Weighing the Evidence: COVID Shots and the Skin

Growing numbers of people continue to get vaccinated against COVID-19, and dermatologists are seeing some patients who develop skin problems, such as itchiness, rashes, hives, and swelling after the vaccine.

In one recent study of 49,197 Mass General Brigham employees who received mRNA COVID-19 vaccines, skin reactions were reported by 776 (1.9 percent) respondents after the first dose. Rash and itching (other than at the injection site) were the most common skin reactions. Skin reactions were more common in females (85 percent) than males (15 percent) and differed by race (62 percent white, seven percent Black, and 12 percent Asian), the study showed. Among employees who experienced a skin reaction to the first dose, 83 percent did not experience a recurrence of symptoms following the second dose. And among those with no skin reaction to the first dose, 2.3 percent reported skin reactions after the second dose, with rash and itching being the most common. The study appears in JAMA Dermatology.¹

Skin diseases and eruptions occurred unabated before, during, and after COVID-19, so it is often difficult to discern which, if any, of these symptoms—as well as untoward events with fillers—are a associated with SARS CoV-2 infection or vaccination, says Joel Schlessinger, MD an Omaha, NE-based dermatologist and founder of Cosmetic Surgery Forum. “I have seen multitudes more of generic viral exanthems and pityriasis rosea, which leads me to believe that this is the proximate cause,” he says.

“The main thing we are seeing are several cases of dermatitis following the vaccines, and we are not sure if they are truly related or not, but in some patients, there was no previous history of skin rashes,” agrees Michael H. Gold, MD, founder of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center, and Tennessee Clinical Research Center in Nashville.

Dr. Gold says these skin reactions are likely an immunological response to the vaccine.

“The news is reassuring,” he says. “These events are rare and not something that should stop anyone from being vaccinated.”

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There are many ongoing studies that follow the challenges related to both COVID-19 and vaccinations against this virus, adds Dr. Schlessinger. “Clearly, the benefits of the vaccination outweigh the minor skin issues we may be seeing, so that isn’t a question at all,” he says. “As for COVID-19 itself, there are many individuals who may or may not know they had COVID-19, yet are presenting for somewhat odd exanthems, and only time (and research) will tell, but let’s hope there is an end in sight and a clear answer on some of these issues as we navigate this disease process.”

Save the dates: Cosmetic Surgery Forum 2021 will be held December 1-4 in Nashville. Visit CosmeticSurgeryForum.com for more information.

1. Robinson LR, et al. Incidence of Cutaneous Reactions After Messenger RNA COVID-19 Vaccines. JAMA Dermatol. 2021;157(8):1000-1002. doi:10.1001/jamadermatol.2021.2114