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Symptoms and Treatment of Baby Skin Rash

" To eliminate skin rash on babies, it helps to identify the underlying cause. As described in detail beowl, these causes range from mildly irritating to fairly serious. There are six very common baby skin rashes described below, to be aware of when caring for your baby. If a rash does not clear up within about three days, make sure you call your doctor, as the cause of the rash may be something that requires medication ."   


Listed below are the most common cause of skin rash in babies. While this may seem overwhelming, if you know what to look for, you will have a good idea of what needs to be done to treat these various baby skin rash causes. Treatment will depend on the specific diagnosis provided by your Doctor.

In addition to prescription medication for baby skin rash, a supportive homeopathic skin cream may also be of benefit.  One product formulated for this purpose is  Chikkie Spot Soother.  Check with your pediatrician.

Common Causes of Baby Skin Rash


Baby skin rash can range from skin lesions that have no medical importance that will quickly disappear to require some type of treatment.  The following types of skin rash in babies are described below:


Baby Face Rash


When a baby is under 6 months of age, there are some common mild baby skin rash conditions that may appear on the face. If you see white pimples, and no accompanying redness, they will go away with no treatment as the baby ages.

Sometimes small red areas will appear on the baby's cheeks or small smooth pimples will appear. Lotions may have minimal effect with the pimples appearing, disapperaing and returning again.  This is not cause for alarm and the condition will naturally go away as the baby gets older.

If the red spots on the face are approximately 1/4 to 1/2 inch in diameter with a white pimple at the center,  these can appear and then disappear on their own.  However, if the red spots become filled with pus or the tops crust, then this can be a sign of infection, requiring medical attention.

Cradle Cap Baby Skin Rash


This baby skin rash condition is referred to a infant seborrheic dermatitis. Symptoms include scaly skin, that is sometimes greasy and  waxy. A skin rash usually appears on an infant’s scalp. However, it may spread to the diaper area and face. Cradle cap Usually affects babies between six and twelve months of age.

Cradle cap symptoms are usually yellowish or white with red inflammation, scaly, greasy/waxy baby skin rash,  and are most often found on the head.  It looks as if the infants skin is dirty.

cradle cap
Cradle Cap
Source: Dr. Mahmoud Hijazy/Principles of Dermatology

Cradle cap treatment is part of a debate as to whether or not treatment is needed for this condition. It looks awful, but does not hurt. The most basic treatment is to use soap and water. Baby oil or olive oil  gently rubbed in will also loosen the scales, followed by combing the hair.  Wash the scalp 15 minutes after oil application with a mild baby shampoo to avoid clogging the pores. See your Doctor is a stronger treatment is needed. 

Persistent Diaper Rash Treatments:


This type of baby skin rash is also called diaper dermatitis. It usually appears on/around the anus, genitals, lower abdomen, and in the folds of skin in the groin area. A usual co-infection is candida, a fungus. It may be the result of a baby being left in a dirty diaper too long, an allergy to plastic pants, disposable diapers, fabric softeners and detergents for cloth diapers, scented powders and lotions.

diaper dermatitis
Diaper Dermatitis is caused by moisture, urine and feces in the diaper area, usually when a baby is in its 2nd or 3rd month.
Source: Dr. Mahmoud Hijazy/Principles of Dermatology

Symptoms of Persistent Diaper Rash:  mild to severe irritation and red splotches that may present itself as small pimples under a diaper. May be combined with a fungal infection called candida. Your doctor will advise you how to treat both diseases at once.

Diaper Rash Treatment involves getting rid of anything that is irritating your baby’s skin. Change diapers often, don't use waterproof pants and clean your baby up thoroughly with plain water and thoroughly pat dry. Wash up only after bowel movements, not every time baby urinates. The key is to keep the baby dry. Stop using lotions or powders to reduce the chance of irritation. If you use cloth diapers, hold off on using fabric softener and don’t change detergents.

If the baby skin rash is in the folds of the skin, it is referred to as being seborrheic. It can be treated with a prescription steroid based ointment.  Diaper rash with fever is due to a staphylococcus germ, and require an antibiotic.  Diaper rash in babies can also be caused by yeast (bright red spots, which join together). A yeast rash also requires a prescription ointment.

Avoid cleaning the baby bottom with soap and baby wipes, and use plain water instead. A petroleum and lanolin ointment can help as well.  Leaving the diaper off for a few hours each day can also help to clear the rash.  

Baby diaper rash after diarrhea requires a quick diaper change and also the use of a petroleum ointment with lanolin or a Zinc Oxide cream such as Desitin.  Adding some baby oil to the bath water may also be of help.

Eczema in Infants:

Pediatric Eczema Video

Baby eczema  is also called atopic dermatitis, infantile atopic dermatitis or infantile eczema. This type of baby skin rash causes itch and  very dry skin. It typically affects children by the age of three.  Eczema usually runs in a family. A medical history of babies with this condition will often show family members with asthma, food and seasonal allergies and allergic rhinoconjunctivitis.

Eczema symptoms includes itchy, red, raised areas may leak fluid. The baby skni rash may be on the legs, arms, neck or face. In younger children they can appear  in the arm and leg creases, the neck and behind the ears on older children.

infant eczema
Infantile Eczema appears before age 6 months in approximately 3% of infants. The case shown here is referred to as acute infantile eczema, meaning that symptoms appeared suddenly.
Source: Dr. Mahmoud Hijazy/Principles of Dermatology

Eczema treatment typically involves using fragrance-free soaps on the body and when doing the laundry, as well as  thick moisturizers to rehydrate the skin (moisturizers that are not sold with a pump, use the type that come in a container such as Eucerin Aquaphor). If the baby doesn't respond, then a low hydrocortisone ointment can be used.  Once the eczema is healed, switch back to the moisturizer. Mild or slightly more potent topical steroids may be prescribed such as Flogocid. Antihistamines can be prescribed for itching. With infection present due to staph bacteria, antibiotics. Non-steroidal anti-inflammatory creams may be used if corticosteroids don’t work.

Infant Impetigo 


This is a bacterial skin infection that can be caused by an insect bite, skin injury, mal nutrition or a weak immune system.  It is very contagious.  Forms of  impetigo baby skin rash includes:

  •  impetigo contagiosa: starts with a flat macule on the face, which is a discolored area that is not raised.  It then develops into a raised blister filled with pus.
  • bullous impetigo: also starts with a painful macule or flat discolored skin area, that also develops into a puss filled blister, followed by a thick crusted skin area.
  • impetigo neonatrum: involves small discolored skin areas. Occurs 4 to 10 days after birth in nurseries.  This type of impetigo can be limited to one skin area or spread across the body.

Infant Impetigo baby skin rash symptoms include small blisters (yellow in color) surrounded by red skin areas.  It is seen in the arm pits, groin and at the edge of the diaper.  The blisters will burst if rubbed or when it ruptures due to a thin covering layer. After bursting the lesion becomes crust covered.  When the crust falls off, it exposes the skin to infection.  

Impetigo neonatrum, in addition to large skin blisters on the face, has symptoms such as fever, diarrhea and green stools.

infant impetigo
Infant Impetigo
Source: Dr. Mahmoud Hijazy/Principles of Dermatology

Immediate medical treatment is needed for this condition with oral antibiotics and antibiotic creams.  Clothes should be disinfected in bleach.

Prickly Heat


Prickly heat in babies (miliaria rubra) is common during hot weather.  It starts on the neck, and them appears on the shoulder where it can then move to the chest, face and ears.

Symptoms of prickly heat include small pink pimples which are surrounded by pink skin blotches. The pimples can blister at the tip. It starts on the neck, and then spreads to the shoulders and chest.  It can even spread to the face and ears.

prickly heat
Prickly heat tens to have no other symptoms, and is represented by clear small blisters. No treatment is needed.  It usually appears during daylight and subsides at night.
Source: Borden Institute, US Army

Prickly heat treatment, involves keeping a baby cool.  Prickly heat home remedies include dusting corn starch on the pimples or use combine 1 teaspoon baking soda with 1 cup of water.  Apply with a cotton ball.  If this baby skin rash does not subside and begins to become more widespread, be sure to see a Doctor for treatment.

Psoriasis in Children

Psoriasis in babies is an autoimmune disease caused by white blood cells that attack the skin. It can be seen in the scalp and diaper areas (may look like diaper dermatitis), and then spread to the trunk and extremities.  It is very rare in infants. 

Diaper psoriasis is referred to as infantile seborrheic dermatitis.  5% of infants that have seborrheic dermatitis develop psoriasis later in life.  The most common forms of psoriasis in infants are referred to as infantile psoriasis and juvenile pustular psoriasis.

Psoriasis can start in the first year of life, although pediatric psoriasis usually starts between age 2 and 10.  Skin lesions are circular or look like a ring as shown below in the first picture.

Infection, injury, certain medications, and hormonal activity can act as triggers for the condition.  In rare cases the sun can act as a trigger, although the sun is helpful in the majority of cases.

Infant psoriasis symptoms includes red, scaly areas in any location on the body, but usually on the scalp and diaper areas. 

infant psoriasis
 The infant psoriasis condition shown above was first mis-diagnosed as seborrheic dermatitis.  Baby skin rash can appear and disappear (remission) spontaneously.
Source: Principles of Pediatric Dermatology

Seborrheic dermatitis is characterized by lighter skin lesions, that are dull looking and covered by scales which are greasy.

infant seborrheic dermatitis
Infant Seborrheic Dermatitis is often confused with psoriasis in babies. Seborrheic dermatitis is treated with a hydrocortisone ointment or mild shampoo as prescribed by your pediatrician.
Source: Dr. Mahmoud Hijazy/Principles of Dermatology

Another form of psoriasis primarily seen in children 2 to 10,  has symptoms which appear as drops of red areas all over the body.  It is referred to as guttate psoriasis and appears on the limbs and trunk.  It comes on suddenly, and can be triggered by an illness such as strep or tonsillitis, skin injury, some medications (antimalarials, beta blockers), and stress.

guttate psoriasis
Guttate Psoriasis looks like "red drops" on the skin.  It is several known triggers including infection (Strep), skin injury, medications (beta blockers), stress and skin injury.
Source:  National Psoriasis Foundation

Rubbing or scratching the areas affected by psoriasis may result in the formation of new lesions, which is called the Koebner phenomenon. If there is a long history of psoriasis, the patient may have arthritis.

Psoriasis treatment usually involves mild prescription topical corticosteroids, UV therapy and vitamin D (D3) derivatives. Antihistamines are provided to help with the itch.  Antibiotics are prescribed if strep infection is present. 

Medical supervision is crucial. 

Download this Guttate Psoriasis Fact Sheet from the National Psoriasis Foundation.

Infant Ringworm

Infant ringworm is caused by the contagious skin fungus dermatophytes. Also referred to a tinea faceii. It can happen anywhere on the body, but typically in early childhood on the face and head. Sometimes ringworm sores itch.

infant ringworm
Infant Ringworm (Tinea Cruris, Candidiasis)
Source: Dr. Mahmoud Hijazy/Principles of Dermatology

Ringworm symptoms presents itself as red circles, scaled at edges. It’s highly contagious and usually shows up on the face and head, but can be found elsewhere and by sharing combs, brushes, hats etc.

Ringworm treatment is accomplished using topical anti-fungals are used for small lesions (griseofulvin). For larger ones and ringworm in the nails or hair, oral anti fungal agents such as itrconazole may be prescribed.

Scabies:

Scabies  is caused by a nasty little mite that burrows under your baby’s outer skin layer. It causes red, itchy lesions that appear as burrow lines. Babies get this from contact with another person who has scabies. Everyone in the house will need to be treated. This is a fairly serious skin disease in babies and medical help is a must.

Scabies symptoms include a red rash spread over the body in various locations, small white lesions in a zigzag or S-shaped pattern and severe itching.

Scabies treatment involves a topical agent left on the skin overnight (see our article on How to Treat Scabies, which includes natural remedies as well). It may also involve antihistamines for the itching and topical steroid creams. This is a serious skin disease and you must have doctor supervision to ensure the topical agent is properly applied for a child. If you are pregnant, you must speak to your doctor about therapy.

References:

Optiderma - Cradle Cap Treatment

MayoClinic.com

National Psoriasis Foundation

Dr. Spocks Baby and Child Care, Benjamin Spock

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