Do you know the different between a heat rash and something more serious?
Recently my sister-in-law called in a panic, because her one-year-old had been sent home from nursery with suspected chicken pox.
She was told not to return with the child until they had visited the doctor and got a doctor’s note or for a couple of weeks until the chickenpox had passed. After frantic work rescheduling and pulling in favours from family and friends, and a trip to the local GP it was found that my nephew had a heat rash and was perfectly fine to continue on at child care.
And despite said doctor’s note, the following week, the same thing happened again.
It made me wonder what is going on when an experienced child care worker can’t recognize the difference between a heat rash and chickenpox. Can anyone except highly trained medical practitioners know the difference?
Do you as parents know the difference?
It’s time to get rash savvy
Let’s face it everyone is afraid of rashes…Ever since we were all instructed to look out for the dreaded meningococcal rash, parents all over the world have gone into a mild panic at the very sight of a few spots. We get out the glasses and start doing the glass test at every tiny spot to see if it disappears or stays visible.
Most rashes are however completely harmless and will go away of their own accord. Kids get rashes all the time. They are another way of their immune system dealing with invading critters.
More often than not they are simple heat rashes or perhaps a mild allergy, but usually nothing to worry about.
However, if your child has developed a rash and seems unwell, or if you’re worried, you should see your GP to find out the cause and for any necessary treatment.
There are so many causes of rashes, but the following guide compiled by the UK’s NHS service, may give you a better idea of the cause of the rash.
DO NOT USE THIS TO SELF-DIAGNOSE YOUR CHILD’S CONDITION – always see a GP for a proper diagnosis.
A parent’s guide to recognising rashes
Here are the most common rashes in young babies:
Neonatal acne (“baby acne”)
Pimples sometimes develop on a baby’s cheeks, nose and forehead within a month of their birth. These tend to get worse before clearing up completely after a few weeks or months.
Washing your baby’s face with water and mild soap can help improve the appearance of their skin. You should avoid acne medicines intended for older children and adults.
Pimples or blackheads that develop after three months of age (infantile acne) tend to be more severe and often need medical treatment.
Cradle cap is where yellowish, greasy scaly patches develop on a baby’s scalp. Occasionally, the face, ears and neck can also be affected.
Cradle cap is not itchy and should not bother your baby. If your baby is scratching or upset, they may have eczema (see below).
Cradle cap is a common condition that tends to develop within two or three months after birth. It will usually get better without treatment in a few weeks or months.
Gently washing your baby’s hair and scalp with baby shampoo may help prevent further patches developing. Read more about treating cradle cap.
Half of all newborns will develop a blotchy red skin reaction called erythema toxicum, usually at two or three days old. It is a normal newborn rash that won’t bother your baby and will soon clear after a few days.
Miliria (“sweat rash”)
A sweat rash may flare up when your baby sweats, for example because they are dressed in too many clothes or the environment is hot and humid. It is a sign that your baby’s sweat glands have become blocked. They may develop tiny red bumps or blisters on their skin, but these will soon clear without treatment.
Other common childhood rashes
Chickenpox is a mild and common viral illness that most children catch at some point. It causes a rash of red, itchy spots that turn into fluid-filled blisters. They then crust over to form scabs, which eventually drop off. Some children have only a few spots, but in others they can cover the entire body.
Learn more about the symptoms of chickenpox.
Eczema is a long-term condition that causes the skin to become itchy, red, dry and cracked. The most common form is atopic eczema, which mainly affects children but can continue into adulthood.
Atopic eczema commonly occurs behind the knees or on the front of the elbows. It is not a serious condition but if your child later becomes infected with the herpes simplex virus, it can cause the eczema to flare up into an outbreak of tiny blisters, called eczema herpeticum, and will cause a fever.
About one in five children in the UK has eczema and many develop it before their first birthday.
Impetigo is a highly contagious bacterial infection of the surface layers of the skin that causes sores and blisters. It is not usually serious. There are two types:
- bullous impetigo – which causes large, painless, fluid-filled blisters
- non-bullous impetigo – which is more contagious and causes sores that quickly burst to leave a yellow-brown crust
If you think your child has impetigo, see your GP for a prescription of antibiotic cream, which should clear the infection within seven to 10 days.
Ringworm is a common fungal skin infection that causes a ring-like red rash on the skin. The rash can appear almost anywhere on the body, with the scalp, feet and groin being common areas.
Ringworm isn’t serious and is usually easily treated using creams that you can buy from the pharmacy.
Prickly heat (heat rash)
A heat rash (prickly heat) may flare up if your child starts to sweat, for example because they are dressed in too many clothes or the environment is hot and humid. They may develop tiny red bumps and blisters on their skin, but these will soon clear.
Erythema multiforme is a skin reaction triggered by medication, an infection (usually the herpes simplex virus) or an illness. Red spots develop on the hands or feet before spreading across the body. Your child will probably feel unwell and may have a fever, but you should be able to treat these symptoms with over-the-counter medicine. It may take between two and six weeks before they feel better.
See your GP if your child has a rash and seems unwell.
Keratosis pilaris (“chicken skin”)
Keratosis pilaris is a common and harmless condition where the skin becomes rough and bumpy, as if covered in permanent goose pimples.
It typically begins in childhood and gets worse in adolescence, around puberty. Some people find that it improves after this and may even disappear in adulthood.
There’s no cure for keratosis pilaris, but it shouldn’t bother your child.
Hand, foot and mouth disease
Hand, foot and mouth disease is a common, mild illness caused by a virus. It causes a non-itchy rash on the palms of the hands and soles of the feet, and can sometimes cause mouth ulcers and a general feeling of being unwell.
Treatment is usually not needed as the child’s immune system clears the virus and symptoms go away after about seven to 10 days. However, hand, foot and mouth disease is easily spread.
Molluscum contagiosum is a viral skin infection that commonly causes clusters of small, firm, raised spots on the skin (see picture at the top of this page).
It commonly affects young children aged one to five years, who tend to catch it after close physical contact with another infected child.
The condition is usually painless, although some children may feel some itchiness. It usually goes away within 18 months without the need for treatment.
Molluscum contagiosum is highly infectious. However, most adults are resistant to the virus, meaning they are unlikely to develop the condition if they come into contact with it.
Pityriasis rosea is a relatively common skin condition that causes a distinctive skin rash of raised, red scaly patches across the body. Most cases occur in older children and younger adults between 10 and 35 years old.
Pityriasis rosea usually clears up without any treatment within 12 weeks.
Find out more about the symptoms of pityriasis rosea.
Scabies is an infectious skin condition caused by tiny mites that burrow into the skin. It causes an intensely itchy rash.
Children tend to catch it after close physical contact with another infected adult or child – for example, during play fighting or hugging.
The mites like to burrow in warm places on the skin. They leave small red blotches and silver lines on the skin, which may be found on the palms of the hands or soles of the feet. In infants, it’s common to find blisters on the soles of the feet.
See your GP for treatment (a lotion or cream) if you think your child has scabies.
Find out more about the symptoms of scabies.
Hives (also known as urticaria) is a raised, red, itchy rash that appears on the skin. It happens when a trigger (see below) causes a protein called histamine to be released in the skin. Histamine causes redness, swelling and itching.
Hives can be triggered by many things, including allergens (such as food or latex), irritants (such as nettles), medicines or physical factors, such as exercise or heat. But usually no cause can be identified. It’s a common skin reaction that’s likely to affect children. The rash is usually shortlived and mild, and can often be controlled with antihistamines.
Slapped cheek syndrome
Slapped cheek syndrome (also known as fifth disease) is a common childhood viral infection that typically causes a bright red rash on both cheeks. It usually affects children aged between three and 15.
Most children won’t need treatment as slapped cheek syndrome is usually a mild condition that passes in a few days.
Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales.
It may be just a minor irritation for some children who are affected, but for others it has a major impact on their quality of life.
There is no cure for psoriasis, but a range of treatments can improve symptoms and the appearance of the affected skin patches.
Find out more about the symptoms of psoriasis.
Cellulitis is a bacterial infection of the deeper layers of the skin and the underlying tissue. The affected area of skin will be red, painful swollen and hot. Your child will probably also have a fever.
Cellulitis can affect people of all ages, including children, and usually responds well to treatment with antibiotics.
Find out more about the symptoms of cellulitis.
Measles is a highly infectious viral illness. Anyone can get measles if they haven’t been vaccinated or had it before, but it’s most common in children aged between one and four years old.
It causes a red-brown spotty rash, which tends to start behind the ears and spread to the head, neck, legs and rest of the body. Your child will usually also have cold-like symptoms and a fever.
Most childhood rashes are not measles, but you should see your GP if you notice the above signs. Learn more about the symptoms of measles.
The following are the main Meningitis warning symptoms. The rash is unfortunately the last stage of meningitis, so it’s important to act on the following symptoms as early as possible:
- Becoming floppy and unresponsive, or stiff with jerky movements
- Becoming irritable and not wanting to be held
- Unusual crying
- Vomiting and refusing food
- Pale and blotchy skin
- Loss of appetite
- Staring expression
- Very sleepy
Trust your instincts. If you think your child has meningitis, see your GP immediately or go to your nearest hospital A&E.
Meningitis is very rare, while rashes are extremely common.
Whatever the cause of the rash, don’t panic! But go to your local GP to get properly diagnosed just in case.
Published for CareforKids.com.au http://www.careforkids.com.au/newsletter/2014/october/1/rashes.html