5 most common kid skin rashes and sensitivities (and how to soothe them)

Your kid’s super soft skin is suddenly angry. Here’s our soothing guide to the most common skin sensitivities.

Your kid’s skin is a shield from the world around him. All too often, this protective layer becomes dry, irritated and blotchy. It can be stressful to see angry rashes or itchy patches pop up on your kids, but as Vancouver dermatologist Sunil Kalia says: “Sensitive skin is quite common in babies and toddlers.” In fact, most skin troubles are preventable or easily treated (moisturizer often works wonders). But when lotion won’t cut it, you’ll need a more targeted approach.

1. ECZEMA
Eczema (also sometimes called atopic dermatitis) is a chronic skin condition that affects an estimated 17 percent of kids, says Miriam Weinstein, a paediatric dermatologist at Toronto’s Hospital for Sick Children. The skin isn’t able to keep moisture in and irritants out and, as a result, can become dry, itchy and inflamed. Just as allergies run in families, eczema can be inherited.

Does my kid have it?
Skin will look dry, red, raised and scaly, and will be quite itchy—you’ll probably see your kid scratching, sometimes to the point of drawing blood. Infants may have patches of eczema on their arms, legs, scalp, forehead and cheeks (the diaper area is often spared because the moisture is kept in). In toddlers, eczema can worsen in elbow creases and behind the knees—anywhere the skin may become irritated by heat and clothing. It can worsen in dry winter air or with heat and sweat in summer. Fragrances and chemicals in lotions, detergents and shampoos, as well as polyester clothing, may also further irritate the skin.

How do I treat it?
Eczema is very uncomfortable, and the itch can keep a kid up at night. It’s important to get a diagnosis, but even then it can be hard to control. “Managing it is an art as much as it is a science,” says Weinstein.

Eczema might first look like a patch of dry skin, but it can quickly worsen as your kid scratches. Keeping the skin well-moisturized is your first line of defence (that, and keeping his nails short). Bathe him, pat his skin and then liberally apply moisturizer while it’s still damp. On days when he doesn’t bathe, keep moisturizing. There are dozens of products formulated for eczema—whether it’s a thin lotion or thick ointment, choose one that’s affordable and works for your kid, because you’ll be applying it often and liberally, says Weinstein.

Focus on moisturizing instead of driving yourself crazy trying to figure out what’s triggering flares, Weinstein says. “People will turn their lives upside down, searching for that one thing that if they could only eliminate it, the eczema would go away. That tends to send them down an unhelpful path.”

Eczema can appear without reason, despite your best efforts. In these cases, your doctor will likely recommend a mild steroid cream (a.k.a. cortisone) to calm the itching and redness—broken skin from scratching can leave kids vulnerable to a staph infection. People with eczema often also have food or environmental allergies. Experts do not recommend eliminating foods in search of a trigger, as it may lead to serious problems, like malnutrition. “It’s like having blond hair and blue eyes,” says Weinstein. “They’re two genetic traits that tend to travel together, but the blond hair doesn’t cause the blue eyes, just as eating certain foods doesn’t typically cause a flare-up of eczema.”

2. HEAT RASH
Heat rash, prickly heat, sweat rash—all these terms refer to a skin upset that develops when your kid gets hot and her skin isn’t properly ventilated. “Sweat gets trapped underneath the skin and causes it to be red and bumpy,” explains Tara Chobotuk, a paediatrician in Halifax. Babies often get heat rash in the winter, when caregivers bundle them up in too many layers. Parents should take heat rash as a warning, she says. “Babies can have difficulty regulating body temperature, and they can get dehydrated quickly. Make sure they’re comfortable and not overheated.” Heat rash can show up on a kid’s back after too much time in a hot car seat or in skin folds from wearing tight or synthetic clothing.

Does my kid have it?
The rash is made up of tiny red bumps. Weinstein says many parents confuse heat rash with heat- and sweat-induced eczema. If the rash appears on an area that’s been covered up, it’s likely heat rash. But when a parent tells her, “Whenever my child gets overheated, she seems to get heat rash,” that’s likely an eczema flare-up.

How do I treat it?
Heat rash isn’t serious and should go away on its own in one to two days. Take the irritation as a sign that your kid isn’t comfortable, and make adjustments in how you’re dressing him.

3. HIVES
Hives are the body’s reaction to an allergen or a virus. The most common cause in kids is a virus—even a stomach bug can bring them on. The allergen or virus activates immune cells that release histamine, causing raised, often red and itchy spots that are as small as a dot or as big as a plate—quite scary—and may be localized or spread all over the body.

Does my kid have it?
A hallmark of hives is that they come and go, sometimes within minutes or hours, but definitely within a day or two. If the spot has been there for more than two days, it’s not a hive. In some cases, the cause might be easy to trace—your kid eats a strawberry and a splotch appears on his upper lip. But sometimes it’s not as easy to figure it out: Hives can appear up to three weeks after a virus has passed. One or two spots don’t necessarily warrant a doctor’s visit, but if you’re unsure, have it checked out.

How do I treat it?
If hives are accompanied by any lip or tongue swelling, breathing difficulties or profuse vomiting, your child may be having an anaphylactic reaction. Call 911 immediately. Otherwise, hives are harmless—but very itchy. To calm the skin, your doctor may recommend an oral non-sedating kids’ antihistamine, like Aerius or Reactine. Benadryl is an option, but it does have a sedative effect. (Talk to your doctor, as these drugs aren’t approved for kids under two.)

4. CHAPPED SKIN
Chapped skin is irritated, red and scaly, and is common in winter, when kids’ faces and hands are exposed to the cold and wind. Frequent handwashing—while a great habit—can cause the backs of hands to become dry and sore. Kids with parched lips often have a tendency to lick them, but their saliva can aggravate the skin around their mouths. “In the winter, I probably see 10 kids a week with what we call lip-licker’s dermatitis,” says Weinstein.

Does my kid have it?
Chapped skin is raised, red and scaly. While it isn’t typically itchy, skin may feel tight, peel or crack, and in severe cases may bleed.

How do I treat it?
Prevention may be the best approach. Apply a little extra moisturizer in the morning. For chapped lips and skin around the mouth, dermatologist Sunil Kalia recommends a thick, greasy, fragrance-free lip balm or barrier cream like petroleum jelly. And remind kids to moisturize after handwashing. Any redness should clear up in a few days.

5. CONTACT DERMATITIS
Sometimes called contact eczema, contact dermatitis is a rash that appears after skin comes in contact with an irritant or allergen. It looks similar to eczema—red and scaly—but is more localized. Potential irritants include detergent, citrus or even a kid’s own saliva. A common cause is nickel, which can be found in jewellery, belt buckles and even onesie snaps; other metals, chemicals and fragrances can also produce allergic contact dermatitis. The rash typically lasts as long as the trigger is present, but a severe reaction may need some help.

Does my kid have it?
While rare, its cause can sometimes be very obvious: Your daughter wears new earrings and a rash appears on her lobes. When the trigger isn’t as evident, Kalia says, contact dermatitis can often be mistaken for and treated as eczema—if the rash doesn’t clear, you’re dealing with contact dermatitis.

How do I treat it?
First, pinpoint and remove the trigger if you possible. If the rash is all over your kid’s body, switch to unscented laundry detergent. If your kid loves citrus but keeps getting rashes on his face, apply a barrier cream like petroleum jelly around his mouth before he eats. (This also works on drooly babies’ chins and necks.) A serious, persistent rash may require a mild cortisone cream to clear it.

Read more:
An age-by-age guide to skin rashes and conditions
Relieve dry skin with an oatmeal bath
10 common rashes (photos): Symptoms and treatment

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