Baby and Toddler Skin Rashes: Complete Visual Guide

What Causes Skin Rashes in Babies and Children?

Skin rashes in babies and children can be caused by viral infections, bacterial infections, fungal infections, allergic reactions, irritation from heat or chemicals, or conditions present from birth. The skin is a large organ that reacts to many different triggers, and rashes are extremely common during childhood, especially in the first year of life.

The skin is the body's largest organ and serves as a protective barrier against the external environment. In babies and young children, the skin is particularly sensitive and prone to various reactions. Rashes are one of the most common reasons parents seek medical advice for their children, and understanding the different types of rashes can help you determine when home care is sufficient and when medical attention is needed.

During the first year of life, it is especially common for babies to develop various rashes and skin changes. Many of these are completely normal and represent the skin's adaptation to life outside the womb. Hormonal changes inherited from the mother, exposure to new environmental factors, and the development of the immune system all contribute to the prevalence of skin changes in infants.

Rashes can appear for many different reasons, including infectious diseases (viral, bacterial, or fungal), allergic reactions, heat and irritation, or they may be present from birth. Understanding the underlying cause helps determine the appropriate course of action. In many cases, rashes are simply a symptom of a common childhood illness and will resolve on their own without specific treatment.

Rashes Look Different on Different Skin Tones

It is important to understand that the same type of rash can look quite different depending on a child's skin tone. On lighter skin, many rashes appear pink or red. On darker skin, the same rashes may appear purple, brown, or darker than the surrounding skin. In some cases, on very dark skin, certain rashes may be less visible but can still be felt as raised bumps or rough texture. This guide describes how each rash appears on both lighter and darker skin to help with identification.

When Should You Seek Medical Care for a Rash?

Seek immediate medical care if your child has a rash that doesn't fade when pressed (do the glass test), fever with a rash and seems unwell, difficulty breathing or swallowing, swelling of the face or mouth, or is unusually drowsy. Most rashes don't require medical attention and resolve on their own.

The majority of childhood rashes are harmless and will resolve without any treatment. However, it is essential for parents to know the warning signs that indicate a rash may be more serious and require medical evaluation. The decision to seek care often depends not just on the appearance of the rash itself, but on how your child is feeling overall.

The most important factor in determining whether to seek care is your child's general condition combined with the characteristics of the rash. A child who has a rash but is otherwise playful, eating well, and acting normally is much less concerning than a child who is lethargic, refusing to eat, or running a high fever along with their rash.

The Glass Test (Tumbler Test)

The glass test is a simple but potentially life-saving technique that every parent should know. It helps identify a non-blanching rash, which can be a sign of meningococcal septicemia or other serious conditions that require immediate emergency care.

To perform the glass test, take a clear drinking glass and press the side of the glass firmly against the area of the rash. Look through the glass while pressing. If the rash fades or disappears when you press (blanches), this is usually a good sign. However, if the rash remains visible and does not fade when you press the glass against it (non-blanching), this is a medical emergency and you should call emergency services immediately.

It is important to note that the glass test works best on lighter skin. On darker skin tones, it can be more difficult to assess whether a rash is blanching or not. In these cases, try pressing on the palms of the hands or soles of the feet where the skin is lighter. If you are unsure and your child seems unwell, always err on the side of caution and seek immediate medical advice.

What Are Common Newborn Skin Conditions?

Common newborn skin conditions include erythema toxicum (newborn rash), milia (small white bumps), baby acne, and stork bites. These are all normal variations that appear in the first weeks of life and typically resolve on their own without treatment. They are caused by maternal hormones and the skin adapting to life outside the womb.

The first few weeks of a baby's life are a time of significant adaptation, and the skin often shows various changes as it adjusts to the new environment. Parents may be alarmed to see spots, bumps, or color changes on their newborn's skin, but most of these are completely normal and require no treatment. Understanding these common newborn skin conditions can provide reassurance during this transitional period.

Erythema Toxicum (Toxic Erythema of the Newborn)

Despite its alarming name, erythema toxicum is a completely harmless and very common newborn rash. It has nothing to do with toxins or poisons. This rash typically appears between one to four days after birth and affects approximately 50% of full-term newborns. The rash consists of small yellowish-white bumps surrounded by a red or pink area on lighter skin, or the bumps may appear on darker skin without the surrounding color change or with a darker surrounding area.

The bumps are most commonly found on the chest, belly, back, and occasionally on the arms, legs, and face. They may appear and disappear over the course of hours, seeming to migrate from one area to another. The cause is unknown, but it is believed to be related to the skin's immune system activating as the baby adjusts to life outside the womb. No treatment is needed, and the rash typically resolves completely within a few days to a couple of weeks.

Milia

Milia are tiny white or yellowish bumps that appear on the nose, cheeks, chin, and forehead of many newborns. They occur when dead skin cells become trapped in small pockets near the surface of the skin. Milia affect approximately 40-50% of newborns and are more visible on darker skin where they appear as small white dots. These tiny cysts require no treatment and will resolve on their own as the skin matures, typically within the first few weeks to months of life.

Stork Bites (Salmon Patches)

Stork bites are flat, pink or red patches that appear on the forehead, eyelids, and back of the neck in many newborns. They are caused by clusters of tiny blood vessels near the surface of the skin. On darker skin, they may appear red or purple. Stork bites on the forehead and eyelids typically fade completely within the first year of life, while those on the back of the neck may persist for years or even into adulthood, though they are usually hidden by hair.

What Does Eczema Look Like in Babies and Children?

Eczema (atopic dermatitis) appears as dry, rough, scaly patches that are red or pink on lighter skin, and darker brown, purple, or grey on darker skin. In babies under one year, it typically affects the cheeks and may spread to the entire body. In older children, eczema most commonly appears in the elbow creases, behind the knees, and on the hands.

Eczema, also known as atopic dermatitis, is one of the most common skin conditions in childhood, affecting approximately 15-20% of children worldwide. It is a chronic inflammatory condition that causes the skin to become dry, itchy, and prone to flare-ups. While eczema can be challenging to manage, understanding the condition and implementing consistent skin care routines can significantly improve symptoms for most children.

The exact cause of eczema is not fully understood, but it appears to result from a combination of genetic and environmental factors. Children with eczema have a skin barrier that doesn't function as effectively as it should, allowing moisture to escape and irritants and allergens to enter. This leads to the characteristic dryness, inflammation, and itching. Eczema is not contagious and cannot be spread from person to person.

The appearance of eczema varies depending on the child's age and skin tone. In infants younger than one year, eczema most commonly appears on the cheeks, often giving the appearance of chapped or rough skin. Some babies develop eczema over larger areas of the body. As children grow older, the distribution typically shifts to the flexural areas - the creases of the elbows, behind the knees, and around the wrists and ankles. The hands are also commonly affected, particularly as children begin school and are exposed to frequent hand washing.

On lighter skin, eczema patches typically appear pink or red during flare-ups and may be lighter or pink when the condition is more controlled. On darker skin, active eczema may appear purple, brown, or darker than the surrounding skin. During healing, these areas may temporarily appear lighter or darker than the normal skin tone. The skin affected by eczema often has a rough, bumpy texture and may show signs of scaling or flaking.

What Are Common Viral Rashes in Children?

Common viral rashes include chickenpox (itchy blisters), measles (red rash starting on face), roseola (rash appearing after fever subsides), fifth disease (slapped cheek appearance), and hand-foot-mouth disease (blisters on hands, feet, and mouth). Most viral rashes are harmless and resolve on their own as the infection clears.

Many common childhood viral infections cause characteristic rashes as part of their symptom profile. These viral exanthems, as they are medically called, are usually harmless and resolve on their own as the child's immune system fights off the infection. However, some viral rashes, such as measles, can be prevented through vaccination, and certain conditions require medical attention or have specific care instructions.

Chickenpox (Varicella)

Chickenpox is a highly contagious viral infection that was once nearly universal in childhood before vaccination became widespread. The rash begins as small red spots that quickly develop into fluid-filled blisters. On darker skin, the initial spots may appear as dark bumps rather than red marks. The blisters are very itchy and eventually crust over to form scabs. New spots continue to appear over several days, so you may see bumps, blisters, and scabs all at the same time on different parts of the body.

The rash typically starts on the chest, back, and face before spreading to the rest of the body, including the scalp and sometimes the mouth and genital area. Most children also experience fever and general malaise. Chickenpox is highly contagious from about two days before the rash appears until all blisters have crusted over. The illness typically runs its course in 7-10 days. Contact your doctor if you suspect chickenpox, but call first rather than visiting in person due to the high contagiousness.

Measles

Measles is a serious viral infection that has become rare in many countries due to widespread vaccination but still occurs, particularly in unvaccinated populations. The characteristic rash begins on the face, starting at the hairline and behind the ears, then spreads downward to cover the body over several days. On lighter skin, the rash appears as flat red or pink spots that may merge together. On darker skin, it may appear darker red or purple.

Before the rash appears, children typically have high fever, cough, runny nose, and red, watery eyes. The tongue may develop a white coating, and small white spots (Koplik spots) may appear inside the mouth. Measles can lead to serious complications including pneumonia and encephalitis. If you suspect your child has measles, contact your doctor immediately by phone – do not visit the clinic without calling first, as measles is extremely contagious.

Roseola (Sixth Disease)

Roseola is a common viral illness that primarily affects children between 6 months and 2 years of age. It is characterized by a distinctive pattern: the child first develops a high fever (often 39-40°C/102-104°F) that lasts for three to five days. The child may be irritable during the fever phase but often doesn't appear seriously ill. Then, as the fever suddenly subsides, a rash appears.

The roseola rash consists of small pink or red spots, often with a pale ring around each spot. On darker skin, the rash may appear as light red spots or may be barely visible. The rash typically starts on the trunk and spreads to the arms, legs, and sometimes the face. It does not itch and usually fades within one to two days. By the time the rash appears, the child is typically feeling much better and the contagious period is usually over.

Fifth Disease (Erythema Infectiosum)

Fifth disease is caused by parvovirus B19 and is common in school-age children. Its most distinctive feature is the "slapped cheek" appearance – bright red patches on both cheeks that look as if the child has been slapped. This cheek rash is followed a few days later by a lacy, net-like rash that spreads to the trunk, arms, and legs. On darker skin, the cheek rash may appear purple or less visible, while the lacy body rash may appear as a pattern of lighter and darker areas.

Before the rash appears, children may have mild cold-like symptoms, headache, or low-grade fever. By the time the rash appears, the child is usually no longer contagious. The rash may come and go for several weeks, often seeming to reappear after sun exposure, exercise, or warm baths. Fifth disease is generally mild and requires no specific treatment, though it can be serious for pregnant women and people with certain blood disorders.

Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease is a common viral infection that causes small blisters or sores in the mouth and a rash on the hands and feet. It is most common in children under 5 years old. The mouth sores can make eating and drinking painful, while the rash on the hands and feet (and sometimes the buttocks) may appear as small red spots or blisters. The blisters may be surrounded by a pink or red halo on lighter skin, while on darker skin the surrounding area may appear darker.

The illness typically begins with fever, reduced appetite, and sore throat. Mouth sores appear one to two days later, followed by the skin rash. Most children recover within 7-10 days without treatment. The main concern is ensuring the child stays hydrated, as the mouth sores can make drinking uncomfortable. Contact your doctor if your child refuses to drink or shows signs of dehydration.

What Are Common Bacterial Skin Infections in Children?

Common bacterial skin infections include impetigo (crusty sores often around the mouth), scarlet fever (rough, sandpaper-like rash with "strawberry tongue"), and cellulitis (spreading red, warm, swollen area). Bacterial infections often require antibiotic treatment and medical evaluation.

While many childhood rashes are caused by viruses and resolve on their own, some are caused by bacterial infections that may require antibiotic treatment. Bacterial skin infections tend to have certain characteristics that distinguish them from viral rashes, including the presence of pus, spreading redness, warmth, and sometimes fever. Recognizing these signs can help parents know when to seek medical attention.

Impetigo

Impetigo is a highly contagious bacterial skin infection most commonly caused by Staphylococcus or Streptococcus bacteria. It typically appears as red sores that quickly develop a honey-colored crust. The sores most commonly appear around the nose and mouth but can spread to other areas through touching or scratching. On darker skin, the sores may appear darker and the crusts may look brown rather than honey-colored.

Impetigo spreads very easily through direct contact or by sharing items like towels or clothing. Children with impetigo should stay home from school or daycare until the sores have dried up and healed, or until they have been on antibiotics for at least 24-48 hours. Most cases can be treated with topical antibiotic ointments, though more extensive infections may require oral antibiotics. Keep the affected areas clean and covered to prevent spread.

Scarlet Fever

Scarlet fever is caused by the same bacteria that cause strep throat (Group A Streptococcus). It produces a distinctive rash that feels rough like sandpaper when you stroke it. The rash consists of tiny, pinpoint bumps that start in the armpits and groin before spreading to the trunk and limbs. On lighter skin, the rash appears red. On darker skin, it may appear the same color as the skin or slightly darker, but the rough texture can still be felt.

In addition to the rash, children with scarlet fever typically have a high fever, sore throat, and a characteristic "strawberry tongue" – the tongue initially has a white coating, which then peels to reveal a bright red, bumpy surface. Scarlet fever requires treatment with antibiotics to prevent complications. Contact your doctor if you suspect your child has scarlet fever.

What Types of Birthmarks Can Babies Have?

Common birthmarks include port-wine stains (flat red or purple marks), hemangiomas (raised red "strawberry" marks that grow and then shrink), café-au-lait spots (light brown patches), and Mongolian spots (blue-grey patches on lower back, common in darker-skinned babies). Most birthmarks are harmless, though some may need monitoring.

Birthmarks are areas of skin that appear different from the surrounding skin, either from birth or developing in the first few weeks of life. They can be caused by abnormal blood vessels (vascular birthmarks) or by variations in skin pigmentation (pigmented birthmarks). Most birthmarks are completely harmless and require no treatment, though some may need medical evaluation or monitoring.

Port-Wine Stains (Nevus Flammeus)

Port-wine stains are flat birthmarks caused by a collection of blood vessels in the skin. They are present at birth and are permanent, typically growing proportionally with the child. On lighter skin, they appear pink or red and may darken to purple over time. On darker skin, they appear dark red or purple. Port-wine stains can occur anywhere on the body but are most common on the face. When located on the face, particularly near the eye, they should be evaluated by a doctor as they may be associated with other conditions. Treatment with laser therapy is available if desired for cosmetic reasons.

Hemangiomas (Strawberry Marks)

Hemangiomas are raised birthmarks caused by a rapid growth of blood vessels. They may be present at birth or appear within the first few weeks of life. Superficial hemangiomas appear bright red and raised on lighter skin, or darker red to purple on darker skin, giving them their "strawberry" nickname. Deeper hemangiomas may appear bluish or skin-colored as they sit beneath the skin surface.

Hemangiomas typically grow rapidly during the first year of life, which can be concerning for parents. However, after this growth phase, they gradually shrink and fade over several years. Most hemangiomas are gone or significantly reduced by age 5-7 years. While most hemangiomas need no treatment, those near the eyes, nose, mouth, or in the diaper area should be evaluated by a doctor. Contact your child health provider if your baby develops six or more hemangiomas, or if a hemangioma appears after six weeks of age.

Mongolian Spots (Dermal Melanocytosis)

Mongolian spots are flat, blue-grey or blue-brown patches that are present at birth. They are most commonly found on the lower back and buttocks but can appear elsewhere. These birthmarks are very common in babies with darker skin tones, occurring in over 80% of Asian, African, and Native American babies, but can occur in babies of any ethnicity.

Mongolian spots are caused by melanocytes (pigment-producing cells) that are located deeper in the skin than usual. They are completely harmless and typically fade gradually during childhood, often becoming much less visible by age 5-6 years. No treatment is needed. It is important for healthcare providers to document Mongolian spots in medical records to prevent them being mistaken for bruises.

What About Ringworm and Other Fungal Infections?

Ringworm (tinea) is a fungal infection that causes round or oval scaly patches with a clear center, giving a ring-like appearance. Despite its name, it is not caused by worms. Ringworm can affect the body, scalp, or feet (athlete's foot) and is contagious. It requires antifungal treatment.

Fungal skin infections, particularly ringworm (tinea), are common in children. These infections thrive in warm, moist environments and can be spread through direct skin contact, or by sharing contaminated items such as combs, brushes, hats, or towels. Despite their alarming appearance, fungal infections are generally not serious and respond well to appropriate treatment.

Ringworm on the body (tinea corporis) typically appears as round or oval patches that may be slightly raised at the edges and clearer in the center, creating the characteristic ring shape. The patches are often scaly and may itch. On lighter skin, they appear red or pink. On darker skin, they may appear brown, grey, or darker than the surrounding skin. As the patches grow larger, the center may begin to look more normal while the active edge continues to expand outward.

Ringworm of the scalp (tinea capitis) is particularly common in children and can cause patches of hair loss with scaly skin. It may also cause small black dots where hairs have broken off at the scalp. Scalp ringworm is highly contagious and requires oral antifungal medication, not just topical creams. Contact your doctor if you suspect your child has ringworm, as proper diagnosis and treatment are important to prevent spread to others.

What Do Allergic Rashes Look Like?

Hives (urticaria) are the most common allergic skin reaction in children, appearing as raised, itchy welts that can change shape and location within hours. They can be triggered by foods, medications, infections, or sometimes have no identifiable cause. Severe allergic reactions with breathing difficulty require immediate emergency care.

Allergic reactions can cause a variety of skin manifestations in children, ranging from mild itchy rashes to severe, life-threatening reactions. Understanding the difference between minor allergic skin reactions and those that signal a more serious problem is important for parents. Most allergic rashes are uncomfortable but not dangerous, though some require immediate medical attention.

Hives (Urticaria)

Hives are raised, itchy welts that can appear anywhere on the body. They are often described as looking like mosquito bites but can vary greatly in size from small spots to large patches several centimeters across. One of the characteristic features of hives is that individual welts typically last less than 24 hours, though new ones may continue to appear. The welts can change shape and location rapidly, seeming to migrate across the skin.

On lighter skin, hives appear as pink or red raised areas. On darker skin, they may appear lighter than the surrounding skin, pink, or the same color as the skin but raised. The welts are almost always itchy, sometimes intensely so. Hives can be triggered by many things including foods, medications, insect stings, infections, heat, or physical pressure. In many cases, especially in children, the cause is never identified.

Most episodes of hives are not dangerous and resolve on their own or with antihistamine treatment. However, hives that occur along with swelling of the face, lips, or tongue, difficulty breathing, or dizziness may indicate a severe allergic reaction (anaphylaxis) and require immediate emergency care. Call emergency services if hives are accompanied by any of these symptoms.