Skin Rashes

Rashes are common in pediatrics and have a variety of causes. Breaking down rashes into two main categories helps determine the type of rash and if any treatment or observation is recommended.

The additional information your pediatrician may review when evaluating a rash includes your child’s medical history, current medications, vaccination record, and any additional pertinent information such as recent travel.

Types of rashes

The two main categories of rashes are:

1. Localized rashes
   Typically located in one area of the body due to direct contact with the skin. Common examples of a localized rash include an irritant diaper rash, chemical rash, localized insect bite, or allergen exposure to the skin.
2. Widespread rashes
   Can be present over large parts of the body, such as the front and back of the chest, arms and legs, or hands and feet.

When to call your doctor

Widespread rashes should be evaluated by your child’s doctor.

For children with a widespread rash, additional symptoms that may indicate serious illness can include:

• Ill-appearing child with a fever
• Blisters of the skin
• A rash that appears as red dots or larger purple dots that do not fade when pushed on

These symptoms require prompt medical evaluation.

Common causes

Widespread rashes can be caused by viruses, reactions to prescription medications, an allergic reaction, strep bacteria, or bacteria from other sources such as hot tubs or insect bites.

Viral rashes

Rashes caused by viruses are common in children. Examples of viral rashes include hand, foot, and mouth disease; roseola; and chickenpox.

Many viral rashes have recognizable patterns that help the pediatrician determine if any treatment is needed, how long the rash will be present, and when the child may go back to school or daycare.

Antibiotic reactions

Parents often have questions when a rash appears after their child started taking an oral antibiotic for a bacterial ear infection, but also has a virus, such as an upper respiratory illness, at the same time.

In this situation, your child will be evaluated by your pediatrician to determine if the rash is consistent with a possible reaction to the antibiotic or if it is likely caused by the viral illness instead. This evaluation of the rash will help the pediatrician choose the most appropriate treatment for your child.

Eczema

Another type of skin rash common in children is eczema, an ongoing condition that can cause itchy, dry, red skin due to a problem with the skin barrier. Eczema can be localized or can involve multiple areas including the creases of the skin. The focus of treatment for eczema is keeping the skin moisturized, reducing inflammation and itching, and reducing the risk of infection.

A helpful tool for finding additional information is available on the Symptom Checker at healthychildren.org, by the American Academy of Pediatrics. This Symptom Checker can provide useful information until your pediatrician is able to evaluate the rash.