Childhood rashes: How to help identify them and tell if they're serious

It can be very worrying when a child gets a rash. Here experts outline what the more common rashes look like and when to seek urgent help

Serious rashes are rare in children, according to the British Skin Foundation, but parents should be vigilant and aware of the various types
Lisa Salmon (PA)

SEEING a rash on a child's skin can be very worrying for many parents, who often fear it could be a sign of a deadly disease like meningitis. Fortunately, such cases are not common, and consultant dermatologist and British Skin Foundation spokesperson Dr Anton Alexandroff reassures: "Most rashes in children aren't serious and parents shouldn't worry about them too much. Serious rashes are rare.''

But if the child is unwell or if there's swelling of lips, tongue or breathing problems, you should see a doctor urgently or go to A&E. And Dr Sweta Rai of the British Association of Dermatologists warns parents not try to diagnose rashes from internet pictures.

"There's such an array of potential causes, and similar types of rash, that even for a professional it is very hard to tell the difference between them without careful study and many years of experience,'' she says.

Here, midwife and nurse Jackie Hall of AXA PPP healthcare outlines some common childhood rashes:

1. Viral rashes

These cause tiny pinprick red spots on the chest, abdomen and limbs which disappear easily when pressed. They can accompany common cough/colds/sore throats/tummy bugs.

TREATMENT: Many viral infections resolve within a few days without treatment, but symptoms can be managed by encouraging fluid intake and taking paracetamol for pain relief and fever control. Always consult a doctor if you're worried about a rash and if spots are accompanied by other symptoms such as drowsiness, unresolving fever, a floppy body, confusion or difficulty awakening, severe headaches, very pale skin, seizures, shortness of breath, sharp chest pain that feels worse with breathing, or coughing up blood.

IS IT CONTAGIOUS? Yes. Although incubation periods vary between viruses, children are generally most infectious in the days prior to rash outbreak, continuing until a few days after the rash has emerged.

2. Meningitis

A rash is often one of the last signs of meningitis or septicaemia, so see a doctor if you're concerned even before you see a rash. A child with meningitis would normally be very unwell, with possible reddish/purple spots which may look like tiny fresh bruises. Dr Alexandroff says if the rash doesn't fade when the glass test is done – by pressing a clear glass against the skin – this is very serious and immediate medical attention is needed.

TREATMENT: Go to an A&E department immediately.

IS IT CONTAGIOUS? Bacterial meningitis can be contagious.

3. Slapped cheek syndrome

This is caused by parvovirus and it leads to a bright red rash on the cheeks, accompanied by slight fever. A child will feel moderately unwell.

TREATMENT: It should clear without specific treatment after a few days, and children should rest and drink plenty of fluids, as with other viruses. Pregnant women exposed to slapped cheek syndrome should see a GP.

IS IT CONTAGIOUS? The virus is contagious before a rash develops, but not once it's visible. Unless a child feels unwell, there's no need for them to stay off school once the rash has developed.

4. Chickenpox

A child will seem a little unwell for a few days, and then a few itchy red raised spots will appear on the neck, face, chest, back or other areas. These turn into little fluid-filled itchy and painful blisters.

TREATMENT: hickenpox is usually mild and most children feel better within a week or so, although some can become more seriously ill and need to see a doctor. It can be more serious in pregnant women and newborn babies. There's no cure but symptoms can be relieved by the same treatment as other viruses – ibuprofen shouldn't be given to children with chickenpox as it can make them very ill. Topical creams can be applied directly on to the rash to help reduce itching and soothe the skin, or children can take a suitable oral antihistamine.

IS IT CONTAGIOUS? Chickenpox is highly contagious and can make some people very ill, so it's important to try and avoid spreading it. Children can be infectious for several days before spots appear and for five days or more after, and they should stay away from nursery or school until all the blisters have dried and scabbed over, usually five or six days after the rash appears.

5. Measles

A mass of red spots break out around the neck and behind the ears and face, although they can appear elsewhere, including inside the mouth. Initial symptoms include a runny or blocked nose, sneezing, swollen eyelids, sore red watery eyes, fever, small greyish-white spots in the mouth, aches and pains, a cough, loss of appetite, tiredness and irritability.

TREATMENT: Contact your GP if you suspect your child has measles. There's no specific treatment and it usually improves within seven to 10 days. If the symptoms are causing discomfort, children should be treated as with other viral illnesses.

IS IT CONTAGIOUS? Children should stay away from school for at least four days from when the measles rash first appears. Avoid contact with vulnerable people such as young children and pregnant women. Children can avoid catching measles by having the measles, mumps and rubella (MMR) vaccine.

6. German measles (rubella)

This is usually a mild illness with small red spots appearing on the face and spreading to other parts of the body. Other symptoms include swollen glands and a cold-like illness. It's of serious concern if a pregnant woman catches it in early pregnancy as it can cause birth defects in the baby.

TREATMENT: Contact your GP if you suspect rubella. There's no specific treatment, and the condition usually improves within seven to 10 days. Symptoms can be eased in the same way as with other viruses.

IS IT CONTAGIOUS? Yes. It's important to reduce the risk of spreading the infection to others, so children should avoid school for four days from when the rash first develops.

7. Eczema

Dry /inflamed patches of skin typically form on creases of elbows and behind knees, but can occur anywhere on the body.

TREATMENT: Eczema normally responds well to the regular use of emollients or moisturisers. Steroids are useful in managing flare-ups but should only be used as prescribed by a health professional. Specific bath additives, shower gels or soap substitutes may also help.


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