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 Medical Self-Care: Skin Rashes 
 
American Institute for Preventive Medicine ©

Skin rashes come in all forms and sizes. Some are raised bumps, others are flat red blotches. Some are itchy blisters; other are patches of rough skin. Most rashes are harmless and clear up on their own within a few days. A few may need medical attention. The skin is one of the first areas of the body to react when exposed to something you or your child is allergic to.

The chart on page 90 lists information on some common skin rashes.


Self-Care Tips
Heat rash is best treated by staying in a cool, dry area. It will usually disappear within 2 to 3 days if you keep the skin cool. Things you can do:
  • Take a bath in cool water, without soap, every couple of hours.
  • Let your skin air dry.
  • Apply calamine (not Caladryl) lotion to the very itchy spots.
  • Put corn starch in body creases (inside elbows, etc.).
  • Don't use ointments and creams that can block the sweat gland pores.
To treat diaper rash in a child:
  • Change diapers as soon as they become wet or soiled (even at night if the rash is extensive).
  • Wash your baby with plenty of warm water, not disposable wipes, to prevent irritating the skin. If the skin appears irritated, apply a light coat of zinc oxide ointment after the skin is completely dry.
  • Keep the skin dry and exposed to air.
  • Before putting on a fresh diaper, keep your baby's bottom naked on a soft, fluffy towel for 10 to 15 minutes.
  • Put diapers on loosely so air can circulate under them. If diposable diapers are used, punch a few holes in them. Avoid ones with tight leg bands.
  • Don't use plastic pants until the rash is gone.
  • Wash cloth diapers in mild soap. Add 1/2 cup of vinegar to your rinse water to help remove what's left of the soap.
For temporary relief from the itchy rash typical of poison ivy, oak and sumac:
  • As soon as possible, remove your clothes and shoes. Wash with soap and water to remove the plant oil from the skin. Rub the affected skin area with alcohol or alcohol wipes and then rinse with water. Wash all clothes and shoes you have on.
  • Trim your nails. Try not to scratch. Keep busy with other activities.
  • Soak the rash area in cool water or take baths with Aveeno (an over-the-counter colloidal oatmeal product) or put one cup of oatmeal in a tub full of water.
  • Take a hot shower if tolerated. At first, the itching will get worse, but after a while it stops and the relief can last for hours. Repeat as soon as the itching starts again. Use calamine lotion every three to four hours.
  • Apply a hydrocortisone cream. Put a very small dab of cream on the rash. Be careful not to rub and spread the poison. If you can see the cream on the skin, you've used too much. Repeat as needed every two to four hours. Do not use these creams near the eyes.
  • Learn how to recognize poison ivy, oak and sumac. Stay away from them.
Hives can be eased if you:
  • Take an antihistamine such as Benadryl. Check the labels of cold medications that contain an antihistamine. Those that have diphenhydramine or chlorpheniramine are good choices. Know, though, that most antihistamines are likely to cause drowsiness.
  • Cool off. Rub an ice cube over the hives, drape a washcloth dipped in cool water over the affected areas or take a cool-water bath.
  • Rub your body with Calamine lotion, witch hazel or zinc oxide.
  • Find and eliminate the cause of the allergic reaction.
For cradle cap in babies:
  • Use an anti-dandruff shampoo once a day, massaging your baby's scalp with a soft brush or washcloth for 5 minutes.
  • Soften the hard crusts by applying mineral oil on the scalp before washing your child's hair. Be sure to thoroughly wash the oil out completely. Otherwise, the cradle cap condition may worsen.
To protect yourself from Lyme disease:
  • Wear long pants tucked into socks and long-sleeve shirts when you walk through fields and forests such as when camping. Light colored, tightly woven clothing is best.
  • Inspect yourself for ticks after these outdoor activities.
  • Remove any ticks found on the skin as follows:
    • Use tweezers to grasp the tick as close to the skin as possible.
    • Pull in a steady upward motion.
    • Try not to crush the tick because the secretions released may spread disease.
    • Wash the wound area and your hands with soap and water after removing ticks.
    • Save any removed ticks in a jar and take them to the doctor to aid in the diagnosis of Lyme disease.
The goals in treating chicken pox are to reduce and relieve the itching for comfort and to prevent scratching off the scabs which could start a secondary infection and/or leave scars.

For chicken pox in children:

  • Encourage your child not to scratch the scabs. Keep him or her busy with other activities.
  • Give your child a cool bath without soap, every 3 to 4 hours for the first couple of days at 15 to 20 minutes at a time. Add one-half cup of baking soda or colloidal oatmeal bath packet, such as Aveeno, to the bath water. Pat, do not rub, your child dry. Or, dip a washcloth in cool water and place it on the itchy areas.
  • Apply calamine (not caladryl) lotion for temporary relief.
  • Trim your child's fingernails to prevent infection caused by opened blisters. Scratching off the crusty scabs may leave permanent scars.
  • Cover the hands of infants with cotton socks if they are scratching their sores.
  • Wash your child's hands three times a day with an antibacterial soap such as Safeguard or Dial to avoid infecting the open blisters.
  • Keep your child cool and calm. Heat and sweating make the itching worse. Also, keep your child out of the sun. Extra chicken pox will occur on parts of the skin exposed to the sun.
  • Give your child Benadryl, an over-the-counter antihistamine, if the itching is severe or stops your child from sleeping. (See label for proper dosage).
  • Give your child acetaminophen (children's versions of the following: Tylenol, Tempra, Liquiprin, Datril, Anacin 3 or Panadol) for the fever. [Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger, unless directed by a physician, due to its association with Reye's Syndrome, a potentially fatal condition.]
  • Give your child soft foods and cold fluids if he or she has sores in the mouth. Do not offer salty foods or citrus fruits that may irritate the sores.
  • Have your child gargle with salt water (one-half teaspoon to 8 ounces of water) to help ease itching in the mouth, if necessary.
  • Reassure your child that the "bumps" are not serious and will go away in a week or so.
For adults with chicken pox:
  • Follow any measures listed above that will bring relief. [Note: Adults may take longer to recover from chicken pox and are more likely to develop complications. See your doctor if this is the case.]
For eczema, see self-care tips on page 82.
Questions to Ask
Are you having trouble breathing or swallowing, or is the tongue swollen? Yes: Seek Emergency Care
No
Do you have any of the following?
  • Fever
  • Headache
  • Sore throat
  • A fine red rash that feels rough like sandpaper
  • Joint pain along with a target-like rash
Yes: See Doctor
No
Are there any large, fluid-filled blisters present or pus or swelling around the rash lesions? Yes: See Doctor
No
Have you recently been exposed to someone with a "strep" infection? Yes: See Doctor
No
If your child has a diaper rash, are there also blisters or small red patches that appear outside the diaper area such as on the chest? Yes: See Doctor
No
When the rash started, were you taking any medications or were you stung by an insect? Yes: Call Doctor
No
Is the rash getting worse, keeping you from sleeping and/or do self-care tips not relive symptoms? Yes: Call Doctor
No
Provide Self-Care

Common Skin Rashes
CONDITION OR ILLNESS CAUSES WHAT RASH LOOKS LIKE SKIN AREA(s) AFFECTED OTHER SYMPTOMS
Diaper Rash Dampness and the interaction of urine and the skin Small patches or rough skin, tiny pimples Buttocks, thighs, genitals Soreness, no itching
Cradle Cap Hormones that pass through the placenta before birth Scaly, crusty rash (in newborns) Starts behind the ears and spreads to the scalp Fine, oily scales
Heat Rash (Prickly Heat) Blocked off sweat glands Small red pimples, pink blotchy skin Chest, waist, back, armpits, groin Itching (may be a result of fever)
Roseola 1 Herpes virus type-6 Flat, rosy red rash Chest and abdomen High fever 2-4 days before rash - child feels only mildly ill during fever
Fifth Disease 1 Human parvovirus B19 Red rash of varying shades that fades to a flat, lacy pattern (rash comes and goes) Red rash on facial cheeks, lacy-like rash can also appear on arms and legs Mild disease with no other symptoms or a slight runny nose and sore throat
Eczema Allergens Dry, red, cracked skin, blisters that ooze and crust over, sufficient scratching leads to a thickened rough skin On cheeks in infants, on neck, wrists, inside elbows, and backs of knees in older children Moderate to intense itching (may only itch first, then rash appears hours to days later)
Chicken Pox 1 Varicella/herpes zoster virus Flat red spots that become raised resembling small pimples. These develop into small blisters that break and crust over Back, chest and abdomen first, then rest of body Fatigue and mild fever 24 hours before rash appears - intense itching
Scarlet Fever 1 Bacterial infection (streptococcal) Rough, bright red rash (feels like sandpaper) Face, neck, elbows, armpits, groin (spreads rapidly to entire body) High fever, weakness before rash, sore throat, peeling of the skin afterward (especially palms)
Impetigo 1 Bacterial infection of the skin In infants, pus-filled blisters, and red skin. In older children, golden crusts on red sores Arms, legs, face and around the nose first, then most of body Sometimes fever - occasional itching
Hives Allergic reaction to food, insect bites, viral infection, medicine or other substance Raised red bumps with pale centers (resemble mosquito bites), shape, size and location of spots can change rapidly Any area Itching - in extreme cases, swelling of throat, difficulty breathing (may need emergency care)
Poison Ivy, Oak, Sumac Interaction of oily resins of plant leaves with skin Red, swollen skin rash and lines of tiny blisters Exposed areas Intense itching and burning
Lyme Disease Bacterial infection spread by deer tick bite(s) Red rash that looks like a bull's-eye: raised edges surround the tick bites with pale centers in the middle. Rash starts to fade after a couple of days Exposed skin areas where ticks bite, often include scalp, neck, armpit and groin No pain, no itching at time of bite. Fever-rash occurs in the week following the bite(s)
1 These conditions are contagious

Healthy Self: The Guide to Self-Care and Wise Consumerism
© American Institute for Preventive Medicine
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