If you’re living with fibromyalgia, you may expect widespread muscle pain and other symptoms like digestive problems, sleepiness, and brain fog. These, however, aren’t the only symptoms linked with this condition. Some people diagnosed with fibromyalgia also develop a skin rash.

These rashes can vary in size and appear anywhere on the body. They’re most often due to medication side effects and can worsen with scratching. Some fibromyalgia rashes are so sensitive that it becomes difficult to wear certain clothes or sleep. But relief is possible.

Here’s what you need to know, including how to identify a rash and how to manage symptoms.

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People with fibromyalgia often report itching, and with repeated scratching, red bumps may appear.

Typically, a rash is red, raised, or bumpy. You may develop skin sensitivity or tenderness with the rash, or you may have itchiness without pain.

In addition, a rash in fibromyalgia can cause a crawling sensation on the skin. If you also have dry skin, this can worsen itchiness and the rash.

When developing its diagnostic criteria for fibromyalgia, the American College of Rheumatology (ACR) asked study participants about rashes and itching, as well as many other symptoms.

However, a rash is not considered in a diagnosis of fibromyalgia. You must present other symptoms of the condition. These include widespread pain that occurs on both sides of the body, digestive problems, and chronic fatigue.

The exact cause of a fibromyalgia rash is unknown, but certain factors are believed to trigger this skin condition.

Immune system response

Immune system activity beneath the surface of your skin may cause a rash, although there is no research to confirm this in fibromyalgia. In this case, your immune system believes that proteins underneath the skin are foreign invaders. This can prompt your immune system to release histamine, which increases skin sensitivity. This can cause the appearance of a rash and itchiness.

Signals from central nervous system

The central nervous system consists of the brain, spinal cord, and nerves. It’s responsible for sending information to different parts of your body. If you have fibromyalgia, your brain may send “itch” signals to the nerves in your skin. This can cause your skin to become oversensitive, triggering a sensation of itchiness. While this is not proven to occur with fibromyalgia, repeatedly scratching your skin can cause a rash.

Chemical imbalance

Neurotransmitters are responsible for controlling communication between your brain and body. If you have fibromyalgia, abnormal levels of neurotransmitters (dopamine and serotonin) in your brain may contribute to itchiness. One study found that the release of serotonin intensified itching in mice. The study was not conducted on humans, but it’s suspected that higher levels of serotonin may also cause itchiness in humans, which can lead to a skin rash.

Medication

A fibromyalgia rash is most often caused by medication. Different medications can be prescribed to help reduce symptoms of fibromyalgia. These include duloxetine (Cymbalta) and milnacipran (Savella), and anti-seizure medications like gabapentin (Neurontin). Occasionally, a rash can develop as a reaction to these drugs.

You can also develop a rash if you’re allergic to over-the-counter pain medications like ibuprofen (Motrin) or acetaminophen (Tylenol). Consult your doctor if you suspect an allergic reaction.

Light sensitivity

Fibromyalgia can sometimes increase sensitivity to light. If you have this symptom, sun exposure could cause skin soreness and a skin rash.

Understanding the cause of a fibromyalgia rash can help you manage and treat this condition. If you believe your rash is caused by medication, let your doctor know. They’ll likely discuss a number of possibilities with you, including changing your medication or lowering the dose.

Here are tips to manage the rash at home:

  • Drink plenty of water. Dry skin can cause itching, which can lead to a skin rash. Increase your fluid intake to keep your body and skin hydrated. If your urine is dark yellow, this means you’re not drinking enough. Here’s how much water you should be drinking.
  • Apply sunscreen. If you’re sensitive to light, apply sunscreen before heading outdoors, even on overcast days. Wear protective covering to avoid sunburn and a skin rash. Here are some guidelines for choosing a sunscreen.
  • Take a lukewarm bath or shower. Take a lukewarm bath or shower to soothe your skin and ease itchiness associated with a rash. Apply a skin moisturizer immediately after a shower or bath to keep your skin hydrated.
  • Apply topical cream. Apply an over-the-counter topical anti-itch cream like hydrocortisone as directed several times a day for short-term relief. This helps block a histamine reaction, which can reduce itchiness and clear up a rash. These creams can also treat rashes caused by an allergic reaction to medication. If you find yourself needing to continue use for more than one week, discuss with your doctor. Long-term use of topical steroids can have side effects.
  • Don’t scratch a rash. The more you scratch, the more the rash may itch. This can damage your skin and worsen a rash.
  • Apply a cold compress to the skin. Wrap an ice pack in a towel and apply the cool compress to your skin for 10 to 20 minutes several times a day. This helps stop inflammation and pain. Learn more about making a cool compress at home.
  • Avoid perfumed soaps and lotions. Scented products can irritate your skin and worsen a rash.

A skin rash doesn’t always occur with fibromyalgia. But if one develops, home remedies can usually ease itching and improve the appearance of a rash.

Never ignore a rash that worsens, doesn’t improve with treatment, or is accompanied by other symptoms like a fever or difficulty breathing. Most rashes are caused by an allergic reaction, which could be a medical emergency. A persistent rash can also be a symptom of another disease, such as lupus. Discuss your symptoms with your doctor. They can order further tests if needed.