From reactivation of herpes infection to loss of hair, several COVID patients in the recovery phase are facing one dermatological complication or another due to lowered immunity, say doctors.

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Skincare experts at leading facilities in Delhi, Mumbai and other cities concurred that coronavirus patients even after being discharged from hospitals or having finished their home quarantine period should watch out for any skin inflammation or consult a doctor immediately if "it grows uncontrollably". Dr D M Mahajan, senior consultant, dermatology, Indraprastha Apollo Hospitals in Delhi, says many post-COVID patients with skin complications are rushing to OPDs, fearing they have contracted mucormycosis or black fungus but people should be cautious, not paranoid.

"Several COVID patients in recovery phase are facing skin complications and the most common one being reported to us are cases of herpes. In many patients with a history of herpes, it is get retriggered and in others, they are just contracting it afresh, both due to lowered immunity", he told PTI. Infection with herpes simplex virus, commonly known as herpes, can be due to either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). Herpes labialis which occurs around the lip area with lesions in cluster preceded by burning pain is caused by HSV.

Herpes zoster is a viral infection that occurs with reactivation of the varicella-zoster virus. It is usually a painful but self-limited dermatomal rash. Skin experts, who are seeing post-COVID patients, say cases of herpes zoster are being reported more than herpes from HSV. Mahajan said cases of infection from Candida fungus have also been seen among the COVID patients who are in the recovery phase. It is a mould like infection and can result from excessive medication or the use of steroids. This infection can cause white patches on the genitalia.

Candidiasis is a fungal infection caused by a yeast (a type of fungus) called Candida. Mumbai-based dermatologist and hair transplant surgeon Dr Sonali Kohli said COVID -19 compromises the immunity of a patient leading to multifarious complications, including in skin, hair and nails. "Though there is no clinical study to correlate the two but herpes infection is being reported in a large number of COVID patients during recovery phase even a month later. Besides hair loss and nail complications are too happening with many patients," she said.

As far as nail complications are concerned, cases of melanonychia or Beau's lines are also being seen in such patients. Melanonychia entails whitish or brown lines on nails, she said. Kohli, consultant dermatologist, Sir H N Reliance Foundation Hospital in Mumbai, said patients should consult a specialist if hair loss persists. Nikhita Kumar, 24, a Delhi-based student, who is recovering from COVID contracted in April, said, she had suffered "copious loss of hair in the initial days of recovery. I had consulted a dermatologist who prescribed some serum. He had said it will subside in a month or two. Also, while reading online on post-COVID complications, I found out that a famous Bollywood actress too had suffered hair loss after COVID," she said.

Dr Nidhi Rohtagi, senior consultant, dermatology at Fortis hospital, Vasant Kunj, said post-COVID hair loss is being seen more in women. "Patients suffer skin complications during treatment too and during recovery may still exhibit some sort of inflammation or spots on forehead or back. But many times these are simple, self-limiting rashes which subside with time after applying appropriate ointment", she said.

But post-COVID patients need to watch out for "invasive" inflammations on the skin and immediately consult a doctor if it increases and causes pain or serious discomfort, Rohtagi said. "The other skin infection being seen in such patients is of pityriasis rosa, in which a mother patch of infection occurs on parts of the body with baby patches around it", she said. In some patients, cases of 'COVID toes' is also being seen in which ulcer or necrosis occurs on the tip of a toe and the neighbouring toe, the doctor said.