Children can get many different types of rashes, and most don’t need to be seen in our office. The best place to go to read about your child’s rash is AskDrSears.com – search rash and read our article on “Common Rashes.” You will likely find your child’s rash among the 15 common rashes we describe in this article, along with guidelines on home treatment and when to be seen by us.

  • The main rash emergency is Petechiae. Any child with a petechiae rash should be seen. These are small red spots on the skin that don’t disappear (don’t blanch) when you stretch the skin around them. There usually would be several dozen on an area of the body. They look as if someone wrote small red dots on the skin with a permanent red felt tip pen. If you stretch the skin around the spot (pulling in two opposite directions away from the spot) and the spot disappears, then these are NOT petechiae and likely not an emergency. Petechiae spots will stay visible even when you stretch the skin. If they are on the face or neck, they are likely just burst capillaries in the skin from the pressure of coughing or vomiting and likely not an emergency. If your child has fever and petechiae anywhere else on the body, it’s possibly a bleeding disorder or serious bacterial infection and you should call us to be seen if during the day or go to an ER if after hours.

  • Hives can be another type of urgent rash as part of an allergic reaction, but these can often just be treated at home and don’t need to be seen (unless a severe allergic reaction is progressing). Don’t panic if hives are on the head, neck, or chest. Our hives page on AskDrSears.com will give you guidance on how to track down the cause (often simply part of a viral illness, or possibly a food allergy) and gives you a dosing chart for Benadryl if you child is uncomfortable. See us if hives keep coming back for a few days.

  • Viral rashes. Rashes with fevers or cold symptoms are usually just part of the viral illness and not a reason to panic. Check out our rash page on AskDrSears.com to track down the culprit. Fever with blisters on the hands, feet, around the mouth, and canker sores inside the mouth are likely hand/foot/mouth disease (see above under Fevers). 

  • Ringworm. This harmless rash is caused by a mild fungus (not a worm). This is probably the most common rash we get sent pictures of. It’s very hard to distinguish between ringworm and round eczema patches, but in general ringworm patches are rings that are clear in the middle and eczema patches are not clear in the middle. You do not need to ask us for help with this rash unless you just want to make an appointment for us to take a closer in-person look. We rarely can tell just by pictures, so sending us pictures isn’t necessary. You can simply try treating the ring rash with an OTC clotrimazole 1% cream twice daily. It takes a few weeks to work. If you think it is an eczema patch, OTC hydrocortisone 1% cream twice daily works within a few days or sooner. Even if you put on the wrong cream, it won’t hurt the rash. If one treatment doesn’t work, try the others. If it persists, THEN see us for an in-person appointment or go to a dermatologist. 

  • Impetigo. This is a bacterial skin infection. It usually resolves with OTC treatments. It looks like clusters of red pimples and may have a honey-colored crusty ooze on them. It usually occurs on the face, under the nose, and around the mouth. You can search online for pictures to see if your child’s rash matches this. Here is a very detailed page on AskDrSears.com that you can use to guide you through treatment. If your child doesn’t respond to the washing, diluted peroxide, and OTC antibiotic ointment, you can try the diluted betadine as suggested, or wash once daily with OTC Hibicleanse liquid soap (from any drugstore). If it still worsens, call our office for a prescription of mupirocin antibiotic ointment (message appt, phone appt or in-person appt). 

  • Baby Acne. This nuisance rash hits virtually every baby when they are around 2 weeks old. It peaks around 4 to 6 weeks of age then goes away by 2 or 3 months. No one really knows the cause or how to prevent it from happening. The main remedy is to dab breast milk on the rash a few days daily to reduce the inflammation. It’s likely NOT related to food allergies. 

  • Drool rashes. These are an inevitable part of teething drool and messy eating. Expect these red areas to come and go for many months until teething subsides and eating becomes more neat. You can try applying lanolin (Lansinoh) ointment to the face or chin. For the redness in the neck folds, open the area twice daily, dab it clean with a warm washcloth, blow it dry, then apply any clear diaper ointment.
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