Skin Rashes Types and Causes in Children

Children often have to visit their pediatrician because of skin rashes. Some may be easily identifiable, such as diaper rash or one due to an insect bite. Others, such as ringworm or measles, may not—either because you haven't seen them before or because they aren't very distinct.

Unless your child's rash has already been formally diagnosed or you are certain about its cause, it's a good idea to have your child evaluated by a healthcare provider.

While rashes can differ, this article can give you a sense of what common childhood skin rashes look like so you can learn what you may (or may not) be dealing with.

Bug Bite

No matter how careful you are about using insect repellents, it is likely that your child will occasionally get a bug bite. These bug bites can be scary for parents. This is because even a normal reaction to a bug bite can include:

• Redness
• Swelling
• Warm skin

The majority of bug bites, whether by insects such as an ant, chigger, or wasp, aren't dangerous. The only exception is if your child is allergic to the insect. If your child is having an allergic reaction following a bug bite, they will likely have other symptoms in addition to the original bite.

Even most spider bites, which often resemble regular bug bites, aren't that dangerous unless caused by a:

• Black widow
• Brown recluse spider

Regular use of insect repellents can help your kids avoid many bug bites.

If your child's bug bite becomes infected, then the redness, swelling, pain, fever, and any other symptoms will likely get worse a few days after the bug bite. Any spreading redness or swelling on the first day of the bite is probably because of the initial bug bite and not a sign of an infection.

Chickenpox

The most notable symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually scab over. The chickenpox rash starts on the chest, back, and face before spreading to the rest of the body. 

Other symptoms of chickenpox typically include:

• Fever
• Malaise
• Headache
• Lack of appetite
• Mild abdominal pain

Chickenpox is contagious from one to two days before the rash and up to six days after blisters form.

There is no specific treatment for chickenpox, but you can take steps to relieve the symptoms. Calamine lotion and cool baths with added baking soda or colloidal oatmeal may help soothe the itchiness caused by the chickenpox rash.

Cold Sores

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Unfortunately, some children get cold sores on a regular basis. They often occur on the same spot on their face or lip. Children will often feel some pain, burning, or itching at the site of the cold sore before it appears.

Symptoms of cold sores include:

• A group of vesicles (small, fluid-filled blisters) appearing on a red area of skin
• Vesicles that quickly develop a crust on them

Although several medicines are available to treat cold sores in children, the one most commonly prescribed is Zovirax (acyclovir). This cold sore medicine must be used four to five times a day. You should start using the medicine as soon as the cold sore develops in order for it to be effective.

Not all experts agree that Zovirax is useful for treating cold sores in children. Even if you don't treat them with medicine, cold sores usually go away in seven to 10 days.

Atopic Dermatitis

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Atopic dermatitis (AD) is a long-term (chronic) skin condition that causes dry, itchy skin. AD is a common type of eczema and mostly affects children. 

AD rashes affect different parts of the body depending on a person’s age.  

• In infants and toddlers, the rash usually starts on the face, outside of the elbows, and on the knees. 
• In older children, the rash tends to be on the hands and feet, the arms, and on the back of the knees. 

The color of the rash can also vary from one child to another. Rashes tend to look purple, darker brown, or ashen grayish in darker skin tones, and red in lighter skin tones. 

Though AD can sometimes be hard to control, there are many things you can do to manage your child’s symptoms and reduce flare-ups.

• Apply a topical corticosteroid: These prescription medications come in many different strengths and forms. Your healthcare provider will help you find the right combination.
• Avoid triggers: It's important to avoid known triggers such as harsh soaps and wool and polyester clothing.
  
• Moisturize: Use a moisturizer every day and within three minutes of getting out of the bath or shower.

Fifth Disease

Fifth disease (also called slapped cheek syndrome) is a viral infection that affects children ages four to 10 years. This common childhood illness got its name because it was the fifth disease on a historical list of six common skin rash illnesses in children. 

The first signs of fifth disease are mild flu-like symptoms, including:

• Headache
• Low-grade fever
• Runny nose
• Sore throat
  

After a few days of these symptoms, your child may develop a bright red rash on their face that makes them appear to have a slapped cheek. That’s why it is sometimes called “slapped cheek syndrome.” 

The rash may also spread to the arms, chest, stomach, and thighs. This rash often has a raised, lace-like appearance and may be itchy.

Although the rash can look alarming, it usually clears up on its own in one to three weeks. If your child is feeling unwell, you can try the following to ease the symptoms:

• Acetaminophen or ibuprofen for fever and headache
• Antihistamines to relieve itchiness
• Fluids to prevent dehydration
  

Lip Licker's Dermatitis

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During the winter, many kids have dry skin. They often also get red, irritated skin around their mouths. Children with eczema experience dry skin that gets red and itchy. But other kids simply get dry arms, legs, or hands from time to time.

As the skin around the mouth gets irritated, many children will begin to lick at it. This makes it even redder and irritated. Eventually, children develop the classic lip licker's dermatitis that many parents and pediatricians see in the winter.

Fortunately, this type of rash usually responds very well to moisturizers, such as:

• Vaseline
• Aquaphor Healing Ointment
• Eucerin Original Moisturizing Cream

The trick is that you have to put the moisturizer around your child's lips frequently. This helps break the cycle of irritation and lip licking.

Measles

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Measles, also called rubeola, is a highly contagious respiratory infection caused by a virus.

Though a blotchy, red rash is the most characteristic symptom of measles, it is usually not the first symptom. Measles typically begins with:

• Cough
• Fever
• Red, watery eyes (conjunctivitis)
• Runny nose
• Small, white spots in the mouth (known as Koplik spots)

The rash appears three to four days after these initial symptoms. It shows up as flat red spots near the hairline before spreading to the rest of the body. As the rash spreads, the spots often join to form larger, blotchy patches.

There is no specific treatment for measles. You just have to let the virus run its course. Make sure your child is resting and drinking plenty of fluids. You can also give them over-the-counter medications, such as acetaminophen or ibuprofen, to help bring down the fever.

Molluscum Contagiosum

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Molluscum contagiosum is a viral skin disease that causes small clear or flesh-colored bumps with a dimple or pit in the center. These wart-like bumps usually pop up on the face, arms, legs, and abdomen, but they can appear anywhere on the body.

The bumps can show up alone or in clusters. Although harmless, molluscum bumps are very contagious. Scratching them can cause them to spread from one part of the body to another (and from one person to another).

Treating molluscum bumps is a lot like treating warts. They can be frozen, scraped, burned, or lasered off. But many doctors advise against treatment because the bumps clear up on their own. Each bump usually disappears in about two to three months, although some can last as long as four years.

Pityriasis Rosea

Pityriasis rosea is often confused with ringworm. This is because the rash often starts with a large pink or tan oval area (sometimes called a herald patch) on the chest, stomach, or back that initially looks like ringworm.

The herald patch is then followed by multiple smaller patches that spread out across the back, neck, arms, and legs. These can be mildly itchy and can linger for several weeks or months. But the child will otherwise have no other symptoms.

It is not known what causes pityriasis rosea. It may be caused by a virus or a reaction to a previous viral infection. No treatment is usually required, except perhaps to control the itching if it becomes annoying.

Poison Ivy

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It is usually not hard to identify a child with a poison ivy rash. A classic case of poison ivy might include a child with known exposure to poison ivy after a camping trip, hike in the woods, or day at the lake. The child then develops a red, itchy rash all over their body a few days later.

Poison ivy rash is an allergic reaction to the oil that poison ivy produces. Your child may have symptoms within hours or a few days after coming in contact with the leaves, stems, or roots of poison ivy.

Typical symptoms of poison ivy rash include:

• Blisters
• Itching
• Redness
• Swelling

The rash can last for one to three weeks.

Prevention depends on identifying poison ivy, poison oak, and poison sumac so that you can avoid them.

Tinea Infections (Ringworm)

Contrary to what the name might suggest, ringworm is not caused by a worm. Also, known as tinea infection, ringworm is caused by a fungus. The infection causes red, ring-shaped rashes on the skin. 

Symptoms look different depending on the body part that’s infected. Generally

• Itchy skin
• Hair loss
• Red, flaky, cracked skin
• Ring-shaped rash

The rash often appears red on lighter skin, and brown, purple, or gray on darker skin.

Ringworm of the scalp and body (tinea corporis) are the most common types of ringworm in children. 

• Scalp ringworm (tinea capitis) often starts as a pimple-like bump or a scaly patch that looks like dandruff. As the bump or patch gets bigger, the hair in the infected area can break off.  
• Body ringworm (tinea corporis) causes a ring-shaped rash that can appear anywhere on the body or face. It starts out flat and scaly, and as the ring grows the edges become raised. 
  

Ringworm usually gets better when you treat it with antifungal cream. These medications usually take several weeks to work. If the antifungal creams don’t work, or if your child has scalp ringworm, your doctor may prescribe antifungal tablets.

Yeast Diaper Rash

Yeast infections can commonly complicate other diaper rashes. You should suspect that a diaper rash might be caused by yeast or Candida when your baby's regular diaper rash just isn't getting better even though you're using your usual diaper rash ointments and creams.

Another good sign of a yeast diaper rash is when a diaper rash becomes bright red and is ​surrounded by red bumps called satellite lesions.

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Impetigo

Impetigo is a highly contagious skin infection that causes red sores or blisters. It occurs when bacteria enter the body through broken or irritated skin. 

Impetigo can look different depending on which bacteria caused it. It usually affects the skin that isn’t covered by clothes, such as around the mouth or nose. The rash can start as a cluster of itchy red bumps or blisters. Eventually, the blisters burst open and form a honey-colored scab. 

Treatment depends on your child’s symptomsImpetigo is typically treated with antibiotics. treated with antibiotics that are either rubbed onto the sores (topical antibiotics) or taken by mouth (oral antibiotics). 

• Prescription antibiotic ointment: A healthcare provider might recommend mupirocin or retapamulin if your child only has a few sores. 
• Antibiotic pill or liquid: If your child has multiple lesions, their healthcare provider might prescribe an oral antibiotic.
  

Hand, Foot and Mouth Disease

Hand, foot, and mouth disease is a contagious illness most commonly caused by a virus called coxsackievirus. It mainly affects children under age 10, but older kids and adults can catch it as well. 

The disease is easy to spot because of its telltale symptoms:

• Skin rash: As the name suggests, the rash tends to develop on the hands and soles of the feet. The rash usually looks like flat, red spots.
• Mouth sores: Small bright pink spots on the tongue and inside of the cheeks that turn into blisters. These can be painful and make it difficult to eat or drink.   

Hand, foot, and mouth disease usually starts with a fever and sore throat. Mouth sores develop within two to three days, and the rash appears shortly after that. 

Since hand, foot, and mouth disease is caused by a virus, antibiotics won’t work. The most you can do is treat the symptoms. Oral anesthetics can help with painful mouth sores. Typically the rash is not painful or itchy, so you don’t need to put anything on it. 

Heat Rash

A heat rash develops when sweat gets trapped under the skin. The rash looks like dots or tiny pimples and the skin often feels prickly to the touch. It is usually found on body areas covered by clothing, such as the neck, diaper area, armpits, upper back, and chest.

Heat rash is harmless and often goes away on its own in a few days. The best thing you can do is dress your child in loose clothing that keeps their skin cool and dry. It’s best to avoid applying topical medications. Topical medications may actually make the rash worse by causing the sweat glands to become even more blocked.

When to Call a Doctor

Contact your child's healthcare provider immediately if your child has:

• A bright red rash that peels off in the sheets
• Bloody crusts on the lips
• Large blisters
• Painful urination with a rash
• Trouble breathing

If your child's rash doesn't get better after a few days or if you are concerned in any way, don't hesitate to call their healthcare provider.

Summary

Children get skin rashes often. Knowing the different types of skin rashes can help you decide whether you should take your child to the pediatrician. While some skin rashes can be prevented, others may be caused by factors outside of your control.

You can treat some skin rashes with over-the-counter medication. Other skin rashes may require prescription medication. Your child's pediatrician can help you figure out what to do about a particular kind of skin rash.