Rashes are often a cause of concern for parents, as well as physicians, as many things can cause our child to develop spots on the skin.
Skin is our biggest organ and it can be a mirror into your child’s health. Children can present with different types of rashes including eczema and allergic manifestations, such as hives. The biggest concern for physicians is to determine whether the rash is caused by an infection, which can be challenging for parents to detect by themselves.
So, what should you do if your child develops bumps on his or her skin? First, examine the behavior of your child — is he or she crying more than usual, less active, less playful, or too sleepy? Are there other symptoms such as fever, change in appetite, cough or runny nose, or episodes of vomiting or diarrhea? Are any of your child’s schoolmates or friends exhibiting the same symptoms?
If any of these are the case, it is imperative that you contact your pediatrician for an emergency visit or go to the emergency room as some bacteria can cause an overwhelming infection in a short amount of time. In younger children, symptoms of a severe infection might be subtle and healthcare providers will usually do some lab tests to help them better understand the cause of the rash.
Most rashes in children are caused by viruses. The two that parents are more familiar with are the coxsackie virus — or “hand-foot-and-mouth disease” — and roseola. “Hand-foot-and-mouth disease” will manifest with bumps on the skin, palms and soles as well as lesions in the mouth that could prevent your child from eating and feeding correctly. The treatment for both coxsackie virus and roseola are typically the same — keep your child hydrated, manage the fever with Tylenol or Motrin, and watchful rest.
Parents may be tempted to apply creams and lotions on the skin or give antimicrobial medications, however they usually do not change the progression of the illness. There are a few exceptions though — herpes simplex virus and varicella can cause a particular type of rash that resembles tiny blisters, are very contagious, and typically require antiviral medication.
Herpes usually develops around the mouth, on the border of the lips and it appears as a bouquet of vesicles. You may probably know the infection as a “cold sore.” When these lesions are situated in concerning locations such as closer to the eye or if they seem to progress fast and severely, Acyclovir, an antiviral medication, is usually administered.
Varicella is an infection that is being seen less and less in the United States because the majority of children are vaccinated. However, if your child is not vaccinated yet, varicella will appear as a red bump that will progress over the course of few hours into a vesicle that will then dry and form a crust. There will be tens of lesions that spread over the next few days accompanied by spikes of fever. Because varicella can get complicated both in young kids as well as older children and teenagers, it is advisable to contact your pediatrician. Antiviral medication could shorten the course of the illness and prevent complications.
Living in Florida also can have its unique differentiators when it comes to rashes. Outdoor play can expose children to different species of ticks that exist throughout the state, even though the majority of the infection transmitted by them are acquired in the North and Northeast regions of the United States. A ”bull’s eye” rash or a “spotted rash” are seen in either Lyme disease or Rocky Mountain Spotted Fever. For these types of infections, your pediatrician will usually prescribe antibiotics.
It is not an easy task for parents to properly identify what kind of rash their child may have, so always consult with a doctor to determine the best course of treatment. Be sure to jot down as much information as you can for your conversation with the doctor such as symptoms and when and where the rash appeared.
It is a good rule of thumb to also take a few photos of the rash. And don’t forget, if your child has a fever, a little fever-reducing medication like Tylenol before you start your journey to the pediatrician office or to the hospital will ensure your child is more comfortable for their visit.
Gabriela Moraru, M.D., is a pediatric infectious disease specialist in her second year of fellowship training within the University of Miami Health System. For more information, visit UHealth.com/patients/pediatrics.