The skin is the best alarm bell for recognizing the presence of the Omicron variant in younger asymptomatic patients

Lorenzo Martini1,2

1University of Siena, Department of Pharmaceutical Biotechnologies, Via A. Moro 2, 53100 Siena, Italy, 2C.R.I.S.M.A. Inter University Centre for Researched Advanced Medical Systems, Via A. Moro 2, 53100 Siena, Italy

Corresponding author: Prof. Lorenzo Martini, M.Sc.

Submission: 10.01.2022; Acceptance: 03.03.2022

DOI: 10.7241/ourd.20223.22

Cite this article: Martini L. The skin is the best alarm bell for recognizing the presence of the Omicron variant in younger asymptomatic patients. Our Dermatol Online. 2022;13(3):319-320.

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© Our Dermatology Online 2022. No commercial re-use. See rights and permissions. Published by Our Dermatology Online.


Since the real symptoms of having contracted COVID-19 and its variants or subvariants are generally cough, a runny nose, fever, and loss of taste, and since these alarms are not evident in asymptomatic patients infected with Omicron, especially children and young boys, and the only affordable evidence is a rapid or swab test, it is highly important to have other options to determine an infection with the Omicron variant, even if the patient does not feel anything at all [1,2].

Two types of skin rashes may be the distinguishing symptoms for individuals who have contracted Omicron and cannot be sure to have the variant (since no fever is one of the most evident signals of the real absence of SARS-CoV-2).

These two types of skin manifestations are:

1) prickly heat rashes,

2) urticaria or hives rash.


The first type of manifestation is detectable in the youngest and may appear anywhere on the body, yet is believed to have been most commonly found on the hands and feet, as well as the elbows. The second type is more similar to a hives rash and appears as raised bumps on the skin. While the first type is more persistent and may last for days or even weeks, the hive-like type tends to come and go in a much quicker fashion.

The skin symptoms discussed here are thought to be visible in some individuals with the virus who are not showing absolutely any other symptoms.

Heat rashes normally go away without treatment. However, there are medicines available to ease the symptoms of itching. These include calamine lotion (which helps ease itching) and antihistamine medicines.

Instead of calamine, even magnesia usta or alumina or, if possible, especially in countries in which the powder may be retrieved (in Scandinavia), deer-horn burnt amalgam, blanc d’Espagne or Tripoli, may be employed. These are the best powders to be the reputed vehicles to maintain the active ingredient in contact with the skin, even in the case of sweat or wet skin.

The best natural antihistamine is the butterbur, of the genus Petasites, flowering plants in the sunflower family, Asteraceae, which are commonly referred to as butterburs and coltsfoots [3,4]. They are perennial plants with thick, creeping underground rhizomes and large, rhubarb-like leaves during the growing season. Most species are native to Asia and southern Europe [35].

Applying butterbur to prickly rashes is a sort of Russian roulette, yet there is an ancestral Neapolitan adage that says: ndove c’è gusto non c’è perdenza (something to be used to abate an affliction is more desirable when the remedy itself is perilous and risky).

Effectively, butterbur extracts may contain harmful components called pyrrolizidine alkaloids if the preparation is not carefully and fully purified. The concentration of the toxic alkaloids is often the highest in the rhizomes and the lowest in the leaves, and may vary depending on where the plants are grown. Long-term health effects and the interaction of butterbur with other drugs have not been well documented. However, an interaction with St. John’s wort (topical use) may potentially lead to an increased concentration of the toxic alkaloids. Yet, it is obvious that those who use butterbur will never apply Hypericum perforatum extract or oil onto the skin.

A panel group of 12 boys and girls (12–24 yrs. old) showing prickly heat rashes and a panel group of 12 boys and girls (12–24 yrs. old) suffering from urticaria [3] (in the presence of a supposed Omicron infection) were recruited to attempt to apply a mash of butterbur to abate the first epidermal malaise or a fluid ointment to defeat the urticaria.

The following is the recipe for the first mash:

  • magnesia usta (magnesium oxide): 88%;
  • butterbur leaves in aqueous extract: 12%


Applications must be replicated for almost fourteen days twice a day. This remedy is only to allow the individual infected with Omicron to feel better.

As far as hive rashes or urticaria are concerned, it is better to employ an oily and fluid emulsion with castor oil (86%) and Solanum nigrum lipophilic extract (14%) [6].

Solanum nigrum is a perennial, infesting, and ubiquitous plant, and the unripe fruits and leaves are exceptional to produce a highly efficient liquor for defeating the itch of whichever hive rash.

One must keep in mind that urticaria, also known as weals, welts, or nettle rash, is a raised, itchy rash that appears on the skin and that may appear on one part of the body or be spread across large areas. The rash is usually very itchy and ranges in size from several millimeters to the size of a hand.

The application may be replicated for an entire week on the spots or onto the areas affected with urticaria. The prickly heat rashes disappear after the twelfth day and, in one case, after the fourteenth, while urticaria disappears after the sixth to seventh day of application.

Statement of Human and Animal Rights

All the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 2008 revision of the Declaration of Helsinki of 1975.

Statement of Informed Consent

Informed consent for participation in this study was obtained from all patients.


1. Bayerische Landesamt für Gesundheit und Lebensmittelsicherheit (LGL). Vierter Fall der Omikron-Variante des SARS-CoV-2 in Bayern mittels Genomsequenzierung bestätigt. Munich:LGL;2021. Available at: 2g%3D%3D

2. Department of Health – Government of Ireland. Statement from the National Public Health Emergency Team on the detection of Omicron variant in Ireland – 1 December 2021. Dublin:

3. Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73:1393-414.

4. Ganjoo S, Vasani R, Gupta T. Urticarial eruption in COVID-19-positive children:A report of two cases. Our Dermatol Online. 2022;13:47-9.

5. Sadowska B, Sztormowska M, Gawinowska M, Chelminska M. Sodium metabisulfi te hypersensitivity in urticaria. Our Dermatol Online. 2021;12:106-12.

6. Fortuin FTJM, Omta SWP. Growth analysis and shade experiment with Solanum nigrum L., the black nightshade, a leaf and fruit vegetable in West Java. Netherlands J Agricult Scien. 1980;28:199-210.


Source of Support: Nil,

Conflict of Interest: None declared.

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