Researchers are still studying the effects of the new coronavirus on the body. Some people may report a set of symptoms affecting the toes or fingers that others may refer to as “COVID toes.”

An infection with the severe acute respiratory coronavirus 2, or SARS-CoV-2, causes coronavirus disease 19, or COVID-19.

There are reports of COVID-19 leading to swelling and discoloration on a person’s toes, fingers, or both.

This article will look at the symptoms of COVID toes, and detail the ways in which COVID toes might be related to COVID-19.

For more advice on COVID-19 prevention and treatment, visit our coronavirus hub.

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According to the American Academy of Dermatology Association (AAD), the condition can affect a person’s fingers and toes. However, most people appear to only develop it on their toes.

A person may initially notice swelling and discoloration. On light skin, COVID toes can appear red and gradually turn purple. On dark skin, COVID toes can lead to purplish discoloration. A person may also notice round spots with a purple hue.

Other symptoms include:

Healthcare professionals and researchers are unsure why COVID toes develops. However, according to a 2020 article, experts have proposed a few theories.

One theory is that COVID toes occurs as a result of COVID-19. Researchers suggest that it can happen due to the immune system reacting to an active SARS-CoV-2 infection.

It may also be a delayed immune response to a past SARS-CoV-2 infection. If this is the case, COVID toes would not be a symptom of COVID-19.

Another theory is that COVID toes may not be a direct result of COVID-19. Instead, the researchers propose that the condition is due to lifestyle changes brought on by the lockdown, such as:

  • walking barefoot in homes that are not heated
  • inactivity
  • increased time spent in sedentary positions

There is not much reliable information about who gets COVID toes.

As one study notes, scientists do not know the proportion of people with COVID-19 who get COVID toes.

The AAD suggests that people of any age can develop COVID toes. However, the condition typically appears in children, teenagers, and young adults.

Moreover, those who develop COVID toes, do not experience, for the most part, the more common symptoms of COVID-19, such as fever or cough. If symptoms do appear, they are mild.

The study also reports that there is some evidence that people with lower BMIs might be more prone to developing COVID toes.

Healthcare professionals do not know whether COVID toes is a contagious condition. They are also unsure whether a person is still contagious when they develop COVID toes.

However, SARS-CoV-2 is contagious. A person can contract the virus through close contact with a person with a SARS-CoV-2 infection.

If a person suspects they have experienced exposure to the virus, they should speak with a healthcare professional over the phone or online.

To reduce the chance of transmission, a person can:

  • wear a mask that covers both the mouth and nose
  • ensure to maintain 6 feet apart from others who do not live in the same house
  • avoid crowds and poorly ventilated indoor spaces
  • wash the hands often using soap and water

Learn more about proper hand-washing here.

The medical profession is divided about the treatment for COVID toes.

Some researchers do not recommend any treatment, as the condition often resolves spontaneously. However, certain doctors have argued that some treatments may help improve a person’s COVID toes symptoms.

For example, people with the condition who used mometasone furoate and heparin gel noticed improvements within 4 days of treatment.

A healthcare professional may also prescribe:

The AAD suggests using hydrocortisone cream to help reduce pain and itching.

A 2020 article reports that COVID toes resolves without treatment and within a few days.

However, the AAD states that, although the condition will go away spontaneously, it is too soon to know for sure how long it lasts. It may last for 10–14 days.

Many different conditions could cause symptoms similar to those of COVID toes. However, the condition most likely to pass for COVID toes is pernio, also known as chilblains.

Pernio is a skin condition that mostly affects a person’s fingers and toes due to prolonged exposure to damp and cold surroundings. It often appears within 24 hours of exposure to the damp and cold.

Symptoms of pernio include:

  • small regions of discolored skin
  • raised areas of skin or other abnormal skin growths
  • blisters or ulcers, which may become infected
  • tender, burning, or itchy sensation
  • damage to toe- or fingernails

Pernio often goes away after a few weeks, especially if a person avoids exposure to the damp and cold.

Treatment

A person with pernio should avoid exposure to the cold and use socks or gloves, depending on the affected area.

A healthcare professional may also suggest topical corticosteroids. However, there is no clear evidence that this treatment is effective. Additionally, excessive use of topical corticosteroids can cause skin damage.

Moreover, certain lifestyle changes, such as quitting smoking, may improve pernio symptoms in some people. This is because smoking can cause a person’s arteries to narrow.

Anyone with symptoms of COVID toes should immediately seek advice from a healthcare professional.

COVID-19 can be a serious condition for many people. It can also spread very easily.

COVID toes is a condition that causes swelling and discoloration of the toes and fingers. It typically affects children, teenagers, and young adults.

Although researchers and healthcare professionals do not know the exact cause, it may occur due to:

  • lifestyle changes resulting from lockdown
  • an immune response to an active infection with SARS-CoV-2
  • a delayed immune response to a past SARS-CoV-2 infection

Although COVID toes will resolve without treatment, a person should contact a healthcare professional if they develop any symptoms of COVID-19 or COVID toes.

Q:

How could a person distinguish between COVID toes and a chilblain?

A:

COVID toes and chilblains may physically look very similar. However, there are certain factors that may assist in determining the cause of why your toes or fingers are discolored and swollen. If the discoloration and swelling occur after exposure to cold temperatures or if this happens during certain times of the year (seasonal), it may be chilblains. If a person develops discolored or swollen toes or fingers randomly or has been in large crowds or around someone who is sick, it could be COVID-19. If there is any change in your health, and you develop any new signs or symptoms, seek medical care.

Lauren Castiello, MS, AGNP-CAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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