Although chronic obstructive pulmonary disease (COPD) is lung disease that’s typically associated with symptoms such as shortness of breath, it can also raise your risk for skin problems that may cause bothersome itching or rashes.

MyCOPDTeam members often discuss itchy skin and rashes that impact their quality of life:

• “Having a good day so far, but my skin is so itchy, and I don’t know why.”
• “I’m breathing well but so darn itchy.”
• “Hopefully I’ll get more than two hours’ sleep with this horrendous itch I have all over my body. I have loads of questions for the doctor.”
• “I didn’t know itch could be COPD-related. There’s a lot my pulmonary doctor hasn’t thought to tell me.”

Itching or skin rash with COPD may be due to the disease itself, reactions to medication, or a related skin condition such as prurigo nodularis (PN). Read on to learn about skin conditions that can occur with COPD. Knowing the signs can help you communicate with your medical care team, get treatment, and improve your quality of life.

1. Damaged Skin Barrier

People with COPD have been found to have significantly higher skin temperature, increased erythema (redness in skin), and changes in the skin barrier that may affect the skin’s ability to maintain moisture. Research has shown that cigarette smoke is associated with inflammation throughout the body, which can be detrimental to skin health.

A damaged skin barrier in people with COPD could be associated with itchy, irritated, dry, or thinning skin. “My whole body itches from severely dry and thin skin,” a MyCOPDTeam member shared.

In some cases, dry skin with COPD may benefit from over-the-counter moisturizers for sensitive skin. If you have a preexisting skin condition such as atopic dermatitis (the most common form of eczema), taking good care of your skin is even more important.

2. Peripheral Edema

People with COPD have a risk of developing peripheral edema — swelling primarily in the lower legs, ankles, and feet — due to retention of fluids. Peripheral edema in COPD may be caused by increased pressure in the blood vessels to the lungs, weakness of the right side of the heart, or reduced blood flow to the kidneys.

Swelling from peripheral edema can stretch the skin and put pressure on it. Skin may become itchy, discolored, or inflamed. When blood pools in the lower legs and puts pressure on the skin, it’s called venous stasis dermatitis.

3. Shingles

Herpes zoster (shingles) causes an itchy and painful rash that usually occurs on one side of the body or face and may cause fever and chills. Like chicken pox, it’s caused by the varicella-zoster virus. People who’ve had chickenpox retain the virus in their nervous system, and it can become active again as shingles — often after the age of 50. A 2011 study found that adults 50 and over with COPD had nearly twice the risk of developing shingles as those without COPD.

“Ending a bout with shingles. I would not wish this on anyone. You have the nerve pain along with a painful, ugly, itchy rash. I’m so tired of this,” said a MyCOPDTeam member.

4. Certain Medications

Some medications used in the treatment of COPD may cause allergic reactions or side effects such as itchy skin and rashes. Some types of corticosteroids, beta-agonists, or anticholinergic inhalers may cause a rash or itching in some people.

“Found out I’m allergic to Advair. Man, this whole body itching was killing me. So now I’m on Symbicort,” said a MyCOPDTeam member.

Another member said, “I had some itching while on prednisone and even later on. My doctor prescribed a good body cream and some anti-itch pills.”

Some types of painkillers, such as opioids, can also cause itchy rash as a side effect. “They’ve reduced my heavy painkiller. I’ve been on it for years now. It’s causing a terrible itch on my body,” a member wrote.

If you think you’re experiencing rash or itching as a side effect from medication, talk to your doctor before making any changes. Some medications may cause more problems if they’re suddenly discontinued.

5. Nicotine Patches

Quitting smoking is an important step for people with COPD. However, if you’re using nicotine patches to help you quit, it’s important to know that they may irritate sensitive skin. In many cases, itching will subside within 24 hours of applying a nicotine patch. If itching persists, however, you may be having an allergic reaction and should contact your doctor.

A MyCOPDTeam member wrote, “I recently was using nicotine patches to try and quit smoking but started getting an allergic reaction to them. The severe itching and redness lasted long after I took the patch off.”

6. Prurigo Nodularis

Prurigo nodularis is an inflammatory skin condition that’s associated with various medical conditions, including COPD. PN causes intense itching in skin, even before a rash is visible. PN often leads to nodules (raised bumps) in the skin that may become discolored and sore. The condition can occur in any area of the body that can be scratched.

Researchers don’t fully understand the exact cause of PN, but they believe it involves problems with the immune system and the nervous system as well as the skin. Diagnosing PN can be difficult because it can look different from case to case. Severe itching that’s hard to identify may be a sign of PN. Be sure to follow up with your doctor if you have persistent and intense itching; you may need a referral to a dermatology specialist.

Although treating PN can sometimes be difficult, newer treatment options are showing promising results for this chronic condition. Finding an effective treatment can often take time. But the earlier a diagnosis is made, the sooner treatment options can be tried in order to manage symptoms and prevent the spread of PN.

For more information on prurigo nodularis, go to MyPrurigoTeam, where you can get support from others with PN.

When a Skin Rash May Be an Emergency

It’s important to talk to your pulmonologist or dermatologist if you’re experiencing uncomfortable itching or symptoms such as hives or other types of skin lesions. Your health care team can help determine the cause of your skin issues to ensure that you are managing these symptoms as well as possible.

A rash that appears suddenly and quickly spreads may be a sign of a life-threatening allergic reaction or infection that requires immediate medical care. If you have a worsening rash that blisters around your mouth, eyes, or groin, or if you have a skin infection with yellow or green fluid, swelling, or pain, those are also signs that you may need to seek emergency care.

Find Your Team

MyCOPDteam is the social network for people with COPD and their loved ones. On myCOPDteam, more than 119,000 members come together to ask questions, give advice, and share their stories with others who understand life with COPD.

Have you had itchy skin and bumps with COPD? Were you diagnosed with prurigo nodularis? Share your experience in the comments below, or connect with other people living with prurigo nodularis on MyPrurigoTeam.