Zika Virus and Associated Rashes

Learn about Zika virus rashes and how to reduce mosquito bites

Close up of mosquito biting the skin
Credits: "Pixabay"

Quick Summary

The Zika virus is primarily a mosquito transmitted illness with outbreaks occurring across the world, including the first identified outbreak in the United States in Miami, Florida.[1]   The Zika virus is transmitted by the Aedes mosquito, which is abundant in Brazil and also carries dengue (a similar viral illness).  Usually, mild symptoms last 2-7 days and include low grade fever, muscle aches, fatigue, headache, conjunctivitis and/or rash.[2]  There is currently no vaccine to protect against Zika virus, and symptoms usually resolve on their own.  However, in some situations the consequences of the Zika virus can be disastrous.  In Brazil the incidence of a severe and relatively rare neurological disease in adults called Guillain-Barre Syndrome (GBS) has increased significantly, and is strongly suspected to be associated with Zika virus.[3]  Zika virus is also associated with a condition called  microcephaly in newborn babies. Microcephaly, meaning small head, is only one of a few other associated complications in the newborn, all involving the nervous system (for example hearing loss).   The rapid advance of the Zika virus epidemic in the Americas and the dire association with microcephaly, Guillain-Barre syndrome, meningitis (inflammation of the layers covering the brain) and encephalitis (inflammation of the actual brain tissue) makes Zika virus an urgent public health situation.[4]

The rash associated with Zika virus is a prominent feature to recognize in instances of infection.  Although it is very similar to other viral rashes (called morbilliform  exanthems), it can provide a clue that a viral illness is active. Correct suspicion of Zika related rash may help physicians to quickly order tests that can establish the diagnosis.  Typically, the rash seen with Zika virus begins on the first day of infection as either flat or bumpy (maculopapular) spots on the face.  The rash then spreads from the face to the rest of the body and fades within one week.  At the same time the eyes may hurt and become red.  Some cases of Zika virus also feature small red dots (petechiae) on the roof of the mouth.[5] One case report described a 39-year-old Brazilian man with Zika virus who presented with acute onset rash described as: (1) swelling and redness of the cheeks, (2) redness of the eyes, (3) mixture of flat and bumpy red spots on the abdomen, (4) redness and pinpoint petechiae (broken blood vessels) on the upper palate, and (5) a sore lymph node behind the left ear.[6]   

Currently, there are 3 confirmed methods of transmission of the Zika virus:

  • Bite from Aedes mosquito
  • Sex (vaginal, anal, oral, and sharing of sex toys) with a person infected with Zika virus
  • Transmission from an infected pregnant woman to her fetus (there are currently no reports of infants becoming infected through breastfeeding

Suspected modes of transmission of Zika virus:

  • There are suspected cases of infection through blood transfusions in Brazil
  • As of June 15, 2016, there is one suspected case of Zika virus in the United States due to laboratory exposure[7]

The best way people can protect themselves from the Zika virus is to prevent mosquito bites.  Guidelines for protection include wearing long sleeves and pants, keeping windows and doors sealed, sleeping under mosquito nets and using an insect repellent.[2] When reading insect repellant labels look for one of the following major active ingredients: DEET,  IR3535 or icaridin.  For people looking for natural insect repellants, essential oils such as lemon eucalyptus oil may work as well as DEET.[8,9] 


* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.

See additional information.


  1. Link to research
  2. Link to research
  3. Ferreira da Silva IR, Frontera JA, Moreira do Nascimento OJ. News from the battlefront: Zika virus-associated Guillain-Barre Syndrome in Brazil. 2016; PMID: 27421544
  4. White MK, Wollebo HS, Beckham JD, et al. Zika virus: an emergent neuropathological agent. Ann Neurol. 2016;Epub ahead of print; PMID: 27464346
  5. Oakley A. Zika Virus. DermNet New Zealand. 2016; http://www.dermnetnz.org/topics/zika-virus/
  6. Brasil P, Calvet GA, de Souza RV, et al. Exanthema associated with Zika virus infection. Lancet Infect Dis. 2016;16(7):866. PMID: 27352763
  7. Link to research
  8. Nasci RS WR, Brogdon WG. Protection Againts Mosquitoes, TIcks, and Other Arthropods. 2015; http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropods. Accessed July 12, 2016.
  9. Carroll SP, Loye J. PMD, a registered botanical mosquito repellent with deet-like efficacy. J Am Mosq Control Assoc.2006;22(3):507-514; PMID: 17067054.