Rashes to rashes: What’s going on with your baby’s skin

If your family has welcomed a new baby recently — congrats!

If you’re new to newborns, you might be surprised by how changeable a baby’s skin can be: clear and soft one day; blotchy and bumpy the next.

The good news is most infant rashes are temporary and not serious. For a breakdown of some of the most common, I spoke with Dr. Elena Pope, head of pediatric dermatology at The Hospital for Sick Children.

DIAPER RASH

Cause Diaper-related rashes can be caused by irritation, an allergen or infections (such as yeast).

What it looks like it can vary depending on what caused it. The most common cause is irritant contact dermatitis, which can be caused by urine and feces or aggressive wiping. You will see redness in the diaper area, except within the baby’s folds. In other words, where the diaper has contacted the baby’s skin.

Allergic contact dermatitis is an allergic reaction. The culprit is usually baby wipes — even supposedly non-allergenic wipes can have chemicals that can cause a reaction. This kind of rash looks similar to the irritant type, but it appears in the baby’s folds as well.

Another common diaper rash is yeast dermatitis, which tends to be a darker red with raised bumps spread around the whole diaper area (including the folds), sometimes up toward the abdomen.

What you can do Prevention is the best strategy. Change diapers frequently, and when you clean the diaper area use a soft cloth moistened with water rather than a drugstore product. Don’t overdo it, meaning don’t scrub. Apply a generous layer of a barrier cream. I would suggest a zinc-based cream, which adheres well to the skin. Avoid anything with a fragrance or hard soaps. If you find it hard to remove the zinc cream, try using a cotton ball moistened with mineral oil, which will clean the thick cream without causing any trauma to the skin.

See a health-care provider if the rash doesn’t improve, if you see any blisters or pus, or the baby is in discomfort. Check in with your health-care provider if you see scattered lesions outside of the immediate diaper area.

INFANT ACNE

Cause Called neonatal cephalic pustulosis, it’s usually caused by a common fungus. Some babies are more prone to it than others. What it looks like small bumps or pustules on the face, although it can sometimes extend to the scalp. It usually appears in the first few weeks of life and can last up to two months.

What you can do Clean the area well. If you find there are widespread lesions or if the baby is uncomfortable, or you don’t know what it is, then seek medical attention.

See a health-care provider if it persists beyond two or three months, or if you see it is causing scarring. Either topical steroids or an antifungal agent can be used to counteract the fungus, but really, you don’t need to treat it — eventually, it goes away.

ROSEOLA

Cause It’s usually caused by a herpes virus called herpes virus number 6.

What it looks like Babies between six months and two years will spike a high fever — some as high as 40 or 41 degrees — for two to three days with no other symptoms. And your baby will be extremely irritable. Then, at about day three or four, the fever breaks abruptly, and you’ll see a faint rash on your baby’s face and the upper part of the body. The rash is very pale, almost salmon pink, and doesn’t cause any lasting effects for the baby.

See a health-care provider if Roseola doesn’t require any treatment. That said, the fever can be so high and so poorly controlled it may lead to febrile seizures in children who are predisposed. Roseola is probably the most common cause of febrile seizures in children.

CHICKENPOX

Cause It’s caused by varicella-zoster virus, which is a type of herpes virus.

What it looks like Typically, chickenpox starts with a few lesions, maybe five to 10 that look like pink bumps. Within a day or so, the bumps become fluid-filled pustules. And then they become a crust.

In the first one or two days, it can be hard to diagnose, but by day three you’ll see new waves of lesions in different stages. This is the hallmark of chickenpox — different types of lesions all over. The lesions can appear anywhere, including the mouth, eyes and genitals, and can last up to three weeks.

Because a lot of children are vaccinated against chickenpox, we tend to see it among babies who have not yet been vaccinated.

What you can do Chickenpox is probably the most itchy thing we see, so try as much as possible to keep your child from scratching. Camomile lotion or wet compresses can help. Your child can be contagious until all the lesions are crusted over and shouldn’t return to school or daycare until this happens.

See a health-care provider if your child becomes unwell. If she has a fever or shows any neurological signs, you need to seek medical attention. Once you know it’s chickenpox, I would suggest you bring your child to see a health-care provider regardless, because we can help prevent complications related to chickenpox, such as infection. HEALTHY KIDS POSES HEALTH QUESTIONS TO EXPERTS AT SICKKIDS. ALWAYS CONSULT YOUR HEALTHCARE PROVIDER WITH SPECIFIC CONCERNS. TORSTAR IS IN A FUNDRAISING AND EDUCATIONAL PARTNERSHIP WITH SICKKIDS FOUNDATION TO HELP RAISE $1.5 BILLION FOR