My child has a rash. What to do?
A series of red bumps spreads across your child’s skin. What is it? What to do?
Few infants and young children avoid contacting some sort of rash caused by an infection, often viral, according to Marie Kayton of Cape Cod Pediatrics in Forestdale. Many childhood rashes are contagious, and while they may be scary-looking and uncomfortable, they’re not necessarily worrisome.
But how do you tell what’s a passing annoyance and what’s a serious problem?
“Most pediatricians will talk to parents (on the phone.) They can describe the rash,” Dr. Kayton said. “I’ll definitely see them in the office, if they have a fever and a rash at the same time.”
She suggests parents or caretakers take cellphone pictures of a rash as it progresses, and send them to their child’s doctor, to help identify the illness.
Not all rashes spring from infections. Allergic reactions, heat and moisture, chemical or plant irritants and insect bites can also cause rashes.
Here are some of the most common childhood infectious rashes Dr. Kayton sees.
A rash that’s distinguished by the fact that it appears after a fever – not simultaneously – is roseola, or roseola infantum.
“Fever breaks after a couple of days, but then they break out in a rash,” which Dr. Kayton said leads parents to say: “We thought we were through it.”
The rash of small pink spots usually starts on the trunk before spreading to the limbs. It typically strikes children ages 2 and younger, and is caused by two strains of herpes virus, according to the Mayo Clinic.
In some cases, a high fever from roseola can cause seizures, which alarms parents. However, Dr. Kayton said these seizures do not lead to epilepsy or neurological damage in later life.
“It’s just a scary thing to see your child seizing,” she said.
As with all communicable diseases, practice good hygiene to prevent spreading roseola.
One of the most common rashes Dr. Kayton said she sees in her practice is molluscum contagiosum. This very contagious, but benign illness forms flesh-colored or white raised lesions with depressed centers. The rash can become sore or itchy, according to the Centers for Disease Control and Prevention
“It can last for ages,” Dr. Kayton said. “It can last for months, even years. They’re really harmless otherwise.”
Waiting for the child’s immune system to resolve the rash “does cause a lot of concern for parents,” Dr. Kayton said. To prevent spreading the poxvirus that causes the rash, affected areas should be covered, she said.
The rash can be spread among adolescents by sexual contact. Treatment is often unnecessary in healthy people, but if the lesions are in visible area, or in the genital region, removal by freezing, scraping or application of topical medicines such as podophyllotoxin and salicylic acid may be tried, according to the CDC.
Hand, foot and mouth disease
Another viral rash that strikes after a fever is hand, foot and mouth disease. It’s so contagious and common that most children come in contact with the virus by the time they reach elementary school, Dr. Kayton said.
“Everybody gets exposed,” she said.
After the fever, this infection causes sores in the mouth and a blistery rash on hands and feet and other areas, according to the CDC. Most children recover without treatment in 7-10 days.
“Try to keep them out of daycare,” Dr. Kayton said. “Toddlers and infants, if they have sores in their mouth, and they don’t drink well, can get dehydrated.”
There is no treatment, just pain relievers (other than aspirin, which should not be given to young children) and sore throat sprays. The disease can be spread via coughing, sneezing, close contact, stool (diapers) and contaminated surfaces, so avoid kissing and hugging and sharing utensils or food with an infected child.
Group A streptococcus bacteria cause impetigo, as well as strep throat and scarlet fever. Staphylococcus aureus bacteria also cause impetigo. These bacteria live on our skin, and can cause impetigo when they enter through a small crack or cut, Dr. Kayton said. This infection is also highly contagious.
“We often see it in the winter,” she said, when the infection starts in a nose raw from a cold or chapped lips.
The disease is most common among children between 2 and 5 years, according to the CDC, and is spread through contact. Older children and athletes can get it through sharing sports equipment, clothing or towels, according to the American Academy of Dermatology.
The rash starts with sores that are frequently itchy. These sores burst and become red and raw before forming honey-colored crusts. They may spread to other areas of the body, where the cycle starts anew.
A variation of the disease, called bullous impetigo, forms fluid-filled blisters instead of sores. These burst and become crust-covered. Both varieties ordinarily heal without scarring if treated promptly with antibiotics, according to the academy.
Prevention includes keeping sores and blisters covered, avoiding skin-to-skin contact with others and washing hands after touching infected skin.
Not caused by a worm, but a fungus, ringworm frequently forms a circular rash with an edge. It’s generally red and itchy. The same fungus, tinea, also causes athlete’s foot and jock itch. If present on the scalp, it can cause bald spots. Children get the fungus on their scalps more often than adults.
Ringworm can be spread through contact, and the fungus can live on clothing, towels and bedding. Affected areas should be covered to prevent transmission, Dr. Kayton said. The fungus can also be spread from infected dogs and cats and from the floors in communal showers and locker rooms, where walking barefoot should be avoided, according to the CDC.
Over-the-counter antifungal ointments and powders can successfully treat ringworm, with the exception of scalp infections, which require prescription oral medicine, according to the CDC.
Several infectious diseases – including measles, rubella (German measles) and chickenpox – that used to be associated with childhood rashes are now regularly prevented in this country via vaccination. These diseases can pose serious threats. Rubella can cause miscarriage or birth defects in a pregnant woman’s child, for example, and chickenpox may result in serious complications, especially for people with weakened immune systems, according to the CDC.
However, while most Americans vaccinate their children, not all do, Dr. Kayton said. In addition, visitors from other countries where vaccination is less routine can carry these diseases here, or Americans who travel overseas may bring infections back with them. She noted how there have been recent measles outbreaks in Europe and the United States. In fact, the CDC reports that 120 people from 15 states came down with measles in 2017.
“That’s why vaccines are so important,” she said.