Alphabetic Guide to Child Care - Rashes

Rashes

Rashes of one kind or another are among the most common occurrences of childhood. Whether it's the discomfort of diaper rash soon after birth, the childhood markings of chicken pox, or a case of poison ivy, most skin eruptions aren't too serious and are usually of brief duration.

The First Six Months

Skin rashes are especially common during the first six months. They may result from overheating or overdressing, or to the use of detergents, powders, perfumes, and oils which cause contact dermatitis . In addition, certain foods may make the baby break out in facial rashes. Prolonged contact with wet diapers causes diaper rash , from the ammonia produced by urine.

Skin rashes can usually be prevented or controlled by:

1. • Control of temperature
2. • Proper clothing
3. • Avoidance of irritating perfumes, powders, and detergents in laundering baby clothes
4. • Avoidance, in certain circumstances, of milk or other foods, as suggested by your physician
5. • Avoidance of rubber pants over diapers
6. • Applications of ointments to rashy areas

If a disturbing skin condition persists or gets worse, your physician will check for special infections like impetigo or fungus, and, should they exist, recommend proper treatment. During the early years, most children develop the characteristic rashes of the contagious childhood diseases, and at these times, a physician's care is usually essential for the prevention of complications.

Eczema

Some children suffer from intermittent eczema that has a tendency to run in families. Eczema can be extremely uncomfortable, because the more it itches, the more it is scratched, and the more it's scratched, the more it itches. This cycle may be triggered by an allergy to a particular food or pollen; it may be a contact dermatitis caused by a particular fabric, or it might flare up because of emotional tension created by family arguments or anxiety about schoolwork. Eczema should be treated by the family physician who may be able to discover its source and prevent further attacks.

Other Allergic Rashes

Other rashes that are essentially allergic in origin are those resulting from contact with poison ivy, oak, or sumac. For information about these and other skin conditions, including hives, see “Disorders of the Skin,” in Ch. 21, Skin and Hair .

The discomfort of many rashes can be eased by ointments or salves. Plain cornstarch is helpful for prickly heat.

Roseola

Among the more common rashes of early childhood is the one known as roseola infantum . It is believed to be caused by a virus. It begins with a high fever that subsides in a few days. There are no other specific signs of illness, and the end of the disorder is signaled by a rash of red spots that disappear overnight. The one aspect of roseola that requires medical attention is the fever. Because high temperature can produce convulsions in infants and babies, efforts should be made to reduce it by sponging and nonaspirin medication.

Pityriasis Rosea

A long-lasting rash thought to be viral in origin is pityriasis rosea , easily identifiable because the onset of this infection is preceded by one large raised red scaly eruption known as the herald patch. The rash itself appears symmetrically and in clusters on the trunk, arms, and legs, and in some children on the hands and feet as well as the face. Unfortunately, this rash may last for more than a month. There is no treatment for it, and, although it leaves without a trace and almost never recurs, it can cause severe itching that should be eased with a salve or ointment. Soap is very irritating and should be avoided.

Rocky Mountain Spotted Fever

Among the diseases caused by organisms known as rickettsiae and transmitted to people by the animal ticks that are infected with them is Rocky Mountain spotted fever , also called tick fever . In addition to rising temperature, headache, nausea, and malaise, this disease produces a characteristic rash that starts on the ankles, lower legs, and wrists, and then spreads to the rest of the body. Children who wander about in the woods during the summer or whose pets run loose in tick-infested areas should be watched for the presence of a tick on the skin and the ensuing rash. Rocky Mountain spotted fever is a serious disease against which youngsters should be protected by wearing the proper clothing.

Lyme Disease

A rash may be the first visible symptom of Lyme disease, which had been reported in all but a few American states by the late 1990s. Its highest incidence occurs in the northeastern, north-central, and western states. Caused by a tick-carried bacterium, the disease can produce neurological problems, heart disorders, and arthritis. The initial rash can extend over a large area. Antibiotics including tetracycline and penicillin may be used in treatment. The risk of infection may be reduced by frequent inspections of skin areas and prompt removal of the pinhead-sized ticks. If not embedded, a tick can be brushed off; if embedded, it can be pulled out carefully. Care should be taken not to crush the tick's body. The skin should be washed carefully with an antiseptic such as rubbing alcohol.

Lyme disease is treated with antibiotics. If it is caught early, patients can recover completely. For certain groups of people, a vaccine against Lyme disease is recommended.