How to Identify Childhood Rashes

Our ‘cutaneous membrane’ (skin) is a marvelous organ … it is waterproof, stretchable, pliable, washable, pretty tough, and automatically repairs its own small cuts and minor burns. Combined with sweat glands, oil glands, hair and nails, it is collectively referred to as the ‘Integumentary System’ … and all it asks for in return, is to receive reasonable care!

It is imperative our skin remains mostly intact, because it has enormous functions to perform:

Our skin synthesises vitamin D from sunlight; keeps in important molecules, such as water; and keeps out molecules too – imagine how water-logged we’d become when swimming if our skin diffused water.

Our skin’s subcutaneous adipose (fatty tissue) insulates us keeping us warm, and cushions our body and internal organs against damage from bumps, cuts, chemicals, heat, cold and sunlight radiation.

Our skin’s blood capillaries and sweat glands enable us to loose excessive body heat; and our skin of course contains nerve receptors for touch, pressure, temperature and pain.

Our skin is also our body’s biggest protector against bacteria, with its ‘phagocytic’ cells that ingest bacteria, and ‘acid mantle’ that inhibits bacteria.

And all that protection, from something only about as thick as a paper towel!

Rashes are temporary eruptions on the skin, typically red and often itchy, which can be a localized reaction, or a outward sign of some other disorder – but if there’s one thing parents can really worry about, it’s rashes as they can mean so many different things.

However, if your child is generally happy, and the rash is not Petechiae or Purpura [see below], then this is a good sign that medical attention is probably not required urgently, if required at all.

Below is a general guide:


Infectious skin disorders are caused by viruses, bacteria and fungi that

invade the skin, and trigger an inflammatory response causing skin rashes.

The three common Viral Rashes are:


A highly contagious disease, that causes small white spots inside the cheeks in the mouth about 1-2mm in diameter known as Koplik’s spots. Then, starting around the ears and hairline, separate pinky-red lesions become joined together like a red-brown rash to the face. Then, these flat red-brown areas become raised up, and spread to the body, arms and legs. Measles is itchy, but not intensively itchy. Usually a mild illness, though does have potentially serious complications, especially for poorly-nourished under four-year-olds.


Spread by coughs and sneezes, this mild illness produces a very small pink flat rash, similar to the measles rash but less extensive, starting around the hairline, face and neck, then spreads to the body, arms and legs, then fades quickly. Note: Do actively avoid exposing the child to pregnant women or potentially pregnant women (half the supermarket!) as such exposure can lead to fetal birth defects.


Highly infectious disease spread by coughs and sneezes, and the virus is also contained in its fluid-filled blisters. Chickenpox starts as small flat red spots on the trunk (body), armpits, scalp and groin; then spots become raised and intensely itchy, forming round, fluid-filled vesicles (blisters) with a red background. The lesions eventually rupture, then crust over. Chickenpox lesions can spread to the entire body including face, arms, legs, eyelids, inside the mouth and inside the vagina. Usually a mild illness treated with paracetamol and an antipruritic (anti-itching) agent such as calamine, as the healing skin can potentially become infected with bacteria through scratching.


Hypersensitivity responses (allergies) are caused by antigen-antibody responses (immune system over-reaction) triggered by topical

(touching the skin) or systemic (eg ingested) antigens.


Itchy rash resulting from the body’s allergy reaction production of histamine. Individual welts (small or large swellings) appear rapidly, spread quickly and resolve spontaneously (come and go); usually appearing on the trunk and perhaps extremities, but rarely the face. There are various types of Urticaria, including Acute Urticaria that can occur as a reaction to the likes of seafood or strawberries.


Common condition caused by two factors: A genetic tendency towards dry irritated skin, and skin allergies to various foods or irritants. Flare-ups result in erythema (Itchy reddened raised patches) with vesicles (blisters) forming, weeping and crusting. In infants and young children it often appears in the inner elbows and behind the knees, and in older children it tends to appear outside the elbows and in front of the knees, but can also be found on the trunk, face, hands and feet.  Eczema is commonly associated with asthma or hayfever.


Itchy raised red swelling (bumps or patches), progressing to blistering and crusting over, on a small area of the body. Or fine, red pimples or spots generalized throughout the body. Dermatitis can be caused by a huge array of irritants, including soaps, bubble-bath, suntan lotions, detergents, fabric softeners, household cleaners, clothing, wool or grass.


This is particularly common in infancy, and is not an allergic response. It is simply caused by a softening of the skin and rupture of sweat glands, due to prolonged exposure to a warm humid environment. It appears as tiny red pimples, bumps or spots, usually appearing on the back of the neck or lower back, but can involve the entire trunk.  Treated by cooling the baby and airing the area.




Cause: Ruptured blood capillaries under the skin

Symptom of: Bleeding problem or serious disease infection such as from Meningococcal bacterial invasion of the blood

Rash Description:

> Petechiae: Tiny, red, pinpoint, flat spots (like little dots made from a red pen)


> Purpura: Similar but larger, can be more purple or blue.

Rash Diagnosing: It is simple to distinguish Petechiae or Purpura from other rashes: They don’t fade (whiten or disappear) when you put pressure on them (easily tested by pressing a clear glass tumbler against them).

Treatment: Immediate emergency medical attention.

Exception: Bad coughing or forceful vomiting can cause non-concerning petechiae on the face, neck or upper chest, but don’t hesitate to still have the rash checked out. Petechiae or Purpura found anywhere else on the body requires immediate GP or after-hours A&E evaluation.

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