Is my child’s rash serious?

Posted on 26 December 2019

Childhood rashes are common – and mostly harmless. But some might require medical treatment.

If your child suddenly develops a rash, pay attention to other signs and symptoms. If they’re alert, well hydrated, don’t have a temperature or swollen glands and are breathing normally, there is generally no cause for alarm. However, if any of these signs are apparent, it’s time to see the doctor.

Heat rash presents as pink bumps, usually found in areas where the sweat ducts become blocked,” says Dr Dilshaad Asmal, a dermatologist at Mediclinic Cape Town. “It’s caused by excessive heat and usually improves once you move your child to a cooler, less humid environment. Heat rash might be itchy, but it’s generally not painful. Don’t apply any cream or ointment,” says Dr Asmal. “Rather ensure that you don’t overdress your baby in warm weather and that your child wears clothes that don’t trap heat.”

Psoriasis is a scaly eruption that can sometime present as symmetrical, red scaly lesions with a well-defined edge,” says Dr Asmal. “The scale is typically silvery white, except in skin fold areas, where it can appear shiny. Psoriasis can be genetic and is often precipitated by infection, injury or  psychological stress.” Your child might need a biopsy to confirm the diagnosis. Treatments include topical creams, light, oral medication and biologics.

If your baby has atopic eczema, it will present as dry, scaly, red patches. Their cheeks will usually be affected and scratch marks may be evident. “Toddlers and preschool children may have eczema on the joint areas, particularly their wrists, elbows, ankles and knees,” Dr Asmal explains. “As a child grows, the pattern can change from the outer aspects to the flexural areas of the joints and may include the face.”

Spontaneous eczema flare-ups are often triggered by soaps, detergents and fragrances, house dust, pollen, animal dander, certain food and synthetic clothing. Topical corticosteroids (steroids), can ease redness and reduce inflammation and itching so your child’s skin can begin to heal.

“Measles is a highly contagious rash caused by a viral infection,” Dr Asmal eplains. It is a serious disease for small children, but can be prevented by a vaccine. “Red spots on the skin range from a few millimetres to one centimetre and will eventually join together,” Dr Asmal says. “This rash can be accompanied by a fever, coughing, lethargy, red eyes and a blocked or runny nose.”

Often Koplik spots (named after the American paediatrician who first described them) in the mouth will appear up to 48 hours before the rash appears. “Treatment for measles includes syrups to decrease the fever, cough medication, adequate hydration and food intake,” says Dr Asmal.


If you are concerned about any skin rashes or other childhood ailments or illnesses, schedule an appointment with one of Mediclinic’s expert paediatricians.

Mediclinic hospitals, day clinics and staff are ready to welcome you for your regular doctor’s appointments and screenings.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.