What Are COVID Toes?
Researchers are learning more about this untypical symptom of COVID. Here's a rundown of what they are, what might be causing them, and more.
Medically reviewed by Michael Menna, DO
Some unusual symptoms have been linked with COVID-19. One of those symptoms is called "COVID toes"—a red or purplish rash or raised bumps typically on the tips of the toes—that can last for weeks.
COVID toes have been shown to affect 14.3% to 72% of people across research studies later in COVID infections. Here's what else you should know about COVID toes, including what to do if you think you have them and how to treat them.
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What Causes COVID Toes?
One suggested cause of COVID toes is your immune system's response to SARS-CoV-2, the virus that causes COVID. "This immune response causes inflammation throughout your body that can present in a variety of different ways on the skin," dermatologist Ife J. Rodney, MD, founding director of Eternal Dermatology Aesthetics and a professor at Howard University, told Health.
Researchers have also indicated other potential causes, including:
Neoangiogenesis—new blood vessel creation
Vasculitis—blood vessel damage from inflammation or swelling
Vessel thrombosis—blood clotting that happens in blood vessels
Risk Factors
Age seems to be a risk factor for COVID toes. The condition has often appeared in healthy children, teens, and young adults.
However, "the reason why some people experience these symptoms more than others is likely because of differences in the degree to which one person's immune system reacts versus another person's," Joshua Zeichner, MD, director of Cosmetic & Clinical Research in Dermatology at Mount Sinai Hospital in New York City, told Health.
Keep this in mind, though, per infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security in Maryland: "COVID toes are not a very common phenomenon, but do occur and should prompt medical evaluation."
Related: What Does It Mean to Have 'Mild' COVID Symptoms? Here's What Doctors Want You to Know
Symptoms and Progression
If you develop COVID toes, one or more of your toes can swell and change color. "In COVID toes, the inflammation also damages small blood vessels in the toes, leading to a reddish-purple discoloration of your skin," explained Dr. Rodney.
Dr. Rodney added that discoloration is usually seen in a condition called chilblains—but chilblain lesions are related to cold temperatures. "We are unsure why the COVID rash takes on this specific presentation, as it does not seem to be more common in the wintertime or related to cold exposure," said Dr. Rodney.
Other symptoms can include:
Areas of rough skin or blisters
Itchiness or pain
Painful raised bumps
Skin changes that affect the toes can also affect the fingers. Still, the changes happen more often to the toes.
Additionally, COVID toes may happen later during a mild infection or in individuals without COVID symptoms. COVID toes last around one to two weeks longer than red rashes related to COVID.
Related: Is an Earache a Sign of COVID-19? Here's What Experts Say
What To Do if You Suspect You Have COVID Toes
If you develop "COVID toes" but don't have any other symptoms of the virus, Dr. Rodney said you shouldn't automatically assume that you have COVID. Some researchers could not confidently connect chilblains to COVID. However, the researchers stated in one study that their results didn't exclude the possibility of a connection.
It's best to get tested for COVID if you have COVID symptoms and COVID toes. You'll then want to follow isolation guidelines based on your test results.
Dr. Zeichner said you could expect COVID toes to last about two weeks, although it could be longer. For some people, COVID toes might last for months.
Related: Can Mosquitoes Carry COVID-19?
Are They Contagious?
Though COVID toes can last for a while, it's unclear if they are contagious. However, COVID is contagious, so get tested if you've had COVID exposure.
Treatment Options
COVID toes can disappear without treatment. However, if you have any pain or itching with COVID toes, try using a hydrocortisone cream for relief. See a dermatologist if the cream doesn't work or if your symptoms get worse.
A Quick Review
COVID toes can present as toe swelling and discoloration sometimes appearing with a COVID infection. The cause is thought to be an immune response to COVID, and the condition seems to happen more often in younger, healthy individuals.
COVID toes can go away on their own without treatment; however, they can last for months. Whether you have COVID toes and COVID symptoms—or not—consult a healthcare provider to confirm a diagnosis and get the appropriate treatment.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
Frequently Asked Questions
How long do COVID toes last?
COVID toes can last anywhere from 10 days to a few months.
What is the difference between COVID toes and chilblains?
COVID toes happen as a potential immune response to having COVID. Chilblains are lesions that are typically in response to cold temperature exposure.
How else does COVID affect your skin?
COVID may result in flat and raised rashes, hives, and fluid-filled blisters. The infection can also cause petechiae, itchy skin, and, rarely, skin problems like COVID arm and alopecia areata.
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