Measles, heat rash or chickenpox?
As a parent it can be difficult to identify even the most common toddler rashes and spots. What’s the difference, and how can you spot them?
Nine out of 10 children in the UK will catch chickenpox, most of them before the age of four, according to research.
Chickenpox causes an itchy rash, spots and fluid-filled blisters, among other symptoms, and is particularly prevalent between March and May.
Scratching can lead to further infections, sleepless nights and permanent scarring.
Before the rash appears, it’s common to experience mild flu-like symptoms including feeling sick, a high temperature of 38oC or over, aching muscles and a headache.
“Chickenpox is a mild and common viral illness that seems to strike most children down at some point, particularly if they are in close proximity to other infants,” says Dr Sarah Jarvis.
“Look out for clusters of red spots, which turn into small, fluid-filled, itchy blisters that break and then scab over.”
Where can chickenpox occur?
Anywhere on the body. Several groups of spots may develop over a few days. Some children only have a few spots whereas others can be completely covered from head to foot.
Who gets chickenpox?
Chickenpox is most common in children under the age of 10 but anyone who hasn’t previously had chickenpox can catch it.
Treatment of chickenpox
Your child is infectious from two days before the rash emerges until all the spots have crusted over.
To avoid the infection spreading further, keep children off nursery or school and away from vulnerable groups of people including pregnant women, elderly and people with a weakened immune system.
Encourage your child not to scratch the spots to avoid scarring, and soothe itchiness with products like Care ViraSoothe Chickenpox Relief Cooling Gel and Spray Gel.
Paracetamol can help with fever and discomfort, but avoid ibuprofen if your child has chickenpox.
For more advice on chickenpox management visit the Care YouTube channel to watch Dr Sarah Jarvis discuss the best ways to treat the illness: https://www.youtube.com/watch?v=qQ5hMIxVz64
Heat rash (prickly heat)
Dr Sarah says: “Heat rash, also known as miliaria or prickly heat, appears as tiny little red bumps or blisters on the skin and it happens when children get too hot. The rash often stings or feels prickly.”
Where can heat rash occur?
It can occur anywhere on the body, but often appears in places covered by clothing.
Who gets heat rash?
Anyone can get it, even very young babies. It happens when children overheat usually during hot weather but can occur any time of the year.
The bumps form when the sweat glands get blocked and the sweat becomes trapped under the skin, causing a rash.
Treatment of heat rash
Heat rash is a sign your child is too warm, so keep them cool and make sure they aren’t dehydrated. It usually goes away on its own but you can ease symptoms with a cool bath.
If your child is prone to heat rash, there are a few things you can do to prevent them from getting it such as dress them in loose, cotton clothing in the heat. This fabric absorbs moisture, rather than trapping it like some synthetic fibres.
“Measles is a type of virus called ‘paramyxovirus’ which can be contracted by an infected person’s salvia - so if they cough or sneeze near a child that is not vaccinated, they could breathe in tiny droplets and pick up the virus,” says Sarah.
“Watch out for tiny white spots with a red outline inside the mouth, followed a few days later by a fine red rash that starts small and becomes blotchy.
“This rash appears after initial cold-like symptoms, such as red eyes, sensitivity to light, a fever and greyish white spots in the mouth or throat.”
Where can measles occur?
The spots develop in the mouth and on the cheeks whilst the rash typically starts behind the ears and then spreads to the body.
Who gets measles?
It is most common in children aged between one and four years old.
Treatment of measles
See your GP immediately if you suspect measles.
A salvia test will be carried out and, if a positive result is confirmed, the local Health Protection Unit will be informed.
Your child should not return to school until the measles are under control.
Though there is no specific treatment for measles, you can give pain relief to relieve fever, aches and pains. You could try Care Ibuprofen for Children Oral Suspension.
Children should also drink plenty of water to prevent dehydration.
“Eczema can often be identified by a dry, red patch of skin that may be broken or cracked,” says Sarah.
The most common form in children is atopic eczema, which presents as small areas of dry skin that are occasionally itchy. In some severe cases, atopic eczema can cause widespread dry skin, constant itching and oozing sores.
Where can eczema occur?
Eczema can occur anywhere on the body but in infants you are most likely to see it on the face, arms and legs and in children on their hands, around their joints, such as the front of their elbows or the back of their knees.
Who gets eczema?
Eczema often runs in families. If you have a family history of ‘atopic’ conditions like eczema, hay fever or asthma, your child is more likely to get eczema. However, any child can get it.
Treatment of eczema
If your child has atopic eczema, their condition may improve over time but the most common treatments include moisturising products such as Care Aqueous Emollient Cream (SLS Free) that can be bought from your local pharmacy.
Topical corticosteroids may also be prescribed to reduce any swelling in affected areas.
Flare-ups of eczema are often caused by a trigger e.g. certain fabrics or scented soaps or bath products. Washing detergents can make things worse, especially if they’re not rinsed out properly.
Light cotton clothing is preferable when skin flare ups occur, as getting warm and sweaty can make symptoms worse.
Sarah says, “Meningitis is an infection of the protective membranes that surround the brain and spinal cord.
“The meningitis rash occurs when septicaemia (blood poisoning) has taken hold.
“It is a blotchy dark red rash that doesn’t disappear under a glass tumbler when pressed firmly.
“There will be other symptoms to look out for including high fever, cold hands and feet (even with a high fever) and a pale, dusky or blue colouring around the lips. Other symptoms include tense or bulging soft spot on babies’ skulls, poor feeding, drowsiness or irritability, and a high-pitched cry.
“In older children, look out for neck stiffness, headache, fast breathing, leg pains and dislike of bright lights.”
Where can meningitis occur?
The rash can appear anywhere on the body and is due to the leaking of the capillaries which results in blood accumulating directly under the skin.
Who gets meningitis?
All ages but babies are at a greater risk because they have a reduced immunity.
Treatment of meningitis
If you suspect meningitis, take your child to the hospital immediately. This is an absolute medical emergency and it’s always better to be safe than sorry.
Sarah says: “There are two types of impetigo: bullous impetigo and non-bullous impetigo.
“Non-bullous impetigo is very common, particularly in children and especially in hot, humid weather.
“It usually starts with small blisters that burst quickly to leave scabby patches on the skin. These can look like cornflakes stuck to the skin, but the skin underneath is red and inflamed. These crusty patches are small at first, around half a centimetre across, but slowly grow.”
Where can impetigo occur?
It is usually found on the face and hands as it occurs most frequently on regularly exposed skin, but it can appear anywhere on the body.
Who gets impetigo?
Impetigo is very contagious and is caused by bacteria called ‘staphylococcus aureus’.
Symptoms appear about four to 10 days after the infection enters the skin, so it’s very easily spread. It is more common in children because their immune system is not fully developed, so they are more vulnerable to infections.
Treatment of impetigo
Impetigo can clear up without treatment within 2 to 3 weeks, but you should visit your GP to make sure your child doesn’t have another, more serious infection.
As it’s so contagious, your doctor will usually recommend treatment with antibiotics, either prescribed as a cream or tablets. After treatment, the symptoms should clear up within 7 to 10 days.
Children should be kept off school or nursery until the blistering and crusting has gone or until they have been taking antibiotics for 48 hours.
Hand, foot and mouth
Sarah says: “The disease causes a non-itchy red rash and sufferers often get mouth ulcers. Symptoms appear 3-5 days after being in contact with someone who’s affected.
“The rash on the hands and feet starts as small red spots but can sometimes then develop into uncomfortable blisters. It is very common in children under 10.
“Hand, foot and mouth often starts with a fever of around 38-39°C, sore throat and sometimes loss of appetite, followed quickly by the appearance of mouth ulcers, then other spots.”
Where can hand, foot and mouth occur?
As the name suggests, hand, foot and mouth appears on the hands, feet and in the mouth but it’s not uncommon to get spots on the buttocks, legs and genital area too.
Who gets hand, foot and mouth?
Anyone can catch hand, foot and mouth. It is caused by a group of viruses known as “enteroviruses”.
Hand foot and mouth is highly contagious until a week after the symptoms begin and is most common in children aged 2-10 years old. It tends to spread fast in nurseries or schools.
Treatment of hand, foot and mouth
It gets better on its own without treatment, usually within seven days.
If your child have a moderately high temperature, make sure to give them plenty of fluids and keep them off school or nursery until they feel better.
Sarah says: “This is an extremely contagious bacterial illness that mainly affects children, although it’s less common than it was a few years ago.
“Scarlet fever is caused by a germ called streptococcus, it gives rise to a distinctive pink-red rash, which feels like sandpaper to touch and looks like sunburn.”
Where can scarlet fever occur?
Scarlet fever usually starts with a sore throat and high temperature, followed within 12-48 hours by a rash. This usually starts on the chest and neck before spreading to other areas of the body, such as the ears and stomach, hands and feet.
The rash usually fades after 5 or 6 days, but as it does skin may peel especially on hands and feet.
Who gets scarlet fever?
It usually affects children under 10, with a peak age for infection at about four years.
Treatment of scarlet fever
See your GP as soon as possible if you suspect your child has scarlet fever. It can usually be successfully treated with a 10-day course of antibiotics (it’s very important to complete the course) and further problems are unlikely.
Courtesy of Care, the number one healthcare brand sold into UK pharmacy, and BBC Health Correspondent and family GP Dr Sarah Jarvis