CHILD HEALTH + SAFETY
Rash Guard: When to Worry About Baby’s Skin By Malia Jacobson Spring is here, and local little ones are enjoying the outdoors in strollers, baby swings and backyards. For some, though, peeling away winter’s heavy layers reveals angry, irritated skin. If your baby’s skin seems unusually irritated these days, they’re not alone. Markus Boos, M.D., Ph.D., a pediatric dermatologist with Seattle Children’s Hospital, says his infant patients are coming in with more severe cases of common rashes, most likely because families are waiting longer than usual to take children to the doctor. “I think families are delaying care because of concerns about the safety of going out in public with their infant during COVID,” he says. Delaying care for skin irritations is understandable, particularly during the past year. After all, rashes on babies are sometimes dismissed as harmless, even unavoidable, childhood nuisances. But skin rashes can sometimes signal more serious health conditions, reactions to medication or even a serious COVID-19 complication, so it’s a good idea to check in with your child’s health-care provider if a rash appears suddenly, seems painful or infected, or is accompanied by cold or flu-like symptoms, such as fever, vomiting, changes in appetite or diarrhea. Here’s a primer on common rashes, along with information about when to worry about them and how to care for irritated skin at home.
children outgrow it by the time they reach kindergarten age. Heat rash As temperatures rise during spring and summer, caregivers may notice clusters of tiny pink or red bumps or water blisters on their child’s upper body, mainly the neck, chest or upper back. Caused by blocked sweat glands, heat rash can be itchy and uncomfortable, but it generally doesn’t signal an underlying illness and it is not accompanied by a fever. To treat heat rash, cool the affected skin with a damp washcloth or a cool (not freezing!) bath without soap and allow the skin to air-dry whenever possible. Psoriasis Scaly, thickened patches of skin covering a red, inflamed rash underneath could signal psoriasis, a frustratingly persistent condition that affects babies, children and adults throughout their lives. This condition has a genetic component, and while psoriasis can’t be cured, it can be managed with treatments that include topical steroids and oral or injectable medications. Psoriasis may be a manifestation of a systemic inflammatory disorder, notes Boos, and treatment may involve working with specialists in immunology, gastroenterology and rheumatology.
Atopic dermatitis
Multisystem inflammatory syndrome (MIS-C)
This hereditary form of eczema, which causes red, scaly patches near the joints and on the cheeks, is the most common condition Boos treats. Although atopic dermatitis has a genetic basis (meaning it can only be managed, not cured), certain factors make flare-ups more likely. Fragrances, harsh soaps and some chemical cleaners or detergents can result in itchy, uncomfortable rashes on babies and young children. Fortunately, the condition is often treated successfully with topical steroids, and many
A red, bumpy rash accompanied by stomachache, fever and fatigue could be a sign of multisystem inflammatory syndrome in children (MIS-C), a condition linked to the virus that causes COVID-19. In children with MIS-C, internal organs, including the brain, lungs, skin and stomach, become inflamed. “Things to look for include conjunctival injection [bloodshot eyes], bright red cheeks, swelling and redness of the palms and around the eyes, and a nonspecific rash that can look like hives, fine bumps or just
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