Identifying the Cause of Your Child’s Rash & Tips on How to Treat Them My Baba 25 June, 2018 Baby, Expert, Kids, Parenting All children get rashes from time to time, ranging from short term illnesses such as chicken pox, to longer term skin conditions such as eczema. Rashes in children are common and whilst they can be an indication of illness, it is important to remember that it is unlikely that you’ll be handling anything life-threatening or a danger to your child’s long-term health. The nature of rashes make their cause tricky to identify as a parent, as they can present themselves in many different forms. Some are unique to a single clinical condition whereas some are associated with a number of different ailments. Essentially the question is, how are you to know if your child is suffering with something that will clear up on its own or that if it’s a rash that will require a trip to your GP? In an attempt to provide clarification on this confusing topic, Dr Akash Deep, Consultant Paediatrician at The Portland Hospital, part of HCA UK, takes us through the most common rashes seen in children, what they look like and when to seek medical advice. Heat Rash (Prickly Heat) Heat rash is an itchy rash of raised spots which create a stinging or ‘prickly’ sensation on the skin. The rash is usually caused by excessive sweating which leads to a blockage of the sweat ducts in the outer layer of skin. The trapped sweat then leads to a rash a few days later. This rash is common in babies (as they can’t control their temperature) as well as in older children. Heat rash can be uncomfortable, but it is mostly harmless and there are measures that you can take to help soothe the symptoms for your child, such as: Dressing them in loose cotton clothing Using lightweight bedding Bathing them in cool water Giving them plenty of fluids to drink to avoid dehydration Applying something cold to the rash, such as a damp cloth or ice pack Tapping or patting the rash instead of scratching it Avoiding the use of perfumed bathing products If the rash doesn’t improve after a few days, it’s important to seek medical advice. Chicken Pox Chickenpox is a viral illness that most children catch at some point in their childhood, most commonly before they reach the age of 10. Having the Chickenpox virus at some stage in childhood is actually preferable to not having it at all as once you have had the condition it is unlikely that you will get it again – working similarly to a vaccination. The Chickenpox rash is very unique to this specific virus; a rash of itchy spots turn into fluid-filled blisters which crust over and form scabs, eventually dropping off. The severity of the rash differs between cases – some children will only have a few spots whereas others will have them all over their body. The spots are most likely to appear on the face, ears and scalp and then make their way to the under arms, chest, belly and the arms and legs. There is no specific medical treatment for Chickenpox as in nearly all cases it will clear up on its own, but you can take steps to relieve some of the symptoms: Ensure your child drinks plenty of fluids Give them Paracetamol to help with pain and discomfort Cut your child’s nails to manage the damage they can make by scratching their skin Use cooling creams or gels from your pharmacy Bathe them in cool water and pat the skin dry (don’t rub) Sometimes anti-allergy medications and skin soothing lotions can help You should look to seek medical attention if: You’re not sure if it’s chickenpox The skin around the blisters is red, hot or painful as this could be a sign of an infection Your child is dehydrated They seem to be getting worse If you think your newborn baby may have Chickenpox, then you should ask your GP for an emergency appointment as they can prescribe medicine to prevent complications. Most medicines will need to be taken within 24 hours of the appearance of the rash, which is why it’s so important to act quickly in this instance. Eczema Eczema is a long-term condition that causes the skin to become itchy, red, dry and cracked. The most common type is atopic eczema, which mainly affects children but can continue into adulthood. It commonly develops behind the knees or on the elbows, neck, eyes and ears. About one in five children in the UK have eczema, it is very common and while there is no cure, it can be managed and kept under control with certain treatments. If you think your child may have eczema, the best thing you can do for them is seek diagnosis from your GP. Together, you can develop a management and treatment plan for the condition, this will likely involve the following: Emollients (moisturisers) – used every day to stop the skin becoming dry Topical corticosteroids – creams and ointments used to reduce swelling and redness during flare-ups Avoiding triggers – this can include certain fabrics, heat, soaps or detergents etc Dietary changes – some foods are linked with triggering eczema symptoms, such as cow’s milk and eggs, but this may be unique to the person suffering. Building a relationship with an eczema specialist Hand, Foot and Mouth Disease Hand, foot and mouth disease is a common, childhood contagious infection that causes mouth ulcers and spots on the palms of the hands and the soles of the feet. Signs of the condition are the described rash, a sore throat, loss of appetite and a temperature above 38C. Unfortunately, there isn’t a cure for the disease and it’s easily spread, so you should keep your child away from school or nursery until they get better. Your child’s immune system will fight the disease and it will typically clear up after about 7 to 10 days. You can help with the symptoms by: Drinking fluids to prevent dehydration – avoid acidic drinks such as fruit juice Eat soft foods like soup Use child-suitable paracetamol or ibuprofen to help ease a sore mouth or throat Impetigo Impetigo is a common and highly contagious skin infection that causes sores and blisters. They soon rupture and leave crusty, golden-brown patches that look a little bit like cornflakes stuck to the skin. There are two types of Impetigo – bullous and non-bullous. Bullous Impetigo typically affects the trunk (the area of the body between the waist and neck) and cause the fluid-filled blisters that rupture and crust, as described above. Non-bullous impetigo typically affects the skin around the nose and mouth, causing sores that quickly burst and leave red, open patches of itchy skin. Impetigo is rarely a serious condition, but it will need prescribed antibiotic cream to help clear it up. You will therefore need to pay a visit to your GP. As the condition is highly contagious as well as painful and uncomfortable your child will need to stay off school or nursery until they are better. If it is impetigo that your child is struggling with you should: Keep their sores, blisters and crusty patches clean and dry Wash your hands and their hands frequently Wash your flannels, sheets and towels at a high temperature Wash or wipe down toys with detergent and warm water or anything your child may have come into contact with The rash stops being contagious 48 hours after you start using the medicine prescribed by your GP. Meningitis Due to the routine meningitis vaccination it is very unlikely that this disease is the cause of your child’s rash, however it’s still important to be aware of how this rash presents itself. One of the key symptoms of meningitis is a blotchy rash that doesn’t fade when you roll a glass over it – if this is the case then you should call 999 or go to A&E. It is very important that meningitis is treated quickly. If the rash does appear to fade under the glass but you’re still concerned, you should, again, seek medical advice as soon as possible – especially if they are suffering other symptoms including: A fever Feeling and being sick Irritability and lack of energy A headache Aching muscles and joints Irregular breathing Cold hands and feet A stiff neck Confusion A dislike of bright lights Drowsiness Seizures Dr Akash Deep, Consultant Paediatrician, The Portland Hospital For more information contact HCAUK@thephagroup.com / 020 7025 1363 About The Portland Hospital Situated in central London and part of the HCA Healthcare UK group of award-winning hospitals, The Portland specialises in three areas: Paediatrics, Obstetrics and Gynaecology. The UK’s largest private children’s hospital with a 10-bed dedicated intensive care unit, 46 paediatric beds and 155 consultant paediatricians who treat children from new-borns up to the age of 18. About HCA Healthcare UK HCA Healthcare UK is the country’s largest provider of privately funded healthcare, with 800,000 patient interactions every year. From complex and urgent care, to primary care, outpatient and day-case treatment, we provide expert medical care across our network of hospitals, outpatient facilities and NHS partnerships. HCA Healthcare UK includes London Bridge Hospital, The Portland Hospital, The Harley Street Clinic, The Lister Hospital, The Princess Grace Hospital, The Wellington Hospital, Roodlane Medical Ltd, and Blossoms Healthcare. HCA UK also partner with leading NHS Trusts to provide care at The Christie Private Care, HCA UK at University College Hospital and Private Care at Guy’s. In 2017 HCA UK invested £50m in its cancer network in London; £38.2m London Bridge Hospital, Private Care at Guy’s and the £12m HCA UK at Sydney Street, an outpatients and diagnostics centre in Chelsea.