There are a number of causes of childhood rashes, many of which are associated with viral infections. However there are some rare instances of serious causes of rashes in children, such as meningitis and anaphylactic reactions.

A new book called What to Do When Your Child Gets Sick gives clear-cut advice about what symptoms should cause particular concern. These rashes can vary in appearance but are usually pink or pale red, flat, not itchy. They tend to disappear over the course of a few days as kids recover from viral illnesses such as upper respiratory tract infections, sore throats, and gastroenteritis. Antibiotics are ineffective against viral rashes.

• The chickenpox rash is fairly distinctive – individual pimples which turn into blisters that burst, forming a crust. The rash usually starts on the chest or back, spreads to the face and the rest of the body, and is extremely itchy. However baking-soda baths and lotions such as calamine can help.
• The measles rash is typically dark purple or brown, starts on the face, spreads down to the chest and then to the rest of the body. Again, there is no specifi c treatment but you can use paracetamol or ibuprofen to make your child more comfortable. (Both chickenpox and the measles can have serious complications so if your child is very unwell or you are at all concerned, take them to the nearest emergency department.)
• Children with hand, foot and mouth disease develop a generalised rash and fever and have painful blisters on the palms of the hands, soles of the feet, on the inside of the lips and on the tongue. There is no link between this disease and the foot and mouth disease suffered by cattle and other livestock, and there is no treatment other than paracetamol or ibuprofen for comfort. These can take on many different forms, but generally, any rash that has either a yellow discharge, pus or a golden-coloured crust is probably the result of a bacterial infection.
• Impetigo. This causes collections of infected blisters with a goldencoloured crust. These tend to occur in groups, mostly on the face, especially around the mouth and nose, and can spread to other parts of the body by touch. It is treated with antibiotics.
• Scarlet Fever. This rash is pale pink and looks similar to sunburn but can feel rough to the touch (a bit like sandpaper). Take your child to your GP for treatment with a course of penicillin. These are usually easy to diagnose and are most often pale pink/red, raised, patchy and itchy, and may spread fast in serious cases. Treatment involves identifying and avoiding the cause and using antihistamines to control the itch if there is a rash alone.

Serious skin conditions

• Meningitis often starts as a rash in an otherwise well child, who deteriorates rapidly to become severely unwell. The rash may be specifi c in appearance, being red to purple in small patches the size of a pinhead or slightly larger. This rash will not turn white when pressed (for example, when a glass is being held to the skin). Meningococcal rash may also be non-specifi c, but often occurs in association with symptoms such as drowsiness, limb pain or cold arms and legs. If you are at all concerned, take your child to the emergency department urgently.
• In anaphylactic reactions, not just the skin but other body systems are affected by the allergic reaction, causing problems such as swollen lips or tongue, wheezing, drowsiness or decreased level of consciousness. This may quickly becomes life threatening, and immediate treatment with a drug called adrenaline is needed. Dial 111 for an ambulance.
• It is important to realise that if you are concerned or worried, no doctor, nurse or paramedic should criticise you for responding urgently, as we all appreciate that lives may be at stake.