A rash may seem superficial and easily treatable, but sometimes there’s more to rashes than meets the eye. And this is particularly true for painful rashes. Painful rashes can pop up anywhere in your body, but what does it mean when they appear at the back of your neck?
We’ve put our detective glasses on and scoured articles and journals to help you uncover why you have a painful rash on the neck.
What Conditions Can Cause A Painful Neck Rash?
There are many causes of painful rashes, and listing all of them will take ages. With this in mind, we’ll be narrowing down our list of culprits to conditions more likely to cause a painful rash localized in the neck. Possible causes include:
- You might be having a reaction to products or substances that come into contact with your skin. This is called contact dermatitis. This can include a reaction to your luxurious soap, favorite perfume, or even your most precious jewelry.
- You may have an inflammatory condition called atopic dermatitis (eczema), or an inflammatory reaction from stress called a stress rash.
- You may be suffering from an infection such as herpes or shingles.
- Dermatomyositis which is a rare skin condition caused by your immune system going haywire.
What Does Contact Dermatitis In The Neck Look Like?
Before we talk about what the rash from contact dermatitis looks like in the neck, you should know that there are two types of contact dermatitis.
Irritant contact dermatitis
This is considered the most common type of contact dermatitis. It occurs when the skin comes into contact with a substance that irritates it. We know it couldn’t get any more obvious than this.
This can happen to your neck when your skin is exposed to strong chemicals such as laundry detergents, hair dyes, and some shampoos. The symptoms of irritant contact dermatitis can appear immediately or within a few hours after exposure to the irritant.
Some of the common skin irritants include:
- Metals in jewelry
- Perfumes
- Soap and detergents
- antibacterial and antiseptic products
- machine oils and solvents
- dust and powders such as cement
- plants such as buttercups, forget-me-nots, and mustard
- Chlorinated and hard water
Allergic contact dermatitis
This occurs when the immune system reacts to a substance that comes into contact with the skin. This type of reaction can happen to your neck when you’re exposed to a substance you are allergic to.
Possible culprits include poison ivy or certain metals from your jewelry. It may even be due to the fabric of your shirt.
The symptoms of allergic contact dermatitis can take a few days to appear after exposure to the substance.
Possible skin allergens include:
- Topical ointments and creams
- Certain metals, such as nickel
- The sticky substance (adhesive) on bandages and plasters
- Plants like poison ivy, poison oak, and poison sumac
The rash's appearance can vary depending on the person and the substance that caused the reaction. Typically, a rash from contact dermatitis is red, swollen, and itchy and usually appears where the skin comes into contact with the triggering substance.
Of the two types of contact dermatitis, irritant contact dermatitis is more likely to cause a burning or painful rash. So if you suspect your painful neck rash is from contact dermatitis, always make sure to patch test whatever you put near your skin.
Can Atopic Dermatitis Cause A Painful Rash In The Neck?
Atopic dermatitis, or eczema, is a condition that causes chronic inflammation of the skin. When we think of eczema, we usually imagine a person constantly scratching their red, dry, and flaking skin. But we might not realize that pain can also be a common symptom of eczema.
“Pain is a relatively common symptom of atopic dermatitis that is often under-recognized.”
– Dr. Bruce Brod, clinical professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania
In fact, in one study, 43% of patients with eczema experienced pain. This is supported by another study in which 61% of patients suffered from pain at least once a week, while 5% suffered from pain daily.
The painful rash from eczema can occur anywhere, including the neck. However, the exact cause of the pain is not fully known. According to one of the studies we mentioned earlier, the pain from eczema resembled neuropathic pain. It may be possible that the inflammation from atopic dermatitis increases your nerves’ sensitivity to pain.
Possible triggers of eczema on your neck include:
- Pet fur and dander
- Shampoos, soap, and cleansers
- Pollen
- Household cleaners and detergents
- Wool and other synthetic fibers, especially in the collars of your shirts
- Food allergies
- Cold or hot and humid climates
What Does A Stress Rash In The Neck Look Like?
A stress rash, also called psychogenic urticaria or stress hives, is a skin condition that can be caused by stress or emotional distress. It causes red, itchy bumps or welts to suddenly show up on the skin. Stress rashes often cause intense itching, which can sometimes be painful. Scratching the area can also cause pain or discomfort.
Like eczema, a stress rash may also cause chronic inflammation and increase your nerves’ sensitivity to pain. Aside from inflammation, the psychological cause of a stress rash, such as anxiety or depression, may also increase your pain sensitivity.
A stress rash may appear on your neck after being exposed to the following:
- Pet fur and dander
- Changes in weather
- Sunlight
- Dust and Pollen
- Certain foods such as peanuts, shellfish, or spicy foods
- Exercise
- Infection
What Does The Shingles Rash Look Like?
Shingles is a really painful condition caused by the reactivation of the varicella-zoster virus. If you’re wondering if you have shingles, try to see if your rash appears as a group of blisters on one side of your neck.
The rash usually appears in a characteristic band-like pattern and can start as red bumps or fluid-filled blisters. These blisters can break open and crust over, and you might also have other symptoms like fever, headache, and fatigue.
Can Shingles Cause Chronic Pain In The Neck?
Yes. Even when you’re rid of the rashes, you may still feel pain in the neck for weeks or even months. This is called “post-herpetic neuralgia.” If you want to learn more about shingles, then we have an article ready for you.
What Type Of Herpes Can Cause A Painful Neck Rash?
When we hear of herpes, we usually think of two types: oral herpes caused by herpes simplex virus type 1 (HSV-1), and genital herpes caused by herpes simplex virus type 2 (HSV-2).
But apparently, HSV-1 is not limited to oral herpes and can actually also cause a type of herpes called “herpes gladiatorum.” It can cause blisters to appear anywhere, including your neck.
Herpes gladiatorum is also called “wrestler’s herpes” or “mat pox” since it commonly affects wrestlers. The blisters from this form of herpes can also appear on the face, shoulders, arms, and trunk and can either be very painful or painless.
What Are The Symptoms Of Dermatomyositis?
Out of all the conditions we mentioned, dermatomyositis is the least likely but not impossible. Dermatomyositis is a rare autoimmune disorder that causes your immune system to attack your skin and muscles.
One of the first signs of dermatomyositis is a painful red rash that appears over the back of your neck, shoulders, and upper back. Because of its location, it’s called the “shawl sign.” There's certainly nothing glamorous about this shawl, though. Other areas where a rash may appear include your face and upper chest.
Aside from the rash, you may also feel muscle pain and weakness, especially in the arms, legs, neck, and trunk. You may also experience fever and weight loss.
How Do You Know If A Rash Is Serious?
According to the American Academy of Dermatology, you should immediately seek medical advice if you have a painful rash, as it could signal something more serious going on with your body. Aside from the pain, here are a few general guidelines you can follow to determine whether or not a rash is serious, such as:
- The rash spreads quickly or covers a large area of your body.
- The rash is accompanied by a fever or other symptoms, such as difficulty breathing, stiff neck, or fatigue.
- A change in your skin color or texture accompanies the rash.
- The rash causes large areas of your skin to peel off.
- The rash does not improve or goes away after a few days.
While most rashes are not deadly, a few can be life-threatening. These include:
- Cellulitis
- Toxic shock syndrome (TSS)
- Staphylococcal scalded skin syndrome (SSS)
- Stevens-Johnson syndrome (SJS)
- Toxic epidermal necrolysis (TEN)
- Pemphigus vulgaris (PV)
Takeaway
A rash can tell you a lot about what’s going on in your body, even more when it’s accompanied by pain. A painful neck rash can be caused by a reaction to a particular substance, an infection, or something more serious, like an autoimmune condition.
If you are concerned about the rash in the back of your neck that’s causing you pain, don’t hesitate to visit a doctor. While most rashes are non-life threatening, painful ones should not be ignored. A doctor’s clinical eye is always best so you can receive the correct diagnosis and treatment.
