Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia


 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Rash - child under 2 years

Baby rash; Miliaria; Prickly heat

 

A rash is a change in the color or texture of the skin. A skin rash can be

  • Bumpy
  • Flat
  • Red, skin-colored, or slightly lighter or darker than skin color
  • Scaly

Considerations

 

Most bumps and blotches on a newborn baby are harmless and clear up by themselves.

The most common skin problem in infants is diaper rash. Diaper rash is an irritation of the skin caused by dampness, urine, or feces. Most babies who wear diapers will have some type of diaper rash.

Other skin disorders can cause rashes. These are most often not serious unless they occur with other symptoms.

 

Causes

 

Causes may include:

  • Diaper rash (rash in the diaper area) is a skin irritation caused by long-term dampness and by urine and feces touching the skin.
  • Yeast diaper rash is caused by a type of yeast called candida, which also causes thrush in the mouth. The rash looks different from a regular diaper rash. It is very red, and there are usually small red bumps on the outer edges of the rash. This rash requires treatment with medicine.
  • Heat rash, or prickly heat, is caused by the blockage of the pores that lead to the sweat glands. It is most common in very young children but can occur at any age. It is more common in hot and humid weather. The sweat is held within the skin and forms little red bumps or occasionally small blisters .
  • Erythema toxicum can cause flat red splotches (usually with a white, pimple-like bump in the middle) that appear in up to half of all babies. This rash rarely appears after 5 days of age and most often disappears in 7 to 14 days. It is nothing to worry about.
  • Baby acne is caused by exposure to the mother's hormones. Red bumps, sometimes with white dots in the center, may be seen on a newborn's face. Acne most often occurs between 2 and 4 weeks of age, but may appear up to 4 months after birth and can last for 12 to 18 months.
  • Cradle cap (seborrheic dermatitis) causes greasy, scaling, crusty patches on the scalp that appear in a baby's first 3 months. It most often goes away by itself, but some cases may require treatment with medicine.
  • Eczema is a condition of the skin in which areas are dry, scaly, red (or darker than normal skin color), and itchy. When it goes on for a long time the areas become thickened. It is often associated with asthma and allergies, although it can often occur without either of these. Eczema often runs in families.
  • Hives are red welts that appear to move around on the body. For example, if you drew a circle to mark one of the welts, a few hours later that circle would not have a welt in it, but there would be welts on other parts of the body. They differ in size and shape. Hives may last for a few weeks. The cause is uncertain.

 

Home Care

 

DIAPER RASHES

Keep the skin dry. Change wet diapers as quickly as possible. Allow the baby's skin to air dry as long as is practical. Launder cloth diapers in mild soap and rinse well. Avoid using plastic pants. Avoid irritating wipes (especially those containing alcohol) when cleaning the infant.

Ointments or creams may help reduce friction and protect the baby's skin from irritation. Powders such as cornstarch or talc should be used cautiously, as they can be inhaled by the infant and may cause lung injury.

If your baby has a yeast diaper rash , the health care provider will prescribe a cream to treat it.

OTHER RASHES

Heat rash or prickly heat is best treated by providing a cooler and less humid environment for the child.

Powders are unlikely to help treat heat rash and should be stored out of reach of the infant to prevent accidental inhalation. Avoid ointments and creams because they tend to keep the skin warmer and block the pores.

Erythema toxicum is normal in newborn babies and will go away on its own in a few days. You do not need to do anything for it.

White or clear milia/miliaria will go away on their own. You do not need to do anything for it.

For hives, talk with your provider to try to find the cause. Some causes require prescription medicines. Antihistamines may help stop the itching.

BABY ACNE

Normal washing is all that is necessary to treat baby acne most of the time. Use plain water or mild baby soap and only bathe your baby every 2 to 3 days. Avoid acne medicines used by adolescents and adults.

CRADLE CAP

For cradle cap, wash the hair or scalp with water or a mild baby shampoo. Use a brush to remove the flakes of dry skin. If this cannot be removed easily, apply an oil to the scalp to soften it. Cradle cap most often disappears by 18 months. If it does not disappear, it becomes infected, or if it is resistant to treatments, consult your provider.

ECZEMA

For skin problems caused by eczema , the keys to reducing rash are to reduce scratching and keep the skin moisturized.

  • Keep the baby's fingernails short and consider putting soft gloves on the child at night to minimize scratching.
  • Drying soaps and anything that has caused irritation in the past (including foods) should be avoided.
  • Apply a moisturizing cream or ointment immediately after baths to avoid drying.
  • Hot or long baths, or bubble baths, may be more drying and should be avoided.
  • Loose, cotton clothing will help absorb perspiration.
  • Consult a provider if these measures do not control the eczema, (your child may need prescription medicines) or if the skin begins to appear infected.

While the majority of children with eczema will outgrow it, many will have sensitive skin as adults.

 

When to Contact a Medical Professional

 

Call your child's health care provider if your child has:

  • A fever or other unexplained symptoms associated with the rash
  • Any areas that look wet, oozing, or red, which are signs of infection
  • A rash that extends beyond the diaper area
  • A rash that is worse in the skin creases
  • A rash, spots, blister, or discoloration and is younger than 3 months
  • Blisters
  • No improvement after 3 days of home treatment
  • Significant scratching

 

What to Expect at Your Office Visit

 

The provider will perform a physical exam. The baby's skin will be thoroughly examined to determine the extent and type of the rash. Bring a list of all the products used on the child's skin.

You may be asked questions such as:

  • When did the rash start?
  • Did symptoms begin at birth? Did they occur after fever was relieved?
  • Is the rash related to skin injury, bathing, or exposure to sunlight or cold?
  • What does the rash look like?
  • Where on the body does the rash occur? Has it spread to other areas?
  • What other symptoms are also present?
  • What type of soaps and detergents do you use?
  • Do you put anything on the skin (creams, lotions, oils, perfumes)?
  • Is your child taking any medications? How long has the child taken them?
  • Has your child recently eaten any new foods?
  • Has your child been in contact with grasses/weeds/trees recently?
  • Has your child recently been sick?
  • Do any skin problems run in your family? Does your child or anyone in your family have allergies?

Tests are seldom required but may include the following:

  • Allergy skin tests
  • Blood studies (such as CBC , blood differential )
  • Microscopic examination of a sample of the affected skin

Depending on the cause of the rash, antihistamines may be recommended to decrease itching. Antibiotics may be prescribed if there is a bacterial infection.

The provider may prescribe a cream for diaper rash caused by yeast. If the rash is severe and not caused by yeast, a corticosteroid cream may be recommended.

For eczema, the provider may prescribe ointments or cortisone drugs to decrease inflammation.

 

 

References

McFarlin AK, LeGros TL, Murphy-Laoie H. Approach to the pediatric patient with a rash. In: Adams JG ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 18.

 
  • What are hives?

    Animation

  •  

    What are hives? - Animation

    Learn the causes of hives, how to treat them, and when to call your doctor.

  • Erythema toxicum on the foot - illustration

    Newborn infants may have Erythema toxicum, a rash that is characterized by patchy redness with central vesicles. The rash is temporary, and the location may move (transient). (Image courtesy of the Centers for Disease Control and Prevention.)

    Erythema toxicum on the foot

    illustration

  • Heat rash - illustration

    To prevent or treat heat rash in an infant, dress the baby in light-weight cotton, use a fan with a gentle breeze (if air conditioning is unavailable), and avoid the use of powders.

    Heat rash

    illustration

  • Miliaria profunda - close-up - illustration

    Miliaria are caused by obstruction of the sweat glands. There are three stages of Miliaria called Miliaria sudamina, Miliaria rubra, and Miliaria profunda (listed from mildest and most superficial to the most severe and deep forms). The condition occurs in those exposed to heat for prolonged periods of time, in infants, and in the obese. This picture is a close-up of the most severe form. Note the numerous papules on the surface of the skin.

    Miliaria profunda - close-up

    illustration

  • Erythema toxicum neonatorum - close-up - illustration

    Erythema toxicum neonatorum is a skin condition seen in about half of newborn infants. It consists of reddish patches that have raised clear bumps in the center. This condition may be present at birth or appear shortly thereafter. It usually lasts several days and clears up without treatment.

    Erythema toxicum neonatorum - close-up

    illustration

  • What are hives?

    Animation

  •  

    What are hives? - Animation

    Learn the causes of hives, how to treat them, and when to call your doctor.

  • Erythema toxicum on the foot - illustration

    Newborn infants may have Erythema toxicum, a rash that is characterized by patchy redness with central vesicles. The rash is temporary, and the location may move (transient). (Image courtesy of the Centers for Disease Control and Prevention.)

    Erythema toxicum on the foot

    illustration

  • Heat rash - illustration

    To prevent or treat heat rash in an infant, dress the baby in light-weight cotton, use a fan with a gentle breeze (if air conditioning is unavailable), and avoid the use of powders.

    Heat rash

    illustration

  • Miliaria profunda - close-up - illustration

    Miliaria are caused by obstruction of the sweat glands. There are three stages of Miliaria called Miliaria sudamina, Miliaria rubra, and Miliaria profunda (listed from mildest and most superficial to the most severe and deep forms). The condition occurs in those exposed to heat for prolonged periods of time, in infants, and in the obese. This picture is a close-up of the most severe form. Note the numerous papules on the surface of the skin.

    Miliaria profunda - close-up

    illustration

  • Erythema toxicum neonatorum - close-up - illustration

    Erythema toxicum neonatorum is a skin condition seen in about half of newborn infants. It consists of reddish patches that have raised clear bumps in the center. This condition may be present at birth or appear shortly thereafter. It usually lasts several days and clears up without treatment.

    Erythema toxicum neonatorum - close-up

    illustration

A Closer Look

 

    Talking to your MD

     

      Self Care

       

      Tests for Rash - child under 2 years

       

         

        Review Date: 2/5/2015

        Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

         
         
         

         

         

        A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



        Content is best viewed in IE9 or above, Firefox and Google Chrome browser.