What’s That Rash?

A variety of skin rashes are quite common during childhood, and many can be cared for with over-the-counter medications while carefully observing your child at home. Here are answers to questions about some of the most common rashes to help guide you.
My child’s skin is suddenly covered in small red, raised patches that are itchy. What could have caused this?
Small red welts or swellings of the skin that are itchy, and move around to different areas of the body over a period of minutes or hours, could be hives (also called urticaria). This type of rash is an allergic reaction to eating certain foods or coming in contact with possible environmental allergens such as dogs, cats or grass. Hives may also develop while a child has a viral illness, such as a cold or upper respiratory infection. Usually, you can treat the rash’s itchy symptoms and swellings with over-the-counter antihistamine medications such as diphenhydramine (Benadryl) or cetirizine (Zyrtec). But if your child has any facial or lip swelling with the hives or is having difficulty breathing, seek urgent medical attention.
We used a new sunscreen yesterday, and my child now has a rash. Could he be allergic to the sunscreen?
If the rash is on the areas of skin where you used the sunscreen, he could be allergic to it. Contact allergy rashes are bumpy and pink, sometimes flaky and often itchy. This type of skin allergy may be caused by contact with certain sunscreen ingredients or fragrances or other chemicals in skin care products. Discontinue use of the product you think caused the allergy and apply an over-the-counter ointment that contains 1 percent hydrocortisone to the affected skin. Mild moisturizers such as Aquaphor and Vaseline can also be soothing.
If you were out hiking, the rash might also be an allergic reaction to poison oak resin.
If the rash starts spreading, becomes very uncomfortable, or the skin becomes open and raw and could get infected, contact your child’s doctor as you may need stronger medication.
My child is taking antibiotics for a bacterial infection and now has a rash. What should I do?
If your child develops a rash while he is taking antibiotics, you should take your child to the doctor. A rash caused by an allergic reaction to the medication usually consists of small red bumps that cover the whole body. Don’t delay seeking medical attention if the rash is on the lips or eyes and the skin looks cracked, raw or is bleeding.
My child has a runny nose and cough, and now a rash has appeared. Should I take her to the doctor?
There are many contagious viral infections that include a rash. These include Fifth disease, also known as slapped-cheek rash, and hand, foot and mouth disease. More serious diseases (such as measles) also include a rash. If your child has a mild rash with a viral illness and doesn’t have a high fever, watch her at home for a few days to see if the rash goes away by itself. If the rash is itchy or uncomfortable, use over-the-counter antihistamines or 1 percent hydrocortisone cream to help calm the skin. If your child has a rash and a high fever, especially if the fever has lasted for a day or two, call your child’s doctor for advice.
I received a notice from my child’s school that there has been an impetigo outbreak. What is this and should I be concerned?
Impetigo (also known as staph) is a common bacterial infection of the skin. The infected area of the skin looks very red, is warm and sometimes raw and crusty. One of the most common locations for impetigo is around the nose. You can first try an over-the-counter topical antibiotic ointment such as Bacitracin, Neosporin or a triple antibiotic product. If the rash spreads to other areas of the body and your child has a fever, take your child to the doctor.
My neighbor’s child has a skin infection called molluscum contagiosum. What is it?
This is a common viral skin infection that often affects young children, but adults can get it, too. The rash consists of small, individual, flesh-colored bumps that often have a central dimple. These bumps can appear anywhere on the body but are found especially where the skin is dry or where a child might have eczema. The rash is harmless but can take months and sometimes even years to go away. If the rash lasts longer than a few weeks and doesn’t seem to be going away on its own, it’s a good idea to go to the doctor to make sure this is the correct diagnosis and find out about possible treatment options.
Amy Gilliam, M.D., is a board-certified pediatrician, dermatologist and pediatric dermatologist at the Palo Alto Medical Foundation’s Palo Alto and San Carlos centers. Advice is not intended to take the place of an exam or diagnosis by a physician.