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27 November 2009
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New York boys

Rash

Dr Trisha Macnair

Viral infections are one of the most common causes of rashes in children.


What is a rash?

A rash is the appearance of spots or patches of a different colour or texture to the normal skin. Most children will have one during their childhood.

Symptoms

The spots may be any size, raised above the skin (called papules or plaques if large, or nodules if lumpy), filled with fluid (vesicles if tiny, blisters if larger) or pus (pustules).

Fever may indicate an infection and there may be other symptoms, such as a sore throat or vomiting, depending on the cause.

Many rashes are itchy, which can be distressing for a child.

Causes and risk factors

There are many causes of rashes in children, which vary depending on their age.

Viral infections are one of the most common - minor respiratory and gastrointestinal infections, chickenpox, measles, rubella, warts and molluscum contagiosum.

Bacterial causes include impetigo and meningococcus, which causes meningitis. The rash of meningococcal infection is a sign of serious illness that everyone should learn to recognise.

. It may start as a tiny rash that looks like small pin pricks. The marks do not fade if you press them. You can tell if they fade by pressing a glass on the rash and if you can still see the rash, it has not faded (or blanched). The rash may spread very quickly. The marks can quickly develop into large blotches that do not fade when pressed. They can be red, or a darker purply colour.

The scabies mite causes another familiar rash in childhood. Ringworm is a rash caused by a fungal infection, and the yeast candida can cause or complicate nappy rash.

Allergies, chemical irritants (urine in nappy rash, for example) and medicines, stings and insect bites may also be to blame. Occasionally, a rash is a sign of a more widespread illness.

The type of rash and how it spreads provides clues to the cause, although it can be difficult to diagnose a rash with complete certainty.

The measles rash, for example, consists of small flat red spots that often start behind the ears and spread down the body. Chickenpox causes crops of red spots that develop central fluid-filled vesicles before crusting over.

Allergic rashes may be accompanied by general signs, such as swelling of the face.

Treatment and recovery

Treatment depends on the cause of the rash.

You can treat itching with something that cools the skin, like a cold face cloth. Combination pain-relieving and antihistamine syrups may help - ask your pharmacist or doctor.

If you're not sure what's causing the rash or your child is generally unwell, see your GP.

If meningococcus could be the cause, or if your child has other worrying symptoms such as fever, headache, stiff neck or drowsiness, call for emergency advice.

This article was last medically reviewed by Dr Orlena Kerek in March 2009


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