221: Do Rashes In Certain Areas Mean Something?

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Have you ever wondered if the placement of your rashes actually was an important clue to your case?

I’ve been asked this A LOT!

So today I thought I’d share some clinical pearls that I’ve picked up along the way to help you become a better skin rash detective!

This observation can also help you by looking back to rash placement in the past (even when you were a child) or before the onset of Topical Steroid Withdrawal (TSW).

Especially because we know that skin rash conditions are often driven by internal inflammation.

But you have to look for those underlying (and often hidden) root causes along the way so that you can actually address them.

So let’s dive into this interesting discussion on what rashes in certain areas of the body actually mean!

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In this episode:

• What do rashes in certain areas mean?
• Do rashes on the abdomen mean I have gut problems?
• Rashes around your eyes and under the nose
• Fungal hotspots (check out the graphic!)

Quotes:

In certain areas such as the armpits or groin, the skin microbiome is considered to be a damp environment making it more prone to fungal rashes.

Don’t assume that rashes around the mid-section automatically mean that you have a gut problem simply due to rash placement.

 

Do Rashes In Certain Areas Mean Something? (FULL TRANSCRIPT)

Welcome back to episode #221 of the Healthy Skin Show!

In today’s episode, I’m answering one of the most common questions that I get — Do rashes in certain areas mean anything?

The short answer is that they can.

While the long answer is that it’s complicated, rash placement can help give you clues to your case and where you need to look in order to confirm potential issues going on.

What I’m going to share is by no means a way to diagnose yourself… that’s the role of your doctor.

I’m simply going to share some clinical pearls with you to help you on your quest to dig deeper into your case!

 

What Do Rashes In Certain Areas Mean?

When it comes to the placement of rashes and what they could potentially correlate to from a root cause perspective, it’s not necessarily so cut and dry.

What we understand about the skin’s microbiome is that different areas on the skin have different microbiome diversity.

For example, in certain areas such as the armpits or groin, the skin microbiome is considered to be a damp environment. That’s one reason they are more prone to fungal overgrowth.

This can be more easily visualized in this diagram here:(1)

 

GRAPHIC IS FROM https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535073/figure/F3/?report=objectonly.

Different concentrations and types of bacteria live in different areas of the skin.

What’s more, the commensal fungal organism called Malasezzia which I’ve discussed on the show tends to live in the areas considered to be sebaceous such as the head and back of the neck. You can check out episode 173 for more on Malasezzia!

Some research specifically on head + neck dermatitis (eczema) points towards a link to Malasezzia being a problem.(2) And then we have to consider that 10% of Dupixent users end up with facial redness that is also looking to be triggered by Malasezzia.(3)

In knowing that the microbiome of your skin varies depending on its location, let’s talk a bit more about some specifics!

 

Do Abdominal Rashes Mean I Have Gut Problems?

I’ve been asked a number of times if rashes on the abdomen immediately mean your gut must be messed up.

In short, if you have rashes on or around your abdomen and back (essentially your midsection), it doesn’t necessarily mean that you have gut problems.

You could have underlying gut issues that I’ve often discussed here on the Healthy Skin Show.

The gut-skin connection is a very real concern that is only now being recognized mostly by more integrative-leaning dermatologists.

But generally speaking, I would caution you from assuming that rashes around the mid-section automatically correlate to a gut problem simply due to rash placement.

It would be important for you to go through my Skin Rash Root Cause Finder Guide to better understand if there are gut function and/or gut microbiome issues at play.

 

Rashes Around The Eyes + Under The Nose

What about those dreaded rashes around the eyes?

Dr. Julie Greenberg had mentioned in a previous episode that eye rashes can point towards a potential fungal issue.

But that said, you have to consider that Staph aureus infections can hide in your nasal passages.

Your nasal passages are connected to your eyes via the nasolacrimal apparatus.(4)

When I’ve asked various guests about eye rashes or even rashes just below the nose on the upper lip, it’s important to rule out Staph aureus (or MRSA) as a culprit with a nasal swab that your doctor can easily do for you.

 

Fungal Red Flags (SEE GRAPHIC BELOW)

I personally think the most interesting correlation I’ve seen clinically is the link between fungal overgrowth of the internal microbiome and rashes on certain areas of the skin.

This doesn’t necessarily mean that the rashes on the skin are due to fungal overgrowth on the skin itself.

But rather it can be a clue to deeper issues that drive internal inflammation.

Plus it can be helpful to better understand what could have been a problem if you look back at rashes historically OR if you struggle with TSW and need to consider where your rashes commonly showed up before the TSW onset.

Again, I’d consider this along with the complete picture of your case and the information that you would derive from going through my Skin Rash Root Cause Finder Guide.

If you struggle (or struggled with in the past) rashes in these areas, you could consider potential fungal dysbiosis as part of your underlying microbiome issue:

These fungal red flags include:

• Dandruff
• Ear rashes
• Eye rashes
• Mouth rashes
• Thrush (fungal overgrowth in the mouth + throat)
• Armpit rashes
• Rashes on the back of your neck
• Rashes under the breast
• Inside of elbow rashes
• Groin rashes
• Jock itch
• Vaginal yeast infections
• Back of the knee rashes
• Athlete’s foot
• Toe and/or fingernail fungus

You don’t necessarily have to have rashes in all of these spots.

But again, I’d consider this with your case because it could provide clues for what’s upending the internal balance and driving inflammation.

Doing an anti-candida diet to fix this won’t likely work (since dysbiosis to this degree often isn’t fully resolved by diet alone).

Keep in mind that friendly commensal bacteria are supposed to keep fungal organisms in check.

Overgrowth could be triggered by drug exposure (like antibiotics, hormonal birth control pills, steroids or certain biologic medications), significant mold exposure, the microbiome that you got from your mother that may have been skewed in a particular fungally direction, diet and other factors.

And typically a fungal problem also can mean there’s a dysbiosis or imbalance of bacteria in your microbiome. That said, without a functional stool test, it’s impossible to tell if the imbalance would point towards undergrowth or overgrowth of bacteria.

For now, this is a great list to run through not only of the rashes that you currently have, but where your rashes typically showed up during your life.

It’s my hope that this clinical pearl will help you become a better detective on the road to healthy skin.

If you’ve got any questions or thoughts to share about this, leave a comment below so I can address them.

And this is a great episode to share with your fellow skin rash warriors who are also seeking answers about how to support their skin while seeking out root causes driving the inflammation.

Before you head off for your day, take a moment to rate and review the Healthy Skin Show on your podcast platform. And hit the subscribe button so you can tune in each week for new research, tips, and inspiration.

Thank you so much for tuning in and I look forward to seeing you in the next episode!

 

REFERENCES

1. Grice EA, Segre JA. The skin microbiome. Nature Reviews Microbiology. 2011;9(4):244-253. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535073/figure/F3/?report=objectonly
2. https://onlinelibrary.wiley.com/doi/epdf/10.1111/pde.14437
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6818397/
4. https://www.reviewofophthalmology.com/article/right-between-your-eyes