Rashes in babies and children

Why rashes are common in children

Most rashes in babies and children are harmless and are caused by viral infections, eczema or minor skin irritation. Parents understandably worry, especially with so many condition names in the news, but the majority of rashes settle without any special treatment.

Knowing a few common patterns helps, although how unwell your child seems matters more than the appearance of the rash alone.

Rashes that need emergency help

Call 999 if any of the following apply to your child:

• Their rash does not fade when you press a clear glass against it (the glass test).
• They have difficulty breathing or their lips look blue.
• They are confused, floppy or difficult to wake.
• They have a rash together with a stiff neck and a severe headache.

These can be signs of meningitis, sepsis or a severe allergic reaction.

Common childhood rashes and what they look like

Chickenpox causes itchy spots that blister and then scab over. It is very common and usually mild, and it remains infectious until all of the spots have crusted over.

Slapped cheek syndrome causes bright red cheeks and sometimes a lace-like rash on the body. It is usually mild, but pregnant women who have been exposed should seek advice.

Hand, foot and mouth disease causes mouth ulcers along with spots on the hands and feet. It is common in nurseries.

Scarlet fever causes a fine, sandpaper-like rash with a sore throat and fever. It needs antibiotics from a GP.

Eczema causes dry, itchy patches of skin, often in the skin creases. It is not infectious and is managed with moisturisers and sometimes steroid creams from a GP.

Hives are raised, itchy welts that come and go. They are often allergic, and antihistamines can help.

Heat rash causes small red spots in hot weather. Keeping your child cool and dressing them lightly helps it settle.

Nappy rash causes sore, red skin in the nappy area. Frequent nappy changes, barrier cream and nappy-free time all help it heal.

How to do the glass test

The glass test is a simple check that helps identify dangerous rashes:

1. Press a clear drinking glass firmly against the rash.
2. If the rash fades under the glass, it is blanching, which makes a meningococcal rash less likely.
3. If the rash does not fade, seek emergency help, especially if your child also has a fever and is drowsy.

The test is not perfect, but a non-blanching rash in a child who is very unwell is an emergency.

Caring for a rash at home

For mild rashes that do not need urgent attention:

• Keep your child’s nails short to reduce damage from scratching.
• Use a fragrance-free moisturiser on dry skin.
• Dress your child in loose cotton clothing.
• Offer plenty of fluids and comfort.
• Give paracetamol or ibuprofen for a fever, using the correct dose for your child’s age.

Avoid new bath products or detergents until the rash clears, because they may irritate sensitive skin.

When to see a GP about your child’s rash

See a GP if:

• The rash is not improving after a week.
• Your child has a rash together with a persistent high temperature.
• You suspect scarlet fever because of a sandpaper-like rash and a sore throat.
• Nappy rash is severe or not responding to simple measures.
• You are unsure of the cause and worried.

Trust your instincts. You know your child, and if they seem seriously unwell, you should seek help even if the rash looks mild.

Infectious rashes and school

Keep your child at home if they have a fever, feel unwell or have an infectious rash. The specific guidance varies with the cause: children with chickenpox should stay off until the spots have crusted over, and children with scarlet fever until 24 hours after starting antibiotics. Check with your nursery or school if you are not sure.

Common questions about rashes in babies and children

What is the glass test for rashes?

The glass test means pressing a clear glass firmly against a rash to see whether it fades. If the colour stays, the rash may be non-blanching, which can be a sign of meningitis or sepsis. Call 999 if this happens alongside fever and your child being very unwell.

What does a chickenpox rash look like?

A chickenpox rash is made up of spots that start red, become fluid-filled blisters, and then scab over, often starting on the chest or face. The spots are very itchy, and new ones can appear in batches over several days.

When is a rash just nappy rash?

Nappy rash causes red, sore skin in the nappy area. Change nappies frequently, use barrier cream, and give nappy-free time. See a GP if the rash is severe, blistered, or not improving — it may be thrush or a bacterial infection needing treatment.

Can teething cause a rash?

Teething can cause drooling that irritates the chin (drool rash). A teething rash is localised around the mouth. Teething does not cause a widespread body rash — that usually indicates an infection.

Should I send my child to school with a rash?

It depends on the cause. Keep them home if they have a fever, feel unwell, or have an infectious rash such as chickenpox (until spots crust over) or scarlet fever (until 24 hours after starting antibiotics). Check with the school or nursery if unsure.

Sources

• NHS — Rashes in babies and children