Children’s rashes and spots in pictures

Chickenpox, measles, meningitis or heat rash? Our real-life photos and expert advice will help you identify the most common rashes and spots and guide you on what to do next

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Some of the most common children’s illnesses come with spots and rashes on the skin. With the expert help of Dr Philippa Kaye, we’ve put together a guide to help you identify the most common spots and rashes, including how to spot the symptoms, how to treat them, how long the spots will last – and when or if you should see a GP.

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We have separate article on rashes in small babies as some of them may look different or be specific to babies only.

Here are most common rashes and spots in children, with pictures.

Chickenpox

What does a chickenpox rash look like?

chickenpox
The photo above shows a typical outbreak of chickenpox: crops of red spots, which turn into small, fluid-filled, itchy blisters that break and then scab over.

What causes it?

The chickenpox virus, which is passed on via the respiratory system: you breathe in the virus, generally after close contact with someone who is already infected. “The virus incubates for 14 to 21 days,” says Dr Philippa, “so it can take that long after being in contact with someone who has chickenpox for the first spots to appear.”

What does it look like?

“Small red spots appear in stages,” says Dr Philippa, “and then turn into fluid-filled blisters. Over a few days, the blisters crust over and then fade away.”

Where on the body will it be?

The spots can appear anywhere on the body, including on the scalp. According to NHS advice on chickenpox, they can stay in one place or spread to other areas of the body.

What other symptoms might accompany it?

“Often a child may be unwell for a few days before the rash appears,” says Dr Philippa, “with a fever, aches and pains, and loss of appetite. By the time the rash appears, they are often feeling well again – but the rash can be very itchy.”

How common is it?

Extremely common. Most people catch chickenpox at some point during childhood.

What other spots and rashes look similar?

“Initially, the little red spots look like lots of other things,” says Dr Philippa, “but the classic blistering rash that follows gives away the diagnosis.”

What do I do if my child has it?

You can treat the fever with age-appropriate doses of paracetamol and plenty of fluid to drink. When the itching starts, you can give antihistamine for the itch (talk to a pharmacist first), or use various soothing lotions, such as calamine lotion or aloe vera gel. Dress your child in loose clothes and cut their nails (so any scratching doesn’t damage the skin).

Is it infectious?

Mum spuddy on our forum says: “I looked after my friend’s little boy for the day on Friday. He’s 20 months and my daughter is 2.5. They played together etc all day… he has now come out with chickenpox today… and I’m wondering  what the likelihood is that my dd [darling daughter] might get them?”

Chickenpox is very infectiousDr Philippa tells us. “You should keep your child at home until all the spots have crusted over,” she adds. “Try, in particular, to avoid contact with pregnant women, newborn babies and people with a weakened immune system, as chickenpox can be more serious for them.”

Do I need to see a GP?

It’s not generally necessary but, according to NHS advice, you should speak to a doctor if:

  • the skin around the blisters is red, hot or painful (this could mean it’s become infected)
  • your child is dehydrated
  • you’re concerned about your child or they get worse

Do be aware of how infectious chickenpox, though. If you do plan visit your GP, tell the receptionist you think your child has chickenpox before going into the surgery: they may arrange a special appointment time when there’s less chance of contact with pregnant women, small babies or others for whom chickenpox is higher-risk.

How long will it last?

The blisters generally crust over generally within 5 days of the first appearing.  The crusts can take a bit longer to resolve.

Will it come back?

No, not as chickenpox. “But the chickenpox virus remains dormant in your immune system,’ says Dr Philippa. “So it can be reactivated later in life, when your immune system is low, and cause shingles.”

Heat rash or prickly heat

What does heat rash look like?

Heat rash or prickly heat

Heat rash is also known as miliaria or prickly heat, it appears as tiny little red bumps or blisters on the skin and it happens when your child gets too hot. They often sting or feel prickly.

What causes it?

As you might guess from the name, as Dr Philippa tells us: “It is related to being too hot, the sweat glands get blocked and the sweat gets trapped under the skin.”

What does it look like? 

It’s a common question – as monkeychopsf on our forum asks: “My little guy has a bit of a rash on him and I’m just wondering what heat rash is like? Basically, says Dr Philippa, it’s very small red bumps or blisters on the skin, and Doesn’t come up in crops.

Three things to look out for, say NHS guidelines on heat rash, are:

  • small red spots
  • an itchy, prickly feeling
  • redness and mild swelling.

Where on the body will it be?

Anywhere, but often in body folds where you get hot and sweaty, says Dr Philippa. And Nina Goad from the British Association of Dermatologists  adds that it often appears in places covered by clothing.

What other symptoms might accompany it?

The rash can be itchy, stinging or feel prickly.

How common is it?

“A really difficult question to answer,” says Dr Philippa. But, basically, anyone can get it. It happens when your child sweats more than usual during hot weather.

But it’s possible to get it any time of the year – it just happens when your child overheats. The bumps form when the sweat glands get blocked and the sweat becomes trapped under their skin, causing the rash.

What other spots and rashes look similar?

Lots of things – but a good start is to be aware of if you have a hot day or your child has been doing something to get them overheated/sweaty.

What do I do next?

Dr Philippa advises: “Keep your little one cool and give plenty of fluids to drink. Dressing in cool natural fabrics such as cotton can help.” It usually goes away on it’s own, but you can also ease symptoms with a cool bath and calamine lotion.

Is it infectious?

No.

Do I need to see a GP?

Not usually – though it might be worth it if you feel your child is dehydrated.

How long will it last?

It can last a few days.

Will it come back?

“If you become too hot again, it can do!” says Dr Philippa. If your child is prone to heat rash, there are a few things you can do to prevent them from getting it: dress them in loose, cotton clothing in the heat. Cotton is great when it’s warm as the fabric absorbs moisture, rather than trapping it like some synthetic fibres.

Meningitis rash

What does meningitis look like?

Meningitis rash

The meningitis rash occurs when septicaemia – blood poisoning – has set in. it is a non-fading rash, it won’t disappear under a glass tumbler when pressed. See here for the tumbler test. Meningitis alone rarely causes as rash.

Meningitis  Research Foundation says: “In addition to the other symptoms of meningitis, other symptoms to look out for in babies and toddlers are blotchy skin, quite pale or turning blue; tense or bulging soft spot; poor feeding; high-pitched crying/irritable,” but it adds that, “The classical signs and symptoms of meningitis may be absent in babies and toddlers.”

What causes it?

Dr Philippa tells us: “The rash occurs when sepsis is present, when the bacteria has entered the bloodsteam, generally pneumococcal or meningococcal bacteria.”

What does it look like? 

The meningitis rash is a non-blanching rash – this means that the rash doesn’t fade when pressure is applied. “A good test is the ‘glass test’, advises Dr Philippa. “Roll a glass over the rash: if it doesn’t fade when you press on it with a glass (like a freckle wouldn’t fade) then call 999.”

Where on the body will it be?

It can occur anywhere on the body.

What other symptoms might accompany it?

“Children with septicaemia are very unwell,” says Dr Philippa. “Your child may have:

  • a high fever
  • be floppy
  • cold at the extremities
  • drowsy or unresponsive,
  • have an odd cry
  • be blue.”

Check NHS guidelines on meningitis for more information about the symptoms.

How common is it?

Thankfully less common with the advent of vaccinations. But do note that after your child’s had vaccinations they might be a bit off for a few days, As Mrs Poon on our forum tells us: “Poor little mite had 3 jabs today and it was the meningitis one that seems to be playing him up – as on previous jabs he has been as good as gold.”

What other spots and rashes look similar?

A non-blanching rash can occur for other reasons, says Dr Philippa – but if your child is unwell with a non-blanching rash seek urgent medical help.

What do I do next?

As Dr Philippa’s already advised, you should seek urgent medical help with a non-blanching rash.

Is it infectious?

Yes. “Again, meningitis is a notifiable disease and if your child is found to have it, measures may be taken to limit the spread,” says De Philippa.

Do I need to see a GP?

Yes – or go to your local A&E as soon as possible.

How long will it last?

This depends on the cause, Dr Philippa tells us: cases of meningococcal and pneumococcal sepsis require intravenous antibiotics in hospital.

Will it come back?

It’s very unusual to have meningitis more than once, but it is possible.

Measles

What does measles look like?

Measles

Tiny white spots with a red outline (called Koplik’s spots) followed a few days later by a fine red rash that starts small and becomes blotchy. This rash proceeds initial cold-like symptoms, such as red eyes, sensitivity to light, a fever and greyish white spots in the mouth or throat.

What causes it?

The measles virus causes measles. “But the good news is that it’s preventable with the MMR vaccine,” says Dr Philippa.

What does it look like? 

Dr Philippa describes it this way: “A red rash that often starts behind the ears or on the face before extending down the rest of the body.  Koplik’s spots are white lesions in the mouth which can also occur.”

Where on the body will it be?

As above, it often starts on the ears or face and moves around the body.

What other symptoms might accompany it?

Children with measles are generally unwell with high fever, conjunctivitis, cough and a runny nose.

How common is it?

Thankfully, it’s rarer than before the MMR vaccine came along –  though Dr Philippa advises that the number of cases are rising again. “Measles is not to common now because of immunisation,” says Adam Finn, Professor of Paediatrics at the University of Bristol. “But anyone who has not been properly vaccinated is potentially at risk.”

It is most common in children aged between 1 and 4 years old.

What other spots and rashes look similar?

According to Practical Parenting book, What’s That Rash?, measles can look like:

  • rubella
  • scarlet fever

What do I do next?

If you are concerned your child has measles phone your GP, says Dr Philippa. “You will be seen but may be asked to wait in a side room to avoid infecting others in the waiting room.”

She goes on to say: “Measles is a notifiable disease, which means that the condition must be reported by your doctor to Public Health. Plenty of fluids and medications to reduce the fever can be used.”

A salvia test can confirm measles, and the local Health Protection Unit will be informed. Your child should not return to school until the measles are under control. There is no specific treatment for measles – all you can do is make your child feel comfortable until it passes, as Philippa has advised.

The NHS guidelines for treating measles recommend liquid baby paracetamol or ibuprofen to relieve their fever, aches and pains. They should also drink plenty of water to prevent dehydration and “damp cotton wool can be used to clean away any crustiness around the eyes.

Use one piece of cotton wool per wipe for each eye,” says the NHS, and “gently clean the eye from inner to outer eyelid.”

Eczema

What does eczema look like?

Eczema

A dry, red patch of skin that may be broken or cracked. The most common form in children is atopic eczema. “People with mild atopic eczema normally have only small areas of dry skin that are occasionally itchy. In more severe cases, atopic eczema can cause widespread dry skin, constant itching and oozing fluid,” says the NHS.

Eczema suffers tend to get “flare-ups”, when their symptoms worsen. During a flare-up, sufferers get extremely red and itchy weeping, swollen skin. The skin can sometimes become infected.

Where does eczema appear?

It 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 around their elbows or the backs of their knees.

Who gets it?

It is thought to be an inherited condition and anyone can get it, but atopic eczema is the most common form in children.

What can you do?

If your child has atopic eczema, their condition may improve over time but the most common treatments include moisturizing treatments – emollients – that can be bought from your pharmacy. Topical corticosteroids may also be prescribed to reduce your child’s swelling.

Although it may be difficult, it is important to discourage your child from scratching. You can keep their nails short to stop them. “Scratching can aggravate the skin, eventually causing it to thicken. Scratching your skin also increases the risk of your eczema becoming infected with bacteria,” says the NHS.

Flare-ups of eczema are often caused by a trigger. Certain fabrics, for example, or heat or detergents may irritate your child’s eczema.

While diet may play some part in causing a flare-up, you should not significantly alter your child’s diet without first talking to your GP. If your GP suspects your child is suffering from a food allergy, they will refer him to an allergy specialist.

German measles (also known as rubella)

What does rubella look like?

German measles - rubella rash

As well as a raised temperature and conjunctivitis, a pink-red rash will appear. It will come up as slightly itchy spots, which may merge to form patches. This rash is often accompanied by swollen lymph nodes and cold-like symptoms.

Where does rubella rash appear?

It usually starts behind the ears and then spreads to the head, neck, trunk, legs and arms.

Who gets it?

It’s a respiratory disease and is fairly rare as most children get immunised against it when they have their MMR vaccine (Measles, Mumps and Rubella). While it isn’t that dangerous for young children, it is extremely dangerous for pregnant women – if exposed to it when in the first trimester, the unborn baby is likely to develop congenital rubella syndrome which can lead to miscarriage stillbirth or severe defects.

What can you do?

The condition usually subsides within 7 to 10 days. Phone your GP if you suspect your child has it, and keep them off school for 6 days from the start of their rash. Make sure to avoid any contact with pregnant women for at least a week.

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You can relieve other symptoms by using paracetamol or ibuprofen; they will reduce the fever and dull the aches and pains. Keep your child cool and hydrated if they have a temperature.

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