Martin D Rudloff, MD.

Rashes are fairly common throughout childhood and disturb many parents and children, however, they are rarely serious and most can be managed at home.

When To Worry

Blisters over a purple base in an infant under one month. This may be a herpes infection in a newborn.

Maroon color spots the size of a pin head or larger at a time a child has fever that do not temporarily blanch or disappear when pressed. Look in the arm pits and groin region for these. This is called purpura and can be a sign of Meningococcal infection

Small red dots over the arms and lower legs that do not blanch or whiten when pressed. These may be petechia and are seen in a number of illnesses.

 When Not To Worry

Rashes that occur after a fever has resolved are usually a sign that a virus has been in a child's body and are rarely serious. They usually begin at the hairline over the forehead and behind the ears. From here they may progress downward over the trunk.

Such rash usually occur on infants and toddlers. They would be rare in older children and should be seen if on a child over three years of age.

These are viral exanthems. Roseola is an example of such a rash.

Sometimes these rashes seem to itch or bother a child for a day or so. Bendadryl can be given

These rashes should disappear in 3 to 5 days. If they persist they should be seen.

One exception to the rule that rashes that appear after a fevers leave are virus is scarletina.

Scarletina is a sign of a strep or possibly a staph bacteria in your child.Scarletina is a fine sandpaper like rash over the abdomen that is usually more prominent in the diaper area and under the arms. It can be red but may be more easily felt that seen on darkly pigmented individuals.

Scarletina may itch and benadryl should be given.

This rash may be present with fever.

Sore throat may or may not have been present.

Not all strep bugs do this.

These rashes need to be seen and need medication for the strep.

Newborn Rashes　

When To Worry  

Blisters over a purple base in an infant under one month. This may be a herpes infection in a newborn.

Generally any fluid filled blister on a newborn should be seen.

When Not To Worry

Infantile seborrhea is a common rash on infants often present in the scalp, over the forehead, behind and on the ears, in front of the ears and may spread down the back. This can be treated with 1& hydrocortisone cream or lotion.

Infantile acne looks like pimples over the cheek and generally requires no treatment, however, there is a treatment available if desires.

As disposable diapers have become better at removing moisture from contacdt with a baby's skin, diaper rashes have cdhanged. When cloth diapers were common infant often got ammonical and irritant diaper rashes. Nowadays these are uncommon unless there is a great deal of diarrhea. For irritant rashes resulting from loose stools Aquaqhor and avoidance of wipes can be helpful.

Most rashes that fail to respond in 2 to 3 days to typical diaper rash medicines are monilial or yeast infections. These are found in young infants or can follow antibiotic use or infections. These can be treated with a number of different medications. Over the counter medicines to try are nystatin and lotrimin.

Yeast rashes a generally raised an bumpy

Think of yeast if the rash is on the scrotum, on the area at the base of the penis, or over the labia of a little girl.

Think of yeast also if the infant has had thrush.

Beyond the Newborn Period

Impetigo is a rash from a strep or staph bacteria that presents as spreading sores. Often it follows a bug bite in the summer that was scratched until sore or sometimes presents as spreading sores around the nose as face. Although there are over the counter medicines that can be helpful such as polysporin call the office during regular office hours for prescription medicines that are more effective.

Poison IVY can be helped with medicine, however, it is never absolutely necessary to treat.

Contrary to popular opinion, once a child's skin is washed, poison ivy is not spread from contact with the rash even if it is weeping.

Poison IVY around the eyes is uncomfortable but not serious

Over the counter treatment considers of hydrocortisone topically and treating the itch of poison ivy with Aveno baths, Itch X, Caladryl clear and oral antihistamines for itching such as benadryl.

In cases that are particularly uncomfortable oral steroid are sometimes given.

Contact results from something that has come in contact with the skin. It can be treated in a manner similar to poison ivy with emphasis on placing hydrocortisone on the spots several times a day.

Eczema is as term for dry itchy skin. There are several type of eczema. Contact dermatitis is a contact eczema. Infantile eczema and atopic eczema are common in young children and present with patches of dry slightly pink skin that itch. Treatment of eczema consists of the following:

In the summer using steroid creams such as over the counter hydrocortisone

In the winter using steroid ointments that help keep moisture in.

There are prescription steroids that are stronger but check with your doctor before using these on the face

Newer prescription agents such as Elidel or Protopic are helpful for some.

Mild soaps such as Dove or Cetaphil

Avoidance of harsh detergents and fabric softener. Consider double rinsing clothes.

Maintain moisture in the skin. After a bath only gently pat your child to remove excess water then apply a moisturizer.

Generally the greasier the moisturizer the more effective. Vasoline, Aquaphor, Moisturel and even Crisco can be used.

If itching bother the child at night benadryl can be given.

Not all rashes that appear in circles are ringworm. Nummlar eczema is dry patch of eczema that presents in a circle. Generally ringworm has a slight scale and central clearing but not always. Think of ringworm especially if you have a new cat or dog in the house. If you are placing a topical steroid such as hydrocortisone on a circular and it is not getting better or is getting worse then it might be ringworm. Use antifungal creams such as lotrimin.

Athlete's foot cures are promoted on radio and television which suggest antifungal sprays and creams. A fungus can be the cause of athlete's foot, however, eczema can also be the cause. If the athlete's foot does not improve using antifungal medications think of eczema and use topical steroids. This is particularly true if the child has a history of eczema elsewhere or his feet sweat a lot in shoes.