Rash, Age 11 and Younger

Topic Overview

Healthy skin is a barrier between the inside of the body and the outside environment. A rash means some change has affected the skin. A rash is generally a minor problem or is part of an illness that will go away on its own. A rash may be caused by contact with a substance outside the body, such as poison ivy (contact dermatitis), or by other more serious illnesses, such as measles or scarlet fever (strep throat with rash).

Generalized rashes over the whole body that are caused by viruses are more common in babies and young children than in adults. A rash may be caused by a viral illness if the child also has a cold, a cough, or diarrhea, or is in a daycare setting where he or she is with other children with viral illnesses. Most rashes caused by viruses are not serious and usually go away over a few days to a week. Home treatment is often all that is needed to treat these rashes.

After a child has had a rash caused by a virus, his or her body generally builds an immunity to that virus. This immunity protects the child from getting that specific viral illness and rash again. Common rashes caused by viruses include:

Chickenpox (varicella). This rash is a common, contagious illness caused by a type of herpes virus.
Fifth disease. This facial rash looks like the cheeks have been slapped. It also causes a lacy, pink rash on the arms and legs, torso, and buttocks.
Roseola (roseola infantum). This rash occurs about 3 days after a high fever.
Unknown virus. Sometimes the specific virus that causes a rash is never known.

Localized rashes which affect one area of the body have many different causes and may go away with home treatment. Common localized rashes that occur during childhood include:

Diaper rash. This rash is caused by rubbing, moisture, chemicals, or bacteria in the baby's urine or stool; substances in disposable diapers; or soaps used to wash cloth diapers.
Impetigo. This bacterial skin infection is caused by strep or staph bacteria.
Heat rash (prickly heat). This rash often results from a well-meaning parent dressing his or her baby too warmly, but it can happen to any baby in very hot weather.
Cold sores. These are sometimes called fever blisters. Cold sores are clusters of small blisters on the lip and outer edge of the mouth caused by the herpes simplex virus.
Contact dermatitis. This rash is caused by contact with a substance, such as food, soap, or lotion, that causes an allergic reaction. Most contact dermatitis is mild and goes away when your child's skin no longer comes in contact with the substance.
Cradle cap. Cradle cap is an oily, yellow scaling or crusting on a baby's scalp. It is common in babies and is easily treated. Cradle cap is not a part of any illness and does not mean that a baby is not being well cared for.

Rashes that may require a visit to a doctor include:

Lyme disease, which is caused by a bacteria carried by deer ticks in some areas. A characteristic expanding red rash usually occurs at the site of the tick bite and is followed by flu-like symptoms, such as a headache, chills, fever, body aches, and stiffness.
A rash that looks like a sunburn and a fever of 38.9°C (102°F) or higher. This type of rash may be caused by a rare condition called toxic shock syndrome.
A very rare and serious type of generalized red rash called toxic epidermal necrolysis (TEN). This type of rash may cause the skin to peel away, leaving large areas of tissue that weep or ooze fluid like a severe burn. TEN may occur after the use of some medicines.

To know how serious the rash is, other symptoms that occur with the rash must be evaluated. Check your child's symptoms to decide if and when your child should see a doctor.

Check Your Symptoms

Does your child have a rash?

Yes

Rash

How old are you?

Less than 3 months

3 to 5 months

6 months to less than 3 years

3 to 11 years

12 years or older

Are you male or female?

Male

Female

The medical assessment of symptoms is based on the body parts you have.

If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.

Does your child have a tick bite?

Yes

Tick bite

Has your child been bitten or stung by an insect or spider?

Yes

Insect or spider bite or sting

Does your baby seem sick?

A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.

Yes

Baby seems sick

How sick do you think your baby is?

Extremely sick

Baby is very sick (limp and not responsive)

Sick

Baby is sick (sleepier than usual, not eating or drinking like usual)

Does your child have symptoms of shock?

Yes

Signs of shock

Could your child be having a severe allergic reaction?

This is more likely if your child has had a bad reaction to something in the past.

Yes

Possible severe allergic reaction (anaphylaxis)

Does your child have symptoms of a serious illness?

The symptoms in a baby are different than the symptoms in an older child.

Yes

Symptoms of serious illness

Have tiny red or purple spots or bruises appeared suddenly?

Yes

Sudden appearance of red or purple spots or bruising

Does your child have any abnormal bleeding?

Yes

Abnormal bleeding

Does your child feel light-headed and dizzy, like he or she is going to faint?

It's normal for some people to feel a little light-headed when they first stand up. But anything more than that may be serious.

Yes

Feels faint or light-headed

Is your child bleeding now?

Yes

Abnormal bleeding now present

Are there any symptoms of infection?

Yes

Symptoms of infection

Are there red streaks leading away from the area or pus draining from it?

Yes

Red streaks or pus

Does your child have diabetes, a weakened immune system, or any surgical hardware in the area?

"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, or surgical hardware in affected area

Do you think that the rash may have been caused by abuse or neglect?

Yes

Rash may be caused by abuse or neglect

Do you think your baby has a fever?

Yes

Fever

Did you take your child's temperature?

This is the only way to be sure that a baby this age does not have a fever. If you don't know the temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Rectal temperatures are the most accurate. Taking an axillary (armpit) temperature is also an option.

Yes

Temperature taken

Is it 38°C (100.4°F) or higher, taken rectally?

This would be an axillary temperature of 37.5°C (99.5°F) or higher.

Yes

Temperature at least 38°C (100.4°F) taken rectally

Do you think your child has a fever?

Yes

Fever

Did you take your child's temperature?

Yes

Temperature taken

How high is the fever? The answer may depend on how you took the temperature.

NOTE: Most people have an average body temperature of about 37°C (98.6°F). But it can vary by a degree or more and still be considered normal. If a low body temperature is the only symptom, it’s usually not something to worry about. But be sure to watch for other symptoms.

High: 40°C (104°F) or higher, oral

High fever: 40°C (104°F) or higher, oral

Moderate: 38°C (100.4°F) to 39.9°C (103.9°F), oral

Moderate fever: 38°C (100.4°F) to 39.9°C (103.9°F), oral

Mild: 37.9°C (100.3°F) or lower, oral

Mild fever: 37.9°C (100.3°F) or lower, oral

How high do you think the fever is?

High

Feels fever is high

Moderate

Feels fever is moderate

Mild or low

Feels fever is mild

How long has your child had a fever?

Less than 2 days (48 hours)

Fever for less than 2 days

From 2 days to less than 1 week

Fever for more than 2 days and less than 1 week

1 week or longer

Fever for 1 week or more

Does your child have a rash that looks like a sunburn?

Yes

Sunburn-like rash

Does your child have a health problem or take medicine that weakens his or her immune system?

Yes

Disease or medicine that causes immune system problems

Does the rash have blisters?

Yes

Rash has blisters

Does the rash cover:

A rash that covers most of the body is on both sides of the body and on most of the legs, arms, back, or belly. A rash in one area may be just one small patch. Or it may be two or three small patches that cover a small area.

Most of the body?

Rash is all over the body

Or is it in one area?

Rash is in one area of the body

Is the rash a red, peeling rash that leaves very large areas raw and oozing fluid?

Yes

Red, peeling rash with large areas that are raw and ooze fluid

Does your child have a sore throat?

Certain illnesses can cause a rash and a sore throat. Your child may need to be seen sooner if he or she has both.

Yes

Sore throat

Are there sores or a rash inside the mouth or nose or in the eyes?

Yes

Rash or sores in mouth, nose, or eyes

Has your child had a sore on the skin for more than a week?

Yes

Sore on the skin for more than 1 week

Does your child have a new rash in the shape of a band or a strip on just one side of the body?

Yes

New band-shaped rash on one side

Do you think that a medicine could be causing the rash?

Think about whether the rash appeared after you began using a new medicine or a higher dose of a medicine.

Yes

Medicine may be causing rash

Is the rash itchy?

Yes

Itchy rash

Is the itching severe?

Severe means that you are scratching so hard that your skin is cut or bleeding.

Yes

Severe itching

Has the itching interfered with sleeping or normal activities for more than 2 days?

Yes

Itching has disrupted sleep or normal activities for more than 2 days

Does the rash hurt?

Yes

Painful rash

Does the rash produce a honey-coloured drainage that dries into crusts and covers an area larger than 5.1 cm (2 in.)?

Yes

Honey-coloured drainage that dries into crusts and covers more than 5.1 cm (2 in.)

Has your child had a rash for more than 2 weeks?

Yes

Rash for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

HomeTreatment

RelatedInformation

Symptoms of infection may include:

Increased pain, swelling, warmth, or redness in or around the area.
Red streaks leading from the area.
Pus draining from the area.
A fever.

If you're not sure if a child's fever is high, moderate, or mild, think about these issues:

With a high fever:

The child feels very hot.
It is likely one of the highest fevers the child has ever had.

With a moderate fever:

The child feels warm or hot.
You are sure the child has a fever.

With a mild fever:

The child may feel a little warm.
You think the child might have a fever, but you're not sure.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
Steroid medicines, which are used to treat a variety of conditions.
Medicines taken after organ transplant.
Chemotherapy and radiation therapy for cancer.
Not having a spleen.

Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.

Oral (by mouth) temperature

High: 40° C (104° F) and higher
Moderate: 38° C (100.4° F) to 39.9° C (103.9° F)
Mild: 37.9° C (100.3° F) and lower

A forehead (temporal) scanner is usually 0.3° C (0.5° F) to 0.6° C (1° F) lower than an oral temperature.

Ear or rectal temperature

High: 40.5° C (104.9° F) and higher
Moderate: 38.5° C (101.3° F) to 40.4° C (104.7° F)
Mild: 38.4° C (101.1° F) and lower

Armpit (axillary) temperature

High: 39.8° C (103.6° F) and higher
Moderate: 37.8° C (100° F) to 39.7° C (103.5° F)
Mild: 37.7° C (99.9° F) and lower

Note: For children under 5 years old, rectal temperatures are the most accurate.

Sudden tiny red or purple spots or sudden bruising may be early symptoms of a serious illness or bleeding problem. There are two types.

Petechiae (say "puh-TEE-kee-eye"):

Are tiny, flat red or purple spots in the skin or the lining of the mouth.
Do not turn white when you press on them.
Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
May spread over a large area of the body within a few hours.
Are different than tiny, flat red spots or birthmarks that are present all the time.

Purpura (say "PURR-pyuh-ruh" or "PURR-puh-ruh"):

Is sudden, severe bruising that occurs for no clear reason.
May be in one area or all over.
Is different than the bruising that happens after you bump into something.

Abnormal bleeding means any heavy or frequent bleeding or any bleeding that is not normal for you. Examples of abnormal bleeding include:

Nosebleeds.
Vaginal bleeding that is different (heavier, more frequent, at a different time of month) than what you are used to.
Rectal bleeding and bloody stools.
Bloody or pink urine.
Gums that bleed easily when you eat or gently brush your teeth.

When you have abnormal bleeding in one area of your body, it's important to think about whether you have been bleeding anywhere else. This can be a symptom of a more serious health problem.

Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to an allergen. While symptoms usually occur within 2 hours, in rare cases the time frame can vary up to several hours after exposure. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.

Symptoms of a severe allergic reaction can vary from person to person. The same person can have different symptoms each time they have a severe allergic reaction. Symptoms can include any of the following:

Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing
Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste

A severe reaction can take place without hives, so make sure to look out for all of the signs of an allergic reaction.

Symptoms of serious illness in a baby may include the following:

The baby is limp and floppy like a rag doll.
The baby doesn't respond at all to being held, touched, or talked to.
The baby is hard to wake up.

Symptoms of serious illness may include:

A severe headache.
A stiff neck.
Mental changes, such as feeling confused or much less alert.
Extreme fatigue (to the point where it's hard for you to function).
Shaking chills.

Many prescription and non-prescription medicines can cause a rash. A few common examples are:

Antibiotics.
ASA, ibuprofen (Advil, Motrin), and naproxen (Aleve).
Pain medicines, such as codeine.
Seizure medicines.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

Passing out (losing consciousness).
Being very sleepy or hard to wake up.
Not responding when being touched or talked to.
Breathing much faster than usual.
Acting confused. The child may not know where he or she is.

A baby that is extremely sick:

May be limp and floppy like a rag doll.
May not respond at all to being held, touched, or talked to.
May be hard to wake up.

A baby that is sick (but not extremely sick):

May be sleepier than usual.
May not eat or drink as much as usual.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

Make an appointment to see your doctor in the next 1 to 2 weeks.
If appropriate, try home treatment while you are waiting for the appointment.
If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

HomeTreatment

RelatedInformation

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
If the symptoms get worse, seek care sooner.

HomeTreatment

RelatedInformation

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care in the next hour.
You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Rash, Age 12 and Older

Tick Bites

Insect Bites and Stings and Spider Bites

Home Treatment

Most rashes will go away without medical treatment. Home treatment can often relieve pain and itching until the rash goes away.

If your child has come in contact with a substance that may cause contact dermatitis, such as poison ivy, immediately wash the area with large amounts of water.

Once a rash has developed, leave it alone as much as possible.

Use soap and water sparingly.
Leave the rash exposed to the air whenever possible.
Encourage your child not to scratch the rash.

If your child has a rash, he or she should not be in contact with other children or pregnant women. Most viral rashes are contagious, especially if a fever is present.

Relief from itching

Itching with a rash is generally not serious, but it can be annoying and may make a rash more likely to become infected. Rashes caused by chickenpox, eczema, or contact dermatitis are much more likely to itch. Sometimes itching can get worse by scratching.

Home treatment may help the itching.

Keep your child's fingernails clean and short, and encourage him or her not to scratch. Cover your baby's hands with socks to help keep him or her from scratching.
Keep your child out of the sun and in a cool place. Heat makes itching worse.
Keep the itchy area cool and wet if your child is older than age 9 months. Put cloths soaked in ice water on the rash a few times a day. Too much wetting and drying will dry the skin, which can increase itching. Do not put cloths soaked in ice water on the skin of a baby younger than 9 months. It may cause the baby's body temperature to go down.
Add a handful of oatmeal (ground to a powder) to your child's bath. Or you can try an oatmeal bath product, such as Aveeno.
Dress your child in cotton clothing. Do not use wool and synthetic fabrics next to the skin.
Use gentle soaps, such as Basis, Cetaphil, Dove, or Oil of Olay, and use as little soap as possible. Do not use deodorant soaps on your child.
Wash your child's clothes with a mild soap rather than a detergent. Rinse twice to remove all traces of the soap. Do not use strong detergents.
Do not let the skin become too dry, which can make itching worse.

Non-prescription medicines for itching

Carefully read and follow all label directions on the medicine bottle or box.

Try calamine lotion for a rash caused by contact dermatitis, such as poison ivy or poison oak rashes.
For severe itching, apply hydrocortisone cream 4 times a day until the itch is gone. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to do so. Do not use in the rectal or vaginal area on children younger than age 12 unless your doctor tells you to do so.
Try an oral antihistamine to help the scratch-itch cycle. Examples include a non-drowsy one like loratadine (Claritin) or one that might make you sleepy like diphenhydramine (Benadryl). Oral antihistamines are helpful when itching and discomfort are preventing your child from doing normal activities, such as going to school or getting to sleep. Don't give antihistamines to your child unless you've checked with the doctor first.

Medicine you can buy without a prescription
Try a non-prescription medicine to help treat your child's fever or pain:
Acetaminophen, such as Tylenol Ibuprofen, such as Motrin or Advil Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a non-prescription medicine:
Carefully read and follow all labels on the medicine bottle and box. Give, but do not exceed, the maximum recommended doses. Do not give your child a medicine if he or she has had an allergic reaction to it in the past. Do not give aspirin to anyone younger than 18 unless directed to do so by your child's doctor. Do not give naproxen sodium (such as Aleve) to children younger than age 12 unless your child's doctor tells you to.

Symptoms to watch for during home treatment

Call your child's doctor if any of the following occur during home treatment:

Other symptoms, such as a fever, feeling ill, or signs of infection, are severe or become worse.
A new rash lasts longer than 2 weeks.
Your child's symptoms become more severe or more frequent.

Prevention

Several childhood diseases that cause a rash can be prevented through immunization. Immunizations help your child's immune system recognize and quickly attack a virus before it can cause a serious illness. Immunizations for chickenpox and for measles, mumps, and rubella (MMR) can prevent these common rash-causing illnesses.

Other tips for preventing rashes include the following:

Dress your baby in as few clothes as possible during hot weather.
Do not bathe your child too often to prevent dry skin. Most children do not need daily bathing. Children with very dry skin may do better if they bathe once or twice a week.

Preparing For Your Appointment

You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:

What is the history of the rash, including:
- When did the rash start?
- Where did the rash start?
- Has the rash spread?
- Has the rash changed?
- Has anything made the rash better or worse?
Has your child had this rash before? If yes:
- What were the circumstances?
- When did he or she last have it?
- How was it treated?
- How long did it last?
What other symptoms has your child had? Symptoms may include itching, burning, stinging, tingling, numbness, pain, tenderness to the touch, fever, cold symptoms, or diarrhea.
Has your child been exposed to a contagious illness, such as measles, rubella, mumps, or chickenpox?
Have you recently used a new food, medicine, or product, such as soaps, detergents, shampoos, lotions, fabrics, new toys, or other object?
Has your child been exposed to poisonous plants. such as poison ivy, oak, or sumac?
Has your child had other health problems during the past 3 months?
Has your child recently travelled to a rural area or to another country?
Does anyone in your immediate family have a skin disorder or an allergy?
What home treatment measures have you tried? Did they help?
What non-prescription medicines have your tried? Did they help?
Does your child have any health risks?