Skin rashes come in all forms and sizes. Some are raised bumps; others are flat red blotches. Some are itchy blisters; others are patches of rough skin. Most rashes are harmless and clear up on their own within a few days, but a few may need medical attention.

Ask Yourself:	Yes	No
Is the child having trouble breathing or swallowing or is the tongue swollen? If yes, give shot and follow other instructions from emergency "bee sting" kit if the child carries one with him or her for severe reactions to insect stings.	Seek emergency care	Go to next question
Does your child have a purple, blotchy rash with cool extremities?	Seek emergency care	Go to next question
Does the child have any of the following: Fever Headache Sore throat A fine red rash that feels rough Ñ like sandpaper Joint pain along with a target-like rash	See doctor	Go to next question
Are there any large, fluid-filled blisters present or pus or swelling around the rash lesions?	See doctor	Go to next question
Has your child recently been exposed to someone with a "strep" infection?	See doctor	Go to next question
If your child has a diaper rash, are there also blisters or small red patches that appear outside the diaper area such as on the chest?	See doctor	Go to next question
When the rash started, was the child taking any medications or was he or she stung by an insect?	Call doctor	Go to next question
Is your child's rash getting worse, keeping him or her from sleeping and/or do Self-Care Procedures not relieve symptoms?	Call doctor	Provide self-care (see below)

Self-Care Procedures:

Diaper rash is best treated by:

Changing diapers as soon as they become wet or soiled (even at night if the rash is extensive)
Washing your baby with plenty of warm water, not disposable wipes, to prevent irritating the skin. If the skin appears irritated, apply a light coat of zinc oxide ointment after the skin is completely dry.
Keeping the skin dry and exposed to air
Keeping your baby naked, on a soft, fluffy towel, for 10 to 15 minutes before putting on a fresh diaper
Putting diapers on loosely so air can circulate under them. If disposable diapers are used, punch a few holes in them. Avoid ones with tight leg bands.
Not using plastic pants until the rash is gone
Washing cloth diapers in mild soap. Add 1/2 cup of vinegar to your rinse water to help remove what's left of the soap.

Cradle cap can be treated by using an antidandruff shampoo. Use it once a day, massaging your baby's scalp with a soft brush or washcloth for five minutes. You can soften the hard crusts of this rash by applying mineral oil on the scalp before washing your child's hair. Be sure to thoroughly wash the oil out; otherwise, the cradle cap condition may worsen.

Heat rash is best treated by keeping your child in a cool, dry area. It will usually disappear within two to three days if you keep the skin cool. You can ease your child's discomfort by:

Giving him or her a bath in cool water, without soap, every couple of hours
Letting your child's skin air dry
Applying calamine (not Caladryl) lotion to the very itchy spots
Putting corn starch in body creases (e.g., inside elbows)
Avoiding ointments and creams that can block the sweat gland pores

Hives can be eased by:

Giving your child an antihistamine such as Benadryl. Check the labels of cold medications. Those that contain diphenhydramine or chlorpheniramine are good choices, too. Remember, though, that most antihistamines are likely to make your child drowsy.
Cooling off your child. Rub an ice cube over the hives, drape a washcloth dipped in cool water over the affected areas or give a cool-water bath.
Applying calamine lotion, witch hazel or zinc oxide to the rash.
Finding and eliminating the cause of the allergic reaction.

To relieve the itchy rash typical of poison ivy, oak and sumac:

As soon as possible, remove your child's clothes and shoes. Wash him or her with soap and water to remove the plant oil from his or her skin. Rub the affected skin area with alcohol or alcohol wipes, then rinse with water. Wash all clothes and shoes your child has on.
Trim your child's nails. Encourage your child not to scratch. Keep your child busy with other activities.
Soak the rash area in cool water, or give your child baths with Aveeno (an over-the-counter colloidal oatmeal product) or put one cup of oatmeal in a tub full of water.
Give your child a hot shower if he or she can tolerate it. At first the itching will get worse, but after a while it stops and the relief can last for hours. Repeat as soon as the itching starts again.
Use calamine lotion every three to four hours.
Apply a hydrocortisone cream. Put a very small dab of cream on the rash. Be careful not to rub and spread the poison. If you can see the cream on the skin, you've used too much. Repeat as needed every two to four hours. Do not use these creams near the eyes.
Teach your child to recognize poison ivy, oak and sumac. Tell your child to stay away from them.

Protect your child from Lyme disease by:

Having him or her wear long pants tucked into socks and long-sleeve shirts when walking through fields and forests. (Light-colored, tightly woven clothing is best.)
Inspecting or having your child examined for ticks after these activities. Remove any ticks found on the skin. Use tweezers to grasp the tick as close to the skin as possible. Pull gently and carefully in a steady upward motion at the point where the tick's mouthpart enters the skin. Try not to crush the tick because the secretions released may spread disease. Wash the wound area and your hands with soap and water after removing ticks. Save the tick in a closed jar of alcohol. It could help in diagnosing Lyme disease.

Common Skin Rashes:

Condition or Illness	Causes	What Rash Looks Like	Skin Areas Affected	Other Symptoms
Diaper Rash	Dampness and the interaction of urine and the skin	Small patches or rough skin, tiny pimples	Buttocks, thighs, genitals	Soreness, no itching
Cradle Cap	Hormones that pass through the placenta before birth	Scaly, crusty rash (in newborns)	Starts behind the ears and spreads to the scalp	Fine, oily scales
Heat Rash (Prickly Heat)	Blocked off sweat glands	Small red pimples, pink blotchy skin	Chest, waist, back, armpits, groin	Itching (may be a result of fever)
¹ Roseola	Herpes virus type-6	Flat, rosy red rash	Chest, abdomen	High fever 2 to 4 days before rash -- child feels only mildly ill during fever
¹ Fifth Disease	Human parvovirus B19	Red rash of varying shades that fades to a flat, lacy pattern (rash comes and goes)	Red rash on facial cheeks; lacy rash can also appear on arms and legs	Mild disease with no other symptoms or a slight runny nose and sore throat
Eczema	Allergens	Dry, red, cracked skin, blisters that ooze and crust over. Sufficient scratching leads to a thickened rough skin	On cheeks in infants; on neck, wrists, inside elbows and backs of knees in older children	Moderate to intense itching (may only itch first, then rash appears hours to days later)
¹ Chicken Pox	Varicella/herpes zoster virus	Flat red spots that become raised resembling small pimples. These develop into small blisters that break and crust over	Back, chest and abdomen first, then rest of body	Fatigue and mild fever 24 hours before rash appears -- intense itching
¹ Scarlet Fever	Bacterial infection (streptococcal)	Rough, bright red rash (feels like sandpaper)	Face, neck, elbows, armpits, groin (spreads rapidly to entire body)	High fever, weakness before rash, sore throat, peeling of the skin afterward (especially palms)
¹ Impetigo	Bacterial infection of the skin	In infants, pus-filled blisters and red skin. In older children, golden crusts on red sores	Arms, legs, face and around nose first, then most of body	Sometimes fever -- occasional itching
Hives	Allergic reaction to food, insect bites, viral infection, drug or other substance	Raised red bumps with pale centers (resemble mosquito bites), shape, size and location of spots can change rapidly	Any area	Itching -- in extreme cases, swelling of throat, difficulty breathing (may need emergency care)
Poison Ivy, Oak, Sumac	Interaction of oily resins of plant leaves with the skin	Red, swollen skin rash and lines of tiny blisters	Exposed areas	Intense itching and burning
Lyme Disease	Bacterial infection spread by deer tick bite(s)	Red rash that looks like a bull's-eye: raised edges surround the tick bites with pale centers in the middle. Rash starts to fade after a couple of days	Exposed skin areas where ticks bite, often includes scalp, neck, armpit, groin	No pain, no itching at time of bite. Fever-rash occurs in the week following the bite(s).

¹These conditions are contagious

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Copyright © 1996 Don R. Powell, Ph.D. From The American Institute for Preventive Medicine's Self-Care: Your Family Guide to Symptoms and How to Treat Them, by arrangement with People«s Medical Society.

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