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Dublin: 4 °C Saturday 17 March, 2018

7 important facts every parent should know about rashes

Dr Nuala O’Connor explains when you need to worry.

Image: Shutterstock

UNDRESSING YOUR LITTLE one only to find that an itchy rash has broken out on their soft skin is up there with the most alarming discoveries for parents.

The good news is, most rashes are quite innocuous and easily dealt with, according to Dr Nuala O’Connor, GP and Lead for Antibiotic Resistance with the Irish College of General Practitioners.

Here’s what she’d like every parent to know about childhood rashes, and how they’re not usually a cause for concern.

1. Gradual rashes are usually treatable skin conditions

First of all, Dr O’Connor reminds that all rashes fall into two groups – those that have come on suddenly and are gone within two weeks, and the ones that have appeared more gradually. If it’s come on gradually, it tends to be a skin condition:

These tend to be things like eczema, psoriasis and actual skin conditions but you will need a doctor to see it in person to diagnose it.

Dr O’Connor alerts that a third of the population is prone to eczema type rashes and that kids “generally grow out of them”, but it’s important to take precautions to avoid drying out skin’s natural moisturisers. This is something which can lead to breakouts:

Eczema is essentially dry skin so hot sudsy water will irritate it. Try soap-free cleansers and moisturisers and pat skin dry with a soft towel rather than  rubbing it. Wipes can also cause a lot of irritation.

2. Be careful about the creams you apply to rashes

shutterstock_584545843 Source: Shutterstock/Africa Studio

Although your first reaction may be to reach for a steroid or antibacterial cream to calm the irritation, this can actually be the wrong thing to do as they alter the appearance of a rash, making it difficult for doctors to determine its type. It can also make things worse:

The problem with steroid cream is that it may make some rashes worse – in chickenpox it can turn it into a more severe form for example.

Generally the advice if your child is itchy is to try a gentle moisturiser or an antihistamine to provide relief but avoid using cream that may have been prescribed to someone else in the house, says Dr O’Connor.

3. There are three types of sudden rashes

When it comes to rashes that have appeared suddenly, there are three causes:

  1. a reaction to something you’ve ingested
  2. an irritant rash from something you’ve put on your skin
  3. an infection (generally, this is the only one that can be a real concern)

Irritant and reaction rashes on the other hand can be caused by strawberries, food colourants, antibiotics, ibuprofen. Dr O’Connor shares that “any drug that you can get over the counter can cause a rash”.

These types of rashes tend to be itchy rashes like hives. Kids won’t be unwell, they’ll just be uncomfortable. If you draw a ring around the rash, it will tend to have moved if you check it a few hours later.

Viral infection rashes tend to be “faint red rashes on their arms, trunks and legs”, with chicken pox being the most common type which tends to appear as “little, itchy blisters”.

4. Dangerous rashes will usually have other, obvious symptoms

Source: St John Ambulance/YouTube

Although the likelihood is that the rash is caused by one of the reasons above, take heed if your child is very unwell and has a bruise-like purpuric rash (that can still be seen through glass, as seen in the video above). The good news is that a meningitis rash “doesn’t occur in isolation”, explains Dr O’Connor:

No one will walk in feeling well with one – they’ll be sick with a possible headache and vomiting and a child won’t be feeding. It will be obvious to everyone that this is a very sick person.

5. A child’s willingness to drink can indicate a lot

Although parents often worry about about their child not eating or a having a high temperature, it’s actually a lack of drinking that you need to watch. This can indicate that the rash may be more sinister, as Dr O’Connor explains:

A child that stops drinking is one that you need to worry about – a symptom of meningitis is that they are so weak that they can’t drink.

6. If a child is crying, it can actually be a positive sign

shutterstock_439995502 Source: Shutterstock/Evgeny Atamanenko

There’s nothing more upsetting than having to listen to your little mite screech at how uncomfortable or sick they are, but it’s actually something that Dr O’Connor sees as a healthy sign:

I’m educating parents about measuring the responsiveness of a child. If a child is cranky or screaming I’m less worried. It’s the quiet child I’m worried about – they are much more sick.

7. Creams can cause nappy rash, not prevent it

Nappy rash can be one of the most common ways that parents experience their tot’s skin being irritated and this is caused by the irritant effect of urine on their skin. Although modern nappies are designed to absorb urine, cream can stop this, says Dr O’Connor:

A lot of cream on a baby’s skin can form a barrier to this and urine tends not to get absorbed. It’s important to change them regularly and pop them in a bath/shower each night to remove any residue.

Babies with severe gastroenteritis can also develop a very uncomfortable rash from the acid in diarrhoea so it’s worth popping them into the bath  to wash away any residue to avoid this – it is difficult to clean diarrhoea adequately with wipes.

Hear Dr O’Connor talk through how best to relieve rashes in the video below.

Source: HSE Ireland/YouTube

Feeling under the weather? Check out for practical advice on how to mind yourself or your family when you’re sick, including advice from doctors around the country. A collaborative effort from the HSE, GPs and pharmacists.

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