Rashes in Children

ByDeborah M. Consolini, MD, Thomas Jefferson University Hospital
Reviewed/Revised Nov 2022
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    A rash is an abnormal change in the texture or color of the skin.

    • Known causes of rashes include irritation, allergies, drugs, and bacterial, fungal, or viral infections.

    • Rashes include redness, white or yellow scales, and pearly pimples, bumps, or cysts.

    • Rashes may itch, be irritating or painful, or cause no symptoms.

    • Rashes that require treatment can be helped by gentle cleansers, moisturizing ointments, antibiotic or corticosteroid ointments, and/or anti-itch drugs.

    Rashes in infants and young children are not usually serious and can have various causes. Irritating substances, drugs, allergic reactions, and disorders that cause inflammation can cause a rash.

    Some common causes of rashes in infants and young children include the following:

    Diaper rash (diaper dermatitis)

    Diaper rash is a bright red rash that usually develops when the infant's skin comes in contact with a diaper that is soiled by urine, stool, or both. The moisture on the infant's skin causes irritation. Typically, the areas of the skin that touch the diaper are most affected.

    Diaper Rash Caused by Irritation
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    This photo shows an infant's irritated skin. The irritation occurs because the infant's skin comes in contact with a diaper soiled with urine and stool.
    © Springer Science+Business Media

    Diaper rash can also be caused by infection with the fungus Candida, typically causing a bright red rash in the creases of the skin and small red spots. Less often, diaper rash is caused by bacteria.

    Diaper Rash Caused by Candida
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    This photo shows a rash caused by the yeast Candida.
    Image provided by Thomas Habif, MD.

    Breastfed babies tend to have fewer diaper rashes because their stools contain fewer enzymes and other substances that can irritate the skin.

    Diaper rash does not always bother the child. It can be prevented or minimized by using diapers that are made with an absorbent gel, by avoiding restrictive plastic diapers or pants that trap moisture, and by frequently changing diapers when they are soiled.

    Candida infection. Antibiotic cream can be used if the rash is caused by bacteria.

    Cradle cap ()

    Cradle cap is a red and yellow, scaling, crusty rash that occurs on an infant's head. A similar rash can occur occasionally in the infant's skinfolds. The cause is not known. Cradle cap is harmless and disappears in most children by 6 months of age.

    Cradle Cap (Seborrheic Dermatitis)
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    This photo shows the thick, yellow, crusted scalp rash of cradle cap.
    Biophoto Associates/SCIENCE PHOTO LIBRARY

    (eczema)

    Atopic dermatitis is a red, scaly, and itchy rash. The rash tends to appear in patches that come and go, often worsening with cold, dry weather. Infants tend to develop red, oozing, crusted rashes on the face, scalp, diaper area, hands, arms, feet, or legs. Older children tend to develop one or a few spots, usually on the hands, upper arms, in front of the elbows, or behind the knees.

    Atopic dermatitis tends to run in families and in many cases is thought to be due to a gene variation that affects the skin's ability to retain moisture and provide protection against bacteria, irritants, allergens, and environmental factors. This weak skin barrier function likely also triggers the immune response that leads to the inflamed skin and itch. Most children outgrow atopic dermatitis, but for others it is a life-long condition. Children with severe cases may intermittently develop infections in areas where they have scratched and torn the skin.

    Treatment of atopic dermatitis includes use of skin moisturizers, gentle soaps, humidified air, corticosteroid creams, and anti-itch drugs. Efforts to avoid triggers of a child's allergies may help alleviate the condition.

    Atopic Dermatitis (Acute)
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    Atopic dermatitis usually develops in infancy. In the early (acute) phase, the rash appears on the face and then spreads to the neck, scalp, arms, and legs.
    Image provided by Thomas Habif, MD.

    Viral infections that cause a rash

    Viral infections often cause rashes in young children. Rashes caused by roseola infantum and erythema infectiosum (fifth disease) are harmless and usually go away without treatment. Rashes caused by measles, rubella, and chickenpox are less common because children receive vaccines that prevent these infections, but they may occur in unvaccinated children.

    Rash Caused by Roseola Infantum
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    This photo shows the flat, red rash caused by roseola infantum.
    SCOTT CAMAZINE/SCIENCE PHOTO LIBRARY
    Rash Caused by Erythema Infectiosum
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    This photo shows the "slapped-cheek" appearance of the rash on the cheeks caused by erythema infectiosum.
    John Kaprielian/SCIENCE PHOTO LIBRARY

    Other causes of rashes

    Dermatophytoses (also called ringworm or tinea) are fungal infections of the skin. In children, infections of the scalp (tinea capitis) and body (tinea corporis) are most common.

    The diagnosis and treatment of dermatophytoses are the same in children and adults and typically includes antifungal drugs applied to the skin or taken by mouth. Some children have an inflammatory reaction to the fungal infection that leads to a painful, inflamed, swollen patch on the scalp called a kerion. A kerion may require additional treatment.

    Ringworm
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    This image shows the fungal skin infection ringworm on the neck and upper back of a 13-year-old boy. Ringworm in this area of the body is known as tinea corporis.
    DR P. MARAZZI/SCIENCE PHOTO LIBRARY

    Molluscum contagiosum is a cluster of flesh-colored pearly pimples or bumps caused by a viral skin infection that usually disappears without treatment. However, the virus that causes this infection is contagious.

    Molluscum Contagiosum on a Child’s Face
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    The photo shows bumps of molluscum contagiosum.
    © Springer Science+Business Media

    Milia are small pearly cysts on the face of newborns. They are caused by the first secretions of the child's sweat glands. Like newborn acne, milia require no treatment and disappear a few weeks after birth.

    Milia
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    This photo shows small, cream-colored cysts commonly seen on the face of newborns.
    SCIENCE PHOTO LIBRARY
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