Rash in children: common causes, treatment and when it is an emergency

A rash is any change in the skin: small pink spots, welts, bumps, tiny blisters or dry, red patches. Rashes are very common in children and usually come from a virus, irritation or a mild allergy.

The best clues are how it looks, where it started, whether it itches and whether it came with a fever or other symptoms.

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The causes table on this page sums up the usual ones:

• Viral rashes: small pink spots on the body that come with a cold or other infection and fade on their own.
• Roseola: common between 6 months and 1 year. A high fever for a few days, then a rash appears as the fever drops.
• Hand, foot and mouth disease: fever, mouth sores and spots or small blisters on the hands and feet. See hand, foot and mouth disease.
• Chickenpox: a rash that turns into itchy blisters and then scabs, starting on the chest, back and face. It is usually milder in vaccinated children. See chickenpox.
• Eczema: dry, red, itchy skin, often in skin folds. See eczema and dermatitis.
• Diaper rash: red skin in the diaper area from moisture, stool or yeast.
• Impetigo: oozing sores that form a honey-colored crust. See impetigo.
• Molluscum contagiosum: small, firm bumps, skin-colored or pink, sometimes with a dip in the center; very common between ages 1 and 10 and usually gone on its own in six months to a year. See molluscum contagiosum.
• Insect bites and allergic hives.

Find a spot with good natural light, bring the camera close to the rash, then pull back so the doctor can see the whole area. For private areas such as the diaper area, the doctor will tell you what to show, and the parent or guardian is present the whole time.

Show the skin only during the video call; do not send photos of your child's skin by WhatsApp or email. See how to prepare your child for the visit.

Treatment depends on the cause: many viral rashes fade on their own, while others, such as eczema, impetigo or a yeast diaper rash, may need a cream or medicine the doctor prescribes if appropriate. If something needs to be confirmed with a test, you get a lab order for a lab near you.

Diaper rash: change the diaper often, as soon as your baby pees or poops, let the skin air-dry, and apply a zinc oxide or petroleum jelly product to clean, dry skin. Get it checked if it gets worse or does not improve in 2 to 3 days, spreads outside the diaper area, has blisters, sores or pus, or if your baby has a fever.

• Lukewarm baths with a mild soap; pat dry.
• Fragrance-free moisturizer for dry skin or eczema.
• Short nails so scratching does not break or infect the skin.
• Light, loose cotton clothes; leave the skin open to the air when you can.
• For fever or discomfort, acetaminophen or ibuprofen dosed by weight. Never give aspirin.

Press the side of a clear drinking glass firmly against the spots. For your child's safety, if you can still see the spots through the glass and they do not fade, and your child has a fever or seems unwell, go to the ER right away. Purple spots that look like bruises are a warning sign.

Call 911 if your child has hives with swollen lips, face or tongue, or is struggling to breathe or swallow. A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs the ER, rash or no rash; see fever in children. If a fever lasts 5 days or more, especially with red eyes, cracked lips or swollen hands and feet, have your child examined in person. A rash with fever, belly pain or bleeding gums can be dengue.

If the rash is yours, read skin rash. We see children and adults.