When to worry about rash on toddler

A rash is an area of irritated or swollen skin. It causes changes in the color, feeling or texture of the skin. Often, the cause of a rash can be determined from how it looks and its symptoms. In some cases, skin testing, such as a biopsy, may also be used to help with diagnosis. Other times, the cause of the rash remains unknown.

Rashes are very common in children. According to the American Academy of Family Physicians, there are more than 12 million office visits annually for rashes and other skin concerns in children and adolescents, of which 68% are made to primary care physicians. Most of them the rashes are harmless and resolve on their own without any problems. It is however important to be observant to be able to identify potentially dangerous rashes in toddlers.

What are the causes of rashes in children?

There are several causes of rashes in children. Apart from dermatitis, most of these causes are contagious and can be spread from one child to another. Viral rashes are notorious for being very contagious.

Dermatitis. This is an umbrella term for any condition that causes skin inflammation. These conditions may cause red rashes, itchiness and dry skin on a child and happen at any age. The types of dermatitis include: diaper rash, cradle cap, eczema (also called atopic dermatitis) and contact dermatitis. The rashes due to dermatitis are often red, dry, itchy patches on the skin. The itching may be severe and constant. With frequent scratching, the skin may develop blisters, oozing, crusting, or sores from infection. the location of the rash may help to differentiate the type of dermatitis. A rash on the diaper area is most likely a diaper rash, while on the scalp may be a cradle cap. Rashes on the face, elbows, back of knees may be due to eczema, while rashes that occur after contact with irritants like soaps, perfumes, or necklaces may be due to contact dermatitis.

Viral rashes.  Viruses can also cause rashes in children. They are often called a viral exanthem. Immunizations has greatly reduced the number of children who have viral exanthems. These infections include fifth disease, roseola, chickenpox, measles, rubella, molluscum contagiosum and hand, foot and mouth disease. Infection with these viruses tend to resolve on their own, but they should still be checked out by a doctor.

The different viral exanthems have distinct characteristics of the rashes. A deep, red, flat rash that starts as small distinct lesions which then combine to form a big rash on the face and spreads down to the trunk, arms, and legs is most likely measles. It usually begins to clear after 3 to 4 days, leaving a brownish discoloration and skin peeling.

Rashes that occur with high fever which are a pinkish, with either flat or raised lesions that start to appear on the trunk and then spreads to the face, arms, and legs maybe due to roseola.

Fifth disease causes a rash during spring of winter. The rash often occurs without fever. It usually starts from the cheeks and is bright red, giving a slapped cheek appearance.  It spreads to the trunk, arms, and legs, and lasts two to four days.

Extremely itchy rash on the trunk, face, under the armpits, on the upper arms and legs, and inside the mouth which may become fluid filled and scab after some days, leaving a scar in some cases is characteristic of chicken pox.

Molluscum contagiosum is another virus that can cause rashes. It causes raised bumps on the toddler’s skin. The bumps are usually flesh-colored, pink or pearly white with indentations in the center. The bumps will show up on the face, chest, stomach, arms and legs. They are painless but they may not go away for several months or years.

Bacteria. Bacteria can also cause rashes. The commonest ones are scarlet fever and impetigo.

Scarlet fever causes a raised, red rash on the neck and upper chest. The rash may then spread to other areas of the body.  The face may be red with a pale area left around their mouth. The rash feels rough like sandpaper and may look like the child has a sunburn. 

 Impetigo on the other hand, causes red bumps, blisters or crusty spots which are most common around the toddler’s mouth and nose and can also be anywhere that skin gets repeatedly irritated. 

Fungus. The common cause of rash in a child due to fungus is ringworm. It causes round or oval patches to develop on the child’s skin. The patches have smooth centers and red, scaly borders and may not look like rings right away till they get bigger. The patches may be itchy and painful and may become puffy and inflamed. 

When to worry about rash on toddler

Even though most rashes on toddlers resolve on their own, it is always a good idea to bring them to the pediatrician to check out. However, associated symptoms are often the main reasons to worry about a rash. Rashes that occur with high fever, weakness, loss of appetite, vomiting, diarrhea, and weight loss should certainly be checked out. Also, if the rashes are rapidly expanding, becoming filled with fluid and pus, become extremely itchy and making the child very irritable, the rash should definitely be checked out.

Contagious rashes like those spreading from one child to the other should also be checked out by the doctor for prompt diagnosis and treatment and to avoid infecting more children.