When to Worry About a Rash on a Child

Rashes pop up on kids frequently. While most are perfectly harmless and go away on their own, they can cause parents to worry. From a diaper rash to a true allergic reaction, there’s more than a handful of reasons a rash might appear on your child’s skin. Taylor Dalsing, DO, UnityPoint Health, explores both common and more serious childhood rashes, their causes and how to treat them.

What Does a Rash Look Like?

There are many types of rashes. Some have a classic appearance, making them easier to diagnose. Other rashes are more difficult to identify. Rashes can look like:

Red dots on the skin
Blisters or bumps
Hive or welts
Scaly or flaky
Skin redness

“Some rashes affect the entire body and others appear only on certain parts of the skin, like a rash on the hands, feet, neck or diaper area. Pediatricians are well-versed on this topic, so see your child’s doctor if you’re worried. They’ll ask about your child’s medical history and symptoms to try and figure out the cause,” Dalsing says.

What Causes Skin Rashes?

In children, there’s a variety of skin rash causes — from infections, irritations, heat, medications and more. Here are some different causes of rashes in babies and kids.

Skin Irritation Rash

Cause: Irritation, or “contact dermatitis,” is a very common cause of rashes in children of all ages. For example, many babies get a rash on the neck due to saliva and the moist environment their neck crinkles create. Older children get a rash when they use soap or perfume that irritates their skin. Poison oak, poison ivy and other plants are also common causes of summertime rashes.

Appearance: A rash due to skin irritation might have red bumps, patches or irritated skin.

Treatment: Clean the area with a gentle soap, patting it dry. Apply Vaseline to the area to act as a barrier against the irritant.

Eczema

Cause: Eczema is another name for “atopic dermatitis,” a rash caused by inflammation of the skin. It’s common in babies and children, especially kids who have asthma and allergies. Environmental and genetic factors break down the barrier of the skin.

Appearance: An eczema rash looks like dry, red patches on the skin.

Treatment: Keep your child’s skin moisturized and clean to prevent eczema breakouts, as they're worse in dry skin. Mild rashes can be treated with Vaseline. If eczema becomes severe, your doctor may prescribe a steroid cream.

Diaper Rash

Cause: A diaper rash is extremely common in children and is caused by irritation of the skin due to moisture.

Appearance: A diaper rash looks like red or pink blotches in the diaper area but can appear differently in children.

Treatment: To make a diaper rash go away, gently clean and air out the area. Avoid harsh soaps or baby wipes. Use a barrier cream, like zinc oxide or petroleum jelly, to protect the skin.

“Without treatment, a diaper rash can develop into a yeast infection, which looks like a beefy, bright red rash in the diaper area. Caregivers need an antifungal medication prescribed by their child’s doctor to treat it,” Dalsing says.

Rashes from Medications

Cause: Rashes from medications can be due to a side effect or allergic reaction. For example, antibiotics like amoxicillin can cause a rash in some people. An amoxicillin rash can be mild and goes away on its own. They're not always due to allergic reactions.

Appearance: Rashes due to an allergic reaction to a medication commonly create hives.

Dalsing says a full body rash can occur when a child has a virus and is also put on amoxicillin. An amoxicillin rash can have raised, itchy, red or pink bumps. It usually lasts about five or six days into the medication course.

“It can be more of a side effect of having a virus while also being on amoxicillin, as opposed to an allergy,“ Dalsing says.

Treatment: If you experience a rash while taking amoxicillin, talk to your doctor. Your provider can help determine if it’s a side effect of the medication, or if you’re allergic.

Heat Rash

Cause: Heat rash is caused by irritated sweat glands in hot and humid environments.

Appearance: A heat rash looks like little red bumps on the skin. It’s often located in folds of the skin on children, such as the armpits, in the diaper area or certain parts of the neck. In older children and adults, heat rash can appear all over the body — wherever there are sweat glands.

Heat rash is also itchy. It can last however long a child is in the heat or may take a couple days to disappear.

Treatment: “To treat a heat rash, clean the area with cold water and pat and dry moisture in the skin folds,” Dalsing says.

Strep Rash

Cause: Strep can cause a rash due to a bacterial infection.

Appearance: Dalsing says “This rash is usually referred to as scarlet fever. A strep rash looks like tiny, pink or skin-colored dots over the entire body.”

Other symptoms: A sore throat, fever, body aches, nausea or vomiting and painful swallowing are common in strep.

Treatment: A strep rash can be treated with antibiotics.

Chlorine Rash

Cause: Chlorine rash is a type of contact dermatitis caused by exposure to chlorine, like what’s in a swimming pool or hot tub.

Appearance: A chlorine rash looks like redness, dryness, scaling or blisters on the skin. It may itch, too. A chlorine rash lasts a few days or week.

Treatment: It resolves on its own. However, you can relieve symptoms from a chlorine rash by staying out of swimming pools or hot tubs for a while, applying a cool compress to the affected area, using an over-the-counter hydrocortisone cream or taking an antihistamine. If the rash persists, see your child’s doctor. Sometimes, hair follicles can get infected with a bacteria and require antibiotics.

Roseola Rash

Cause: A roseola rash is caused by a virus.

Appearance: A roseola rash lasts for a few days. It occurs in young children, usually six months to three years old. “Kids will break out in kind of a pink, fine rash on their chest, tummy, which then spreads to the arms, legs and, sometimes, the face,” Dalsing says.

Other symptoms: Symptoms start with a high fever.

Treatment: Roseola goes away on its own. Caregivers should focus on keeping their child comfortable.

Fifth’s Disease (Parvovirus) Rash

Cause: Fifth’s disease rash is caused by a virus.

Appearance: A parvovirus rash looks bright, red and lacy. The parvovirus rash starts on the cheeks and moves down the body.

Other symptoms: A high fever follows a Fifth’s disease rash, along with symptoms such as fatigue, joint pain, headache and loss of appetite. It’s most common in school-age kids.

Treatment: Dalsing says, “Because Fifth’s disease is a virus, we don’t treat it with antibiotics. Bringing down any fevers with at-home remedies is a good idea, but the virus resolves on its own in a few days.”

Ensure your child gets plenty of rest, fluids and over-the-counter pain relievers (if needed), clean the rash and apply cold compresses to help reduce fevers and discourage scratching.

Herpes Rash

Cause: A herpes rash can be transmitted to a newborn during childbirth or pregnancy if the mother has an active herpes infection when she delivers. While not all newborns exposed to herpes develop a rash, it’s possible.

Appearance: A herpes rash looks like little blisters filled with clear or yellow fluid. A herpes rash can appear as cold sores or blisters around the mouth. In severe cases, it’s widespread on the body.

Treatment: Dalsing says, “You need to see a doctor for this type of rash, especially when it appears in newborns or young babies. It can lead to severe complications, such as meningitis or encephalitis (inflammation in the brain).”

Purpura & Petechiae Rash

Cause: A purpura or petechiae rash is caused by bleeding under the skin due to several factors:

Viral or bacterial infections
Medications
Platelet disorder
Inflammation in the blood vessels (vasculitis)
Trauma or injury
Blood disorders or cancer

Appearance: Purpura rashes look like reddish-purple splotches under the skin. Small, pinpoint-sized purpura are called petechiae. If you press your finger on the spot with firm pressure, they won’t go away for any amount of time.

Other symptoms: Dalsing says petechiae are a reason to worry. They appear with certain infections, such as meningitis, or an indication that platelets — the clotting cells in your blood — are low.

Treatment: Call your child’s doctor or go to the emergency room if you see a rash that looks like purpura or petechiae.

Lupus Rash

Cause: Lupus is a rare cause of a rash in children. It’s an autoimmune disease that affects the body’s connective tissue and causes a rash.

Appearance: A rash from lupus looks like red patches on the cheeks and nose. Since it appears in the shape of a butterfly, it's commonly referred to as “butterfly rash.”

“Children with lupus typically have other symptoms, like fatigue, joint pain or weight loss. So, this isn’t something we think of right away when we see a cheek rash,” Dalsing says.

Treatment: Treating a lupus rash depends on the type of lupus and how severe the rash is. Treatment may include topical creams to help reduce inflammation and itching, oral or injected corticosteroids to help control the immune system, moisturizers and more.

Hives vs Rash

Hives are a type of rash. They’re usually itchy and look like raised, pink or red bumps or welts on the skin. Some have a pale center. Hives easily travel to different spots on the body.

“One minute, they’re on the upper arm, and a few minutes later, they may be on the lower arm. Hives can be large or small, appearing as big welts or tiny red spots on the skin,” Dalsing says.

A true allergic reaction typically produces hives. Dalsing says, “If it’s a severe reaction, like anaphylaxis, that’s when you see other symptoms — like difficulty breathing, mouth swelling, vomiting, diarrhea and fainting.”

Not all skin reactions mean you’re allergic though. Your skin may be irritated from coming into contact with lotion, perfume, sweat, laundry detergent, etc. Skin irritation, or dermatitis, looks more like red bumps or red blotches on the skin that may or may not be itchy.

Dermatitis is the name for inflammation of the skin. It has a lot of different causes, but irritation is the most common.

While hives are mostly associated with allergic reactions, Dalsing says they have a handful of triggers:

Certain medications
Cold environments
Heat
Sunlight
Viral infection

“When hives are caused by a virus, they can last up to a couple of weeks. If they’re caused by allergy reaction, it’s important to notice if your child has any signs of a severe reaction, like mouth swelling, wheezing, trouble breathing, vomiting, diarrhea or lightheadedness. In this case, it’s an emergency, and you need to call 911,” she says.

However, if a child has mild hives without other symptoms, it’s OK to keep an eye on them at home.

How to Get Rid of a Rash Quickly

Dalsing says most rashes in children are mild, don’t require treatment and resolve on their own. Getting rid of a rash overnight may not be feasible, but watching and waiting is usually the best course of action.

“They may not go away quickly, but a lot of times, we don’t need to give medications or ointments for rashes, especially if they aren’t bothering your child.”

It’s why Dalsing doesn’t recommend home remedies to treat rashes in children. She says few are proven to make the rash go away sooner.

“When I have parents who want to use something for their child’s rash, I recommend gentle things like Aquaphor or Vaseline,” she says.

In some cases, though, how to treat a rash depends on your symptoms and the underlying cause, such as:

If the rash is itchy, your doctor may prescribe anti-itch medication, like an antihistamine.
Contact, or irritant, dermatitis is sometimes treated using steroid creams.
Infectious rashes, like a strep rash, need to be treated with antibiotics.