Rashes in babies and children

Rashes in Babies and Children

Skin rashes are very common in babies and children. They can be caused by infections, allergies, irritants, or underlying medical conditions. Most rashes are mild and temporary, but some may indicate serious illness requiring urgent medical attention.

---

Common Causes of Rashes in Babies and Children

1. Viral Infections

   • Measles, rubella, chickenpox, roseola, hand-foot-and-mouth disease, and viral exanthems.

   • Typically associated with fever, cough, runny nose, or sore throat.

2. Bacterial Infections

   • Scarlet fever (caused by group A streptococcus).

   • Impetigo (golden-crusted patches around the mouth, nose, or limbs).

3. Allergic Reactions

   • Food allergies, medications, insect bites, or exposure to chemicals (soaps, detergents).

   • Often present with hives (raised, itchy welts).

4. Irritant Rashes

   • Nappy rash: due to prolonged contact with urine or stool.

   • Heat rash (prickly heat): tiny red spots on skin folds or areas covered by clothing.

5. Chronic Conditions

   • Eczema (atopic dermatitis): dry, itchy, inflamed patches.

   • Psoriasis: thick, scaly patches (less common in children).

---

Symptoms to Watch For

• Mild rashes: flat or raised spots, redness, sometimes itchy but not severe.

• Warning signs (seek urgent medical help):

  • Purple or bruise-like spots that don’t fade when pressed (possible meningitis).

  • Rash with high fever, stiff neck, or sensitivity to light.

  • Blisters, oozing, or rapidly spreading rash.

  • Severe swelling of lips, eyes, or face (possible allergic reaction).

---

Treatment and Management

• Viral rashes: Usually self-limiting; supportive care with fluids, rest, and fever control (paracetamol or ibuprofen if needed).

• Bacterial rashes: Antibiotics may be required (e.g., penicillin for scarlet fever, fusidic acid or flucloxacillin for impetigo).

• Allergic rashes: Antihistamines (cetirizine, loratadine, or chlorphenamine). Avoid known allergens.

• Nappy rash: Keep the area clean and dry, use barrier creams (zinc oxide or petroleum jelly). In severe cases, mild hydrocortisone cream may be prescribed.

• Eczema: Regular use of emollients (moisturizers), short courses of topical corticosteroids (hydrocortisone 1%, betamethasone valerate for severe flare-ups).

---

Precautions

• Avoid scratching; keep nails short to reduce skin damage.

• Use mild, fragrance-free soaps and detergents.

• Ensure good hydration and balanced diet.

• Keep babies cool in hot weather to prevent heat rash.

---

When to Seek Medical Advice

• Rash with fever, vomiting, or drowsiness.

• Rash that spreads quickly or is associated with breathing difficulty.

• Unresponsive rash that persists despite home care.

• Any concern of meningitis (non-blanching rash).

---

Medicines and Doses (General Guidance)

• Paracetamol (acetaminophen):

  • Children: 10–15 mg/kg every 4–6 hours (max 4 doses/day).

• Ibuprofen:

  • Children: 5–10 mg/kg every 6–8 hours (max 3 doses/day).

• Antihistamines:

• Cetirizine (over 2 years): 2.5–5 mg once or twice daily.

• Loratadine (over 2 years): 5 mg once daily.

• Chlorphenamine (over 1 year): 1 mg every 4–6 hours (sedating).