As a Canadian registered nurse, I see rashes on children all year-around, with a surge in the summer months where Canadians spend more time in nature and are closer to environmental irritants (Carson & Spence, 2010). Generally, most of these rashes are harmless and require no intervention, causing discomfort and redness for only a couple days before fading away (Tinsley, 2016). However, there are still a few rashes that should be taken seriously by parents like yourself, and treated as a sign of a potentially more serious illness. This post will cover four of these rash-generating illnesses: Fifth disease, Hand-Foot-Mouth Disease, Impetigo, and Scabies.
From my nursing experience, these four rash-generating illnesses are common but are also largely unknown to parents. To help you avoid such uncertainty if your child is diagnosed with one of these four illnesses, I want to share with you some key nursing knowledge. Specifically, this nursing knowledge will entail (1) what to expect during the course of the disease, and (2) how to successfully manage the disease from home – All information that I hope you will find helpful in getting your little one feeling better!
Receiving its name from once being listed as the fifth disease in a classification book, this common viral infection is transmitted by respiratory droplets (coughing, sneezing) and is generally no longer infectious once your child starts showing symptoms.
What to Expect: Flat, spotted red rash on face, body, and extremities. Usually accompanied by a low-grade fever, congestion, headache, and in adolescents, joint swelling or pain. In young children, the rash will often appear first on the cheeks and may appear as if your child has been slapped (called a slapped-cheek rash).
How to Manage: Being a viral illness your child typically won’t receive any antibiotics for fifth disease, nd must wait for symptoms to resolve on their own. But, there are a few things you can do as a parent to keep your child comfortable in the meantime.
- Treat fever and pain with Acetaminophen and/or Ibuprofen as outlined on the manufacturer’s package (I do not recommend the use of aspirin due to the risk of Reye’s Syndrome). If fevered, dress in light clothing for comfort.
- Continuously offer small sips of fluids to your child to keep them hydrated. Electrolyte fluids are recommended if your child has been fevered or drank little over a long period, such as Pedialyte or Gatorade. Though any of their favorite fluids can be offered to prevent dehydration.
- Provide Diphenhydramine (Benadryl) and soothing baths to help relieve itch (No bubble bath, just warm water). If Diphenhydramine makes you child excessively sleepy, try a half dose for relief without drowsiness.
(CDC, 2015; Johnson & Keogh, 2010)
Another viral infection in children, hand-foot-and-mouth disease often occurs in large outbreaks due to a lack of handwashing at daycare centers or schools.
What to Expect: More painful than itchy, the rash of hand-foot-and-mouth disease appears like blisters in the mouth, soles of hands and feet, and on buttocks. A sore throat, fever, lethargy, and loss of appetite are also seen with this disease.
How to Manage: As discussed above with fifth disease, managing the pain and fever of your child is important during this illness. Other treatments unique to hand-foot-and-mouth include:
- Offer your child soft foods and fluids, such as ice cream and soups, to decrease pain related to the rash in their mouth or sore throat.
- Can obtain an over the counter oral numbing cream to relieve mouth and throat pain as well.
(Mayo Clinic, 2015a)
Impetigo is a bacterial skin infection found in children usually less than six years of age, and is transferred between children by touch contact. Isolation or restricted exposure to other children is recommended during an outbreak of impetigo, as this infection is considered highly infectious.
What to Expect: An impetigo rash can range in size from a few millimeters to several centimeters, and often changes color depending on the stage of disease progression. For example, the rash tends to be red with a honey-colored crust at first, but may rupture to give way to a red, moist rash. The impetigo rash tends to be itchy, and can occur in children who already have eczema.
How to Manage: Being a bacterial infection, you will likely receive an oral antibiotic and/or an ointment to place on the rash (wear gloves during application). Use both medications as prescribed, and ensure you complete the dosing for each. Though I always tell parents, don’t fret if some cream rubs off on clothing or not all the antibiotic is swallowed, just try your best!
The most important way to overcome impetigo is to avoid touching (or licking for younger children) the rash, as the infection can easily spread to other parts of your child’s body or to others. If the rash is touched, thorough hand washing with soap and water is required to prevent any further spread of the disease. Other ways to stop the transmission of impetigo and help your child feel comfortable include:
- Separate towels, wash clothes, and bed linens for the child with impetigo. No swimming in public pools or waterholes.
- If possible, cover the rash with clothing or a bandage to prevent direct touching or itching. Excessive itching can cause secondary infection and scarring, so try to explain to your child how important it is that they do not itch! Cut their nails if need be.
- To help relieve the itch, try the medication Diphenhydramine, and use a wash cloth and Dermburo (5% Aluminum Acetate, available at pharmacies) to make a compress to place over the rash. This compress is also a safe way to remove debris and crusts from around the rash.
(Johnson & Keogh, 2010)
Scabies are similar, but not the exact same, to bed bugs. Essentially, scabies and bed bugs both feed from humans, but scabies make unique burrows within the skin that cause a red rash. Like bed bugs, scabies love to travel to other humans, so use touch contact precautions with your child.
What to Expect: Red, itchy rash around your child’s wrist, hands, armpits, feet, and ankles. The itch might be so intense it may feel like a burning sensation.
How to Manage: Because scabies often live in your home, everyone in your family may need to be treated if one child is diagnosed. Treatments at home include:
- Wash and dry all clothing and linens at high-heat settings to kill the mites.
- Use a scabicide cream to kill the mites. This cream must be applied with gloves, and stay on the skin for a full 8 to 14 hours (follow manufacturer’s directions). Ensure the cream is placed under your child’s nails where scabies may have been trapped while itching.
- Though some itching is normal after cream application, as the skin is raw and needs to heal further, an oral medication may be needed in some children to fully kill the scabies. Watch out for itching that continues past a week!
- Avoiding applying the cream on your child after a hot bath, and avoid all contact with eyes. If you child can tolerate it, a cool bath actually tends to reduce itch more effectively with scabies’ rashes.
- Provide your child with Diphenhydramine and Calamine lotion to reduce feelings of itch after the scabicide cream treatment
(Johnson & Keogh, 2010; Mayo Clinic, 2015b)
Before you go, I must also caution that if you are pregnant when your child contracts one of these illnesses please let your physician know, as there may be a risk for illness to your unborn child. Letting your physician know about the pregnancy will help them gauge what medications and precautions best suit your family to keep everyone healthy.
4 Tips to Manage Your Child’s Illness After Being Sent Home
Enjoyed this post and want to learn more? I’ve put together 4 of my best nursing tips to help you better manage any general illness your child has contracted after leaving the emergency department or physician’s office! Get your children feeling better and back to enjoying summer sooner with this free resource!
Click Here to Download
I also recommend the Mayo Clinic website if your interested in learning more about any of these childhood diseases.
The contents of this post do not constitute as medical advice. Each case of illness is unique, and the information provided here is not to be applied rigidly or followed in all cases. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding your child’s medical condition. Never disregard professional medical advice or delay in seeking medical care because of the content of this post.
If you think your child may have a medical emergency, call your physician or 911 immediately. Any reliance on the information provided by Nurse Crystal, references appearing in this post, or other visitors to the Canadian Mom Blog is solely at your own risk.
Carson, V., & Spence, J. C. (2010). Seasonal variation in physical activity among children and
adolescents: A review. Human Kinetics Journal, 22(1), 81-92 https://doi.org/10
Johnson, J.Y., & Keogh, J. (2010). Pediatric nursing demystified: A self-teaching guide. New
York, NY: McGraw-Hill.
Mayo Clinic (2015a). Diseases and conditions: Hand-foot-and-mouth disease. Retrieved from
Mayo Clinic (2015b). Diseases and conditions: Scabies. Retrieved from http://www.may
Tinsley, E. (2016). Minor injuries and ailments: Non-contagious rashes. Journal of Health
Visiting, 4(10). https://doi.org/10.12968/johv.2016.4.10.504
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Crystal has been a registered nurse, working in emergency, medical inpatients and obstetrics, for over four years in rural southwestern Ontario.A self-proclaimed life-long learner, she is also a master student at Western University where she conducts research surrounding childhood health and disease. Outside of work and school, Crystal spends most of her time taking long walks with her fur-kid Scruffie.
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