sensitivity or tenderness, or sensations similar to crawling on the skin.

Appearance of a fibromyalgia rash

For people who do experience skin complaints, a rash on the face or legs are two common issues. These rashes are characterized by reddish patches or clusters of small, red, raised bumps.

A fibromyalgia rash on the face can give the appearance of blushing or flushing and may be accompanied by sensations of stinging or a general increase in skin sensitivity. Tenderness, dryness, or flaking of the facial skin can also be symptoms. Like many aspects of fibromyalgia, the severity and occurrence of facial rashes can fluctuate from one day to the next.

A fibromyalgia rash on the legs can also cause itching or a burning sensation and may vary in size and sensitivity.

What causes a fibromyalgia rash?

While the triggers of skin rashes in fibromyalgia are often quite individual – with stress being a major reason for a flare – the underlying causes remain somewhat elusive. That said, ongoing research is shedding light on potential causes.

1. Immune system response: People with fibromyalgia may have more mast cells under the skin.4 Mast cells are part of the immune system and play a role in allergic reactions, by releasing chemicals that cause symptoms such as flushing and itching. There is a potential link between the immune system and central sensitization, which could also be leading to skin rashes that resemble allergic reactions.
2. Nerve fiber sensitivity: Because central sensitization can affect the nervous system throughout the whole body, for people who live with fibro, nerve fibers in the skin might be more affected by stimuli such as temperature and touch. It’s possible that this overactivity can make the skin prone to redness, itching, and the development of bumps or blisters.5
3. Medication side effect: Different people respond to medications in different ways. For some people, medications that are often used to treat fibromyalgia, including Cymbalta (duloxetine) and Lyrica (pregabalin), can cause skin rashes as side effects. Reactions can range from itching and hives, to blisters and peeling rashes. Even over-the-counter pain relievers can trigger skin reactions for some people.
4. Neurotransmitter imbalance: For people who have an imbalance in their brain chemicals, such as serotonin, this imbalance can sometimes influence the way we perceive itchiness and pain. Scratching, rubbing, and other ways to counter an itch can then cause a rash.
5. Light sensitivity: Some people with fibromyalgia have heightened sensitivity to light, which can result in skin soreness and rashes following exposure to sunlight.

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Managing fibromyalgia flares & rash symptoms

Fibromyalgia, with its complexity and varied symptoms, including skin rashes, calls for a multifaceted and personalized treatment approach, so always talk with your healthcare team. 

While there are no specific guidelines exclusively for fibromyalgia rashes, combining several strategies can effectively manage these symptoms.

The MoreGoodDays® program is a  comprehensive approach to fibromyalgia treatment. We know that pain, fatigue, skin complaints, and the other symptoms that you might experience are influenced by a mixture of biological, psychological, and social factors, and we address each of these.

Our multidisciplinary strategy will explain fibromyalgia, help you to identify your unique triggers, and teach you to retrain your pain system through various techniques. This includes psychological approaches such as cognitive behavioral therapy and mindfulness, helping you to get better sleep and manage stress in your life, nutrition and an anti-inflammatory diet, and physical therapy.

We aim to reduce your pain severity, the frequency and length of flare-ups, and the emotional distress that comes with a chronic condition, while providing personalized support. Our service complements medical advice rather than replacing it.

1. Quality sleep: Getting enough sleep and getting good quality sleep is crucial for overall wellbeing in fibromyalgia, including skin health. Quality sleep supports cell regeneration and collagen production, which are essential for maintaining healthy skin and mitigating issues like rashes.
2. Stress reduction techniques: Implementing stress reduction practices such as meditation, progressive muscle relaxation, or deep breathing exercises can positively affect skin health by promoting skin barrier recovery and reducing stress-related inflammation.
3. Balanced diet for skin health: A nutrient-rich diet can support skin health and reduce rash occurrence. It doesn’t have to be tricky or expensive, simply incorporating a variety of fruits, vegetables, lean proteins, and whole grains will give you a blend of essential vitamins and minerals. Including omega-3 fatty acids, found in fish and flaxseeds, can provide anti-inflammatory benefits, while limiting processed foods and sugar helps reduce potential inflammation triggers.

Medications & topical treatments

Topical creams for rash relief that contain hydrocortisone can help to reduce inflammation, while those with lidocaine can numb your discomfort. Opt for creams suited for sensitive skin and consult a healthcare provider before starting any new treatment.

Antihistamines are over-the-counter medicines for allergies, and can be effective in reducing rash symptoms such as redness, swelling, and itchiness. Antihistamines can be taken orally or applied as a topical lotion or cream. And always check with a doctor or pharmacist so you know the best type and dosage for your specific needs.

Commonly prescribed medications for fibromyalgia, such as antidepressants and anticonvulsants, can help alleviate your overall symptoms. Nonsteroidal anti-inflammatory drugs such as ibuprofen can help with pain relief, although they usually don't address fibromyalgia-related tissue inflammation so you might not find them useful for rash relief.

Natural relief strategies for fibromyalgia rashes

What counts as “natural” can be up for debate. However, there are many non-drug options for managing sensitive skin and preventing rashes.

Some effective, gentle strategies to care for your skin, ensuring it remains healthy and resilient include:

1. Gentle cleansing: Avoid abrasive scrubs and opt for mild, gentle skin cleansers to prevent irritation.
2. Balanced bathing: Use lukewarm water rather than hot water to avoid drying out your skin and try to limit your skin’s exposure to water, for example, by wearing gloves while cleaning.
3. Sun protection: Limit your exposure to the sun to keep your skin young and reduce the risk of rashes. When outdoors, use sunscreen, even on overcast days, and consider wearing UV-protective clothing, such as long sleeves and a wide-brimmed hat.
4. Regular moisturization: Keep your skin well-moisturized, particularly after bathing, to maintain hydration.
5. Hydration: Drink plenty of water to keep your body and skin hydrated. A good way to know if you are drinking enough is by the color of your urine when you use the bathroom – if it’s darker than straw-colored you probably need to be drinking more.
6. Avoid scratching: While it may be tempting, try not to scratch rashes or itchy skin to prevent developing rashes or worsening ones that are already there.
7. Cool compress: Use a cool compress wrapped in a towel on affected areas to alleviate inflammation, itching, and discomfort.
8. Fragrance-free products: Choose unscented soaps and lotions to reduce the likelihood of skin irritation.

Remember, understanding the causes and triggers of your skin symptoms is crucial for dealing with them effectively. And combining strategies offers a holistic approach to managing fibromyalgia and associated skin issues.

Always work closely with your healthcare professionals to tailor any treatments to your specific needs and to ensure the effectiveness and safety of your care plan, especially if you suspect a medication-related rash or have other concerns about your skin health.