Skin rashes in children

Skin rashes are common in children, and most of the time there's nothing to worry about.

Your child is unwell with a rash and:

• has a stiff neck
• is bothered by light
• seems confused
• has a high temperature
• has difficulty breathing (you may hear grunting noises or see their tummy sucking in under their ribs), is breathless, or is breathing very fast
• has a rash that looks like small bruises or bleeding under the skin and does not fade when you press a glass against it
• has skin, lips or tongue that look pale, blue, grey or blotchy

On brown and black skin, the rash or colour changes may be easier to see on the soles of the feet, palms, lips, tongue and inside the eyelids.

Cellulitis is an infection of the deeper layers of the skin and the tissue underneath. Bacteria usually cause it. They can get into the deeper layers when the skin is broken, by a cut for example.

It often affects the legs, but it can appear anywhere on the body. The affected area will be:

• red
• painful
• swollen
• hot

Children may also have a fever.

See a doctor immediately if an area of your child's skin suddenly turns red, hot and tender. If you can't see a doctor on the same day, go to a hospital emergency department.

Doctors can usually diagnose cellulitis by assessing the symptoms and examining the skin. It usually responds well to treatment with antibiotics.

Chickenpox is a viral illness that most children catch, and it's most likely to affect children under 10.

The main symptom is an itchy, spotty rash. It starts as red, itchy spots that turn into fluid-filled blisters. The blisters then crust over to form scabs, which eventually drop off. The rash can appear anywhere on the body. Some children only have a few spots, while others have them all over.

The blisters can be very itchy, and some may burst. After a while the scabs drop off.

There's no treatment for chickenpox. But you can get remedies from your pharmacy that help with the symptoms. These include:

• paracetamol to help bring down a fever
• calamine lotion and cooling gels to ease itching

The most common type of eczema is atopic eczema. It mostly affects children, but it can carry on into adulthood. Atopic eczema makes the skin itchy, red, dry and cracked.

Eczema is a long-term condition that causes the skin to become:

• itchy
• red
• dry
• cracked

Atopic eczema often develops on the:

• backs of the knees
• elbows
• neck
• eyes
• ears

Eczema isn't a serious condition. But if a child with eczema becomes infected with the herpes simplex virus, the eczema can flare up into an outbreak of tiny blisters. This is called eczema herpeticum, and it will cause a fever.

Creams and ointments can help with eczema symptoms like itching and redness.

If you think your child has eczema, speak to a doctor. They'll be able to tell you which treatment is most suitable.

Erythema multiforme is a skin rash. It's caused by an allergic reaction to the herpes simplex virus, and it's usually mild.

The rash usually appears on your hands and feet, then spreads to your tummy, chest, back or face. It might feel itchy or like it's burning.

Erythema multiforme causes spots that look like targets, with a dark red centre and a paler ring around the outside. The hands or feet are usually affected first, followed by the limbs, upper body and face.

Children may also have a fever and feel unwell.

In rare cases, erythema multiforme can be triggered by a reaction to certain medicines, including antibiotics or anticonvulsants. This more severe form is called Stevens-Johnson syndrome, and it can be life-threatening.

Speak to a doctor if your child has a rash and seems unwell.

Hand, foot and mouth disease is a common infection that spreads easily from person to person. Young children get it most often, particularly those under 10, but older children and adults can catch it too.

It causes ulcers in the mouth and spots on the hands and feet.

• mouth ulcers
• spots and blisters on the palms of the hands and soles of the feet

There's no cure for hand, foot and mouth disease. Your child's immune system will fight the virus, and it should clear up after about 7 to 10 days.

Hand, foot and mouth disease spreads easily, so your child must stay away from school or nursery until they're better.

Make sure children drink plenty of fluid. If eating and swallowing is uncomfortable, give them soft foods like mashed potatoes, yoghurt and soup.

Impetigo is a common skin infection, and it spreads very easily from person to person. The sores usually show up on the hands and face, especially around the nose and mouth. It causes sores and blisters.

There are 2 types:

• non-bullous
• bullous

Non-bullous impetigo usually affects the skin around the nose and mouth. The sores burst quickly and leave a yellow-brown crust.

Bullous impetigo typically affects the trunk (the area of the body between the waist and neck). It causes fluid-filled blisters, which burst after a few days and leave a yellow crust.

If a child has symptoms of impetigo, speak to a doctor or pharmacist. The child will usually be prescribed an antibiotic cream or tablets, and this should shorten the illness to around 7 to 10 days.

The infection isn't usually serious and often improves within a week of treatment.

Hives is a common skin reaction, and it often affects children. You may also hear it called urticaria, weals, welts or nettle rash. The rash can show up as small, circular patches of raised skin.

Hives is raised and itchy. It can affect one part of the body, or it can spread across large areas.

It starts when a trigger causes high levels of histamine and other chemicals to be released in the skin. These substances make the blood vessels in the skin open up, and that leads to:

• redness or pinkness
• swelling
• itchiness

There are many possible triggers of hives, including:

• allergens, like food or latex
• irritants, like nettles or medicines
• physical factors, like heat or exercise

Sometimes no cause for the hives can be found.

A hives rash is usually short-lived and mild. Antihistamines can often bring it under control.

Keratosis pilaris is a common and harmless skin condition. It causes small, painless bumps on your skin.

It usually begins in childhood and gets worse during puberty. Some people find it improves after this, and it may even disappear in adulthood.

Keratosis pilaris makes the skin on the back of the upper arms rough and bumpy, as if it's covered in permanent goose pimples. Sometimes other areas of the body can be affected too, like the:

• buttocks
• thighs
• forearms
• upper back

There's no cure for keratosis pilaris. It often gets better on its own without treatment. But there are some things you can do that may improve a child's rash.

You could use:

• non-soap cleansers rather than soap
• an emollient to moisturise the skin

Your doctor or pharmacist will be able to recommend a suitable cream.

Measles is a highly infectious illness that most often affects young children. It's now rare in the UK because the measles, mumps and rubella (MMR) vaccine works so well.

The spots of the measles rash are sometimes raised, and they can join together to form blotchy patches. They're not usually itchy.

The rash is made up of red-brown blotches. It usually starts on the head or upper neck and then spreads outwards to the rest of the body. A child may also have a fever and cold-like symptoms.

Phone your doctor immediately if you think a child has measles. It's best to phone before you go, because the clinic may need to make special arrangements. This will help to reduce the risk of the infection spreading to others.

Measles usually passes in about 7 to 10 days without causing further problems.

Paracetamol or ibuprofen can be used to relieve fever, aches and pains. Children must also drink plenty of water to avoid dehydration.

Molluscum contagiosum is a viral skin infection. It often affects young children aged between 1 to 5, and they usually catch it after close physical contact with another infected child.

Most adults are resistant to the virus. This means they're unlikely to catch it, even if they come into contact with it.

The rash causes spots that are about 2 to 5 mm wide. They're raised and dome-shaped, with a shiny white dimple in the centre. Molluscum contagiosum causes clusters of small, firm, raised spots on the skin.

The condition is usually painless, although some children may feel some itchiness.

It usually goes away within 18 months without the need for treatment.

Pityriasis rosea is a fairly common skin condition. Most cases happen in older children and young adults, aged between 10 and 35.

The rash is usually ring-shaped. It can grow or spread, and you may see more than one patch. It appears as raised, red, scaly patches that don't last forever, but they can be very itchy.

In most cases, pityriasis rosea clears up without treatment. It usually takes 2 to 12 weeks to go, though in rare cases it can last up to 5 months.

Emollients, steroid creams and antihistamines can be used to help relieve the itch.

The rash doesn't usually leave scars, but the skin can sometimes be discoloured afterwards.

Prickly heat, also called heat rash or miliaria, happens when the sweat ducts in the outer layer of the skin (the epidermis) get blocked.

The rash is itchy and made up of small, raised red spots, each about 2 to 4 mm wide. Some of them may be filled with fluid. It gives a stinging or prickly feeling on the skin.

You can get heat rash anywhere on the body, but it often shows up on the:

• face
• neck
• back
• chest
• thighs

Infants can sometimes get prickly heat if they sweat more than usual, for example when the weather is hot and humid or when they're overdressed.

Heat rash isn't a serious condition and rarely needs any specific treatment.

Psoriasis is a long-lasting (chronic) skin condition. It causes areas of red, flaky and crusty skin.

The patches are covered with silvery scales. How bad the condition gets varies from person to person.

There's no cure for psoriasis, but there are treatments that help improve the symptoms and the look of the skin patches. These include topical corticosteroids, such as creams and ointments.

Ringworm is a fungal skin infection, and it spreads easily from one person to another. It can cause a ring-shaped rash that's red or silvery.

The patch can be scaly, inflamed or itchy. It often shows up on the arms and legs, but it can appear almost anywhere on the body.

Similar fungal infections can affect the scalp, feet, groin and nails.

Ringworm can usually be treated easily with antifungal medicines, which you can get from a pharmacy.

When ringworm affects the scalp, it can cause scaling and patches of hair loss. This type is treated with antifungal tablets, often together with an antifungal shampoo.

Scabies is a contagious skin condition caused by tiny mites that burrow into the skin.

In children, it usually spreads through long periods of skin-to-skin contact with an infected adult or child, for example during play fighting or hugging.

A scabies rash can appear anywhere, but it's common between the fingers. The mites leave small, red blotches, and these are often found on the palms of the hands or the soles of the feet. In infants, blisters are often found on the soles of the feet. The rash can be very itchy.

If you think your child has scabies, see a doctor. It's not usually a serious condition, but it does need to be treated. The doctor will prescribe a lotion or cream.

Scarlet fever is a highly contagious bacterial infection. It usually affects children between 2 and 8.

The illness causes a distinctive rough pink-red rash. It feels like sandpaper when you touch it, and it may be itchy.

Scarlet fever often starts with a sore throat, fever and headache. The rash then develops 2 to 5 days after infection. You will usually see it first on the chest and stomach, and then it spreads to other parts of the body, like the ears and neck.

Speak to a doctor if you think a child has scarlet fever.

Antibiotics are used to treat it, and it usually clears up after about a week.

Slapped cheek syndrome is a viral infection that's common in children aged 6 to 10. You may also hear it called fifth disease or parvovirus B19. It can cause a red rash on one or both cheeks.

The infection causes a distinctive bright red rash on both cheeks. This can look alarming, but it usually clears up by itself in 1 to 3 weeks.

Unless your child is feeling unwell, they don't need to stay away from school. Once the rash appears, the infection is no longer contagious. Still, it's a good idea to tell your child's school about it.