Child Rashes: Complete Visual Guide to Skin Conditions
📊 Quick Facts About Child Rashes
💡 Key Takeaways for Parents
- Most rashes are harmless: The majority of childhood rashes resolve on their own without medical treatment
- Glass test for emergencies: A rash that doesn't fade when pressed with a glass may indicate meningitis - seek emergency care immediately
- Rashes look different on different skin tones: On darker skin, rashes may appear purple, brown, or darker rather than red
- Fever plus rash needs attention: A child with both fever and rash who seems unwell should be evaluated by a doctor
- First year is most active: Skin changes are extremely common in babies' first year of life
- Take photos: Document rashes with photos as they may change or fade before your doctor's appointment
What Causes Rashes in Children?
Rashes in children are caused by viral infections, bacterial infections, allergic reactions, eczema, fungal infections, heat, irritants, or inherited skin conditions. The skin is the body's largest organ and reacts to many different triggers, making rashes one of the most common reasons parents seek medical advice.
The skin is an incredibly responsive organ that can react to internal changes (like infections or immune responses) as well as external factors (like irritants, allergens, or temperature). This means rashes can have many different causes, and understanding these helps parents know what to expect and when to worry.
Rashes are particularly common during a child's first year of life. The developing immune system, sensitive newborn skin, and frequent exposure to new substances all contribute to the prevalence of skin changes in infants. While this can be alarming for new parents, most of these rashes are completely normal and resolve without intervention.
The same type of rash can look quite different from one child to another, or even different on the same child at different times. Factors like skin tone, the stage of the rash, the child's temperature, and recent activities all influence appearance. This variability can make identification challenging, which is why understanding the general patterns and key warning signs is more important than trying to match a rash exactly to a description.
Common Categories of Childhood Rashes
Childhood skin conditions generally fall into several main categories, each with distinct characteristics and management approaches:
- Infectious rashes: Caused by viruses (chickenpox, measles, roseola) or bacteria (impetigo, scarlet fever)
- Allergic and inflammatory rashes: Including eczema, hives, and contact dermatitis
- Birthmarks: Present at birth or appearing shortly after, including hemangiomas and port-wine stains
- Heat and sweat-related rashes: Including heat rash and newborn skin conditions
- Fungal infections: Such as ringworm and yeast-related rashes
When Should I Take My Child to the Doctor for a Rash?
Seek medical care if your child has a rash with fever and appears unwell, if the rash spreads rapidly, if it doesn't fade when pressed (petechial rash), if there are signs of infection, or if your child has difficulty breathing. Most rashes don't require medical attention, but knowing the warning signs is crucial.
One of the biggest challenges for parents is knowing when a rash is simply part of normal childhood and when it requires medical attention. The general rule is that how your child feels overall is more important than how the rash looks. A child who is playful, eating normally, and seems well is unlikely to have a serious condition, even if the rash looks concerning.
However, certain features of a rash or accompanying symptoms should prompt immediate medical evaluation. Understanding these warning signs can help you make confident decisions about when to seek care and when to manage symptoms at home.
- The rash doesn't fade when pressed (do the glass test - press a clear glass against the rash)
- Your child has a high fever with a rapidly spreading rash
- Your child has difficulty breathing or swelling of the face/lips
- Your child is confused, unusually sleepy, or difficult to wake
- Your child has a stiff neck with fever and rash
A non-blanching (petechial) rash with fever can indicate meningitis or sepsis - call emergency services immediately. Find your emergency number →
The Glass Test
The glass test is a simple but potentially life-saving check that every parent should know. Press a clear drinking glass firmly against the rash. If the rash fades or disappears under pressure and returns when you lift the glass, this is called a "blanching" rash and is usually not serious. If the rash stays visible through the glass and doesn't fade, this is a "non-blanching" or "petechial" rash, which can indicate bleeding under the skin and requires immediate medical attention, especially if accompanied by fever.
- The rash is spreading rapidly over hours
- Your child has fever and seems unwell or unusually tired
- The rash has blisters or open sores
- There are signs of infection: increasing pain, spreading redness, pus, or warmth
- The rash is around the eyes
- Your child is under 3 months old with any rash and fever
- The rash hasn't improved after 2 weeks of home treatment
What Are Common Infectious Rashes in Children?
Common infectious rashes include chickenpox (itchy blisters), fifth disease (slapped cheek appearance), roseola (rash after fever), hand-foot-mouth disease (blisters on hands, feet, mouth), measles (spreading red rash), scarlet fever (sandpaper-textured rash), and impetigo (honey-colored crusts). Most viral rashes resolve without treatment in 3-7 days.
Infectious rashes are among the most common skin conditions in childhood. They occur when the body's immune system responds to viral or bacterial infections, often producing characteristic patterns that can help with identification. Understanding these common infectious rashes helps parents know what to expect during the course of illness and when complications might be developing.
Chickenpox (Varicella)
Chickenpox
Chickenpox is a highly contagious viral infection that causes an itchy, blistering rash. While much less common since vaccination became widespread, cases still occur. The rash typically starts on the trunk and spreads to the face, arms, and legs, including the scalp and sometimes inside the mouth.
On lighter skin:
Red bumps that develop into fluid-filled blisters, then crust over
On darker skin:
Bumps may appear the same color as surrounding skin or slightly red; texture changes are more noticeable than color
Timeline: New spots appear for 3-5 days, with bumps, blisters, and crusts visible simultaneously. Complete healing takes 1-2 weeks.
Associated symptoms: Fever, tiredness, headache, reduced appetite
When to seek care: If blisters become infected (increasing redness, pus), if your child has high fever or is very unwell, or if there are blisters near the eyes. Always call before visiting a clinic as chickenpox is highly contagious.
Fifth Disease (Erythema Infectiosum)
Fifth Disease
Fifth disease, caused by parvovirus B19, is known for its distinctive "slapped cheek" appearance. By the time the rash appears, the child is no longer contagious. The condition is generally mild in healthy children but can be concerning during pregnancy.
On lighter skin:
Bright red rash on both cheeks (slapped cheek appearance), followed by lacy, net-like rash on arms, legs, and trunk
On darker skin:
May appear as a darker or reddish-purple discoloration on cheeks; the lacy pattern may be less visible but texture can be felt
Timeline: Cheek rash lasts a few days; body rash may come and go for weeks, especially after warm baths, exercise, or sun exposure
Associated symptoms: Mild fever, runny nose, and tiredness before the rash appears; joint pain in older children
When to seek care: Most children don't need medical care. Seek advice if your child has sickle cell disease or other blood disorders, or if a pregnant woman has been exposed.
Roseola (Sixth Disease)
Roseola (Three-Day Fever)
Roseola is a common viral infection in children aged 6 months to 2 years. It's characterized by several days of high fever followed by a rash that appears as the fever breaks - a pattern that can be reassuring once you know to expect it.
On lighter skin:
Small pink or light red spots, starting on trunk and spreading to limbs and face
On darker skin:
Spots may be subtle or barely visible; texture changes may be more apparent than color changes
Timeline: High fever for 3-5 days, then rash appears as fever breaks and lasts 1-3 days
Associated symptoms: High fever (often 39-40°C/102-104°F), irritability, mild diarrhea, swollen eyelids
When to seek care: Seek care for fever lasting more than 3 days, if your child has a febrile seizure, or if they seem very unwell. The rash itself doesn't require treatment.
Hand, Foot, and Mouth Disease
Hand, Foot, and Mouth Disease
This common childhood infection causes painful sores in the mouth and a rash on hands and feet. It's most common in children under 5 and spreads easily in childcare settings. Despite the uncomfortable symptoms, it's usually mild and resolves on its own.
Mouth:
Painful blisters and sores on tongue, gums, inside of cheeks, and back of throat
Hands and feet:
Flat or raised spots with blisters, sometimes extending to buttocks and legs. On darker skin, spots may appear darker brown or grayish rather than red.
Timeline: Symptoms last 7-10 days; mouth sores typically most painful for first few days
Associated symptoms: Fever, sore throat, reduced appetite due to mouth pain, drooling in young children
When to seek care: If your child won't drink fluids, has high fever, or symptoms worsen after the first few days.
Measles
Measles
Measles is a highly contagious viral infection that has become rare in countries with high vaccination rates but remains a significant concern globally. It causes a distinctive rash along with respiratory symptoms and can lead to serious complications.
On lighter skin:
Flat red or reddish-brown spots that start behind ears and on forehead, spreading downward. Spots often merge together.
On darker skin:
May appear as darker brown, purple, or dusky patches. The merging pattern is still visible.
Timeline: Rash appears 3-5 days after first symptoms, spreads over 3 days, then fades in the same order it appeared
Associated symptoms: High fever, cough, runny nose, red watery eyes, white spots inside mouth (Koplik spots) before rash
When to seek care: Always contact a healthcare provider if you suspect measles, but call first rather than visiting in person due to high contagiousness. Measles can have serious complications.
Scarlet Fever
Scarlet Fever
Scarlet fever is caused by group A streptococcus bacteria, the same bacteria that causes strep throat. It produces a distinctive sandpaper-textured rash and requires antibiotic treatment. Early treatment prevents complications and reduces contagiousness.
On lighter skin:
Fine, rough-textured rash that looks like sunburn with tiny bumps. Starts in armpits and groin, spreads to trunk and limbs. May be more intense in skin folds.
On darker skin:
Texture change (sandpaper feel) may be more noticeable than color. Some redness may be visible, or skin may appear slightly darker.
Other features:
"Strawberry tongue" - white coating followed by bright red, bumpy tongue. Flushed cheeks with pale area around mouth.
Timeline: Rash appears 1-2 days after illness starts, lasts about a week, then skin may peel (especially fingertips)
Associated symptoms: Sore throat, fever, headache, swollen lymph nodes in neck
When to seek care: Contact a healthcare provider if you suspect scarlet fever. Antibiotic treatment is needed to prevent complications.
Impetigo
Impetigo
Impetigo is a highly contagious bacterial skin infection common in young children. It typically appears around the nose and mouth but can occur anywhere on the body. It spreads easily through direct contact and shared items.
Appearance:
Starts as small red spots or pimples that develop into blisters. Blisters burst and form characteristic honey-colored or golden crusts. The infected area may spread outward or appear in new locations.
Timeline: Without treatment, can persist for weeks. With treatment, healing begins within 24-48 hours and clears in 7-10 days.
Associated symptoms: Usually no fever or general illness. May be mildly itchy or sore.
When to seek care: See a healthcare provider for diagnosis and treatment. Prescription antibiotic cream or oral antibiotics speed healing and reduce spread. Keep children home from school/daycare until sores have dried.
What Does Eczema Look Like in Children?
Eczema (atopic dermatitis) appears as dry, itchy, rough patches of skin that can become red, inflamed, and cracked. In babies, it commonly affects cheeks and scalp. In older children, it typically appears in arm and knee creases, hands, and around the eyes. On darker skin, eczema may appear darker brown, purple, or grayish rather than red.
Eczema is the most common chronic skin condition in children, affecting 15-20% of children worldwide. It typically begins in infancy or early childhood and, while many children outgrow it, some continue to have symptoms into adulthood. Understanding eczema helps parents manage symptoms effectively and know when flare-ups need medical attention.
The hallmark of eczema is the "itch-scratch cycle" - the skin itches, the child scratches, and scratching damages the skin barrier, leading to more inflammation and more itching. Breaking this cycle through proper moisturizing, trigger avoidance, and appropriate treatment is the key to management.
Eczema (Atopic Dermatitis)
On lighter skin:
Dry, rough, scaly patches that appear pink or red during flare-ups. May have small bumps. Skin may weep or crust when severely inflamed.
On darker skin:
Patches may appear darker brown, purple, or grayish. Redness may not be visible, but texture changes (roughness, scaliness, small bumps) are apparent. May appear ashy or lighter than surrounding skin when dry.
Common locations by age:
- Babies (0-1 year): Cheeks, forehead, scalp; may spread to trunk and limbs
- Toddlers and older children: Inner elbows, behind knees, wrists, ankles, neck, around eyes
Key features: Intense itching (often worse at night), dry skin, recurring pattern in typical locations, family history of allergies or asthma common
Management:
- Daily moisturizing with fragrance-free emollients
- Lukewarm (not hot) baths, pat dry gently
- Identify and avoid triggers (certain soaps, fabrics, foods, allergens)
- Cotton clothing next to skin
- Keep nails short to reduce scratch damage
When to seek care: If the eczema is severely affecting your child's sleep or daily life, if there are signs of skin infection (oozing, crusting, increased pain, spreading redness), or if over-the-counter treatments aren't helping.
What Causes Hives (Urticaria) in Children?
Hives (urticaria) are raised, itchy welts that appear suddenly, often moving around the body. They're commonly triggered by viral infections, allergies, medications, or unknown causes. Individual welts last less than 24 hours but new ones may appear. Most cases resolve within days, but seek emergency care for hives with breathing difficulty or facial swelling.
Hives are one of the most alarming rashes for parents because they appear suddenly and can look dramatic. However, in most cases, hives in children are triggered by common viral infections rather than dangerous allergies. Understanding when hives are part of a serious allergic reaction versus a normal response to infection helps parents respond appropriately.
Hives (Urticaria)
On lighter skin:
Raised, red or pink welts of varying sizes, often with pale centers. May form large patches when welts merge.
On darker skin:
Raised welts may appear lighter than surrounding skin, or the same color with visible texture change. May have a slightly purple or brownish tint.
Key feature:
Individual welts typically last less than 24 hours, but new welts appear in different locations - they seem to "move around" the body.
Common triggers in children:
- Viral infections (most common cause in children)
- Allergic reactions (food, medications, insect stings)
- Physical triggers (pressure, cold, heat, exercise)
- Unknown cause (often no trigger identified)
Treatment: Antihistamines are the main treatment. Cool compresses may help relieve itching. Most cases resolve within days to weeks.
- Difficulty breathing or wheezing
- Swelling of tongue, lips, or throat
- Dizziness or fainting
- Vomiting or severe abdominal pain
- Rapid heartbeat
These signs indicate anaphylaxis, a severe allergic reaction requiring immediate treatment. Find your emergency number →
What Are Common Birthmarks in Children?
Common birthmarks include stork bites (pink patches on eyelids, forehead, neck), hemangiomas (raised red "strawberry" marks), port-wine stains (flat purple-red marks), and Mongolian spots (blue-gray patches common in babies with darker skin). Most birthmarks are harmless, though some require monitoring or treatment.
Birthmarks are extremely common, with around 80% of babies having at least one type. They form from abnormal clusters of blood vessels (vascular birthmarks) or pigment cells (pigmented birthmarks). While most are completely harmless and many fade over time, some types benefit from early evaluation and treatment.
Stork Bites (Salmon Patches)
Stork Bites / Salmon Patches / Angel Kisses
These are the most common type of birthmark, present in up to 50% of newborns. They consist of tiny blood vessels visible through thin newborn skin.
On lighter skin:
Flat pink or red patches, most common on eyelids, forehead (between eyebrows), and back of neck
On darker skin:
May appear as red or purple patches, sometimes subtle and may be less visible
Outlook: Marks on the face typically fade by age 1-2 years. Marks on the back of the neck ("stork bite") often persist into adulthood but are usually covered by hair.
Treatment: None needed. Completely harmless.
Hemangiomas (Strawberry Marks)
Hemangiomas
Hemangiomas are benign tumors made of blood vessels. They're not usually present at birth but appear within the first few weeks of life, grow during the first year, then gradually shrink and fade over several years.
On lighter skin:
Raised, bright red, bumpy surface (like a strawberry). Deeper hemangiomas may appear blue or purple.
On darker skin:
May appear darker red, purple, or blue. Surface texture is similar.
Timeline: Appear by 6 weeks of age, grow for 6-12 months, then slowly shrink over years. Most are gone or significantly faded by age 5-10.
When to seek care: Consult a doctor if hemangiomas are near the eyes, nose, mouth, or in the diaper area; if your baby has multiple hemangiomas (6 or more); or if they appear to be growing rapidly or ulcerating. Some may need treatment to prevent complications.
Port-Wine Stains
Port-Wine Stains (Nevus Flammeus)
Port-wine stains are permanent birthmarks caused by abnormal capillaries in the skin. Unlike stork bites, they don't fade on their own and may darken over time.
On lighter skin:
Flat, pink to deep purple patches. May darken to deep red or purple over time and develop a thickened, bumpy texture in adulthood.
On darker skin:
May appear dark red, purple, or very dark brown
Location: Can occur anywhere but commonly on the face. May occur on one side only.
Treatment: Laser treatment can lighten port-wine stains and is most effective when started early in life. Facial port-wine stains, especially around the eye, should be evaluated by a specialist as they can be associated with other conditions.
Congenital Dermal Melanocytosis (Mongolian Spots)
Congenital Dermal Melanocytosis
These are flat, blue-gray patches most commonly seen in babies with Asian, African, Hispanic, or Native American heritage, though they can occur in babies of any ethnicity. They're caused by pigment cells in deeper layers of skin.
Appearance:
Flat, blue-gray or blue-black patches, often resembling bruises. Most commonly found on the lower back and buttocks, but can appear elsewhere.
Outlook: Gradually fade and usually disappear by school age, though some may persist. Completely harmless.
Important note: These can sometimes be mistaken for bruises. If there's any question about whether marks are bruises or birthmarks, a healthcare provider can help distinguish them.
What Other Skin Conditions Are Common in Children?
Other common childhood skin conditions include ringworm (circular fungal infection), molluscum (small pearly bumps), warts, keratosis pilaris (rough bumps on arms), heat rash (prickly heat), and cradle cap. Most are harmless and either resolve on their own or respond well to simple treatments.
Ringworm (Tinea)
Ringworm
Despite its name, ringworm is a fungal infection, not a worm. It's common in children and spreads through direct contact with infected people, animals, or contaminated objects.
On lighter skin:
Round or oval patches with raised, red, scaly edges and clearer centers (ring shape). May be itchy.
On darker skin:
Patches may appear brown, dark brown, or gray. The ring pattern with raised edges and clearer center remains characteristic.
Treatment: Antifungal cream from pharmacy usually clears it within 2-4 weeks. See a doctor if it's on the scalp (may need oral treatment), if it's not improving with treatment, or if it's widespread.
Molluscum Contagiosum
Molluscum Contagiosum
Molluscum are small, painless skin growths caused by a virus. They're common in children and spread through skin contact. While harmless, they can persist for months or even years.
Appearance:
Small (2-5mm), dome-shaped bumps with a characteristic dimple or pit in the center. May be skin-colored, pink, or pearly white. On darker skin, may appear slightly lighter than surrounding skin.
Location: Commonly on trunk, arms, face, and armpits. Can occur anywhere except palms and soles.
Outlook: Each bump typically lasts 2-3 months before resolving, but new bumps may continue to appear. Complete resolution takes 12-18 months on average, sometimes longer.
Treatment: Usually no treatment needed as they resolve on their own. Children can continue normal activities including swimming.
Heat Rash (Miliaria)
Heat Rash / Prickly Heat
Heat rash occurs when sweat becomes trapped in the skin, common in hot weather or when babies are overdressed. It's very common in infants whose sweat glands are still developing.
Appearance:
Small bumps or blisters, often in clusters. On lighter skin, appears as small red or pink bumps. On darker skin, bumps may be less visible but texture is noticeable.
Location: Typically in areas where sweat collects - neck, chest, back, armpits, groin, skin folds
Treatment: Cool the skin - remove excess clothing, move to cooler environment, use cool (not cold) compresses. Usually resolves within hours to a day once skin is cooled.
Keratosis Pilaris
Keratosis Pilaris
Keratosis pilaris causes rough, bumpy skin often described as "chicken skin." It's extremely common and harmless, caused by a buildup of keratin around hair follicles.
On lighter skin:
Small, rough bumps that may be skin-colored, pink, or red
On darker skin:
Bumps may appear darker than surrounding skin or have a slightly lighter appearance
Location: Most common on upper arms and thighs; can also appear on cheeks (especially in children)
Treatment: No treatment necessary. Moisturizing and gentle exfoliation may improve appearance. Often improves with age.
What Skin Changes Are Normal in Newborns?
Normal newborn skin changes include erythema toxicum (red blotchy rash with yellow centers), milia (tiny white bumps on face), baby acne (small pimples), and newborn peeling. These are extremely common in the first weeks of life and resolve without treatment. Skin changes are part of the normal transition from womb to outside world.
Newborn skin goes through many changes in the first weeks of life as it adapts from the protected environment of the womb to the outside world. These changes can be alarming for new parents but are almost always completely normal and temporary.
Erythema Toxicum (Newborn Rash)
Erythema Toxicum Neonatorum
Despite its alarming name, this is a completely harmless and very common newborn rash, occurring in up to 50% of newborns. The cause is unknown.
Appearance:
Blotchy red areas with small yellow or white bumps in the center, resembling insect bites or small pimples. On darker skin, the red blotchiness may be less visible, but the yellow-white bumps are apparent.
Location: Primarily on chest, back, face, and limbs. Spares palms and soles.
Timeline: Appears between days 1-4 of life, comes and goes, completely resolves within 1-2 weeks
Treatment: None needed. Despite its appearance, it doesn't itch or cause discomfort.
Milia
Milia
Milia are tiny cysts containing keratin (skin protein) that appear as small white or yellow bumps on newborns' faces.
Appearance:
Tiny (1-2mm) pearly white or yellow bumps, like small seeds
Location: Most common on nose, cheeks, chin, and forehead
Timeline: Present at birth or appear within first few weeks; resolve on their own within weeks to months
Treatment: None needed. Don't squeeze or pick at them. They'll resolve naturally.
Frequently Asked Questions About Child Rashes
Medical References and Sources
This article is based on current medical research and international guidelines. All claims are supported by scientific evidence from peer-reviewed sources.
- American Academy of Dermatology (2023). "Guidelines for Pediatric Atopic Dermatitis." AAD Guidelines Evidence-based guidelines for diagnosis and management of eczema. Evidence level: 1A
- World Health Organization (2023). "Global Burden of Skin Disease." WHO Report Global epidemiological data on childhood skin conditions.
- European Academy of Dermatology and Venereology (EADV) (2024). "Guidelines on Pediatric Dermatology." European guidelines for childhood skin conditions.
- Pediatric Dermatology Journal (2023). "Recognition of Skin Conditions in Skin of Color." Clinical guidance on appearance of rashes in different skin tones.
- Centers for Disease Control and Prevention (CDC) (2024). "Childhood Rashes and When to Seek Care." CDC Guidance Public health guidance on infectious childhood rashes.
- British Association of Dermatologists (2023). "Patient Information Leaflets on Childhood Skin Conditions." Evidence-based patient education materials.
Evidence grading: This article uses the GRADE framework (Grading of Recommendations Assessment, Development and Evaluation) for evidence-based medicine. Content is regularly reviewed against current guidelines and updated research.