Doctor's Notes on Skin Rashes in Children
Skin rashes in children are common in children. A skin rash is considered as a sign of an underlying problem, and the rashes vary according to the cause of the rash. Rashes that occur with life-threatening underlying causes are as follows:
- Petechiae are flat red dots on the skin that do not fade when pressure is applied. Causes include bacterial sepsis and meningococcemia.
- With Rocky Mount spotted fever, red spots on the wrist and ankles spread toward the trunk and blanche (turn white) when pressure is applied and later becomes petechiae.
- In Lyme disease, a red tender nodule enlarges into a red ring that spreads outward.
- With Kawasaki disease, there are flat red lesions, raised red lesions, blisters, and possibly all of the rash types on a single child. Redness and swelling of the fingers and toes may be associated with peeling skin.
- In toxic shock syndrome, a person may have sunburn-like rash in areas normally covered by clothes. Some children also have skin peeling on their palms and soles of their feet.
Rashes that occur with bacteria as the underlying causes are as follows:
- Impetigo: Small superficial blisters rupture and are then covered often by a light-yellow crust that is itchy.
- Scarlet fever: A red sandpaper-like rash that looks like "sunburn with goosebumps" usually does not occur on the palms and soles.
Rashes that occur with viruses as the underlying causes are as follows:
- Chickenpox: Small superficial blisters rupture in 1-2 days and form a crusty scab that falls off in 2-3 days.
- Measles: Reddish or purplish rash on the face and behind the ears eventually spreads down the body to the thighs and feet.
- Rubella: A pink or light reddish rash on the face spreads to the body with mild itching.
- Fifth disease: Bright red cheeks on the face fade after a day or two to form a lacey red rash throughout the body but mainly on the arms.
- Roseola infantum: Small pink, flat, slightly red lesions appear in the trunk and spread to the extremities and last only about 1-2 days.
- Hand, foot and mouth disease: Blisters develop in the mouth and tongue and on the palms and soles. Some children may have involvement of the lower legs, buttocks, and/or the genital area.
Rashes that occur with parasitic or fungal organisms as the underlying causes are as follows:
- Scabies: An itchy reddish rash usually occurs between the fingers and in armpits and wrists and arms. It may develop a wavy pattern.
- Ringworm: A reddish oval with scaly skin in the middle enlarges over time. Hair loss in the rash may occur (also termed tinea corporis or tinea capitis).
- Athlete's foot: very itchy reddish skin between the toes (also termed tinea pedis)
- Milia: small white bumps on the nose, cheeks, and chin in newborns
- Cradle cap: Greasy, scaly, bumpy red skin occurs on the scalp and behind the ears, in the armpits, and in the diaper area (also known as seborrheic dermatitis).
- Infantile acne: raised reddish bumps usually on the cheeks and nose of infants
- Erythema toxicum: multiple flat reddish areas with a small raised white or yellow bump in the center
- Miliaria: small clear blisters usually on the nose (also known as prickly heat)
- Candidal rash: very red, raised area with discrete borders usually in the diaper area and the genitalia and in the creases and folds of baby's skin (also termed diaper rash or yeast infection)
- Irritant diaper rash: similar to candidal rash but not in the creases and folds
Another rash type that is the result of an immune reaction in the skin is termed contact dermatitis rash that is red, itchy and may blister; it usually only occurs where the skin has touched the irritant. For example, underneath a ring on a finger.
What Are the Treatments of Rashes?
There are many types of rashes that are treated by diagnosing the underlying cause and then treating it. For example, treating a diaper rash requires drying the area and ridding the rash area of Candida fungi while other rashes that occur from skin infections may require antibiotics. Many rashes, however, can be treated at home with one or more of the following:
- Zinc oxide ointment topically
- Calamine lotion topically
- Hydrocortisone cream topically
- Oral antihistamine
- Cold compress
You may detect items that cause a rash, like perfumes or certain chemicals. Avoid them or do not let them touch your skin. Seek medical care immediately if the rash forms blisters, or if a rash spreads quickly, or if you develop a fever and or if you have fluid oozing from the rash.
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Allergic ReactionAn allergic reaction is an overreaction to a harmless substance. Symptoms and signs of an allergic reaction include hives, rashes, swelling, itching, wheezing, nausea, and even anaphylactic shock in severe reactions. Treatment involves avoiding triggers, taking oral antihistamines, applying anti-inflammatory steroid creams, and using an EpiPen.
Athlete's FootAthlete's foot is a superficial skin infection of the foot caused by a mold-like fungus, though the term is often used for any inflammation of the foot skin. Symptoms include itching, sores between toes, scaly white skin, reddish soles of the feet, and painful lesions.
ChickenpoxChickenpox (varicella) is a highly contagious infection that typically affects children. Symptoms and signs include an itchy red blistering rash that forms first on the torso and then spreads to the extremities. Treatment may incorporate Tylenol or Advil for fever, IV fluids for dehydration, antibiotics for bacterial skin infections, calamine lotion, cool compresses and baths, and Benadryl, Claritin, or Zyrtec for itch relief.
Contact DermatitisDermatitis is an inflammation of the skin. Contact dermatitis is a localized rash or irritation of the skin caused by contact with a foreign substance. Contact dermatitis treatment can include medications, such as corticosteroids and oral antihistamines, home remedies, and avoiding irritants.
CoxsackievirusCoxsackievirus infection is spread from person to person when an infected person does not cover their mouth when coughing or sneezing or touches someone with unwashed hands. Though most cases of coxsackievirus infection are mild, with symptoms including diarrhea and sore throat, the infection may also cause meningitis, encephalitis, chest pain, and myopericarditis. Infection in newborns may be deadly. There is no specific treatment for coxsackievirus, though acetaminophen and ibuprofen may be used to treat the symptoms.
Diaper RashDiaper rash appears on the skin under a diaper. Symptoms and signs include red, irritated skin on the baby's bottom or genital area. Treatment involves frequent diaper changes, cleaning the affected aread with a mild soap, and using a barrier cream.
Diaper Rash (Candida, Yeast Infection) in BabiesCandida albicans is a common cause of diaper rash. Diaper rash is red, elevated, and fluid may be visible under the skin. The rash may be found in the creases of the skin. Treatment involves antifungal topical treatment and decreasing moisture in the diaper area.
Fever in ChildrenFever is defined as a rectal temperature over 100.4 F or 38 C. Fever isn't life-threatening unless it is persistently high - greater than a 107 F rectal temperature. Fever is usually caused by an infection. Treatment focuses on controlling the temperature, preventing dehydration, and monitoring for serious illness.
Fifth DiseaseFifth disease (human parvovirus B19) is a common illness in children. Symptoms and signs include fever, sore throat, headache, and a rash as if the face has been slapped. Treatment is geared toward alleviating symptoms by drinking a lot of fluids, taking acetaminophen, and taking hygiene measures to avoid spreading the virus.
Heat RashHeat rash (prickly heat, miliaria) is thought to be due to plugged hair follicles and sweat ducts on the skin. Overexposure to a hot environment, for example, working or exercising in a hot environment, are causes heat rash. There are three types of heat rash, clear, red, and deep.Signs and symptoms of heat rash include itching (prickly heat), red bumps, blisters, or large welts on the face, neck back, stomach, buttocks, groin, or the fold under the breasts. Home remedies for heat rash include first aid, cool baths or showers, and avoiding skin-to-skin contact. OTC and prescription medications may be necessary for treatment. People at risk for heat rash include infants, children younger than four years of age, and people with congenital decreased sweating, are overweight or obese, are bedridden and unable to walk, and the elderly.
How Do You Get Rid of a Yeast Infection Rash?When candida grows out of control it can cause infections. While yeast infections tend to refer to vaginal candidiasis, yeast infections can also occur on the skin and result in rashes. Treatment includes topical anti fungal ointments and improved hygiene.
ImpetigoImpetigo is a common baterial infection of the skin. The bacteria enter through a cut or other injury to the skin. Symptoms and signs include rash and/or pus-filled blisters. Treatments include oral and/or topical antibiotics.
Kawasaki DiseaseKawasaki disease is an illness that mainly affects children under 5 years of age. Symptoms and signs include rash, strawberry tongue and fever. Treatment involves administering IV immunoglobulin and high-dose aspirin until the fever ends, followed by low-dose aspirin for 6-8 weeks.
Lyme DiseaseLyme disease, sometimes referred to as Lyme infection, is a bacterial illness, transmitted to humans by the bite of deer ticks (Ixodes ticks) carrying a bacterium known as Borrelia burgdorferi. Symptoms and signs include a red bull's-eye rash and flu-like illness in the early stages of Lyme disease. Doctors will treat primary or early Lyme disease with oral antibiotics including doxycycline, penicillins, or erythromycin.
Measles (Rubeola)Measles, also known as rubeola, is a viral respiratory infection. Measles and German Measles (a different but similar virus also known as rubella) are serious infections that cause fever and rash. Most recover without incident, but measles infections can lead to pneumonia and brain inflammation. Vaccines have reduced measles infections to a few dozen a year in the U.S., but no cure exists. Patients should treat symptoms with pain relievers, fever reducers, and fluids.
Rash (Causes, Types, and Cures)A rash is a visible skin outbreak. Examples of noninfectious rashes include eczema, psoriasis, contact dermatitis, seborrheic dermatitis, rosacea, hives, and allergic dermatitis. Types of infectious rashes include ringworm, impetigo, scabies, herpes, chickenpox, and shingles. Rashes may be caused by fungi, viruses, bacteria, and parasites. Treatment depends upon the type of rash.
Ringworm on BodyRingworm (or tinea corporis) is a common fungal infection resulting from dermatophytes. Symptoms and signs include lesions on the trunk, legs, arms, neck, and face. Read about the cause of ringworm, how to get rid of ringworm, and whether ringworm is contagious. Learn about treatments and home remedies for ringworm.
Ringworm on ScalpScalp ringworm (tinea capitis) is a very common fungal infection among children throughout the world. Symptoms and signs include hair loss, reddening, crusting, and scaling of the scalp. Treatment typically involves oral antifungal medications and medicated shampoo.
Rocky Mountain Spotted FeverRocky Mountain spotted fever is a tick-borne disease. A bite from a tick infected by the Rickettsia rickettsi bacteria causes symptoms and signs that include nausea, vomiting, headache, muscle aches, fatigue, fever, rash, joint and abdominal pain, and diarrhea. Treatment with the antibiotic doxycycline is recommended in adults and children.
RoseolaRoseola is a mild viral illness caused by the human herpesvirus. Symptoms and signs include a high fever, swollen glands, and a red rash. Treatment focuses on lessening the symptoms, such as controlling the fever.
ScabiesScabies is a skin condition that causes severe itching. Scabies lesions on the skin may look like pimples, and the skin may also be red. Treatment involves washing all clothing and bed linens, vacuuming rugs and furniture, and applying a prescription cream to kill the mites.
Scarlet FeverScarlet fever is predominantly a disease that affects children. Scarlet fever is caused by infection with the bacteria Streptococcus pyogenes. Symptoms and signs include: fever, rash, sore throat and strawberry tongue. Antibiotics are used in the treatment of scarlet fever.
Severe Allergic Reaction (Anaphylactic Shock)Anaphylactic shock is a severe allergic reaction that is life-threatening. The symptoms of anaphylactic shock are breathing problems, shock, or death. A severe allergic reaction may be caused by an insect sting or certain foods to which the body has been "sensitized" and has developed a powerful antigen for. Anaphylactic shock is an emergency and requires immediate medical treatment.
Toxic Shock SyndromeToxic shock syndrome (TSS) is a rare, life-threatening illness that is caused by toxins (poisons) that circulate in the bloodstream. Symptoms and signs include fever, headache, sore throat, cough, nausea and vomiting, diarrhea, and abdominal pain. Treatment involves finding and removing the source of infection, IV antibiotics, IV fluids, correcting electrolytes, and monitoring kidney and liver functions.
What Causes Ringworm Rash?Ringworm is a skin infection caused by dermatophytes, which are a type of fungus that lives on the dead outer layer of skin. Despite the name, there is no worm involved in the condition. It’s called “ringworm” because it can cause a circular rash shaped like a ring.
What Does a Roseola Rash Look Like?Roseola is a common childhood viral infection that causes symptoms and signs that include high fever, a pink or red rash, and red spots in the mouth. There is no treatment for roseola, and the infection eventually resolves on its own.
Yeast Infection Skin RashCandidiasis is by far the most common type of yeast infections in human skin. Candidiasis is infection with Candida species. More than 20 species of Candida exist. Signs and symptoms of a candidal infection can vary depending on the location of the infection. Most candidal infections can be treated at home with over-the-counter or prescription medication and can clear up within a week.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.