Gluten Rash: Symptoms, Treatments, and More

Medically Reviewed By Adam Bernstein, MD, ScD

Dermatitis herpetiformis, also known as gluten rash or Duhring’s disease, is a rare skin condition characterized by itchy blisters and raised skin lesions. It can occur as a result of gluten sensitivity or of celiac disease. Gluten rash is a skin manifestation of associated gluten sensitive enteropathy, which is more commonly known as celiac disease. Symptoms occur as a result of gluten ingestion.

Read on to learn more about gluten rash. This guide includes information about what the symptoms of gluten rash look like, what causes it, treatments, diagnosis, and more.

What does a gluten intolerance rash look like?

See the slideshow below for gluten rash, or dermatitis herpetiformis, pictures.

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This shows gluten rash on the back of the hand.

Photography courtesy of Madhero88, 2010/Wikimedia

dermatitis-herpetiforme-4-slide.jpg

This is a closeup of gluten rash.

Photography courtesy of BallenaBlanca/Wikimedia

dermatitis-herpetiformis2-slide.jpg

This is a closeup of gluten rash.

Photography courtesy of Madhero88/Wikimedia

What are the symptoms of gluten rash?

There are slices of bread on a table.
Natalie JEFFCOTT/Stocksy United

Symptoms of gluten rash can affect the skin, mouth, and gastrointestinal tract.

Skin symptoms

Symptoms affecting the skin include:

  • itchy blisters
  • groups of raised skin lesions
  • itchiness or a burning sensation that may feel almost intolerable

Lesions most commonly appear in the following places:

  • scalp
  • buttocks
  • elbows
  • knees

They less frequently affect the face and groin.

Oral symptoms

Alongside a rash, the autoimmune response to gluten sensitivity may result in tooth enamel defects. This can include:

  • discoloration
  • horizontal grooves
  • pits

In rare cases, it can also result in oral ulcerations or canker sores.

Gastrointestinal symptoms

Gluten sensitivity can result in inflammation and damage to the small intestine. Symptoms may include:

What causes gluten rash?

Consuming gluten as part of the diet can lead to gluten rash in people who have gluten sensitivity or celiac disease.

Genetics may also play a role in developing gluten rash. Having a first-degree relative with gluten rash increases your risk of both gluten rash and celiac disease.

The genes that experts believe are associated with gluten rash are HLA types, including HLA-DQ2 and HLA-DQ8.

Learn about gluten sensitivity.

How do I treat gluten rash?

Treatment for gluten rash typically involves removing gluten from your diet. Following a gluten-free diet can be effective in reducing gluten rash and related gastrointestinal symptoms.

It is important to note that it can take several months for you to notice the benefits of a gluten-free diet. A dietitian or nutritionist can help you identify sources of gluten and provide you with an alternative eating plan.

Discover tips for going gluten-free.

Other treatments

Other treatments for gluten rash include:

  • antibiotic dapsone, which may lead to improvements within several hours after the first dose
  • sulfapyridine if you are intolerant to dapsone
  • topical corticosteroids for short-term relief from itchiness

As you remove gluten from your diet, your doctor may gradually reduce your dosage of dapsone.

Dapsone can cause side effects, so you may require frequent monitoring. Anemia is the most common side effect of dapsone. You may also experience headaches, depression, and, in rare cases, nerve damage.

It is important to contact your doctor if you experience any side effects from your treatment.

How long does gluten rash last?

Once you remove gluten from your diet, it can take anywhere from 6–24 months for the rash to disappear fully. However, taking all medications your doctor prescribes, such as antibiotics, can help reduce symptoms.

When should I contact a doctor?

Contact your doctor as soon as you notice symptoms of what may be gluten rash. It is important to receive an accurate diagnosis for a persistent or painful rash to ensure that you receive the correct treatment.

Your doctor will also be able to refer you to a dietitian or nutritionist to help you adjust your diet to remove gluten if this is needed.

How do doctors diagnose gluten rash?

Your doctor may take a full medical history and carry out a physical examination. They may also perform a skin biopsy for laboratory testing.

Skin biopsies involve removing a small sample of the affected skin and sending it to the laboratory for testing. Tests for gluten rash include direct immunofluorescence microscopy. This helps with identifying antibodies that may be present if you have gluten rash.

Your doctor may also carry out a blood test to help confirm the diagnosis.

Find out more about how doctors diagnose gluten sensitivity and celiac disease.

Nutritional deficiency tests

Your doctor may carry out tests to screen for nutritional deficiencies. These include:

  • a full blood count
  • liver function tests
  • serum calcium tests
  • tests to measure your levels of iron, zinc, vitamin B12, and folate
  • thyroid function tests

Are celiac disease and dermatitis herpetiformis the same?

Dermatitis herpetiformis, or gluten rash, is a skin manifestation of celiac disease.

Celiac disease is a chronic condition that causes damage to the small intestine. It is triggered by eating gluten.

Gluten rash can occur as a manifestation of celiac disease or as a result of gluten sensitivity.

Learn more about celiac disease.

How common is gluten rash?

Gluten rash affects 11.2–75.3 per 100,000 people in the United States and Europe.

Up to 13% of people with celiac disease have gluten rash.

Gluten rash can occur at any age, though it is uncommon in children.

What are the complications of gluten rash?

You may experience complications with gluten rash, particularly if it is a manifestation of celiac disease.

Possible complications include:

Contact your doctor if you have concerns about complications of gluten rash. Following your treatment plan may help reduce the risk of complications occurring.

Can I prevent gluten rash?

You may be able to prevent gluten rash by avoiding foods that contain gluten. Gluten is a protein present in wheat, barley, and rye.

You may also require medication while transitioning to a gluten-free diet to help prevent flares.

If gluten rash occurs as a manifestation of celiac disease, following your treatment plan for celiac disease can help reduce the risk of gluten rash.

Summary

Gluten rash occurs as a result of consuming gluten. It can occur if you have gluten sensitivity or celiac disease.

Treatments for gluten rash typically involve removing gluten from your diet and taking antibiotics such as dapsone. Although dapsone can improve symptoms within a few hours, it may take several months for you to notice the effects of removing gluten from your diet.

Contact your doctor if you have any concerns about gluten rash. They will be able to evaluate your symptoms and offer a diagnosis and treatment plan.

Medical Reviewer: Adam Bernstein, MD, ScD
Last Review Date: 2022 Jul 29
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