Rashes In Babies
Rashes in babies
- Common rashes in newborns
- Allergy Rashes
- Eczema
- Rashes needing urgent attention
Rashes in babies can be caused by a number of different things. Most are temporary and harmless but some, such as the rash associated with meningitis, indicate serious infection.
Common rashes in newborns
Milia
These are tiny white spots, similar to tiny pimples, mainly found over the bridge of the nose and cheeks but also on the forehead and chin. Milia are due to blocked sweat glands and are harmless. No treatment is necessary and they disappear within a few weeks.
Erythema toxicum
More than 50% of babies get a rash called erythema toxicum on the second or third day of life. The rash consists of small flat red blotches with a small white lump in the centre. The cause of this rash is unknown. It usually disappears by the time an infant is two weeks old. No treatment is necessary.
Heat rash (milaria)
Small babies find it difficult to regulate their body temperature and can easily over-heat. Heat rash, also called “prickly heat”, is caused by blocked-off sweat glands. Tiny pink bumps appear, usually on the chest, back or neck and cause itching. Occasionally, pinpoint-size water blisters occur. The rash fades on cooling.
Acne of newborn
More than 30% of newborn babies develop small red bumps on their face. This “acne” is thought to be due to transfer of maternal androgens (hormones) to the baby just prior to birth. No treatment is necessary and the rash settles spontaneously.
Drooling rash
Dribbling often causes an intermittent red rash on a baby’s face. Keeping baby’s skin clean and dry (including under the chin), will ease it.
Nappy Rash
Nappy rashes are caused by prolonged contact with moisture, bacteria, and ammonia (caused by urine and faeces). Treatment includes frequent nappy changing, proper cleaning and drying of the nappy area, barrier creams and exposure of the baby’s bottom to air.
If the rash does not improve, it is possible that your baby has a yeast infection (Candida). Candida causes a bright red, raw rash with red dots at the edge. It can be treated with anti-thrush creams.
Cradle cap
The scalp is covered in a crusty ‘cap’ of thick white, yellow or cream scales. It develops a few weeks after birth and clears by about eight to twelve months. Treatment consists of applying oils or emollients to the scalp to soften the cap, followed by shampooing.
Allergic Rashes
Babies can get a rash when they are exposed to something they are allergic to e.g. penicillin. An urticarial rash is a type of allergic rash consisting of itchy, raised, red areas that look like nettle-stings and can develop after certain medications, foods, viruses, or exposure to certain plants.
Eczema
Eczema (also called ‘dermatitis’) is very common skin condition in children. Babies tend to develop one of two types of eczema: seborrhoeic eczema and atopic eczema.
Seborrhoeic eczema (dermatitis) usually develops in the first six weeks of life and is associated with cradle cap. A thick, yellow, scaling rash occurs in the nappy area. An angry, red, scaling rash can develop under the arms. The rash looks sore but is not itchy and the baby is not particularly bothered by it.
Careful cleaning and application of a moisturiser such as aqueous cream may help. Sometimes a low strength hydrocortisone cream is recommended. The rash usually settles by the time the baby is out of nappies.
Atopic eczema develops at any time after six weeks of age.
The skin becomes dry, red, scaly and itchy and cracks may develop. It usually starts on the face, behind the ears and scalp but later involves the skin folds of the elbows, knees and knees.
There is a higher incidence of eczema in families where there is a history of other allergic disorders such as hayfever or asthma. Certain things provoke or aggravate eczema such as wool, biological washing powder and the house dust mite.
The following tips will help keep the eczema under control:
- Keep the skin well moisturised with emollient creams, oils and ointments.
- Do not use soap as this will dry the skin.
- Avoid anything that seems to aggravate baby’s eczema e.g. wool, biological powders
- Keep baby cool in loose, cotton clothes.
- Keep the bedroom as dustfree as possible.
- Keep baby’s nails short and clean.
- Use sleep suits with cotton sleeve extensions or soft cotton socks taped to sleepsuit.
When eczema is very red and angry, your doctor may recommend a short course of cortisone cream to bring it under control. Sometimes cracks in the skin cause infection and antibiotic treatment may be necessary.
Rashes needing urgent attention
Any rash that does not fade when pressed, or any rash in a sick baby needs urgent medical attention.
Meningococcal septicaemia (meningitis bacteria in the bloodstream)
This rash accompanies infection with the Meningitis C virus and is associated with a characteristic rash that all parents should become familiar with. Meningococcal septicaemia is a life-threatening condition.
The rash can occur anywhere on the body – the entire skin surface should be checked.
It consists of red-purple or brownish spots or bruises (caused by bleeding under the skin). If a glass tumbler is pressed against the rash, the rash does not fade; it remains visible through the glass.
A rash that does not fade when pressed in a baby is a medical emergency (especially if baby is sick or has a high temperature). Contact your doctor immediately. If there is any delay in contacting your doctor, go to the nearest A&E Department. It is important to note that not all cases of meningitis C are accompanied by a rash. Other symptoms to look out for include: irritability, refusal to feed, vomiting, high-pitched cry, drowsiness, pale or blotchy skin.
Fever
A fever over 39.5°C (103°F) can cause a blotchy pinkness of the skin.
Treating a rash
Treatment of a specific rash depends on the cause. Contact your doctor for advice. Viral rashes usually disappear within 48 hours. If the redness is caused by a fever, it will clear when the fever comes down.
The following measures help to relieve itching regardless of the cause:
- Cool baths.
- Calamine lotion.
- For very itchy spots, apply 1% hydrocortisone cream (except chickenpox).
- Cut your child's fingernails short.
- Loose-fitting cotton clothes.
When to call the doctor
Call your doctor if:
- The rash becomes purple or has non-blanching blood-coloured spots or dots.
- The rash becomes bright red and tender.
- Your baby is ill (not feeding, lethargic, drowsy, irritable).
- Your baby has a high temperature.
- The rash is not settling.
- You are not sure what is causing the rash.
Written by
VHI Healthcare
www.vhi.ie
Ireland's leading Early Years education Magazine
