Common Childhood Rashes
What are common childhood rashes?
Infants, toddlers, and children are susceptible to a number of rashes that don’t usually affect adults. While they can have the same rashes that adults typically get—like contact dermatitis, eczema, hives, and ringworm—the following rashes are much more common in children.
Since viruses can cause rashes in kids, it’s important to call your pediatrician if your child has a rash with a fever or other bodywide symptoms. And always check about the correct dosage before giving any medication.
What causes a rash in children?
"Any virus can trigger a rash. Some classic ones are roseola (high fever for a few days followed by a rash of rose-colored papules), fifth disease (mild cold symptoms, fever, and bright red cheeks), and coxsackie (fever and small blisters on the hands, feet, and mouth). Sometimes after coxsackie, the nails shed 3–6 weeks later. This is known as onychomadesis. It looks scary, but it is not dangerous and the nails will grow back."—Dr. Lauren Levy
Types of rashes
Cradle cap (seborrheic dermatitis)
Cradle cap, or seborrheic dermatitis, is a rash that occurs on the scalp (and sometimes the face) of newborns and infants. It looks like red patches with a yellow crust and scales on top that can be rubbed or picked off easily. Cradle cap is caused by overactive oil glands or hormones that pass from parent to baby before birth. Another cause may be the overgrowth of a type of yeast called malassezia.
- Yellow crust or scales on red patches on the scalp, eyebrows, and behind the ears
Age range affected and how common: Cradle cap affects about 10% of infants [Source: UptoDate].
General duration, and when to see a doctor: A baby usually stops having cradle cap by the time they are one year old. You may be able to treat it at home by gently removing the crust with a baby toothbrush or baby oil. If that doesn’t work, discuss with your pediatrician, who may recommend an OTC or prescription antifungal shampoo.
Diaper rash is redness or irritation in the diaper area. It can be caused by moisture from urine or acidic bowel movements when a diaper is left on for too long. Sometimes there may be an overgrowth of yeast (candida) in the diaper area that causes the rash.
- Redness or chapped skin in the diaper area
- Small pus-filled bumps (if from yeast)
Age range affected and how common: Diaper rash can occur in any child who wears a diaper. Almost every child has irritation in the diaper area at some point.
General duration, and when to see a doctor: Diaper rash usually goes away 5 to 8 days after starting treatment with OTC diaper cream, such as zinc oxide or Triple Paste. Make sure to change the child’s diaper frequently to keep the skin as clean and dry as possible. See your pediatrician if the rash spreads down the legs or worsens, or your child has a fever.
How do you treat diaper rash?
"Some tips to prevent diaper rash: 1. Change the diaper frequently. 2. Use plain wipes with warm water. Some baby wipes have preservatives that can be irritating. 3. Apply a barrier cream with every diaper change. Aquaphor, Triple paste, or Desitin (zinc oxide) are my go-to favorites. 4. If your child has some mild irritation, give some diaper-free time between changes."—Dr. Levy
Impetigo is a contagious skin infection caused by the staphylococcus aureus bacteria. It looks like yellow crusting and may cause blisters. Impetigo can appear anywhere on the body, but it most often affects areas of exposed skin, such as around the nose and mouth or on the arms and legs.
- Yellow crusting on the skin
- Blisters that break open easily and leak clear fluid or pus
Age range affected and how common: Impetigo affects people of all ages, but is most common in children age 6 and under. Impetigo occurs in about 10% of children [Source: Medscape].
General duration, and when to see a doctor: If you think your child has impetigo, see your pediatrician as soon as you can. Your child may be prescribed topical antibacterial ointments or oral antibiotics, depending on the severity of the infection. It usually takes about 1 week to go away completely.
Fifth disease is a rash caused by the virus parvovirus B19. It causes flu-like symptoms and a “slapped cheek rash,” which looks like redness on both cheeks. Some children first have a rash on their cheeks and then get a lace-patterned rash on the arms and chest that may be itchy.
- Red cheeks
- Runny nose or sore throat
- Arthritis and swollen joints (more common in adults, especially women)
Common: Fifth disease is a common rash that occurs in children between the ages of 5 and 15. Adults can develop it as well.
General duration, and when to see a doctor: The rash will go away in about 10 days without any treatment. See a doctor if it’s causing severe joint pain.
Roseola causes a high fever and rash and is common in infants between 6 and 24 months of age. It is caused by human herpesvirus-6 (HHV-6). It starts with a high fever that lasts 3-5 days, usually without any other symptoms. When the fever goes away, small pink or red bumps develop on the chest, back, and stomach. The rash is usually not itchy and lasts for a few days.
Very common: Most children have roseola during their childhood.
General duration, and when to see a doctor: The rash lasts 7-10 days. Since it is not itchy, no treatment is necessary. You should see your doctor if your child’s fever does not respond to Children’s Tylenol or Motrin, they’re not eating well, or they become irritable.
Hand, foot, and mouth disease (coxsackie virus)
This rash is caused by the contagious coxsackie virus, which spreads through saliva, stool, and shared surfaces. The virus causes painful blisters on the lips, inside the mouth, and on the palms of hands and soles of feet. There may be blisters on the buttocks and other parts of the body as well.
- Painful blisters in the mouth
- Difficulty eating
- Blisters on the palms and soles
- Sore throat
Common: Hand, foot, and mouth disease is most common in children under 5 years old, but older children and adults can get it too.
General duration, and when to see a doctor: The rash usually disappears in about 10 days without treatment. Hand, foot, and mouth disease very rarely causes complications, so you see your pediatrician right away if your child experiences severe headaches or fevers that don’t go away after taking Children’s Tylenol or Advil.
A heat rash (prickly heat) develops when the sweat glands become blocked, leading to small red bumps on the back and chest. It often occurs in hot and humid weather and is common in newborns who are swaddled for most of the day. Heat rash may also develop when the body temperature rises, like from a fever.
Common: The most common type of heat rash, miliaria rubra, occurs in up to 30% of people [Source: UpToDate].
Other symptoms you may have:
Treatment and urgency: Heat rash disappears on its own and doesn’t need to be treated by a doctor. Wearing looser and lightweight clothing, applying cool compresses to the affected areas, and bringing down body temperature can help it go away faster. If the rash is still there, OTC topical steroids and a soothing anti-itch lotion (like Sarna) or OTC oral antihistamines can help with symptoms.
Can I send my kid to school with a rash?
"Always ask your doctor if the rash that your child has is contagious and when they can go back to school/day care."—Dr. Levy
What does a viral rash look like on a child?
A viral rash can look different depending on the virus. Usually it appears as pink or red bumps and flat patches on the chest, stomach, and back. The rash may travel to the face, arms, and legs, but is not as common there. It usually doesn't itch. The rash may develop a few days after a fever or cold symptoms go away, and can last another 7-10 days.
Can you use over-the-counter cortisone creams on children?
Yes, you can use over-the-counter cortisone creams on children. These creams are safe to use on the body and even the face for 7-10 days. If you do not notice an improvement in the rash after this time frame, you should see your pediatrician. Do not put topical steroids near the eye without instruction from your doctor.
When should I worry about a rash on my child?
Some rashes may be caused by a virus that may make your child feel sick in other ways. You should call your pediatrician if your child has a rash with a fever, which typically means there’s a viral infection. Call your pediatrician if your child is not eating or drinking or is acting extra tired and not doing any activities.
Also call the doctor if a rash causes pain, blisters on the skin, or if your child has severe headaches.