A rash on a child's skin can be worrying for parents. While many are harmless, some can be a sign of a serious condition that needs medical attention.
Probably chief among these is the rash associated with a deadly disease such as meningitis. So for parents it's important to understand rashes and to know when further action is needed, reports the Liverpool ECHO.
Speaking in 2018, Dr Anton Alexandroff - a consultant dermatologist - said: "Most rashes in children aren’t serious and parents shouldn’t worry about them too much. Serious rashes are rare.”
The NHS says a baby or child should go straight to A&E or a parent should call 999 if they have the following symptoms:
- have a stiff neck
- are bothered by light
- seem confused
- have a high temperature
- their rash does not fade when you press a glass against it
- difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs), breathlessness, or they're breathing very fast
- their skin, lips or tongue look pale, blue, grey or blotchy
Midwife and nurse Jackie Hall of AXA PPP healthcare outlined 10 childhood rashes for DerbyshireLive in 2018. Here are the 10 skin rashes:
Viral rashes
These cause tiny pinprick red spots on the chest, abdomen and limbs which disappear easily when pressed. They can accompany common cough/colds/sore throats/tummy bugs.
Treatment
Many viral infections resolve within a few days without treatment, but symptoms can be managed by encouraging fluid intake and taking paracetamol for pain relief and fever control. Always consult a doctor if you’re worried about a rash on your child and if spots are accompanied by other symptoms such as drowsiness, unresolving fever, a floppy body, confusion or difficulty awakening, severe headaches, very pale skin, seizures, shortness of breath, sharp chest pain that feels worse with breathing, or coughing up blood.
Is it contagious?
Yes. Although incubation periods vary between viruses, children are generally most infectious in the days prior to rash outbreak, continuing until a few days after the rash has emerged.
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Slapped cheek syndrome
This is caused by parvovirus and it leads to a bright red rash on the cheeks, accompanied by slight fever. A child will feel moderately unwell.
Treatment
It should clear without specific treatment after a few days, and children should rest and drink plenty of fluids, as with other viruses. Pregnant women exposed to slapped cheek syndrome should see a GP.
Is it contagious?
The virus is contagious before a rash develops, but not once it’s visible. Unless a child feels unwell, there’s no need for them to stay off school once the rash has developed.
Chickenpox
A child will seem a little unwell for a few days, and then a few itchy red raised spots will appear on the neck, face, chest, back or other areas. These turn into little fluid-filled itchy and painful blisters.
Treatment
Chickenpox is usually mild and most children feel better within a week or so, although some can become more seriously ill and need to see a doctor. It can be more serious in pregnant women and newborn babies.
There’s no cure but symptoms can be relieved by the same treatment as other viruses, although ibuprofen shouldn’t be given to children with chickenpox as it can make them very ill. Topical creams can be applied directly onto the rash to help reduce itching and soothe the skin, or children can take a suitable oral antihistamine.
Is it contagious?
Chickenpox is highly contagious and can make some people very ill, so it’s important to try and avoid spreading it. Children can be infectious for several days before spots appear and for five days or more after, and they should stay away from nursery or school until all the blisters have dried and scabbed over, usually five or six days after the rash appears.
Measles
A mass of red spots break out around the neck and behind the ears and face, although they can appear elsewhere, including inside the mouth. Initial symptoms include a runny or blocked nose, sneezing, swollen eyelids, sore red watery eyes, fever, small greyish-white spots in the mouth, aches and pains, a cough, loss of appetite, tiredness and irritability.
Treatment
Contact your GP if you suspect your child has measles. There’s no specific treatment and it usually improves within seven to 10 days. If the symptoms are causing discomfort, children should be treated as with other viral illnesses.
Is it contagious?
Children should stay away from school for at least four days from when the measles rash first appears. Avoid contact with vulnerable people such as young children and pregnant women. Children can avoid catching measles by having the measles, mumps and rubella (MMR) vaccine.
German measles (rubella)
This is usually a mild illness with small red spots appearing on the face and spreading to other parts of the body. Other symptoms include swollen glands and a cold-like illness. It’s of serious concern if a pregnant woman catches it in early pregnancy as it can cause birth defects in the baby.
Treatment
Contact your GP if you suspect rubella. There’s no specific treatment, and the condition usually improves within seven to 10 days. Symptoms can be eased in the same way as with other viruses.
Is it contagious?
Yes. It’s important to reduce the risk of spreading the infection to others, so children should avoid school for four days from when the rash first develops.
Impetigo
Impetigo is caused by overgrowth of skin bacteria and often begins as a red patch of skin around the nose or mouth, although it can occur anywhere on the body. The red patches become a crusty/brownish colour after a few days.
Treatment
Impetigo may get better without treatment within a few weeks, although it spreads easily if left untreated. It can be cleared by antibiotics, which can reduce the length of the illness and the risk of spreading.
Is it contagious?
Most people are no longer contagious after 48 hours of treatment or once their sores have dried and healed. It’s important children stay away from school until then.
Eczema
Dry/inflamed patches of skin typically form on creases of elbows and behind knees, but can occur anywhere on the body.
Treatment
Eczema normally responds well to the regular use of emollients or moisturisers. Steroids are useful in managing flare-ups but should only be used as prescribed by a health professional. Specific bath additives, shower gels or soap substitutes may also help.
Is it contagious?
Eczema isn’t contagious.
Allergic wheals (urticaria)
These are blistery, reddish, raised skin blotches which can appear rapidly on different parts of the body. They tend to be itchy and are usually due to exposure to an allergen such as animal hair or food, although there may be no obvious cause.
Treatment
Antihistamines can be helpful in reducing symptoms. Most often the rash settles quickly over 24 hours but if there’s associated swelling of the face, lips or any breathing problems, call 999.
Is it contagious?
Allergic wheals aren’t contagious.
Neonatal heat spots
These small red spots with a tiny white pimple on top appear on babies’ faces, necks and upper chests. They are the result of immature sweat glands becoming blocked when the baby gets hot. They are very common, usually of no concern and will disappear after a few months.
Meningitis
A rash is often one of the last signs of meningitis or septicaemia, so see a doctor if you’re concerned even before you see a rash.
A child with meningitis would normally be very unwell, with possible reddish/purple spots which may look like tiny fresh bruises. Dr Alexandroff says if the rash doesn’t fade when the glass test is done – by pressing a clear glass against the skin – this is very serious and immediate medical attention is needed.
Treatment
Go to an A&E department immediately.
Is it contagious?
Bacterial meningitis can be contagious.
