by Katie Porterfield
September 20, 2011
It’s upsetting when your soft-skinned baby or toddler is suddenly covered with an angry red rash. The first time it happens, you’ll likely call your child’s pediatrician in a bit of a panic, but you’ll soon discover that rashes are quite common in early childhood, and they rarely require an urgent trip to the doctor or emergency room. In fact, some rashes may come and go before the doctor’s office returns your call (and you may never know what caused them). Others may be associated with a virus that simply has to run its course. Still others may be the result of an allergic reaction.
If a rash persists for several days or weeks or worsens, contact your child’s health care provider. In general, seek immediate medical attention if your child has fever, breathing difficulties, or persistent vomiting in addition to the rash. And be aware that rashes known as petechiae and purpura (read on for more details) require immediate medical attention.
The types of rashes your child may experience include:
Contact dermatitis occurs when your child comes in contact with an irritating substance or allergen and develops red, bumpy, scaly, itchy or swollen skin. Irritants may include soaps, cosmetics, fragrances, jewelry, or plants such as poison ivy or poison oak. It’s important to try to identify what your child came in contact with so that he can avoid doing so in the future. The rash isn’t contagious or life-threatening and will likely go away in 2–4 weeks, as long as your child stays away from the culprit that caused it. In the meantime, your child’s pediatrician may recommend an antihistamine and a cool compress to relieve the itching.
Eczema, known also as atopic dermatitis, is a chronic condition that often appears in children who have a family history of allergies or eczema. It is characterized by red, dry, peeling skin and small, fluid-filled bumps that ooze a clear liquid. Eczema often begins with itchy, red bumps on the forehead, scalp or cheeks that spread to the arms or trunk between 2–6 months of age. Later in childhood, eczema is scalier and appears on the elbows, knees, wrists, and ankles. Though there isn’t a cure, about 60 percent of babies outgrow eczema. Pediatricians often treat the skin condition with non-steroidal or steroid creams and sometimes suggest an antihistamine to relieve itching. Parents are also advised to avoid giving children with eczema long, hot baths and to moisturize skin daily with an unscented cream.
A heat rash looks like small red and pink pimples. These pimples can appear anywhere but often cover a baby’s head, neck, and shoulders. Heat rash is common in hot, humid weather and often occurs when an infant is wearing too many layers of clothing. If you see this type of rash on your child, move him to a cooler environment. To prevent heat rash, make sure your child is wearing lightweight, loose-fitting clothing in warm weather and easily removable layers in cooler weather. The rash will usually go away by itself.
Also known as urticaria, hives are raised pink or white bumps on the surface of the skin. They often appear on the back, chest, and stomach, but can also be seen on the extremities and the face. The hives can be single or in clusters, and often come and go within a 10–15 minute period. While hives, according to the American Academy of Allergy, Asthma and Immunology (AAAAI), can result from non-allergic causes such as heat or exercise, they often occur as an allergic reaction to medications, food, or insect bites. When you or your child has an allergic reaction to a substance, your body releases histamine into your bloodstream that leads to swelling of the skin. Fish, shellfish, cow’s milk, eggs, wheat, and nuts are among the foods that commonly cause allergic reactions. Hives usually itch, but they are not contagious. The most common treatment for hives is an over-the-counter antihistamine such as Benadryl, but parents should contact their child’s health care provider for dosing instructions. Parents should seek urgent medical care for their child if hives are accompanied by difficulty swallowing or breathing or vomiting.
Impetigo (a contagious, bacterial infection) causes sores that most often occur around a child’s mouth and nose. The sores can erupt on healthy skin, but impetigo usually occurs when bacteria enter the skin through cuts or insect bites. Either way, the rash will likely clear up on its own in 2–3 weeks. Though impetigo is rarely serious, your child’s pediatrician may still prescribe an antibiotic to prevent possible complications.
PETECHIAE & PURPURA
Marked by flat, round spots that look like pinpoints, petechiae appears when there is bleeding under the skin. These spots can be red, brown, or purple, and are usually flat to the touch. The spots don’t lose color when you press on them. Similarly, purpura, which also indicates that there may be ruptured blood vessels under the skin, are larger areas that may initially be red and then turn purple or brownish-yellow. Because this type of rash may signal a serious underlying condition, it is important to get your child to a doctor right away if she shows signs of petechiae or purpura.
Some rashes are associated with viral illnesses. Though they are often accompanied by fever or cold symptoms, there’s usually no cause for concern. Chicken Pox, Fifth Disease, Roseola, and Hand-Foot-Mouth Disease are the most common rash-causing viruses. Fifth Disease, also known as “slapped cheek disease,” causes a rash that begins on the cheeks, making it appear as if your child has been slapped. It then spreads as pimply bumps to your child’s stomach and extremities. The rash may also be accompanied by a fever, runny nose, and cough. Other viruses that yield rashes include Roseola, which begins with a few days of high fever; once the fever subsides, a splotchy, raised, pink rash appears. It starts on the chest, back, and stomach and spreads to the neck and arms. Hand-Foot-Mouth Disease (or Coxsackie) is a virus that begins with a few days of fever and then causes blister-like sores in the mouth and/or a skin rash on the palms of the hands and soles of the feet. With the exception of Chicken Pox, viral rashes generally are not contagious once a child has been fever-free for 24 hours, and most will clear up on their own with little to no treatment.
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