Rash, Age 11 and Younger

Topic Overview

Healthy skin is a barrier between the inside of the body and the outside environment. A rash means some change has affected the skin. A rash is generally a minor problem or is part of an illness that will go away on its own. A rash may be caused by contact with a substance outside the body, such as poison ivy (contact dermatitis), or by other, more serious illnesses, such as measles or scarlet fever (strep throat with rash).

Generalized rashes over the whole body that are caused by viruses are more common in babies and young children than in adults. A rash may be caused by a viral illness if the child also has a cold, a cough, or diarrhea, or is in a day care setting where he or she is with other children with viral illnesses. Most rashes caused by viruses are not serious and usually go away over a few days to a week. Home treatment is often all that is needed to treat these rashes.

Once a child has had a rash caused by a virus, his or her body generally builds an immunity to that virus. This immunity protects the child from getting that specific viral illness and rash again. Common rashes caused by viruses include:

• Chickenpox (varicella). This rash is a common, contagious illness caused by a type of herpes virus.
• Fifth disease. This facial rash looks like the cheeks have been slapped. It also causes a lacy, pink rash on the arms and legs, torso, and buttocks.
• Roseola (roseola infantum). This rash occurs about 3 days after a high fever.
• Unknown virus. Sometimes the specific virus that causes a rash is never known.

Localized rashes which affect one area of the body have many different causes and may go away with home treatment. Common localized rashes that occur during childhood include:

• Diaper rash. This rash is caused by rubbing, moisture, chemicals, or bacteria in the baby's urine or stool; substances in disposable diapers; or soaps used to wash cloth diapers.
• Impetigo. This bacterial skin infection is caused by strep or staph bacteria.
• Heat rash (prickly heat). This rash often results from a well-meaning parent dressing his or her baby too warmly, but it can happen to any baby in very hot weather.
• Cold sores. These are sometimes called fever blisters. Cold sores are clusters of small blisters on the lip and outer edge of the mouth caused by the herpes simplex virus.
• Contact dermatitis. This rash is caused by contact with a substance, such as food, soap, or lotion, that causes an allergic reaction. Most contact dermatitis is mild and goes away when your child's skin no longer comes in contact with the substance.
• Cradle cap. Cradle cap is an oily, yellow scaling or crusting on a baby's scalp. It is common in babies and is easily treated. Cradle cap is not a part of any illness and does not imply that a baby is not being well cared for.

A very rare and serious type of generalized red rash is toxic epidermal necrolysis (TEN). This may cause the skin to peel away, leaving large areas of tissue that weep or ooze fluid like a severe burn. If this type of rash occurs, a visit to a doctor is needed. TEN may occur after the use of some medicines.

To know how serious the rash is, other symptoms that occur with the rash must be evaluated. Use the Check Your Symptoms section to decide if and when your child should see a doctor.

Check Your Symptoms

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Home Treatment

Most rashes will go away without medical treatment. Home treatment can often relieve pain and itching until the rash goes away.

If your child has come in contact with a substance that may cause contact dermatitis, such as poison ivy, immediately wash the area with large amounts of water.

Once a rash has developed, leave it alone as much as possible.

• Use soap and water sparingly.
• Leave the rash exposed to the air whenever possible.
• Encourage your child not to scratch the rash.

If your child has a rash, he or she should not be in contact with other children or pregnant women. Most viral rashes are contagious, especially if a fever is present.

Relief from itching

Itching with a rash is generally not serious, but it can be annoying and may make a rash more likely to become infected. Rashes caused by chickenpox, eczema, or contact dermatitis are much more likely to itch. Sometimes itching can get worse by scratching.

Home treatment may help the itching.

• Keep your child's fingernails clean and short and encourage him or her not to scratch. Cover your baby's hands with socks to help keep him or her from scratching.
• Keep your child out of the sun and in a cool place. Heat makes itching worse.
• Keep the itchy area cool and wet if your child is older than age 9 months. Put cloths soaked in ice water on the rash a few times a day. Too much wetting and drying will dry the skin, which can increase itching. Do not put cloths soaked in ice water on the skin of a baby younger than 9 months. It may cause the baby's body temperature to go down.
• Try an oatmeal bath to help relieve itching. Wrap 1 cup of oatmeal in a cotton cloth or sock and boil it as you would to cook it. Allow it to cool to room temperature, and then use it as a sponge while bathing your child in cool water without soap. You can also buy a product at the store, such as Aveeno Colloidal Oatmeal bath.
• Dress your child in cotton clothing. Do not use wool and synthetic fabrics next to the skin.
• Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay, and use as little soap as possible. Do not use deodorant soaps on your child.
• Wash your child's clothes with a mild soap, such as CheerFree or Ecover, rather than a detergent. Rinse twice to remove all traces of the soap. Do not use strong detergents.
• Do not let the skin become too dry, which can make itching worse. See the topic Dry Skin and Itching for additional home treatment.

Nonprescription medicines for itching

Carefully read and follow all label directions on the medicine bottle or box.

• Try calamine lotion for a rash caused by contact dermatitis, such as poison ivy or poison oak rashes.
• For severe itching, apply 1% hydrocortisone cream 4 times a day until the itch is gone. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to do so. Do not use in the rectal or vaginal area on children younger than age 12 unless your doctor tells you to do so.
• Try an oral antihistamine to help the scratch-itch cycle. Examples include chlorpheniramine maleate, such as Chlor-Trimeton, and diphenhydramine, such as Benadryl. Oral antihistamines are helpful when itching and discomfort are preventing your child from doing normal activities, such as going to school or getting to sleep. Don't give antihistamines to your child unless you've checked with the doctor first.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your child's symptoms if any of the following occur during home treatment:

• Your child's rash worsens even with home treatment.
• Symptoms become so bad that your child is very uncomfortable.
• Other symptoms, such as a fever, feeling ill, or signs of infection, are severe or become worse.
• A new rash lasts longer than 2 weeks.
• A rash that has been diagnosed lasts longer than 4 weeks or is not following the expected course.
• Your child's symptoms become more severe or more frequent.

Prevention

Several childhood diseases that cause a rash can be prevented through immunization. Immunizations help your child's immune system recognize and quickly attack a virus before it can cause a serious illness. Immunizations for chickenpox and for measles, mumps, and rubella (MMR) can prevent these common rash-causing illnesses. For more information, see the topic Immunizations.

Other tips for preventing rashes include the following:

• Dress your baby in as few clothes as possible during hot weather.
• Breast-feed your child for at least the first 6 months, especially if either parent has a history of any allergy, including hay fever. Breast-fed children may develop fewer food allergies than those who are not breast-fed.
• Do not bathe your child too often to prevent dry skin. Most children do not need daily bathing. Children with very dry skin may do better if they bath once or twice a week.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:

• What is the history of the rash, including:
  • When did the rash start?
  • Where did the rash start?
  • Has the rash spread?
  • Has the rash changed?
  • Has anything made the rash better or worse?
• Has your child had this rash before? If yes:
  • What were the circumstances?
  • When did he or she last have it?
  • How was it treated?
  • How long did it last?
• What other symptoms has your child had? Symptoms may include itching, burning, stinging, tingling, numbness, pain, tenderness to the touch, fever, cold symptoms, or diarrhea.
• Has your child been exposed to a contagious illness, such as measles, rubella, mumps, or chickenpox?
• Have you recently used a new food, medicine, or product, such as soaps, detergents, shampoos, lotions, fabrics, new toys, or other object?
• Has your child been exposed to poisonous plants. such as poison ivy, oak, or sumac?
• Has your child had other health problems during the past 3 months?
• Has your child recently traveled to a rural area or to another country?
• Does anyone in your immediate family have a skin disorder or an allergy?
• What home treatment measures have you tried? Did they help?
• What nonprescription medicines have your tried? Did they help?
• Does your child have any health risks?

Related Information

• Allergic Reaction
• Blisters
• Diaper Rash
• Insect Bites and Stings and Spider Bites
• Mouth Problems, Noninjury
• Scalp Problems
• Skin Changes
• Sore Throat
• Swollen Glands and Other Lumps Under the Skin

Credits