What is my child’s rash? How to identify 10 rashes and tell if they’re serious

Seeing a rash on a child’s skin can be very worrying for many parents, who often fear it could be a sign of a deadly disease like meningitis.

Fortunately, such cases are not common, and consultant dermatologist and British Skin Foundation spokesperson Dr Anton Alexandroff reassures: “Most rashes in children aren’t serious and parents shouldn’t worry about them too much. Serious rashes are rare.”

But  if the child is unwell or if there’s swelling of lips, tongue or breathing problems, you should see a doctor urgently or go to A&E.

And Dr Sweta Rai of the British Association of Dermatologists warns parents not try to diagnose rashes from internet pictures.

“It can be tempting for parents to use the internet to diagnose a rash – we strongly advise against this,” she says.

“There’s such an array of potential causes, and similar types of rash, that even for a professional it is very hard to tell the difference between them without careful study and many years of experience.”

Rashes have many causes (Thinkstock/PA)

Here, midwife and nurse Jackie Hall of   AXA PPP healthcare  outlines 10 childhood rashes:

1. 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.

2. 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.

3. 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.

4. 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.

A toddler with chickenpox (Thinkstock/PA)

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.

5. 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.

6. 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.

7. 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.

8. 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.

 9. 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.

10. 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.


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