Feb 09, 2022 3:00 PM

Author: University of Utah Health Communications


When your child comes to you with a rash, don’t panic – yet. Many childhood rashes are simple to treat or simply require time to go away. Cindy Gellner, a University of Utah Health pediatrician, says the five most common rashes she sees are:

  1. Eczema (atopic dermatitis)
  2. Molluscum contagiosum
  3. Pityriasis Alba
  4. Coxsackievirus (hand foot mouth disease)
  5. Diaper Rashes

Eczema

“There's a bunch of different types of eczema - intrinsic, flexural, dyshidrotic, nummular - but they're all basically the same thing: an itchy, dry, scaly, often red rash likely to affect people with allergies or asthma,” says Gellner.

Eczema is not contagious and can be treated with lotions for sensitive skin (no fragrance or dye) or topical steroids such as hydrocortisone or, if severe, a prescription strength steroid cream.

“Don’t use steroid creams on a regular basis because it can thin your skin, though eczema is often a lifelong condition,” Gellner says. “But without any treatment, eczema can crack the skin which can lead to impetigo, a bacterial skin infection.”

Molluscum Contagiosum

Molluscum contagiosum is a viral rash caused by the poxvirus and it's normally seen in toddlers through elementary age,” says Gellner. “At the center of the small flesh-colored papules, there is a white core. That is essentially where the virus lives, that eventually comes out. It basically looks like the little papule has a belly button.”

“Usually, we just let this rash run its course as the treatment can be worse,” says Gellner. “The rash is actually harmless, but it is contagious. The body's immune system will eventually kill the virus, though it can take months, or even a couple of years.

Pityriasis Alba

“Pityriasis Alba of is the loss skin pigment from the melanin due to skin irritation,” Gellner says. “The cause can be something as simple as dry skin, but it is not caused by a vitamin deficiency as some families have feared, and it’s not contagious.”

The hypopigmented patches usually appear on the face, upper chest, upper back, and the upper arms of people with dark skin.

“There’s nothing to make it better faster, but if you keep the skin hydrated you might avoid triggering more patches,” says Gellner. “The bottom line is you just have to wait for the skin cells to start making pigment again.”

Coxsackievirus (Hand, Foot, and Mouth Disease)

“I always joke with parents that it should be called hand-foot-butt-mouth disease because that’s where the rash appears,” says Gellner. “The classic case is red papules on the palms of the hands and soles of the feet, and on the buttocks. You can also get the rash around and inside the mouth.”

Coxsackievirus tends to show up in the summer and fall and the rash on the hands and feet is painless, though the ones in the mouth are painful” Gellner says. “Keep kids hydrated, but nothing's going to make it go away any faster. It’s also highly contagious, lasting about seven to 10 days.”

Diaper Rashes (Candidal and Irritant)

“Yeast is normally on our skin, but a diaper is a dark, moist environment that can make yeast go a little crazy and cause a candida diaper rash.”  Gellner says moisture can also cause irritation diaper rashes. She notes that babies can be changed often but still develop a candida diaper rash.

“Candida diaper rashes have what we call satellite lesions; a red bumpy, rash, usually on the front, with little red bumps on the fringe area and down the legs. It’s very itchy and can make the skin peel if it’s not treated.”

Gellner says she also sees lots of kids with standard diaper rashes, from irritation, and she always tells their parents to simply use diaper rash cream and change diapers frequently.

When to Worry: Purple Paint Specks

So, when might you need to worry? Gellner says to act immediately if your child has something that looks like purplish paint on their legs. “Like somebody took a paint brush with dark purple paint and just kind of spattered it on them, like tiny dots. That’s bad, and can be meningitis or idiopathic thrombocytic purpura,” says Gellner. Both conditions must be treated at a hospital.

Washing Away Protection

The body has a natural protective moisture barrier that helps keep out bad bacteria. Too much bathing and chemicals can break it down.

“Kids usually don't need a bath every single day and definitely not bath bombs,” says Gellner. “Some parents will overdo the baths and then their kids come in with dry irritated skin and they're worried. It’s important to keep the body’s natural moisture barrier intact.”

See a pediatrician near you.

pediatrics kids health rash eczema molluscum contagiosum Pityriasis Alba hand foot mouth diaper rash

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