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Should Your Child See a Doctor?

Rash – Localized and Cause Unknown

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Definition

  • Rash on one small part of the body (localized or clustered)
  • Red or pink rash
  • Small spots, large spots or solid red
  • Includes localized areas of redness or skin irritation

Causes 

  • Main cause: skin contact with some irritant.

Return to School 

  • Children with localized rashes do not need to miss any child care or school.

When to Call Your Doctor for Rash - Localized And Cause Unknown

Call 911 If…

 
  • Your child is not moving or is too weak to stand
 

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Purple or blood-colored spots or dots that's not from injury or friction
  • Bright red area or red streak (but not sunburn)
  • Rash area is very painful
  • Age under 1 month old and tiny water blisters (like chickenpox)
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Severe itching or fever is present
  • Looks like a boil, infected sore or other infected rash
  • Teenager with genital area rash
  • Lyme disease suspected (bull's eye rash, tick bite or exposure)
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Blisters unexplained (EXCEPTION: Poison Ivy)
  • Pimples (Apply antibiotic ointment until seen)
  • Peeling fingers
  • Rash lasts longer than 7 days
 

Parent Care at Home If

  • Mild localized rash and you don't think your child needs to be seen
 

Home Care Advice for Localized Rashes

  1. Reassurance: New localized rashes are usually due to skin contact with an irritating substance.
  2. Avoid the Cause:
    • Try to find the cause.
    • Consider irritants like a plant (e.g., poison ivy), chemicals (e.g., solvents or insecticides), fiberglass, detergents, a new cosmetic, or new jewelry (e.g., nickel).
    • A pet may be the intermediary (e.g., with poison ivy or oak) or your child may react directly to pet saliva.
     
  3. Avoid Soap: Wash the area once thoroughly with soap to remove any remaining irritants. Thereafter avoid soaps to this area. Cleanse the area when needed with warm water.
  4. Local Cold: Apply a cold wet washcloth or soak in cold water for 20 minutes every 3 to 4 hours to reduce itching or pain.
  5. Steroid Cream: If the itch is more than mild, apply 1% hydrocortisone cream (no prescription needed) 4 times per day. (EXCEPTION: suspected ringworm)
  6. Avoid Scratching: Encourage your child not to scratch. Cut the fingernails short.
  7. Contagiousness: Children with localized rashes do not need to miss any child care or school.
  8. Expected Course: Most of these rashes pass in 2 to 3 days.
  9. Call Your Doctor If:
    • Rash spreads or becomes worse
    • Rash lasts over 1 week
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

References

  1. Carter S. Etiology and treatment of facial cellulitis in pediatric patients. Pediatr Infect Dis J. 1983;2:222.
  2. Cohen BA. Warts and children: Can they be separated? Contemp Pediatr. 1997;14(2):128-149.
  3. Darmstadt GL. A guide to abscesses in the skin. Contemp Pediatr. 1999;16(4):135-145.
  4. Friedlander SF. Contact dermatitis. Pediatr Rev. 1998;19:166-171.
  5. Honig PJ, Frieden IJ, Kim HJ, Yan AC. Streptococcal intertrigo: an underrecognized condition in children. Pediatrics. 2003; 112(6):1427-1429.
  6. Tibbles CD, Edlow JA. Does this patient have erythema migrans? JAMA. 2007;297:2617-2627.
  7. Weston WL and Bruckner A. Allergic contact dermatitis. Pediatr Clin North Am. 2000.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/18/2010 6:29:03 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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