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What's that spot you've got

Here’s how to identify what your child’s rash is and if its serious.

Gauteng GP Dr Sylvia Guest says viral skin infections, such as measles, rubella (German measles) and chickenpox, are highly contagious. “Symptoms include a sore throat, high temperature and red eyes before a blotchy, itchy rash starts on your child’s torso. The rash changes from red to dark brown in colour. With rubella, children often complain of muscle or joint pain and a headache before a finer, red rash appears on the torso and spreads to the rest of the body. In both diseases, a child is contagious one week before the rash begins until two weeks after it disappears.”

Chickenpox has the longest incubation period, with symptoms only appearing up to 21 days after exposure to the virus. “It starts as red dots that develop into hundreds of blisters. It is spread by direct contact with the blister fluid, which contains the varicella-zoster virus, so children are contagious until the last blister has scabbed and dried.”

Younger children and infants

“The first sign of fifth disease is usually bright red cheeks that look as though the child has been ‘slapped’,” says Guest. “The rash then moves to the arms and legs and can last up to 10 days. Hand, foot and mouth disease starts as small red spots in the mouth that develop into painful ulcers. Blisters also form on the soles of the feet and palms of the hands. Children are contagious during the first week and can remain contagious even after symptoms have gone. Roseola is common in children aged six months to two years. Often a child will have a high temperature for a few days and once it drops, patchy, small, pink bumps appear on the back, chest and abdomen.”

Specialist dermatologist Dr Jeanne Louw of the Cape Town Dermatology Clinic & Skin Laser Centre, says heat rash develops as small red or pink pimples on the head, neck, and shoulders and is a result of blocked sweat ducts, often caused by parents dressing their baby too warmly. “Another common skin disorder is hives, which appears as welts that itch, burn or sting and move or change shape. Flare-ups can be triggered by an allergic reaction and can be treated with over-the-counter antihistamines.”


While rest, pain medication or calming topical lotions and lots of TLC are usually all that’s needed to treat viral skin diseases, bacterial diseases often require a doctor’s visit. “If your child develops scarlet fever or impetigo they will need a course of antibiotics,” advises Guest. “A classic sign of scarlet fever is a sore throat and a very red, swollen tongue. A fine rash starts on the face and chest before spreading. The skin on your child’s hands and feet may peel. Children with impetigo usually develop pus-filled, round lesions on the face and then the body. The sores heal slowly and seldom scar.”

Parents should be aware of rashes that could be a sign of a serious infection called meningococcemia – a condition where blood starts to clot throughout the body. Symptoms include a very high fever, lethargy and a stiff neck, followed by a tiny rash that looks like pin pricks and develops into large purply blotches. Should your child develop any of these symptoms, seek medical attention immediately.

Read our other articles to find out more about birthmarks and eczema.

Vaccinate your child

It is advisable to vaccinate your child against:

  • measles, at nine and 18 months;
  • chickenpox at 12 to 18 months and again between the ages of four and six years old, and
  • measles, mumps and rubella with the MMR vaccine between 15 to 18 months and again between the ages of five and seven years old.

Vanessa Papas