Rash, Age 11 and Younger

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Rash, Age 11 and Younger

Topic Overview

Healthy skin is a barrier between the inside of the body and the
outside environment. A rash means some change has affected the skin. A rash is
generally a minor problem or is part of an illness that will go away on its
own. A rash may be caused by contact with a substance outside the body, such as
poison ivy (contact dermatitis), or by other more serious
illnesses, such as
measles or
scarlet fever (strep throat with rash).

Generalized rashes over the whole body that are caused
by viruses are more common in babies and young children than in adults. A rash
may be caused by a viral illness if the child also has a cold, a cough, or
diarrhea, or is in a day care setting where he or she is with other children
with viral illnesses. Most rashes caused by viruses are not serious and usually
go away over a few days to a week. Home treatment is often all that is needed
to treat these rashes.

After a child has had a rash caused by a
virus, his or her body generally builds an immunity to that virus. This
immunity protects the child from getting that specific viral illness and rash
again. Common rashes caused by viruses include:

  • Chickenpox (varicella). This rash is a
    common, contagious illness caused by a type of herpes virus.
  • Fifth disease. This facial rash looks like the cheeks
    have been slapped. It also causes a lacy, pink rash on the arms and legs,
    torso, and buttocks.
  • Roseola (roseola infantum). This rash
    occurs about 3 days after a high fever.
  • Unknown virus. Sometimes
    the specific virus that causes a rash is never known.

Localized rashes which affect one area of the body
have many different causes and may go away with home treatment. Common
localized rashes that occur during childhood include:

  • Diaper rash. This rash is caused by
    rubbing, moisture, chemicals, or bacteria in the baby's urine or stool;
    substances in disposable diapers; or soaps used to wash cloth
    diapers.
  • Impetigo. This bacterial skin infection is caused by
    strep or staph
    bacteria.
  • Heat rash (prickly heat). This rash often results from
    a well-meaning parent dressing his or her baby too warmly, but it can happen to
    any baby in very hot weather.
  • Cold sores.
    These are sometimes called fever blisters. Cold sores are clusters of small
    blisters on the lip and outer edge of the mouth caused by the herpes simplex
    virus.
  • Contact dermatitis. This rash is caused by contact
    with a substance, such as food, soap, or lotion, that causes an
    allergic reaction. Most contact dermatitis is mild and
    goes away when your child's skin no longer comes in contact with the
    substance.
  • Cradle cap. Cradle
    cap is an oily, yellow scaling or crusting on a baby's scalp. It is common in
    babies and is easily treated.
    Cradle cap is not a part of any illness and does not mean that a baby is not
    being well cared for.

Rashes that may require a visit to a doctor include:

  • Lyme disease, which is caused by a bacteria carried by deer ticks in some areas. A characteristic
    expanding red rash usually occurs at the site of the tick bite and is followed
    by flu-like symptoms, such as a headache, chills, fever, body aches, and
    stiffness.
  • A rash that looks
    like a sunburn and a fever of
    102°F (38.9°C) or higher. This type of rash may be
    caused by a rare condition called
    toxic shock syndrome.
  • A very rare and serious type of generalized red rash called toxic
    epidermal necrolysis (TEN). This type of rash may cause the skin to peel away, leaving large
    areas of tissue that weep or ooze fluid like a severe burn. TEN may occur after the use of some
    medicines.

To know how serious the rash
is, other symptoms that occur with the rash must be evaluated. Check your child's symptoms to decide if and when your child should see a
doctor.

Check Your Symptoms

Does your child have a rash?
Yes
Rash
No
Rash
How old are you?
Less than 3 months
Less than 3 months
3 months to less than 3 years
3 months to less than 3 years
3 to 11 years
3 to 11 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Does your child have a tick bite?
Yes
Tick bite
No
Tick bite
Has your child been bitten or stung by an insect or spider?
Yes
Insect or spider bite or sting
No
Insect or spider bite or sting
Does your baby seem sick?
A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.
Yes
Baby seems sick
No
Baby seems sick
How sick do you think your baby is?
Extremely sick
Baby is very sick (limp and not responsive)
Sick
Baby is sick (sleepier than usual, not eating or drinking like usual)
Does your child have symptoms of shock?
Yes
Signs of shock
No
Signs of shock
Could your child be having a severe allergic reaction?
This is more likely if your child has had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Does your child have symptoms of a serious illness?
Yes
Symptoms of serious illness
No
Symptoms of serious illness
Have tiny red or purple spots or bruises appeared suddenly?
Yes
Sudden appearance of red or purple spots or bruising
No
Sudden appearance of red or purple spots or bruising
Does your child have any abnormal bleeding?
Yes
Abnormal bleeding
No
Abnormal bleeding
Does your child feel lightheaded and dizzy, like he or she is going to faint?
It's normal for some people to feel a little lightheaded when they first stand up. But anything more than that may be serious.
Yes
Feels faint or lightheaded
No
Feels faint or lightheaded
Is your child bleeding now?
Yes
Abnormal bleeding now present
No
Abnormal bleeding now present
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Does your child have diabetes, a weakened immune system, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, or surgical hardware in affected area
No
Diabetes, immune problems, or surgical hardware in affected area
Do you think that the rash may have been caused by abuse or neglect?
Yes
Rash may be caused by abuse or neglect
No
Rash may be caused by abuse or neglect
Do you think your baby has a fever?
Yes
Fever
No
Fever
Did you take a rectal temperature?
Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.
Yes
Rectal temperature taken
No
Rectal temperature taken
Is it 100.4°F (38°C) or higher?
Yes
Temperature at least 100.4°F (38°C)
No
Temperature at least 100.4°F (38°C)
Do you think your child has a fever?
Yes
Fever
No
Fever
Did you take your child's temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long has your child had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
From 2 days to less than 1 week
Fever for more than 2 days and less than 1 week
1 week or longer
Fever for 1 week or more
Does your child have a rash that looks like a sunburn?
Yes
Sunburn-like rash
No
Sunburn-like rash
Does your child have a health problem or take medicine that weakens his or her immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Does the rash have blisters?
Yes
Rash has blisters
No
Rash has blisters
Does the rash cover:
A rash that covers most of the body is on both sides of the body and on most of the legs, arms, back, or belly. A rash in one area may be just one small patch. Or it may be two or three small patches that cover a small area.
Most of the body?
Rash is all over the body
Or is it in one area?
Rash is in one area of the body
Is the rash a red, peeling rash that leaves very large areas raw and oozing fluid?
Yes
Red, peeling rash with large areas that are raw and ooze fluid
No
Red, peeling rash with large areas that are raw and ooze fluid
Does your child have a sore throat?
Certain illnesses can cause a rash and a sore throat. Your child may need to be seen sooner if he or she has both.
Yes
Sore throat
No
Sore throat
Are there sores or a rash inside the mouth or nose or in the eyes?
Yes
Rash or sores in mouth, nose, or eyes
No
Rash or sores in mouth, nose, or eyes
Has your child had a sore on the skin for more than a week?
Yes
Sore on the skin for more than 1 week
No
Sore on the skin for more than 1 week
Does your child have a new rash in the shape of a band or a strip on just one side of the body?
Yes
New band-shaped rash on one side
No
New band-shaped rash on one side
Do you think that a medicine or a vaccine could be causing the rash?
Think about whether the rash appeared after you began using a new medicine or a higher dose of a medicine. Or did it start after you got a shot or vaccine?
Yes
Medicine may be causing rash
No
Medicine may be causing rash
Is the rash itchy?
Yes
Itchy rash
No
Itchy rash
Is the itching severe?
Severe means that you are scratching so hard that your skin is cut or bleeding.
Yes
Severe itching
No
Severe itching
Has the itching interfered with sleeping or normal activities for more than 2 days?
Yes
Itching has disrupted sleep or normal activities for more than 2 days
No
Itching has disrupted sleep or normal activities for more than 2 days
Does the rash hurt?
Yes
Painful rash
No
Painful rash
Does the rash produce a honey-colored drainage that dries into crusts and covers an area larger than 2 in. (5.1 cm)?
Yes
Honey-colored drainage that dries into crusts and covers more than 2 in. (5.1 cm)
No
Honey-colored drainage that dries into crusts and covers more than 2 in. (5.1 cm)
Has your child had a rash for more than 2 weeks?
Yes
Rash for more than 2 weeks
No
Rash for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

  • Your age. Babies and older
    adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
    disease, you may need to pay closer attention to certain symptoms and seek care
    sooner.
  • Medicines you take. Certain
    medicines, herbal remedies, and supplements can cause symptoms or make them
    worse.
  • Recent health events, such as surgery
    or injury. These kinds of events can cause symptoms afterwards or make them
    more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
    use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

  • Try home treatment to relieve the
    symptoms.
  • Call your doctor if symptoms get worse or you have any
    concerns (for example, if symptoms are not getting better as you would expect).
    You may need care sooner.

If you're not sure if a child's fever is high, moderate, or
mild, think about these issues:

With a high fever:

  • The child feels very hot.
  • It is likely
    one of the highest fevers the child has ever had.

With a moderate fever:

  • The child feels warm or hot.
  • You are
    sure the child has a fever.

With a mild fever:

  • The child may feel a little warm.
  • You
    think the child might have a fever, but you're not sure.

Abnormal bleeding means any heavy or
frequent bleeding or any bleeding that is not normal for you. Examples of
abnormal bleeding include:

  • Nosebleeds.
  • Vaginal bleeding that is
    different (heavier, more frequent, at a different time of month) than what you
    are used to.
  • Rectal bleeding and bloody stools.
  • Bloody
    or pink urine.
  • Gums that bleed easily when you eat or gently brush
    your teeth.

When you have abnormal bleeding in one area of your body, it's
important to think about whether you have been bleeding anywhere else. This can
be a symptom of a more serious health problem.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle
    cell disease, and congenital heart disease.
  • Steroid medicines,
    which are used to treat a variety of conditions.
  • Medicines taken
    after organ transplant.
  • Chemotherapy and radiation therapy for
    cancer.
  • Not having a spleen.

Symptoms of infection may
include:

  • Increased pain, swelling, warmth, or redness in or
    around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature.

Oral (by mouth), ear, or rectal temperature

  • High:
    104°F (40°C) and
    higher
  • Moderate:
    100.4°F (38°C) to
    103.9°F (39.9°C)
  • Mild:
    100.3°F (37.9°C) and
    lower

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate:
    99.4°F (37.4°C) to
    102.9°F (39.4°C)
  • Mild: 99.3°F (37.3°C) and lower

Note: For children under 5 years old, rectal temperatures are
the most accurate.

Symptoms of serious illness in a baby
may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn't respond at all to being held, touched, or talked
    to.
  • The baby is hard to wake up.

Symptoms of serious illness may
include:

  • A severe headache.
  • A stiff
    neck.
  • Mental changes, such as feeling confused or much less
    alert.
  • Extreme fatigue (to the point where it's hard for you to
    function).
  • Shaking chills.

Sudden tiny red or purple spots or
sudden bruising may be early symptoms of a serious
illness or bleeding problem. There are two types.

Petechiae (say "puh-TEE-kee-eye"):

  • Are tiny, flat red or purple spots in the skin or
    the lining of the mouth.
  • Do not turn white when you press on
    them.
  • Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
  • May spread over a large area of the body within a few hours.
  • Are different than tiny, flat red spots or birthmarks that are
    present all the time.

Purpura (say "PURR-pyuh-ruh" or “PURR-puh-ruhâ€):

  • Is sudden, severe bruising that occurs for no clear
    reason.
  • May be in one area or all over.
  • Is different
    than the bruising that happens after you bump into something.

Symptoms of a severe allergic reaction
(anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives)
    all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble
    breathing.
  • Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused,
    or restless.

A severe reaction can be life-threatening. If you have had a
bad allergic reaction to a substance before and are exposed to it again, treat
any symptoms as an emergency. Even if the symptoms are mild at first, they may
quickly become very severe.

A baby that is extremely sick:

  • May be limp and floppy like a rag
    doll.
  • May not respond at all to being held, touched, or talked
    to.
  • May be hard to wake up.

A baby that is sick (but not extremely
sick):

  • May be sleepier than usual.
  • May not eat
    or drink as much as usual.

Many prescription and nonprescription medicines can cause a
rash. A few common examples are:

  • Antibiotics.
  • Aspirin, ibuprofen (Advil,
    Motrin), and naproxen (Aleve).
  • Pain medicines, such as
    codeine.
  • Seizure medicines.

Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury.

Symptoms of shock in a child may include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard
    to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused.
    The child may not know where he or she is.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms
    and arrange for care.
  • If you cannot reach your doctor or you don't
    have one, seek care today.
  • If it is evening, watch the symptoms and
    seek care in the morning.
  • If the symptoms get worse, seek care
    sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and
    arrange for care.
  • If you cannot reach your doctor or you don't have
    one, seek care in the next hour.
  • You do not need to call an
    ambulance unless:

    • You cannot travel safely either by driving
      yourself or by having someone else drive you.
    • You are in an area
      where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

  • Make an appointment to see your doctor in the
    next 1 to 2 weeks.
  • If appropriate, try home treatment while you
    are waiting for the appointment.
  • If symptoms get worse or you have
    any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need
emergency care.

Call 911 or other emergency services now.

Rash, Age 12 and Older
Insect Bites and Stings and Spider Bites
Tick Bites

Home Treatment

Most rashes will go away without
medical treatment. Home treatment can often relieve pain and itching until the
rash goes away.

If your child has come in contact with a substance
that may cause
contact dermatitis, such as
poison ivy, immediately wash the area with large
amounts of water.

Once a rash has developed, leave it alone as much
as possible.

  • Use soap and water sparingly.
  • Leave
    the rash exposed to the air whenever possible.
  • Encourage your child
    not to scratch the rash.

If your child has a rash, he or she should not be in contact
with other children or pregnant women. Most viral rashes are contagious,
especially if a fever is present.

Relief from itching

Itching with a rash is generally
not serious, but it can be annoying and may make a rash more likely to become
infected. Rashes caused by
chickenpox,
eczema, or contact dermatitis are much more likely to
itch. Sometimes itching can get worse by scratching.

Home treatment
may help the itching.

  • Keep your child's fingernails clean and short,
    and encourage him or her not to scratch. Cover your baby's hands with socks to
    help keep him or her from scratching.
  • Keep your child out of the
    sun and in a cool place. Heat makes itching worse.
  • Keep the itchy
    area cool and wet if your child is older than age 9 months. Put cloths soaked
    in ice water on the rash a few times a day. Too much wetting and drying will
    dry the skin, which can increase itching. Do not put
    cloths soaked in ice water on the skin of a baby younger than 9 months. It may
    cause the baby's body temperature to go down.
  • Add a handful of oatmeal (ground to a powder) to your child's bath. Or you can try an oatmeal bath product, such as Aveeno.
  • Dress your child
    in cotton clothing. Do not use wool and synthetic fabrics next to the
    skin.
  • Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of
    Olay, and use as little soap as possible. Do not use deodorant soaps on your
    child.
  • Wash your child's clothes with a mild soap, such as
    CheerFree or Ecover, rather than a detergent. Rinse twice to remove all traces
    of the soap. Do not use strong detergents.
  • Do not let
    the skin become too dry, which can make itching worse.

Nonprescription medicines for itching

Carefully read
and follow all label directions on the medicine bottle or box.

  • Try calamine lotion for a rash caused by
    contact dermatitis, such as poison ivy or poison oak
    rashes.
  • For severe itching, apply
    hydrocortisone cream 4 times a day until the itch is gone.
    Note: Do not use the cream on children younger than age
    2 unless your doctor tells you to do so. Do not use in the rectal or vaginal
    area on children younger than age 12 unless your doctor tells you to do so.
  • Try an oral
    antihistamine to help the scratch-itch cycle. Examples
    include a non-drowsy one like loratadine (Claritin) or one that might make you sleepy like diphenhydramine (Benadryl). Oral antihistamines are helpful when itching and discomfort
    are preventing your child from doing normal activities, such as going to school
    or getting to sleep. Don't give antihistamines to your child unless you've
    checked with the doctor first.
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your child's fever or pain:

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these
safety tips when you use a nonprescription medicine:
  • Carefully read and follow all labels on
    the medicine bottle and box.
  • Give, but do not exceed, the maximum
    recommended doses.
  • Do not give your child a medicine if he or she
    has had an
    allergic reaction to it in the past.
  • Do not give aspirin to anyone younger than age 20 unless directed to do so
    by your child's doctor.
  • Do not give naproxen
    sodium (such as Aleve) to children younger than age 12 unless your child's
    doctor tells you to.

Symptoms to watch for during home treatment

Call your child's doctor if any of the following occur during home
treatment:

  • Other symptoms, such as a fever, feeling ill, or
    signs of infection, are severe or become worse.
  • A new rash lasts
    longer than 2 weeks.
  • Your child's
    symptoms become more severe or more frequent.

Prevention

Several childhood diseases that cause a
rash can be prevented through immunization. Immunizations help your child's
immune system recognize and quickly attack a virus
before it can cause a serious illness. Immunizations for chickenpox and for
measles, mumps, and rubella (MMR) can prevent these common rash-causing
illnesses.

Other tips for preventing
rashes include the following:

  • Dress your baby in as few clothes as possible
    during hot weather.
  • Do not bathe your child too often to prevent dry
    skin. Most children do not need daily bathing. Children with very dry skin may
    do better if they bathe once or twice a week.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your
doctor diagnose and treat your child's condition by being prepared to answer
the following questions:

  • What is the history of the rash, including:
    • When did the rash start?
    • Where
      did the rash start?
    • Has the rash spread?
    • Has the rash
      changed?
    • Has anything made the rash better or worse?
  • Has your child had this rash before? If yes:
    • What were the circumstances?
    • When
      did he or she last have it?
    • How was it treated?
    • How
      long did it last?
  • What other symptoms has your child had? Symptoms
    may include itching, burning, stinging, tingling, numbness, pain, tenderness to
    the touch, fever, cold symptoms, or diarrhea.
  • Has your child been
    exposed to a contagious illness, such as measles, rubella, mumps, or
    chickenpox?
  • Have you recently used a new food, medicine, or
    product, such as soaps, detergents, shampoos, lotions, fabrics, new toys, or
    other object?
  • Has your child been exposed to poisonous plants, such
    as poison ivy, oak, or sumac?
  • Has your child had other health
    problems during the past 3 months?
  • Has your child recently traveled
    to a rural area or to another country?
  • Does anyone in your
    immediate family have a skin disorder or an allergy?
  • What home
    treatment measures have you tried? Did they help?
  • What
    nonprescription medicines have you tried? Did they help?
  • Does your
    child have any
    health risks?

Credits

ByHealthwise StaffPrimary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical Reviewer Adam Husney, MD - Family Medicine

Current as ofJanuary 29, 2018

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