Rash

As a parent, this probably isn’t the first rash you’ve dealt with, and it certainly won’t be your last. Your brain immediately starts scanning all of the things your child has come into contact with and you probably feel a little overwhelmed at the possibilities. My biggest tip with rashes is to focus on other symptoms, not the rash itself. Take a deep breath and arm yourself with knowledge.

A skin rash is a red or pink spot that can be widespread, meaning it covers a large part of the body. These are usually spread through the bloodstream and are caused by viruses, bacteria, toxins, and/or food or drug allergies.

Or the rash can be localized to one spot, like your kiddo’s booty – a diaper rash! See, you knew that one. This is usually caused by contact with the skin from an irritant – chemicals, bug bites, bacteria or fungus. This is also referred to as contact dermatitis. Other examples of this would be coming into contact with poison oak or poison ivy rash.

The rash might be solid, speckled, spotted, flat, raised, itchy, hot. So many options. Let’s first talk about when we should worry and then we can talk about what the rash might be.

When to worry about a rash?

• Your kiddo is lethargic
• A new medication was started within the last 3 days
• Rash with blisters, spreading red streaks, or yellow crust
• Bright red skin that peels off in sheets
• An older kiddo that has started her period and is using tampons
• Purple or blood-colored spots (no fever: call for an appointment; fever: head to the ER)
• Fever, depending on age:
• 0-3 months: >100.4℉
• 3-24 months: >102℉
• 2 years+: >104℉

Head to the ER if your child is having trouble breathing or swallowing

What are the most common types of skin rashes?

Rashes that are caused by a virus will resolve as the virus goes away. You usually see small, pink spots on the chest, stomach, and/or back. Your child may have other symptoms such as diarrhea or a fever – this is also due to the virus.

Types of viral rashes:

• Roseola
• Chickenpox
• Shingles
• Hand-foot-and-mouth disease
• Parvovirus (better known as fifth disease or slapped-cheek disease because of the characteristic red rash on the cheeks)

What does shingles look like?

Shingles rash usually begins with pain and tingling on either the face or torso, followed by small, fluid-filled blisters.

How to treat poison ivy? What does poison ivy look like?

Poison ivy rash is from coming into contact with the oil (called urushiol) on the leaves, stems, and roots of poison ivy, poison oak, or poison sumac.

It depends on how the plant comes into contact with your skin but it often looks like a straight line of red bumps and blisters. It is itchy and it is contagious.

This usually goes away on its own in 2-3 weeks but you can also try cool baths or soothing lotions, if it helps with the discomfort. If it is severe, see your doctor for something stronger.

What do hives look like? What to do if you get them?

Hives are raised pink bumps with pale centers, like mosquito bites. Just like any rash, hives can either be localized (when your skin comes into contact with something irritating, like a plant or food) or widespread (from things that enter the bloodstream, such as a medication). Bee stings can be both – if the hives are in one spot, it is likely a reaction to the venom; if the hives are spread elsewhere, it could be a serious allergic reaction to bee stings.

Hives are present in over 80% of anaphylactic reactions. Anaphylaxis is life-threatening and occurs within 20 minutes to 2 hours after exposure to possible allergen. If you or your child ever have trouble breathing or swallowing within that 2 hour timeframe, call 911.

The other common types of rashes your kiddo can have:

• Scarlet fever, caused by strep throat. See the doc for strep throat and the rash will go away with it!
• Dermatitis/Eczema leads to chronic dry skin, itching, and thickened patches of red to brown skin. May also include small, weeping bumps.
• Allergic reaction rash due to medication. This can be tricky to distinguish because if your babe has a virus, you may be giving them medications for comfort. The rash is actually only a medication allergy in 10% of these cases! 90% of them time, it is just caused by the virus itself and not worrisome.
• Allergic reaction rash due to food – much less common than we worry about though!
• Heat rash from overheating. Baby heat rash is more common but heat rash in adults happens too! Heat rash treatment? Cool that skin down!
• Petechiae and purpura are characterized by purple or dark red spots that could be due to a bacterial infection. Petechiae are very small, whereas purpura look like bruises. Neither of them fade when pressed on. These are life-threatening emergencies and need to be assessed by a doctor immediately.
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How to get rid of a rash?

• Give your babe a cool bath, no soap. If the rash is itchy, you may add 2 ounces of baking soda to the water.
• Another option for itchy rashes is a 1% hydrocortisone cream. Apply 2-3 times per day. You can get this over-the-counter so you don’t need a prescription from the doc.
• For diaper rashes, change diapers frequently and apply a barrier cream/ointment.
• You can give medication to help with discomfort or fevers but remember: a fever is our body fighting! So only treat if necessary.
• No medications for babes <3 months old.
• No ibuprofen for babes <6 months old.
• No aspirin for kids <18 years old.
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Again, I want to emphasize that how your child is actually feeling is more important than the rash you’re seeing. As we say in nursing: treat the patient! Any time you are concerned, call the doctor for peace of mind.