A guide to baby rashes and how to work out the cause

baby with rash

by Maria Martin |

As a parent, it can be difficult to identify even the most common baby rashes and spots. What’s the difference, and how can you spot them?

If you are concerned about your baby, you should contact the NHS as soon as possible.

Baby rashes checklist

Spotting a rash on your baby’s delicate skin can be a worry – here’s the checklist you need to work out the cause

Your baby has really delicate skin which can be easily irritated by products and ingredients. So if you spot a rash emerging then it could just be because something has aggravated it, but it’s still a good idea to run through this checklist to ease your mind that it’s nothing more serious.

1. Does your baby have a temperature?

Take their temperature and see what it reveals. If their temperature is above 38.5°C, then it may indicate your baby has measles and it’s advisable to see a GP. Generally speaking, if your baby doesn’t have a temperature then the rash is unlikely to be serious.

2. Does your baby look unwell?

Trust your judgment and decide if you think your baby looks unwell (despite the rashes). If they look pale and sweaty, then try making sure they're not dehydrated by feeding them.

3. Have you tried the glass test?

Gently press the side of a glass to the patch of skin with a rash. If you can see the rash through the glass then your baby may be showing signs of meningitis, which requires medical attention.

4. Are they still feeding?

A good way to tell if a baby is unwell is by seeing if they'll still feed normally. If they don't want to feed, then give it a while and try again. If that doesn’t work, chances are they're not feeling right and it’s best to consult your GP.

5. Is their urine and poo output normal?

Check what’s in your baby’s nappy every so often. If they're feeding normally, your baby should have up to 10 wet nappies a day.

6. Are they too hot?

If your baby is sweating or their tummy feels hot, they may be overheating. Remove some layers and see if it makes a difference – the aim is to keep them from overheating.

7. Have you changed your baby’s nappy recently?

If the rash is surrounding your baby’s bottom, then chances are its nappy rash, which can develop for a number of reasons. Try changing and top and tailing your baby, leave them to dry with no nappy on and apply some barrier cream – available from supermarkets and the pharmacy.

8. Have you used a new skincare product or washing powder?

Lots of things can irritate your baby’s delicate skin – including your own perfume. Certain products or a change of products can lead to flare-ups of eczema and other skin conditions. Gently clean your baby and gently pat them dry, without applying any products. If the rash remains, baby eczema products may help.

Expert information provided by Dr Tim Ubhi, consultant paediatrician for the Royal College of Paediatrics and Child Health.

Baby rashes to look out for

Chickenpox

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.”

Heat rash (prickly heat)

“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," explains Dr Sarah.

It can occur anywhere on the body, but often appears in places covered by clothing.

Measles

“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.”

The spots develop in the mouth and on the cheeks whilst the rash typically starts behind the ears and then spreads to the body. You should see your GP immediately if you suspect your child has measles.

Eczema

“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.

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.

Meningitis

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," says Sarah. "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 a 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.”

If you suspect meningitis, you should ring 999 or take your child to the hospital immediately.

Impetigo

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," says Sarah.

“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.”

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. 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.

Hand, foot and mouth

This 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," says Sarah.

“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.”

As the name suggests, hand, foot and mouth appear on the hands, feet and in the mouth but it’s not uncommon to get spots on the buttocks, legs and genital area too.

Scarlet fever

"This is an extremely contagious bacterial illness that mainly affects children, although it’s less common than it was a few years ago," explains Sarah.

“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.”

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.

See your GP as soon as possible if you suspect your child has scarlet fever.

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