Skin Symptoms of Zika Virus

Cutaneous Manifestations of Zika Virus

Zika virus has always been around. People have known about Zika virus since 1949 when it was isolated from a monkey. (1) Yet it seems like Zika virus became a worldwide public health concern overnight. The virus was originally contained within the equatorial belt in African and Asia, but in 2007 the first case was documented in a human host. (2) And now it’s made its way to the United States. Zika virus infection is an important diagnosis for the dermatologist to keep in mind. The infection presents with classic dermatologic symptoms. The skin symptoms of Zika virus are discussed in this post.

What is Zika?

Zika virus causes a viral illness that is spread by the Aedes mosquito (A. aegypti and A. albopictus).

skin symptoms of zika virus mosquito

This virus was first isolated in the Zika Forest of Uganda, hence the name. The virus belongs to the family of viruses called Flaviviridae, which also include dengue, West Nile, yellow fever, and Japanese encephalitis viruses. (2)

How is Zika virus transmitted?

Zika virus travels from person to person by the bite of mosquitoes. The mosquitos bite a person who is infected with the virus, become infected themselves, then infect their next human victim when they bite. However, mosquito bites are not the only way Zika virus can be transmitted. Transmission has been reported through blood transfusions, sexual contact, and from mother to fetus.

Who gets Zika virus?

Anyone can develop Zika virus infection. There is no age or sex predilection. After a symptom-free period of 3-12 days, about 20% of people infected with Zika virus will develop symptoms.

What are the symptoms of Zika virus?

As I mentioned before, only 20% of infected people will actually show symptoms of Zika virus. These symptoms can last a few days to a week. The symptoms are:

• Fever that comes and goes

• Rash

• Muscle pain

• Joint pain

• Headache

• Conjunctivitis (aka pink eye)

cdc skin symptoms of zika virus rash

Skin Symptoms of Zika virus

The most common skin presentation of Zika virus is a widespread rash with flat and raised red spots. This usually appears 3-12 days after the initial infection. It begins to resolve within 2-3 days and is gone by 1 week.

The rash tends to begin on the face and extends to the trunk and limbs. It can also be itchy.

skin symptoms of zika virus rash

The rash can also develop small red dots that are due to small bleeds under the skin. People can even develop bleeding gums.

Diagnosis of Zika Virus

It is hard to diagnose Zika virus disease by clinical presentation alone. The rash of Zika virus is very similar to the rash with dengue and chikungunya virus. (2) Laboratory tests can more definitively diagnose Zika virus. Some of the laboratory tests used include:

• Reverse transcription polymerase chain reaction

• Enzyme-linked immunosorbent assay

• Zika specific IgM antibodies

What is the treatment for Zika virus?

For most people, Zika virus can be treated like any other viral illness. Rest, fluids, and Tylenol for pain. Zika virus becomes more complicated when a pregnant woman is infected.

What are the long-term complications of Zika virus?

The biggest problem with Zika virus is its ability to infect babies that are still in the womb. Researchers believe that there is a link between Zika virus infection in the womb and the development of microcephaly. (3) Microcephaly is a medical condition where a baby’s head is much smaller than normal. This can lead to intellectual disabilities.


Another complication of Zika virus infection is Guillain-Barre syndrome. Guillain-Barre syndrome causes paralysis and muscle weakness that begins from the extremities and spreads upwards to the rest of the body.

How to Prevent Zika Virus Infection

The best way to prevent Zika virus is to avoid mosquito bites. This is the most common method of transmission. Wear long sleeves and pants to cover up your skin. Use mosquito repellant to keep the mosquitos away. Stay indoors when mosquitos are most active.


Currently, there is no specific treatment or vaccine for Zika virus.


  1. Zika Virus.
  2. Farhanik B, Beroukhim K, Blattner CM et al. Cutaneous manifestations of the Zika virus. JAAD. 2016; 74:1286-7.
  3. Dermatology Times. Zika Considerations.,2

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