Your child will invariably break out with spots, dots, bumps, blotches or stripes sometime in their life. So here is the ultimate rash guide. Most rashes are caused by either an infection, allergy, irritation or sweating.  Fortunately, there are very few rashes that you need to be concerned about. Like anything else, look at how your child is acting. If they are covered head to toe with a rash & they are running around playing and smiling, they are probably fine.

Rashes cannot be diagnosed over the phone and, as a result, should be seen by your doctor in order to make the correct diagnosis & treatment.

** For children of any age: If your child is well-appearing, has no fever and develops a rash – it is usually not serious.

Red Flags

  • Petechiae – looks like your child has been dotted with a red or purple felt tip pen. The dots don’t blanch (disappear) when you press on them.

  • Fluid filled vesicles (blisters)

  • Rash accompanying a sick appearing child.

Allergic: Common Name: Hives (Urticaria)

  • Allergy: May be due to any type of allergen such as food, environmental or even viral
  • Rash comes and goes for up to 7-10 days even after cause has been removed
  • Rash increases around tight areas of clothing or when the body is hot
  • Large, smooth, red blotches, sometimes with white central area
  • May occur on any part of body or face
  • Areas where blotches conglomerate or come together may look swollen such as groin, hands and feet
  • Itchy
  • Benadryl every 6 hours as needed (see dosing sheet). Blunts allergic reaction and relieves itching
  • No creams (rash comes and goes due to internal allergic reaction, putting something on the skin will not do anything)

Common Name: Roseola (HSV 6)

  • 1-3 days of high fever (may be 101-105 degrees F)
  • Rash develops 12-24 hours after the fever breaks
  • Rash may persist for up to a 1 week. Resolves on own
  • May have other viral symptoms such as cough and runny nose
  • May be very fussy for a couple days even after fever resolves
  • Fine, red, bumpy rash that may cover the entire body
  • Not itchy or painful
  • Not contagious and self-resolves
  • None, supportive care

Common Name: Fifth’s Disease (Parvovirus B-19)

  • Cold symptoms such as runny nose, cough or fever
  • Rash may occur with or without fever and self-resolves in about 1 week
  • “Slapped cheek” rash (cheeks will be red and rosy like they were just slapped)
  • Smooth, fine, lacy red rash all over the body
  • None, supportive care
  • Concern: Notify your obstetrician if pregnant

Chicken Pox (Varicella)

  • 3-5 days of fever may be present at onset
  • May have other viral symptoms such as cough & nasal congestion
  • Rash appears within 14-21 days of exposure
  • Rash resolves within 1-2 weeks
  • Small, clear fluid filled blisters on a red base
  • Described as a “dew drop on a rose petal
  • Commonly starts on the chest and may spread to any part of the body
  • Very itchy
  • Lesions scab over in 7-10 days
  • Many stages may be present at any one time. For example, new blisters may appear as old ones are scabbing over
  • None
  • Supportive care with anti itch creams, such as calamine lotion
  • Oatmeal bath
  • Contagious until all skin lesions are scabbed over.