9 Causes of a Circular Rash

A circular rash is commonly caused by a fungal infection called ringworm. However, other common skin infections, an allergic reaction, and chronic skin disorders can also cause a circular rash. The treatment for a circular rash depends on what is causing it but can include medications taken by mouth or put on the skin. 

This article will explain the causes of a circular rash and how to get treatment. 

Ringworm

Ringworm (tinea corporis) is a skin infection that is caused by a fungus. It is common in children but can affect people of all ages. The ringworm fungus likes moist and warm areas. It can grow on the surface of the skin, on the scalp, on nails, on the feet, between the toes, and on the bottom of the feet.

Ringworm is contagious and can spread from person to person as well as from pets to people. Ringworm can be caught if you touch contaminated items in a pool, shower, or sink (for example, clothing, makeup, brushes, and combs).

Signs

Ringworm causes a ring-shaped patch. The rash can look a little different depending on what part of the body it forms on. The patch from ringworm can be:

• Clear in the center (at first)
• Itchy
• Raised, round, and flat, with a raised scaly border
• Pink, red, gray, or brown (depending on skin tone)

Other Causes

If you have a circular rash on your skin and it's not ringworm, there are also some other conditions that could be the cause.

Lyme Disease

Lyme disease is a bacterial infection that is spread by the bite of an infected tick. People living in or visiting the Northeast and northern Midwest United States tend to get Lyme disease the most. 

Symptoms of Lyme disease vary depending on what stage of the infection you're in. But if it's left untreated, Lyme can lead to other health conditions if it spreads to the heart, nervous system, and joints.

Typically, the symptoms of Lyme appear between three and 30 days after the bite. Signs and symptoms of Lyme disease can include:

• Headache
• Chills
• Fever
• Aches in joints
• Swollen lymph nodes

These Lyme symptoms may come on before the rash or instead of the rash. Contact your healthcare provider if you have any of these symptoms after getting bitten by a tick or have been in a tick-infested area.

The rash from the infected tick bite, erythema migrans, affects about 70% to 80% of people with Lyme disease.

Here are some things to keep in mind about a Lyme rash:

• Has a “bull’s–eye” appearance
• Appears at the site of tick bite within seven days (but can show up within three to 30 days)
• Can grow up to 12 inches
• Area around it may feel warm
  

Other Lyme disease symptoms that can happen later on in the infection include:

• Irregular heartbeat
• Nerve pain
• Numbness or tingling in hands and feet
• Heart palpitations
• Severe headache and neck stiffness
• Arthritis and joint swelling in large joints
• Tendon pain
• Dizziness
• Shortness of breath
• Temporary paralysis of facial muscles in which one side of the face droops (Bell’s palsy)

Eczema

Eczema (atopic dermatitis) is an inflammatory skin condition that is usually very itchy. It appears as dry rashes, scaly patches, or blisters. It’s very common—over 31 million Americans have eczema. It can develop in people of all ages, including newborns.

Some people have a mild form of eczema, while others have a more severe form that needs specialized treatment. The rash can appear anywhere on the body and show up in multiple places.

Nummular eczema is a type of eczema that causes red or brown coin-shaped or oval patches, similar to ringworm. They are dry and scaly. It can be very itchy and is often seen on the arms and legs.

Some people with eczema also have allergies and other skin conditions. Some common symptoms of eczema are:

• Itching
• Dry patches of skin
• Round thick and hard patches
• Discoloration of skin
• Bleeding or leaking of clear fluid when the area is scratched

Granuloma Annulare

Granuloma annulare is a skin condition that affects people of all ages. The skin condition is a circular ring of raised bumps that has a sunken center.

The cause is unknown. It is known to be common in people who have diabetes or thyroid disease. 

Granuloma annulare is not contagious and will usually clear up on its own. However, since it looks like other common skin conditions that do need treatment, you should still see a provider to have the rash diagnosed. 

The most common signs of granuloma annulare are:

• Rings of bumps on the hands, feet, or legs
• Red or skin-toned bumps that are thick and firm
• A ring that stays in one area or spreads to multiple areas
• Rings that remain for several years

Contact your healthcare provider if you have a ring anywhere on your skin that lasts more than a few weeks.

Psoriasis

Psoriasis is a chronic autoimmune skin disease that speeds up the time it takes for new skin cells to be made. In psoriasis, it happens in a matter of days rather than the usual weeks. Skin cells will start to pile up, causing itchy, red, sometimes circular patches of skin that join together.

The patches are usually scaly, thick, and discolored. Some of the patches may hurt or be excessively dry with stinging and burning. 

Psoriasis will commonly show up on the hands, feet, knees, elbows, scalp, and back. Some of the common symptoms of psoriasis are:

• Dry, cracked skin
• Excessively dry skin that may itch and/or bleed
• Soreness, burning, and painful itching
• Discolored round patches (e.g., pink, red, purple, or brown, depending on underlying skin tone)
• Plaque-like patches of skin with silvery and thick scales

Psoriasis is a common condition, affecting 2%-3% of the global population. Since a lot of people have psoriasis, your provider may be able to recognize the rash by looking at it. If not, they can refer you to a specialist who knows about skin health (dermatologist) for a diagnosis and treatment.

Pityriasis Rosea

Pityriasis rosea is a common skin condition that will usually go away without treatment. It most appears in younger people between the ages of 10–35. The cause is still unknown, but it is thought to be viral.

Pityriasis rosea starts with what is called a herald patch. It is round or oval, red or pink in color, and has a raised edge. It usually appears on the trunk and can be from 0.8 inches to almost 4 inches wide.

Typically, within days to weeks, more oval patches appear and follow the Langer lines (folds) of the front and back of the trunk, arms, and legs. These are usually smaller, 0.4–0.8 inches wide.

Before the herald patch shows up, a person may feel like they have a cold or the flu, with symptoms like a sore throat, fatigue, nausea, and headache. The rash is only itchy in about half of people with the condition.

In cases where the rash or itching is severe, corticosteroids can be prescribed.

Lupus

Discoid lupus is an autoimmune disease that can cause a rash that can look somewhat circular (discoid). The rash is thick, raised, and scaly. Sometimes, it’s also itchy.

The rash is usually on the face, ears, and scalp. They can take days to a few weeks to heal. A rash from discoid lupus can usually be treated with creams, injections, or oral medicines that help with inflammation. 

Contact Dermatitis

Contact dermatitis can happen if an irritant or allergen touches the skin and causes a reaction. Substances like soaps, perfumes, and plants are common causes of a rash from contact dermatitis. 

The rash from contact dermatitis can look like a circular patch, depending on what area of skin was exposed to an irritant or allergen. 

Usually, the rash from contact dermatitis will go away within a week. The discomfort it causes can usually be managed with topical creams that help with inflammation and itching. Avoiding triggers is key to preventing the rash from coming back.

Hives

Hives (urticaria) are itchy welts (wheals) that can be circular or take on other shapes. They usually happen because the skin is reacting to an allergen or another trigger, like cold temperatures or an infection in the body.

Some people get hives occasionally and they clear up quickly without any issue. However, some people develop chronic hives that can be harder to treat.

Cold compresses, OTC anti-itch creams, and taking care of your skin (e.g., keeping it hydrated) can help treat hive symptoms until they get better and help manage chronic outbreaks.  

Treatments

The treatments for circular rash vary depending on what’s causing it. For example, antibiotics are needed for Lyme disease, while mild skin irritation that leads to a rash may not need any specific treatment.

For other rashes, your healthcare provider will often recommend home remedies and over-the-counter (OTC) products before suggesting prescription medications and treatments.

Home Remedies and OTC Products

There are a few things you can do to treat a circular skin rash from ringworm as well as other causes at home. In general, these tips will help you take care of your skin and keep it healthy, as well as soothe any irritation that a rash is causing.

Ringworm:

• Use OTC antifungal creams twice a day for seven to 10 days.
• Don't cover the ringworm rash with a bandage.
• Keep the area clean and dry.

For other skin rashes:

• Keep the skin hydrated with OTC fragrance-free, hypoallergenic, emollient-rich lotion after bathing.
• Bathe in lukewarm water and use a mild cleanser rather than soap.
• Try wet wrap treatment using petroleum jelly and plastic wrap or a wet bandage.
• An oatmeal bath may also help. Try adding finely ground oatmeal powder or a commercial oatmeal bath.
• Wear loose, non-scratchy clothing.
• Use products that are made for skin disorders, like coal tar for eczema or special psoriasis soap.
• Try OTC hydrocortisone cream to help with itching and inflammation.
• Apply a cool compress to help with itching, especially from hives.

Prescriptions and Treatments

The type of treatment that you have depends on the specific condition:

• Antifungal medication can help people who have ringworm infections. It can come in creams, ointments, and pills. Most creams and ointments are available without a prescription. In some cases, the healthcare provider may need to prescribe antifungal pills for severe disease.
• Antibiotics usually are prescribed for people who have Lyme disease. If antibiotics are given early enough, there is a higher chance of full recovery and prevention of complications.
• Cryosurgery using liquid nitrogen (applied to the skin) is a treatment option for granuloma annulare if it is extreme and widespread. Other options for widespread granuloma annulare are Aczone (dapsone), retinoids, and niacinamide. Typically, this condition clears up on its own.
• Corticosteroids are commonly prescribed for skin conditions, including eczema, psoriasis, pityriasis rosea, and granuloma annulare. They are available in lotions, shampoos, creams, and ointments.
• Light therapy (phototherapy) is a treatment that can help patients with eczema and psoriasis. It exposes the skin to a controlled amount of light. This treatment can be used with other treatments or on its own. Your healthcare provider can help come up with the best plan based on the specific condition.

When to Talk to Your Healthcare Provider

If you have a rash that is excessively itching, painful, and not going away within a few days, contact your healthcare provider.

In addition, if you were bitten by any type of insect (including a tick) and notice a rash appearing on your body, contact your healthcare provider right away. They can help you determine the cause and the right treatment option for you.

Summary

A circular rash is typical of ringworm (a contagious fungal skin infection). You can also get a circular-looking rash from other conditions such as Lyme disease, eczema, psoriasis, pityriasis rosea, hives, dermatitis, or granuloma annulare.

You’ll need to see your healthcare provider for a diagnosis of any circular rash that does not get better on its own or is getting worse. The type of treatment given will depend on the cause of the rash but could include OTC products for symptoms and prescription medications to treat infections.