9 Common Skin Rashes in Children

When your child develops an itchy, red, or strange-looking rash, your initial reaction may be to consult a friend, family member, or even turn to the internet for answers. However, understanding what common skin conditions look like in children may save you a panicked ER visit for a simple case of diaper rash or dry skin. Well-informed parents can make informed decisions about their child’s health. That’s why we’re breaking down some of the most common pediatric skin rashes and how you can effectively manage them at home or seek professional help from a pediatrician.

Eczema

Also known as atopic dermatitis is a common skin condition in babies and kids. In infants, it usually appears first on the cheeks and then the trunk (the main section of the body containing the chest, abdomen, pelvis, and back). This rash is characterized by red, dry, irritating, and itchy skin. Treatment of eczema for children usually involves a thick moisturizer like CeraVe applied anywhere from two to four times a day.

Eczema Treatment

To treat the redness and itching, your doctor may prescribe a topical steroid and an antihistamine (typically used only for older children). After the rash has cleared up, children will often need to reapply moisturizer throughout their lives to avoid flare-ups. Since eczema is considered an allergic condition, it can also be affected by seasonal allergies, asthma, food allergies, or a family history of allergies, increasing the risk of developing eczema.

Hives

Common allergens such as cats, dogs, pollen, and other household irritants could trigger an allergic response that may present as a rash. One of the most common forms of allergic reaction is hives. Hives are characterized by wheal-and-flare lesions, which are red, raised bumps or welts on the surface of the skin that are often very itchy. Environmental allergens, food, or even medications can trigger hives. In the case of food and medication allergies, hives typically appear within 5-20 minutes of ingestion.

Treatment for Hives

Hives are often treated with a simple antihistamine, like Zyrtec or Allegra, at higher doses than one would use for just allergies. Discuss the dosage of antihistamines with a trusted pediatrician to determine the most effective dosage for your child. In certain cases, when the hives spread to the neck and face, your pediatrician may recommend a steroid to prevent any potential blockage of your child’s airways.

Erythema Multiforme

Another skin rash due to an allergic reaction is erythema multiforme. While not as common as hives, this rash is characterized by a bull’s-eye-shaped lesion. The lesions usually have a circular and flat shape and can sometimes look purple in the middle. They can appear quickly and can be very uncomfortable for your child. Drug reactions are a more frequent cause of erythema multiforme.

Erythema Multiforme Treatment

Treatment of erythema multiforme involves antihistamines to alleviate the reaction and oral steroids to keep the child comfortable. Children with erythema multiforme should not be given any kind of nonsteroidal drugs, like Motrin or Aleve, as it can worsen the reaction.

Strep Rash 

Strep rash, also known as scarlet fever or scarlatina, is a form of infectious rash caused by strep throat. This rash is characterized by very fine, red raised bumps. The rash may feel like sandpaper to the touch and can spread over the entire body.

Strep Rash Treatment

Doctors treat strep rash the same way they would treat a case of strep throat—with an antibiotic. Parents should also know that a strep rash may peel afterward, which is completely normal and not cause for alarm.

Diaper Rash

Yeast thrives in wet dark places like diapers and can cause rashes much more easily than other forms of underwear. Diaper rash is characterized by red areas of skin around the diaper area and can result in peeling, flaky, or scaly skin.

Diaper Rash Treatment

If your child has a diaper rash, use gentle wipes around the area and make sure the area is as dry as possible (try using the cool setting on your blow dryer to dry the area). Additionally, your pediatrician can prescribe a topical anti-yeast medicine to apply during diaper changes. Children who have taken antibiotics frequently often develop a yeast diaper rash because, while antibiotics kill bad bacteria, they also kill off good bacteria on the skin that works to balance with normal yeast. When you take the good bacteria away, the yeast is able to cause diaper rash.

Roseola

A common rash usually seen in babies and toddlers; roseola typically occurs within 24 hours of a broken fever. This rash, characterized by a red, flat rash spreading over the body, shouldn’t result in any pain or discomfort for the child.

Roseola Treatment

While it may look concerning, this rash will resolve on its own within about a week and does not require additional treatment.

Hand, Foot & Mouth Disease

Hand, foot, and mouth disease is also very common in children and toddlers. This condition, in children, is characterized by a fever and fussiness caused by painful blisters in the back of the throat. Once the fever breaks and the child’s throat begins to feel better, they’ll begin to break out into a rash on the hands, feet, and sometimes other parts of the body. For children, hand, foot, and mouth disease is one of the only things that will cause lesions on the palms and soles of the feet, however, these lesions do extend to the trunk (torso) in some cases. Fortunately, these lesions, once visible on the skin, are rarely painful and won’t itch.

Treatment for Hand, Foot & Mouth Disease

Treatment for hand, foot, and mouth disease involves keeping the child comfortable and supported. Tylenol, Motrin or cool, soft foods like yogurt pouches will soothe their pain due to the lesions in the throat.

“The thing I tell parents is that in the beginning they (the child) look fine but don’t feel good. Once they get better, they feel good but don’t look fine (due to the painless rash on the body),” said Carol M. Steiner, MD, FAAP, an experienced pediatrician with TPMG James River Pediatrics in Newport News.

Children who’ve had hand, foot, and mouth disease can usually return to school once they aren’t running a fever. Some daycares or childcare services may be leery to send children back until the lesions on the skin have resolved themselves, however, this is not necessary. The lesions will typically resolve within five to seven days of treatment. In some cases, skin conditions like eczema will exacerbate the lesions which may require topical antibiotic treatment.

Lyme Disease

The rash associated with Lyme disease is often referred to as a bullseye rash because it presents with alternating rings clear skin and redness. The rash typically appears within a couple of weeks after being bitten by a tick carrying the organism that causes Lyme disease. Contrary to common misconception, this rash can appear anywhere on the body after being bitten, not just at the site of the bite. This rash isn’t always accompanied by concerning symptoms like other rashes; however, it is important that you exercise caution as it may lead to some serious side effects. Left untreated, Lyme disease has the potential to cause significant damage to your tissues, joints, and nervous system.

Treatment for Lyme Disease

If your child has been bitten by a tick, closely monitor them and see your pediatrician as soon as possible if they exhibit the rash or begin to experience fever or fatigue. Since testing for this disease take a long time to come back, doctors typically treat a suspected case of Lyme disease with antibiotics immediately rather than test.

Petechiae

One of the more serious rash presentations, petechiae are little, red dots that won’t blanch when you touch them. Small purple bumps called purpura can also present with petechiae.

Petechiae Treatment

If your child has petechiae, you’ll want to take them to the nearest emergency room as soon as possible.

When to See Your Pediatrician for a Skin Rash

The bottom line? If you’re worried about your child’s skin rash, call your primary care provider for the next steps. It’s better to eliminate doubt and keep your children safe and comfortable. At TPMG James River Pediatrics in Newport News, VA, concerned parents can also choose to come in for a physical visit or send pictures of the rash via the patient portal for examination. In some cases, your doctor may need to see the rash in person to prescribe medication or render a diagnosis.

Gale Pearson

About Dr. Carol M. Steiner, MD, FAAP

 

TPMG board certified pediatrician, Carol M. Steiner, MD, FAAP has over 22 years of experience caring for patients from the first days of life to young adulthood. A premature infant herself, Dr. Steiner’s experience with a devoted pediatrician inspired her to enter the medical field. She graduated from the University of North Carolina at Chapel Hill with a Bachelor of Science in Medical Technology and earned her medical degree from Georgetown University in Washington D.C.

TPMG welcomed Dr. Carol Steiner to TPMG James River Pediatrics in 2019.

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