Skin rashes in babies

Baby with rash

When you suddenly notice a bright, red rash on your baby, it’s natural to feel a bit panicky. But panic not; skin rashes are a normal part of babyhood and very common. Your baby’s skin is his largest organ and, just like any other organ, it is still developing. While it's worth being aware of the more serious conditions that can cause a rash, most rashes are mild and many can be treated at home – without medical treatment or panic.

The newborn rash

What is the newborn rash? The newborn rash, also known as erythema toxicum, usually appears in babies that are two or three days old. It looks like red pimples and blotches with an undefined edge.
How is the newborn rash treated? This rash is fairly mild and occurs in almost half of all newborns. It comes with no other symptoms and will usually go away by itself. It’s unlikely to cause your baby any discomfort but do steer clear of any strongly fragranced products that might cause further irritation.

Baby acne

What is baby acne? Some babies develop pimples within their first month. These spots usually appear on the forehead, cheeks and nose and are raised and inflamed. If your baby develops acne, it is likely to have been caused by exposure to your hormones while in the womb.
How is baby acne treated? Baby acne usually gets worse before it gets better and may take a few weeks to clear up. You can wash your baby’s skin once a day with warm water and a mild, unfragranced soap but avoid acne products designed for teenage skin. A mild moisturiser may also help the appearance of your little one’s skin. If the acne hasn’t gone after a month, speak to your doctor.

Eczema

What is eczema? Eczema is known for its red, itchy, dry patches of scaly skin. Where the condition is severe, your baby’s skin might even bleed or ooze fluid. It usually occurs in the folds of the skin around the elbows and knees but can appear anywhere including the scalp. The most common type of eczema is atopic dermatitis. Research has shown that babies that have this type of eczema are more likely to go on to develop asthma in later life. Eczema can run in families but may also be caused by a weakened immune system or environmental factors. If your baby has eczema he may also have food allergies or other sensitivities. Though eczema isn’t an allergic reaction itself, it can flare up if your baby’s allergies are triggered.

How is eczema treated? Mild eczema is treated simply by taking extra care of the skin. Moisturising with a suitable lotion will help to prevent the condition from flaring up, which often happens when the skin gets too dry. A moisturiser containing ceramides is best. If your baby’s eczema is severe you can get a hydrocortisone cream from your chemist. You should use laundry powder and soaps designed for sensitive skin and dress your baby in loose, cotton clothing. Do your best to stop him from scratching, which may cause bleeding, with scratch mitts and long sleeves. If these measures don’t improve your baby’s eczema, then you should speak to your GP.

Nappy rash

What is nappy rash? Nappy rash usually occurs if your baby has spent too long in a wet or dirty nappy. Contact with stools can be a particular irritant. As the name implies, the rash occurs in the nappy area but can spread to the genitals. Occasionally, nappy rash can be a symptom of something else, such as breastfeeding thrush.

How is nappy rash treated? Simple changes to your baby’s nappy changing routine can help to treat and avoid the rash. Change him frequently and clean him gently but thoroughly. You can also use super-absorbent nappies and a barrier cream before putting on a fresh nappy. This will prevent his skin from coming into contact with urine or faeces. Giving your baby some nappy-free time each day will also allow his skin to breathe.

Slapped cheek

What is slapped cheek syndrome? Slapped cheek syndrome (also known as Fifth disease) gets its name from the bright red rash that appears on a baby’s cheek. It might look a bit like your baby is teething, except that the rash will be raised and possibly spread to other areas of the body after a few days. Your baby might also have a high temperature. It’s spread by saliva droplets from sneezing and coughing, so take care around other infected children.

How is slapped cheek treated? It's a mild illness, which usually passes without the need for a doctor. You can give your baby paracetamol or ibuprofen to help lower his temperature. Offer plenty of feeds to prevent your baby from becoming dehydrated while he’s poorly.

Prickly heat

What is prickly heat? Prickly heat, also called miliaria, is a heat rash that appears when your baby sweats, gets too hot or is exposed to the sun. It looks like small, red pimples and appears in areas that are prone to sweat, such as the neck, armpits or nappy area. It is most likely to occur on hot days when your baby is at risk of overheating, or if he is overdressed.
How is prickly heat treated? Prickly heat will usually go away once your baby cools down. Keep him dry and cool and dress him in loose-fitting clothing on warmer days.

Ringworm

What is ringworm? Ringworm is a fungal infection that can appear anywhere on your baby’s body but usually on his scalp, chest, back or thighs, in the shape of a red ring. The edges of the ring will usually be hard or crusty and the centre will be smooth to touch. It may cause a small bald spot if it appears on the scalp. Ringworm has nothing to do with worms but is caused by the same fungus that causes athlete’s foot.
How is ringworm treated? You can treat ringworm in your baby with an over-the-counter antifungal cream containing clotrimazole or miconazole. This should clear the infection in three to four weeks but if it doesn’t you should seek your doctor’s advice.

Impetigo

What is impetigo? Impetigo is a bacterial infection that is highly contagious. It usually starts off around your baby’s nose and mouth and is made up of small blisters. It’s likely to make your baby itchy and the blisters may burst and then dry up. The bacteria infects your baby through broken skin so having conditions such as eczema can make your baby prone to the illness.
How is impetigo treated? Impetigo can clear up by itself in a few weeks but your doctor may prescribe an antibiotic cream to help with the infection. If this doesn’t work, your baby may be prescribed a course of antibiotics.

Erythema multiforme

What is erythema multiforme? Erythema multiforme usually occurs as an allergic reaction to the cold sore virus but it can also be a reaction to medication or an immunisation. The rash consists of small, red spots that resemble a bullseye with a dark centre and a pale outer edge.The spots may blister and your baby might develop a fever. The rash can spread quickly and is often found on the hands and feet before spreading to other areas of the body. It tends to be symmetrical in nature so if your baby has it on one arm, he’ll likely develop it on the other arm, too.
How is erythema multiforme treated? As with most rashes, erythema multiforme can clear up by itself but you could also try an over-the-counter cream to relieve the itching, as well as cold compresses. If the rash is accompanied by a high temperature or other symptoms, you should see your doctor.

Hives

What are hives? Hives, also called urticaria, are raised, red bumps on the skin with a wavy edge. They are the result of an allergic reaction to something. It will likely be a reaction to a food, such as milk or eggs, but it could also be triggered by a lotion or detergent you’ve used, or a reaction to a bite or sting.
How are hives treated? You can relieve your baby’s itching by applying cold compresses or calamine lotion to his skin. An over-the-counter antihistamine will also help. If the hives are recurring, it may be that your baby has an ongoing sensitivity to something and you should speak to your doctor.

Milk spots

What are milk spots? Milk spots, or milia, are tiny, white spots that appear on a baby’s nose, cheeks and around his mouth. Contrary to the name, they have nothing to do with feeding and are actually blocked oil glands. They often appear in the first two weeks after birth, when the oil glands are still developing.
How are milk spots treated? Milia require no treatment and will usually go away by themselves within a few weeks.

Hand, foot and mouth disease

What is hand, foot and mouth disease? The disease gets its name from the blister rash that appears on a baby’s hands, feet and inside of the mouth. It is caused by the coxsackievirus and is highly contagious. Hand, foot and mouth is spread through saliva droplets, contact with blister fluid or the faeces of an infected person. The blisters are usually accompanied by a high temperature, a sore throat and cough.
How is hand, foot and mouth disease treated? There’s no cure as such for hand, foot and mouth and as it’s a virus, it can’t be treated with antibiotics. It will go away within seven to 10 days, but you should keep your baby away from daycare and other children until he is symptom-free. Try giving him paracetamol or ibuprofen to help with the sore throat and fever. Keep him hydrated and offer short, frequent feeds, which will be easier for him if he has sores in his mouth.

Cradle cap

What is cradle cap? Cradle cap looks like greasy, yellow, scaly patches on your baby’s scalp, although it can spread to the face, too. It usually appears in your baby’s first eight weeks but can take months to go. The cause is unknown but it could be due to maternal hormones left over in your baby’s system from pregnancy.
How is cradle cap treated? Cradle cap usually goes by itself but you can take steps to ease it. Use some baby oil to soften the scaly patches then brush out using a soft-bristled baby brush before shampooing out with baby shampoo.

Scabies

What is scabies? Scabies occurs when tiny mites burrow into your baby’s skin. Anyone of any age can catch it but if your baby has it then it’s likely come from him being in prolonged skin-to-skin contact with someone who has it. Your baby can also catch it from being in contact with the clothes of someone who has scabies. Scabies appears as small red bumps that scab from itching. You’ll usually first notice the rash between your baby’s fingers, on his elbows and chest but it does spread to other areas of the body.
How is scabies treated? Your doctor can usually diagnose it just by looking at the rash but occasionally she may take a skin sample. Your baby will be prescribed an ointment to apply to the skin. It’s important that you wash all of your baby’s clothes and bed linen on a very hot wash to kill any mites that might be nesting and prevent the rest of your family from becoming infected. Anything that can’t be washed, such as toys, can be sealed in a plastic bag or placed outside the house to kill the mites, as they can only survive on human skin.

Roseola

What is roseola? Roseola is caused by the human herpes virus. It is most common in babies aged between six months and two years. If your baby has roseola, he will have a sudden high temperature followed by a rash that usually starts on his belly before spreading to his arms and legs. The rash won’t itch but it might be accompanied by other symptoms, such as a sore throat or mild diarrhoea.
How is roseola treated? It’s wise to see your doctor if you notice the above symptoms, particularly a high fever. The doctor may want to rule out other illnesses. As roseola is a virus, it can’t be treated with antibiotics and will need to run its course. You can give your baby a bit of relief from the symptoms by keeping him cool and hydrated – offer lots of feeds and water if he’s older. You can also try giving him paracetamol or ibuprofen to help bring down his fever.

Could it be something else?

Most skin rashes are mild and are part and parcel of infancy. Occasionally though, a rash can be linked to a more serious illness such as meningitis, measles or chickenpox.

Meningitis symptoms include a stiff neck, aversion to bright lights, refusing feeds, being drowsy and difficult to rouse, stiff or jerky movements, fever but with cold hands and feet, an unusual cry and a confused state. The rash is usually the last symptom to appear. If your baby is displaying any of these symptoms, don’t wait for the rash to appear – seek medical advice immediately.

Measles symptoms include fever, sore throat, cold and cough, runny nose and conjunctivitis. The rash resembles red-brownish blotches. See your doctor to have your baby diagnosed if you suspect measles.

Chickenpox symptoms include a red, spotty rash followed by blisters. In addition, your baby might have a high temperature, loss of appetite and aches and pains with chicken pox.