Overview

Healthy skin is a barrier between the inside of the body and the outside environment. A rash means that some change has affected the skin. In most cases, a rash is 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 are over the whole body. Ones 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 daycare setting with other children who have viral illnesses. Most rashes caused by viruses aren't serious. They usually go away over a few days to a week. Home treatment is often all that's needed to treat these rashes.

After a child has had a rash caused by a virus, their body often 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 rash on the face 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 affect one area of the body. They 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 is caused by a well-meaning parent dressing a 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. They are 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. It goes away when your child's skin no longer comes in contact with the substance.
• Cradle cap. This is an oily, yellow scaling or crusting on a baby's scalp. It's common in babies and is easy to treat. It's not a part of any illness. A baby can be well cared for and still get cradle cap.

Rashes that may require a visit to a doctor include:

• Lyme disease. It's caused by a type of bacteria carried by deer ticks in some areas. A specific expanding red rash usually occurs at the site of the tick bite. It's followed by flu-like symptoms, such as a headache, chills, fever, body aches, and stiffness.
• A rash that looks like a sunburn along with a fever of 38.9°C (102°F) or higher. This type of rash may be caused by a rare condition called toxic shock syndrome.
• A very rare and serious type of generalized red rash called toxic epidermal necrolysis (TEN). This type of rash may cause the skin to peel away, leaving large areas of tissue that weep or ooze fluid like a severe burn. 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 looked at.

Self-Care

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

After a rash appears, leave it alone as much as you can.

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

But if your child has come in contact with a substance that may cause contact dermatitis, such as poison ivy, wash the area with a lot of water right away. If you can, use liquid dish soap or a mild soap and very warm running water.

If your child has a rash, they should not be in contact with other children or anyone who is pregnant. Most viral rashes are contagious, especially if the person also has a fever.

In most cases, itching with a rash isn't serious, but it can be annoying. And it may make a rash more likely to get infected. Rashes caused by chickenpox, eczema, or contact dermatitis are much more likely to itch. Sometimes itching can get worse if you scratch.

Relief from itching

Try these tips to help relieve your child's itching from a rash.

• Keep your child's fingernails clean and short.

  Encourage your child not to scratch. Cover your baby's hands with socks to help keep your baby 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. Don't 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.

• Add a handful of oatmeal (ground to a powder) to your child's bath.

  Or you can try an oatmeal bath product, such as Aveeno.

• Dress your child in cotton clothing.

  Don't use wool and synthetic fabrics next to the skin.

• Use gentle soaps on your child's skin.

  Examples of these soaps are Basis, Cetaphil, Dove, and Oil of Olay. Use as little soap as you can. Don't use deodorant soaps on your child.

• Wash your child's clothes with a mild soap.

  Try using ones such as CheerFree or Ecover. Rinse twice to remove all traces of the soap. Don't use strong detergents.

• Don't let the skin get too dry.

  Dry skin can make itching worse.

• Try non-prescription 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 hydrocortisone cream 4 times a day until the itch is gone.

    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.

  • If itching affects your child's sleep, ask the doctor about giving your child an antihistamine that might reduce itching and make your child sleepy, such as diphenhydramine (Benadryl). Be safe with medicines. Read and follow all instructions on the label.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse signs of infection, such as warmth, redness, swelling, pus, or a fever.
• Symptoms occur more often or are more severe.

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