Skin Rashes - How do I treat my child’s rash and when should I be concerned?

Skin Rashes / Skin Care / Sunscreen / Insect Bites

How should I treat my child’s rash? Eruptions of the skin have many causes and are so variable that treatment over the phone is generally not accurate. Rashes in children with fever require prompt evaluation. Any rash that appears to be blood or hemorrhages in the skin (does not blanch with pressure) require immediate evaluation. Most other acute rashes in childhood, however, will be related to contact irritants or viral illnesses. Chronic rashes are most commonly eczema (atopic dermatitis) and are best managed with skin lubricants such as Aquaphor or Cetaphil. Your pediatrician may also decide to prescribe a topical steroid cream. Additionally, if the rash seems itchy, an antihistamine (Benadryl, Zyrtec, Claritin) may be beneficial.

How should I keep my child’s skin healthy? Newborns require very little, if any, skin care products, as they tend to naturally peel and acquire stronger skin in the first few weeks of life. Older infants and children are usually bathed several times per week using a mild soap such as Dove or Cetaphil. Ideally, immediate application of moisturizer after towel drying is helpful, particularly if your child’s skin is prone to dryness.

At what age can I use a sunscreen, and which ones are recommended? Infant skin is damaged more by sunburn than older children’s skin, and any sunburn should be completely avoided. Pediatric, hypoallergenic sunscreens are recommended. In babies less than six months of age, use sunscreen conservatively. We suggest applying a “test patch” to your child’s back or upper leg, waiting 24 hours to be certain there is no reaction, prior to applying to the entire body. Effective sunscreens should protect against both UVA and UVB lights (indicated on the label) and have an SPF of at least 25. Remember to reapply often, particularly after swimming or excessive sweating.

How can I prevent and/or treat insect bites, especially tick bites? Safe insect repellants for children should have labels with “family” on them, such as Family Off and Family Cutter. The active ingredient is DEET, which is extremely effective. In younger children, use products with 10% DEET or less. Tick bites that involve tick attachment less than 18 hours are of very little risk of disease transmission, i.e., Lyme disease, but ticks should be removed as quickly as possible. Rashes that occur with tick bites, especially from ticks that have been attached for prolonged or unknown periods, should be medically evaluated in the office. Signs of Lyme disease include fever, joint pain, swelling, and stiff neck. Ticks can be removed from the skin by using tweezers close to the skin. Use firm pressure, without crushing the tick. Removed ticks should be kept because they can be examined in the lab for Lyme disease.