Spooked and alarmed by that angry, red rash splashed across your child’s body? Rashes run the spectrum, signaling anything from a mild viral infection to a chronic or even life-threatening illness. Since the list of rashes and their causes is extensive, you may wonder what’s what and when to call the doctor.
First, avoid self-diagnosis. “Viral and allergic rashes both can present as a diffuse, splotchy, blanching, pinkish rash. Because the rashes look similar, it can be impossible sometimes to tell the difference just by appearance,” says dermatologist Reginald B. Henry, M.D., of Sentara Dermatology Specialists.
Below are the more common types of childhood rashes and typical treatment methods. Check with your family physician or dermatologist to correctly diagnose and treat a mysterious rash.
Even the most conscientious diaper-changing parent may see an uncomfortable, red, puffy rash blossom on her baby’s bottom. Babies can suffer from diaper rash after a bout of diarrhea, as a side effect from antibiotics or if they recently started eating solid foods. Change your baby’s diaper frequently, and use wipes without alcohol or fragrances to gently pat the area dry. Treat the area with a protective barrier ointment after each diaper change. If the skin appears infected with blisters, oozing discharge or painful open sores, call your pediatrician.
About 10 percent of infants and children suffer from atopic dermatitis or eczema. The chronic disease is especially common in families with a history of allergies and asthma. According to the National Eczema Association, 65 percent of children are diagnosed in their first year of life and 90 percent by the time they are five years old. Eczema is extremely itchy, but is not contagious. It appears as red, scaly dry skin and can vary in severity.
Physicians generally treat eczema first with an over-the-counter cortisone cream to calm the red, inflamed skin. Throughout the year, treat skin with moisturizers. “Lotions are better in the humid months, ointments in the winter months,” Henry says. “Don’t over-treat your child if the dermatitis isn’t really bothering her.”
Staphylococcal and streptococcal bacteria often cause infections with rashes, including impetigo, scarlet fever (strep throat with a rash), folliculitis and cellulitis. Lyme disease, caused by the bacterium Borrelia burgdorferi and transmitted by ticks, can cause a bull’s eye rash. If you suspect Lyme disease, seek medical attention immediately. Bacterial infections are typically treated with antibiotics.
Viral-related rashes are splotchy, blanching (disappears when pressed), pinkish-colored and usually accompany other symptoms, like fever, diarrhea, sore throat and lethargy. Typical childhood viruses that present with a rash include fifth disease, molluscum contagiosum, chicken pox (varicella), roseola, and hand, foot and mouth disease. Depending on the diagnosis, your physician may prescribe antiviral medications.
Warts are another viral skin condition commonly seen among kids. Although warts generally resolve on their own, “due to the fact they are contagious, we tend to treat them with a spray or liquid nitrogen every one to two weeks until they are gone,” says dermatologist Donna Corvette, M.D., with Dermatology Center of Williamsburg. “We can also treat with various topical acids and sometimes we use blister beetle juice which is quite effective.”
A pimple-like skin rash that’s extremely itchy and contagious could be caused by scabies, which is a mite that burrows into the skin. Because scabies can spread quickly through skin-to-skin contact, your physician may recommend treating the entire family with a topical medication.
The name might make you shudder, but ringworm (tinea corporis) a red, circular skin rash—is caused by a fungal infection, not a worm. The rash doesn’t always itch, but can spread from skin-to-skin contact. Treat with an anti-fungal product.
Rashes like hives are allergic reactions that are typically splotchy, blanching, pinkish and intensely itchy. In some cases a new food or a new medication could be the culprit. Consult with your doctor for diagnosis and treatment. (Seek immediate medical attention if your child has trouble breathing or experiences swelling of the tongue, lips or face.)
Contact dermatitis, like poison ivy or exposure to other irritants, can also cause itchy allergic reactions. Treat the area with an over-the-counter cortisone cream. For insect bites, try ammonia-containing products like AfterBite Kids®. Henry also recommends oatmeal baths, baking soda compresses, and Sarna® lotion or Noxzema® cooled in the refrigerator to help relieve itching.
When to emergency seek care
“Special care and concern should be given to the child who appears acutely ill with fever and rash,” Corvette says. “Seek prompt care in an emergency room setting for urgent treatment. Do not procrastinate on these types of rashes.”