Why am I getting itchy rashes and diarrhea with Acyclovir?

Question

Hi doctor,

I am 27 years old, and I have been treating a recurring herpes infection for almost a year with Acyclovir. Recently, I noticed scattered rashes on my body, particularly around my wrists, thighs, and buttocks. I have done a few tests, and HIV and hepatitis B both came out negative.

The rashes do not have any fluid coming from them, but they are itchy and appear red or pink. Additionally, I have been experiencing diarrhea.

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Overall, the situation does not appear to be serious, and your negative tests for HIV (human immunodeficiency virus) and hepatitis are reassuring.

Based on your description, the itchy red-pink rashes on your wrist, thigh, and buttocks without any fluid are unlikely to be herpes. This is especially true since your genital herpes is currently dry and localized. The rash pattern sounds more like an allergic skin reaction, urticaria, contact dermatitis, or a viral-related skin eruption.

The diarrhea occurring around the same time may indicate a recent viral illness or a food-related trigger, which can sometimes lead to both gastrointestinal symptoms and skin rashes. For treatment, Loratadine and Hydrocortisone are suitable first-line options that should help reduce itching and inflammation.

For now, please continue taking loratadine once daily and apply Hydrocortisone thinly to the affected areas twice daily for up to five to seven days.

Avoid hot showers, fragranced soaps, and tight clothing, and ensure that your skin remains well moisturized.

You may continue taking Acyclovir only if genital herpes lesions reappear, as it will not help with the rashes on your body.

I want to clarify a few things to help guide you better:

Did the rash start suddenly or gradually?
Are the rashes moving or changing location?
Have you recently consumed any new foods, antibiotics, painkillers, or supplements?
Is the diarrhea ongoing, or has it started to improve?

I hope this helps with your concerns, and I look forward to your feedback for better patient care.

Thank you.