Rash in children: causes, symptoms and treatment

Skin diseases
Skin diseases in children are a common problem that has various causes, from genetic predispositions to reactions to external stimuli such as allergens.

Atopic eczema
Atopic eczema, also known as atopic dermatitis, is one of the most common skin conditions in children, including babies. It is a chronic inflammatory skin disease that is often genetically determined. Typical symptoms are dry, itchy and red skin that often cracks and is more prone to infections.
In eczema, a rash may appear on the face, neck, limbs and other parts of the body. A rash around the eyes, including the eyelids, is also common. A compromised skin barrier increases susceptibility to yeast or other secondary infections.
Triggers include various allergens (e.g. dust or food), stress, dry air or irritants (e.g. perfumed products).
Treatment of eczema
The treatment of eczema consists of regularly lubricating the skin with moisturising creams or ointments, minimising contact with irritants and allergens and using gentle products. As a moisturiser, we recommend, for example, Dermaguard, which helps to restore and strengthen the skin's natural protective barrier.  It is available for purchase in our e-shop.
In some cases, eczema is treated with corticosteroid creams or antihistamines to relieve itching.

Contact dermatitis
Contact dermatitis is an inflammatory skin reaction that occurs after skin contact with an irritant or allergen, usually on the face, hands or feet. It occurs frequently in children because their skin is particularly sensitive to various substances in their environment.
Contact dermatitis is a type of allergic rash that is triggered by substances such as certain metals (e.g. nickel), latex, certain ingredients in cosmetics and detergents, or plants (poison ivy ad).
Symptoms usually appear at the site of contact with the irritant and include redness, itching, rash and sometimes blistering or peeling of the skin. The reaction occurs immediately or may develop gradually over several days after exposure.
Treatment of contact dermatitis
The first step in the treatment of contact dermatitis is to remove the irritant or allergen. To relieve symptoms and promote healing, the use of moisturizing creams or ointments is recommended. In case of stronger reactions, doctors prescribe corticosteroid creams or antihistamines.

Seborrheic dermatitis
Seborrheic dermatitis, also known as "baby psoriasis" occurs in infants and manifests itself as excessive sebum production on the scalp. This leads to the formation of yellow oily scales and sometimes red, inflamed skin.
Treatment of seborrhoeic dermatitis
Seborrheic dermatitis is treated by regularly washing the head gently with a special shampoo for babies, which helps to dissolve and remove oily scales. Gentle brushing of the hair shafts is recommended and in cases of more severe symptoms the use of shampoos with ketoconazole, salicylic acid or tar.
Prescription creams, such as those with hydrocortisone or antifungal ingredients that fight yeast, are also used to reduce inflammation.

Diaper dermatitis
Diaper dermatitis is the most common skin disease of infants and toddlers. It presents with redness, rash and swollen areas where the skin comes into contact with the nappy.
Treatment of diaper dermatitis
It is important to keep the diaper area clean and dry, to change the baby frequently and to leave the baby undressed for a while during changing. Ointments or creams with zinc oxide or petroleum jelly also help.

Pink pityriasis
Pink pityriasis is a dermatological disease that is probably related to a viral infection. It manifests itself as a rash on the back, abdomen, chest and limbs in the form of pale pink oval patches that may itch. The rash usually starts with one larger spot, followed by smaller ones.
Treatment of pink pityriasis
Pityriasis usually goes away on its own. Antihistamines or topical corticosteroids are used to relieve itching. It is important to keep the skin moisturized and avoid irritating soaps.

Keratosis pilaris (chicken skin)
This is a non-infectious, often hereditary disease caused by excessive accumulation of keratin in the mouth of hair follicles. This excess keratin causes the formation of small, hard scales or pimples that are rough to the touch and often appear on the arms, thighs, cheeks or buttocks.
Treatment of keratosis pilaris
Treatment usually involves regular skin care aimed at moisturizing and removing dead cells. It is recommended to use moisturizing creams or ointments that contain urea, salicylic acid or alpha-hydroxy acids, which help to soften and smooth the skin.
Gentle exfoliating products will help remove excess keratin from the skin surface. In some cases, topical retinoids are used to regulate skin cell renewal.

Reactions to heat or cold
Reactions to heat or cold can cause different types of rashes that arise due to overheating, sunlight or, conversely, exposure to cold.
Solar urticaria (sun allergy or sun rash)
This itchy rash from the sun manifests itself in tiny blisters on unprotected parts of the body and is caused by hypersensitivity to sunlight.
Cold urticaria (allergy to cold)
Cold urticaria manifests as a red itchy rash on the body, which may be accompanied by swelling, in areas exposed to cold. Some children may experience more severe reactions, such as breathing difficulties.
Treatment of sun and cold urticaria
Treatment focuses primarily on relief of itching, as well as antihistamines to reduce itching and inflammation. For sun urticaria, it is important to use high SPF sunscreen and protective clothing, while for cold urticaria, it is important to wear warm layers and avoid direct contact with the cold. Cool compresses or ointments are also helpful for treating acute symptoms.

Rash
Sweats often occur in infants and are related to thermoregulation, which is not fully developed in children under one year of age. They are tiny pink pimples caused by a blockage of the sweat glands, usually in hot weather or during a fever. They appear in the folds of the skin, on the neck, in the armpits or under nappies.
Treatment of sweat glands
Sweat glands usually go away on their own within a few days. Light, breathable clothing and more frequent bathing or rinsing the skin with lukewarm water are recommended. Oil-based ointments or creams are not suitable as they often worsen the blockage of the sweat glands.

Heatstroke
Heatstroke is caused by overheating, when the body is unable to regulate its temperature. Symptoms include reddening of the skin, rash, fever, nausea, dizziness and sometimes loss of consciousness.
Treatment of heatstroke
Treatment involves moving the child to a cool environment, removing excess clothing and giving cold drinks and cold compresses. If the condition does not improve, it is essential to seek medical attention.

Viral infections
The most well-known viral infections in children include fifth disease, sixth disease, chickenpox, measles, rubella, molluscum, shingles and seventh disease.

Fifth disease
The typical manifestation of fifth disease is a bright red rash on the cheeks, which usually does not itch and is often accompanied by fever, fatigue or headache. Gradually a rash appears on the abdomen, buttocks and legs.
Treatment of the fifth disease
Treatment includes medication to relieve pain and fever, such as ibuprofen or paracetamol. Antihistamines will help relieve uncomfortable itching.

Sixth disease (Roseola)
The sixth disease, also known as roseola or three-day fever, manifests itself as a fever lasting several days, after which a red rash spreading from the trunk to the extremities appears.
Treatment of the sixth disease
Treatment of the sixth disease involves reducing the fever with antipyretics such as paracetamol. The rash usually does not require specific treatment and resolves itself within a few days. It is important to monitor your child's temperature and well-being to avoid complications associated with high fever.

Chickenpox
Chickenpox is a highly infectious viral disease spread by the droplet route. The typical manifestation is a rash all over the body in the form of blisters that burst and eventually become scabs.
Treatment of chickenpox
Treatment is aimed at alleviating the symptoms, as the infection itself must run its natural course. Cooling preparations help to relieve itching and antipyretics such as paracetamol or ibuprofen are given to reduce fever.
It is important to follow good hygiene habits, including regular hand washing and short nails, to prevent the spread of infection.

Measles
Measles is a highly contagious disease whose typical manifestation is small spots that gradually darken. The rash first appears behind the ears and on the face and gradually spreads to the whole body. Other symptoms include high fever, cough, runny nose and conjunctivitis.
Treatment of measles
The primary treatment for measles is aimed at relieving symptoms and preventing complications, as there is no specific cure for measles. Adequate fluid intake to maintain hydration and rest is recommended. Antipyretics such as ibuprofen or paracetamol are helpful to reduce fever and pain.
Because of the risk of serious complications such as pneumonia or encephalitis, it is important to monitor your health closely and seek medical attention if it worsens. The most effective way to prevent measles is vaccination.

Rubella
Rubella (rubeola) is transmitted by the droplet route and manifests itself as a tiny pink or red rash that first appears on the face and gradually spreads to the whole body. Other symptoms include temperature, swollen local nodes, joint pain and mild chills. After contracting rubella, lifelong immunity remains.
Treatment of rubella
Treatment for rubella is mostly symptomatic, as the disease itself is usually not serious and will resolve on its own without specific treatment. Rest, adequate fluid intake and paracetamol to reduce fever are recommended. In case of itching, you can apply a cooling cream or antihistamines.
An effective prevention against rubella is vaccination. This especially protects pregnant women, where infection in the first trimester can lead to serious birth defects in the baby.

Molluscs (Molluscum contagiosum)
Molluscs are highly contagious and spread by direct contact, saliva, parts of clothing or towels. The disease is manifested by small, pearly growths with a dimple in the middle. When squeezed, a light-coloured fluid oozes out. Molluscs often appear on the hands, face, arms, legs and intimate areas. Although they are usually not painful, they often cause itching.
Treatment of moles
In many cases, moles go away on their own without treatment because the immune system gradually suppresses the virus. Methods such as cryotherapy (freezing with liquid nitrogen), needling, cauterisation or removal with a sharp spoon (curettage) are often used to treat moles.
For home care, doctors prescribe creams containing salicylic acid or potassium hydroxide to help break down the calluses. It is also important to prevent the spread of the infection by avoiding children sharing personal items and observing strict personal hygiene.

Shingles
Shingles most commonly occurs in older children or individuals with weakened immunity. It is manifested by a red rash and blisters that occur along the nerve pathways, usually on one side of the body. It may be accompanied by pain, itching and fever.
Treatment of shingles
Shingles is treated with antiviral drugs, which, if given early, can shorten the duration of the infection and reduce its severity. Analgesics and creams with local anaesthetics are suitable for pain. Moisturizing the skin and avoiding scratching the blisters to prevent infection is also recommended.

The seventh disease
The seventh disease is manifested by a rash on the hands, feet and mouth (called hand-foot-mouth syndrome). The child may also have a fever, sore throat and sores in the mouth that make swallowing difficult. Seventh disease most often affects young children, especially those in preschool.
Treatment of seventh disease
Treatment is symptomatic, as the disease resolves on its own within 7 to 10 days. Antipyretics are useful to reduce fever, analgesics to relieve pain, and adequate fluid intake is also important.

Bacterial infections
Childhood bacterial infections include scarlet fever and impetigo.

Scarlet fever
Scarlet fever usually starts with a high temperature, sore throat and headache. The typical symptom is a raised red crusty rash on the child's chest and neck, which may spread to other parts of the body, such as the face, abdomen or back. A raspberry-coloured tongue is typical.
Scarlet fever can also manifest itself by disturbance of the bacterial balance, e.g. diarrhoea, constipation or flatulence.
Treatment of scarlet fever
Scarlet fever is treated with antibiotics.

Impetigo
Impetigo is most common in children aged 2 to 5 years, but can occur at any age. It is manifested by blisters that burst and form a yellow-brown crust. They are most common around the mouth and nose, but can be anywhere there is repeated skin irritation.
Treatment of impetigo
Impetigo is treated with antibiotics. It is important to follow hygiene measures such as frequent hand washing and not sharing personal items (towels, toys) to prevent the spread of infection.

Conclusion
Some rashes can be managed on your own as a parent using over-the-counter products and home care. However, if you are unsure of the cause or the rash does not go away within a few days, is accompanied by other symptoms such as fever, swelling or breathing difficulties, see a doctor.

Resources:
https://www.nhs.uk/conditions/rashes-babies-and-children/
https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/skin-rashes-in-children/
https://www.nidirect.gov.uk/conditions/skin-rashes-children)
https://my.clevelandclinic.org/health/diseases/6951-skin-conditions-in-children)