Skin in Infancy and Childhood

What Are the Various Types of Skin Rashes in Babies?

Several skin conditions can affect infants and children throughout their lives. These conditions may include diseases caused by dermatitis, viral infections, bacterial infections, and fungal infections. Some of these common variations include:

1. Dermatitis: Dermatitis is a group of conditions that cause skin inflammation. These conditions may cause itchiness, red rashes, and dry skin. Types of dermatitis include cradle cap, diaper rash, contact dermatitis, and eczema.

• Diaper Rash or Diaper Dermatitis: This is one of the common forms of dermatitis seen in babies that occurs when moisture in the baby's diaper area causes irritation or growth of fungi or bacteria on the skin. It is often associated with damp or infrequently changed diapers, chafing, and skin sensitivity. It commonly affects babies, though anyone who wears a diaper can develop the condition. Diaper dermatitis usually improves with simple home-based treatments, like air drying, frequent diaper changes, and ointment or cream containing zinc oxide or petroleum jelly.

• Cradle cap: This is also called infant seborrheic dermatitis. It is a skin condition that causes yellow crusty or oily scaly patches often surrounded by a red rash on the baby's scalp. The condition is not itchy or painful. But it can lead to thick scales that are not easily removable. Overproduction of the oil-producing sebaceous glands on the baby's scalp may cause a cradle cap. The cradle cap usually clears up in weeks or a few months by home care measures such as washing the baby's scalp daily with mild baby shampoo. However, if the cradle cap lasts longer or seems severe, the doctor may suggest a medicated shampoo, lotion, or other treatments.

• Contact Dermatitis: This is an itchy skin rash that can occur when babies react to an allergen (such as poison ivy or medications) or an irritant (such as perfumes, soaps, cleaners, and paints). The condition is not contagious but can be very painful and uncomfortable. Contact dermatitis treatment includes moisturizers, anti-itch creams, and topical steroids. One can also take self-care steps, such as soothing the skin with a cool, wet cloth.

• Eczema or Atopic Dermatitis: Eczema is a long-lasting or chronic skin condition that makes a baby's skin red, dry, itchy, and inflamed. Problems with the skin barrier make the child's skin more sensitive and predisposed to infections and dryness. Controlling the eczema symptoms is the goal of treatment. Good skincare habits such as moisturizing regularly and bathing in lukewarm water ease itching and prevent flares. Medicated ointments or creams can also benefit in alleviating symptoms.

2. Viral Infections: A wide range of viruses causes viral rashes in babies. These infections include roseola, fifth disease, chickenpox, measles, rubella, hand, foot, and mouth.

• Fifth Disease: Also called slapped cheek disease. Slapped cheek disease is a mild viral infection caused by the human parvovirus B19. It is a common condition among children between four and ten years. Slapped cheek disease is named for its common symptom- bright red rashes on cheeks that look like the child has been slapped. It is also called as fifth disease or erythema infectiosum. Treatment includes non-steroidal anti-inflammatory drugs (NSAIDs), anti-itch creams, or antihistamines.

• Roseola: Also called the sixth disease. This viral illness usually affects children between six months and two years. Human herpesvirus 6 causes roseola. With roseola, the baby suddenly develops a high fever lasting up to a week. A raised, spotty pink rash can occur on the baby's chest or stomach as the fever breaks. The rash can spread to other areas, such as the upper arms and neck, and then it will fade after about 24 hours. Treatment may include Acetaminophen for the baby's fever, but the rash does not itch or cause pain.

• Chickenpox: This is a contagious viral infection caused by the varicella-zoster virus (VZV) that often causes a rash on the baby's face, chest, and back, but it may spread to the entire body. The rash turns into itchy, fluid-filled blisters, and then blisters become scabs. Chickenpox generally goes away on its own in one to two weeks. The child's symptoms can be treated with antihistamines and Acetaminophen.

• Measles: This is a very contagious viral infection easily preventable by the measles or measles, mumps, and rubella (MMR) vaccine. It typically causes a rash that begins on the child's face, particularly behind the ears or around the mouth. Then it spreads over the entire body. The rash begins as flat red spots but later turns into more minor raised white spots that may occur on top of the red spots. The spots may fuse as it moves down the child's body. Measles usually goes away within about two weeks unless complications develop. Acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) help relieve the symptoms of fever and achiness.

3. Bacterial Infections: Baby rashes may also include bacterial infections like scarlet fever and impetigo.

• Impetigo: This is a mild infection caused by group A Streptococcus or Staphylococcus aureus bacteria. It is most common in children aged 2 to 5 but can happen at any age. Impetigo causes red itchy bumps and blisters that break open and leak a clear fluid or pus for a few days. It primarily affects sun-exposed areas around the nose and mouth or on the arms or legs. Impetigo treatment usually includes topical or antibiotics.

• Scarlet Fever: This is a bacterial illness caused by a bacteria called group A Streptococcus. Scarlet fever often begins with a fever, sore throat, and headache, but the characteristic symptom is a raised, red rash on the child's neck and upper chest. The rash may then travel to other areas of the child's body. The child's face may turn red, with a pale area left around the mouth. The rash often feels rough, like sandpaper, and may look like the child has a sunburn. Antibiotics are the preferred treatment for scarlet fever.

4. Fungal Infections: Common skin rashes in babies, toddlers, and children include fungal infections like ringworm.

• Ringworm: A fungus causes ringworm causes round or oval patches to develop on the child's skin. These patches have smooth centers and red, scaly borders and may not look like rings immediately. But later, the rings get bigger. The patches are painful and itchy and may become puffy and inflamed. Treatments for ringworm include oral antifungal medicines or put directly on the skin.

5. Birthmarks: There two main types of birthmarks are red birthmarks and pigmented birthmarks. Red birthmarks refer to colored, vascular skin markings that develop immediately after birth. Pigmented birthmarks are skin markings present at birth different from their skin color.

Red Birthmarks

• Strawberry Hemangiomas: It is a non-cancerous tumor due to the abnormal overgrowth of tiny blood vessels. They appear in the first six months of life. They often grow up until 12 months and eventually decrease in size between 12 and 15 months. They regress entirely by five to six years of age. They often occur on the eyelids, conjunctiva, and the eye socket or orbit. Propranolol is the first line of treatment for capillary hemangiomas. It is usually taken orally and has a very favorable safety profile. In addition, steroid medications help stop the progression of hemangiomas. They are taken orally, injected directly into the hemangioma, or applied to the skin surface.

• Cavernous Hemangiomas: These hemangiomas resemble strawberry hemangiomas. But they are deeper in the child's skin and often darker in color. Cavernous hemangiomas often go away on their own as the child ages.

• Port-Wine Stains: A port-wine stain is a reddish-purplish discoloration caused by the abnormal formation of blood vessels in the skin. It occurs in 0.5 percent of newborns. In the early stages, port-wine stains appear flat and pink. However, the stain also grows as the child ages, and the color may deepen to dark red or purple. Port-wine stains usually occur on the face but appear on other body parts. The affected area can get thickened and give a cobblestone-like appearance with time. Laser therapy is effective in removing port-wine stains. The type of laser depends on the person's age, skin type, and particular port-wine stain.

• Salmon Patches: The salmon patch (stork bite) comprises dilated dermal capillaries. It is the most common vascular malformation during infancy. It appears as a light red to pink patch and occurs in about 70 percent of white newborns and approximately 60 percent of black newborns. These lesions are often present on the nape of the neck and sometimes on the upper eyelid. Watchful waiting is the best option in such conditions. The flash-lamp pumped pulsed dye laser (FPDL) may be used if treatment is desired.

Pigmented Birthmarks

• Mongolian Spots: These birthmarks are characterized by bruised or bluish that often develop on the buttocks or back of babies. Mongolian blue spots are primarily harmless when pigment cells make melanin under the skin's surface. This birthmark often disappears by the age of four and does not need treatment.

• Cafe-Au-Lait Spots: (Coffee With Milk): These birthmarks appear as flat light brown-to-dark brown spots with smooth or irregular borders on the skin. The spots are present at birth or in early life. These spots can be treated with laser therapy if treatment is desired.

• Nevi (Moles): Molesare small flesh-colored, brown, tan, or pink flat or raised spots. Most moles are benign or non-cancerous and do not cause problems; some may develop melanoma skin cancer. Most moles do not require treatment. Cancerous moles are removed through excisional biopsy.

Conclusion

Getting a rash, bump, mark, or other skin conditions on the baby's body can be scary and a cause of concern for parents. But babies have many variations in normal appearance, from color to the shape of the head. Some of these skin conditions are temporary and should not cause too much worry. However, birthmarks may be permanent. Speak with a healthcare professional if someone has any concerns. They can diagnose the skin condition and get the child started on any necessary treatment.