Most of us are familiar with the major symptoms of COVID-19, such as a persistent dry cough, a high fever and shortness of breath. However, there are other symptoms that have become apparent during the pandemic that you should watch out for, including COVID toes.
What are COVID toes?
An infection by the COVID-19 coronavirus can affect your skin and cause various types of rashes. It is often a symptom of a COVID-19 infection, and for some, changes in their skin might actually be the *only* indication that they have (or have had) COVID-19.
Data from around the world has shown that some people who test positive for coronavirus develop swollen and discoloured toes. Their toes change colour from an initial bright pink to a purplish colour as they swell. The swelling is caused by inflammation of the blood vessels in the feet. The swollen toes can itch, be painful and rub together, causing blisters. Areas of skin may become rough, and the affected foot can develop raised bumps.(1)
What to do if you think you have COVID toes
If you develop COVID toes, consult your physician, dermatologist or pharmacist without delay. You should ask them about taking a COVID-19 test, as you may not show any other symptoms but might be still infectious. Your physician may prescribe a cream to reduce any pain and itching, and reduce the swelling.
Who develops COVID toes?
COVID toes seems to be more often seen in children and young adults, although anyone of any age can develop it. The condition can also affect the fingers, although this is less common. The general opinion is that COVID toes lasts from just a few days to around two weeks, although as with many things COVID-19, COVID toes can persist for as long as 120 days.(2)
A study in Spain found that out of 666 COVID-19 patients, 121 developed “Irritations on their palms and soles of their feet” (3). Another Spanish study found that the majority of the 372 participants who tested negative for COVID-19 with a throat swab test, actually had the virus in the walls of the blood vessels in their skin.(4)
Blood clotting and COVID toes
A Canadian study led by Dr. Douglas Fraser, a professor at Western University’s Schulich School of Medicine & Dentistry and paediatric critical care physician at London Health Sciences Centre London, described the link between cell damage, blood clots and COVID toe:
“(COVID-19) creates an inflammatory effect [that] damages the endothelial cells, which line the blood vessels. Along with that injury to the blood vessel, you’re much more likely to have clotting or blood clotting … So, some of these [skin] lesions, particularly on the toes, are related to blood vessels that are inflamed and angry and clotting.”(5)
Skin care after COVID
The ZOE COVID Symptom Study app (7), launched by health science company ZOE with scientific analysis provided by King’s College London, published the latest COVID toes information in early April 2021, saying:
“COVID-19 rashes are usually itchy and this may lead to poor sleep. Some people with rashes also experience sensitivity to ultraviolet (UV) light, getting red patches on their face after being outside for a short period of time.” (6)
This is important for anyone looking to boost their Vitamin D levels through exposure to natural sunlight. According to the British Medical Journal, a vitamin D supplements “Has a modest protective effect against acute respiratory infections.” (8) So, the risks of skin damage and UV sensitivity should be balanced against the modest gains in vitamin D through exposure to sunlight.
Chilblains and COVID toe
COVID toe can look and feel like chilblains, a very similar skin condition. Chilblains develop when you are exposed to cold temperatures, and particularly if you are standing on cold, wet ground and your feet get cold. This can cause swelling and cause the skin to become blue. Again, you should consult your physician, pharmacist or dermatologist to check whether you have COVID toes or chilblains.
Interestingly, the ZOE data suggest that COVID toes are a form of chilblains but they may not itch as much as chilblains.
“Chilblains are occurring more frequently and even in warm weather among those who have COVID-19. It appears as reddish and purplish bumps on the fingers or toes but also the palms. COVID fingers and toes can affect many digits and are usually sore but not itchy. For example, people find it painful when typing on a keyboard or walking.”
The team also reported that COVID toes can appear weeks after the initial infection and can “Be stubborn and may require prescribed medication.” They may also appear/reappear after a vaccination, albeit briefly.
Taking care of your feet
At Hunt Footcare, we help keep your feet healthy and pain-free with professional podiatric services, including treatments for common foot ailments from athletes foot to sports injuries.
Contact us to discuss your requirements at any of our three Ontario foot clinics:
London: 519 432 3636
Stratford: 519 271 8834
Ingersoll: 519 485 1750
We look forward to meeting your feet!
(1) American Academy of Dermatology https://www.aad.org/public/diseases/coronavirus/covid-toes