Skin conditions in childhood are common and often treatable at home. Here we cover different conditions from chickenpox, to hand foot and mouth, to heat rash.
If your child is very unwell with a rash, please use your parental judgment and seek urgent care.
As per NHS advice, call 999 or go to A&E now if:
Your child is unwell with a rash and has any of these symptoms:
- a stiff neck
- bothered by light
- seems confused
- a high temperature
- difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs), breathlessness, or they’re breathing very fast
- a rash that looks like small bruises or bleeding under the skin and does not fade when you press a glass against it
- their skin, lips or tongue look pale, blue, grey or blotchy
- On brown and black skin, it may be easier to see the rash or colour changes on the soles of the feet, palms, lips, tongue and inside the eyelids.
Infection rashes:
Slapped cheek syndrome:
This is a self-limiting infection which usually settled after 2-3 weeks.
Rash first appears on the cheeks, mainly both cheeks. Can occur on only one cheek, then spread to the rest of the body. Looks red and angry looking, dry and can resemble eczema.
Unlike eczema, it is associated with your child having a high temperature, runny nose, sore throat and sometimes a headache.
He/ she may be miserable and off food.
What to do:
- Close observation of symptoms and treat accordingly:
- Calpol or ibuprofen for high temperature, sore throat and headaches, plenty of fluids to keep hydrated, soft soothing food, not too hot in temperature to encourage solid food.
- Antihistamines and soothing, moisturizing creams if the rash is itchy or irritating.
Hand, foot and mouth disease:
Normally settles after 7-10 days.
Associated with tiny blisters on the hands, feet and blisters and ulcers on the tongue and the inside of the mouth and lips.
Children may have a high temperature and a sore throat. Due to ulcers in the mouth, they may not want to eat very much.
What to do:
- Close observation of the symptoms and treat accordingly:
- Calpol and/ or Ibuprofen to help with temperature and pain
- Plenty of fluids for hydration
- Bonjela junior gel can help with symptoms of pain in the mouth
- Encourage soft, soothing foods like yoghurt, porridge, rice pudding, soups: not too hot in temperature which can worsen the ulcer pain. No acidic foods/ drinks such as oranges/ apple/ orange juice.
- Antibiotics doesn’t help since it is not bacterial in origin.
Scarlet fever:
This is a contagious bacterial infection which can be easily treated with antibiotics.
It usually lasts for a week.
Symptoms start with a mild flu-like symptoms with a high temperature, sore throat and large neck lymph glands, shortly followed after 12- 48 hours later by the rash.
The rash usually starts on the chest and spreads to the rest of the body: the rash is generalized, red, raised, scaly rash. Feels like sand paper.
The rash doesn’t appear on the cheeks although it may look red because of the high temperature.
The tongue has a white coating and is red underneath with small little bumps resembling a ‘strawberry’.
What to do:
- If you think your child has Scarlet fever, please book an appointment with your GP for a full checkup and antibiotics.
- Your child should stay away from nursery or school for at least 24 hours after taking the first dose of antibiotics.
- In the meantime, give Calpol and/or Ibuprofen, fluids, calamine lotions to sooth the rash which may be itchy/ irritating.
- Antihistamines can also help with the itch. The side effect of antihistamines is drowsiness. If taken at night, it can help with sleep due to this.
Measles:
Measles is a viral infection that can spread very easily. But thanks to widespread immunization programmes in the UK (MMR vaccines), it is less common.
Measles start with a cold like symptoms (high temperature, cough, sneezing, red, watery eyes) followed by a rash a few days later which is widespread.
Your child is contagious for 4 days after the rash appears. Therefore, avoid attending nursery or schools for at least 4 days after the rash appears.
The rash starts on the face, spreads to behind the ears and then the rest of the body. It is red and can be raised, round and widespread.
You can sometime see white spots on the tongue and on the inner side of the lips and mouth.
If your child is fully immunized, it is unlikely to be measles.
What to do:
- If you think it is measles or unsure, please see your GP for a full checkup.
- It is all about making sure your child is fully supported in terms of having Calpol/ Ibuprofen for the temp and aches and pains; moisturizing creams to sooth the skin, Fluids for hydration, good calorie intake with soft, easy to eat foods, staying away from nursery or school.
- To avoid being in contact with pregnant women, people who have a weak immune system such as the elderly, newborns and people who may not have had the MMR vaccine.
Itchy rashes:
Heat rash:
This rash is self-limiting and is cause by excessive sweating where the sweat glands and ducts get blocked and sweat is trapped inside the skin causing an irritating, itchy bumpy/ blistery rash.
Heat rash is also known as prickly heat or Miliaria.
What to do:
- As the cause and the name implies, the main thing is to keep your child cool with damp clothes on the skin to keep cool, loose clothing, soothing creams such as calamine lotion and antihistamines to stop the itchy. If the rash is quite severe, a short course of a mild steroid cream can help. Please consult with your GP for this.
Ringworm
This is a single round, well-bordered rash.
If you find a single ‘perfectly formed’ raised scaly, itchy rash on your child with no other patches anywhere else, then we need to consider a fungal infection called ringworm.
This is easily treatable with anti-fungal creams and sometimes oral medication.
What to do:
- If you think the rash could be ringworm ( a fungal infection), you can either ask your pharmacy to advise an anti-fungal creams.
- It is contagious. Therefore you need to make sure you use separate pillows, towels and wash your hands thoroughly. If it is on the scalp, to use separate combs and brushes for the child affected.
- If you are unsure of what it is and if it is on the scalp/head, please seek advice from your GP for a full examination. Skin scrapings can be done to confirm the diagnosis.
Allergic reaction
If your child has a raised, flat and sometimes spot like rash which is very itchy, it could be an allergic reaction to a topical products (creams, lotions) or to foods or medicines or to insect bites.
There may be a family history of allergies.
They normally settle after a few days
What to do:
- If your child is well, active and alert with the rash, to try anti-histamines which can help with the itch and the allergic reaction.
- Calamine lotion and other soothing creams can help with the itch and irritation. Calpol/ Ibuprofen can help with any pain/ irritation cause by the reaction.
- If the rash is widespread or there is swelling of the face and eyes, you need to seek advice from your GP.
Spots and blisters:
Chicken pox
Chicken pox is common among young children. It is a viral infection and resolves by itself after 1-2 weeks.
It starts of as small tiny red spots which eventually develops into small clear blisters which eventually dry out and scabs off. The rash can be anywhere on the body and can even be in the inside of the mouth.
Your child may have a temperature, be miserable, the skin may be irritating and itchy.
What to do:
- Keep a close watch on your child and treat the symptoms such as giving Calpol for the temp or any aches and pains, fluids for hydration and Calamine or other soothing lotions for skin irritation. Try not to scratch the spots which can cause secondary infections.
- Bonjela junior may be good for ulcers/ blisters in the mouth.
- To try antihistamines for the itch and also to help with sleep in the night.
- Your child is infectious until the last spot dries out. So, stay off nursery/ school until then.
- Don’t go near pregnant women or people with a weakened immune system as in the elderly, new born babies and people who are chronically ill.
- You can have more than one episode of chicken pox.
Impetigo
This is a bacterial skin infection which is common in children. It usually lasts for 7-10 days.
It is contagious.
The rash starts of as a red spot or blister which grows and spreads to the surrounding area in little clusters. Once the blisters develop, then burst and forms a honey coloured crust on the outside which is typical of this skin infection.
One of the complications of impetigo is when it spread to the deeper layers of the skin (cellulitis).
Normally, the rash is contained in one small area and dries out eventually.
Your child may be miserable, the rash maybe itchy and painful. He/ she may be off their food.
What to do:
- Make sure he/ she is drinking plenty of fluids for hydration.
- Given Calpol or ibuprofen if they have a temperature or are in pain.
- It is highly contagious: therefore wash your hands to avoid spread. Your child should be off nursery. School until the rash dries out and crusts or 48 hours after starting an antibiotic cream.
- If the rash spread despite the creams, you need to consult with your GP for consideration of oral antibiotics.
Rashes without fever or itch
Molluscum Contagiosum
This is a harmless viral infection common in children which is contagious.
Wash your hands thoroughly and do not share towels within the family.
The spots are small approximately 1-2mm in diameter, smooth dome shaped with a small dimple in the middle. They can occur anywhere in the body and can in in a group or widespread. They are not painful or itchy.
Parents tend to seek advice because of the unsightly nature of the spots.
If left alone without treatment, they can resolve after a few weeks to months. It can take up to 18 months for the spots to go.
What to do:
- If your child is well, do nothing. It will go on its own.
- If the spots are spreading, creams can be prescribed or we can freezing the individual spots.
- You can apply creams to sooth the spots of scratched accidently.
- If you are unsure, always seek expert advice from a doctor.
Rashes on newborn babies
Milia
Small little white or yellow spots on the nose and cheeks of the newborn which settled after a few weeks.
No need to do anything
Erythema Toxicum
Rash of the new born which last for a few weeks after birth: red spots on the face and spreads to the trunk. It is harmless contrary to the alarming name.
No need to do anything.
Baby acne
You may notice small red spot on your baby on the nose and cheeks 2 weeks after birth. This is harmless especially if your child is well with it. Normally baby acne settles without any treatment.
Some researchers believe baby acne is due to maternal hormones still in the baby’s system which eventually clears.
No need to do anything.
Cradle cap
You may notice that your baby has scalp, flaky and oily scalp which can also effect the forehead, cheeks. Some lesions are quite thick and alarm new parents.
This skin condition is harmless and usually settles by one year of age.
What to do:
- Moisturise the scalp and skin to loosen the scales, brush with a soft brush to take the scales off and wash with gentle baby shampoo.
We see children of all ages, so can help with a dermatology consultation if you need additional medical support. Your GP can help too and please seek urgent care if your child is unwell as per the top of this post.
Got more questions? Get in touch as we’re always happy to help.
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