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Viral Rashes in Babies: Types, Pictures, Diagnosis, Treatment

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Babies may get skin rashes due to infections caused by various pathogens, including viruses. Viral infections cause different types of skin rashes, such as spots, small bumps, pimples, vesicles, and blisters. Any skin rash caused by viral infections is called a viral rash.

Viral rashes may go away in a few days or may last up to several weeks.It is essential to seek medical care if your baby has skin rashes since rashes may indicate other severe illnesses, as well.

Read this post to know more about common types of viral rashes in babies and how to treat and prevent them.

Types Of Viral Rashes In Babies

Viral rashes in babies can be of various types, depending on the virus that caused the infection. Observing the type of skin rashes and other symptoms and signs could help the doctors diagnose viral illnesses.

The following viral infections can be diagnosed by looking at the type of skin rashes (1).

1. Roseola

The skin rash in roseola is spotty, red, and flat. It is non itchy. Usually, the roseola rash begins on the belly and spreads to other parts of the body. Viral rash during roseola often appears after the fever goes away. The rash may persist for a few hours to two days.

Skin rashes in roseola

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The skin rash in roseola can be a rose-colored with tiny spots. Usually, the roseola rash begins on the belly and spreads to other parts of the body. Viral rash during roseola often appears after the fever goes away.

Other symptoms and signs

  • High fever, usually sudden in onset and lasting three to five days
  • Runny nose, sore throat, stomach upset are seen in a few cases
  • Enlargement of lymph nodes at the back of the head, sides of the neck and behind the ears
  • Febrile seizures

High fever can be the cause of febrile seizures in babies. Diagnosis is usually clinical and treatment is directed towards symptomatic relief as like with most of the other viral infections roseola is taken care of by the body’s immune system.

2. Measles

Measles, also called rubeola, is a highly contagious viral infection caused by the rubeola virus. This is a respiratory virus that can quickly spread from one person to another through airborne droplets. It is contagious for several days both before and after the appearance of the rash. However, this disease is no longer a common cause of viral illness in babies due to vaccinations. Babies who are not vaccinated against measles can get the disease.

Skin rashes in measles

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Measles rashes may develop after three to five days from the onset of other symptoms. Rashes can be red, flat spots along the hairline initially, and later on, the spots may become raised, itchy bumps. You may notice the spread of rash down the body.

Other symptoms of measles

  • Stuffy or runny nose
  • High fever
  • Red and watery eyes
  • Hacking cough

Infection may provide lifelong immunity for the survivors. However, measles may result in serious complications including brain damage or fatalities in quite a few cases. Also the immune system is weakened post measles infection, which may lead to severe bacterial infections like pneumonia. An attack of measles adversely affects the nutritional status of the child and may even lead to malnutrition due to complications like chronic diarrhoea.

If measles infection occurs, treatment is directed towards symptomatic relief and complication management.

Vaccination is the best way to avoid measles.

3. Chickenpox

Varicella-zoster virus (also known as herpesvirus 3) causes chickenpox (varicella) infection. Chickenpox has become less common due to availability of vaccine against it.

Skin rash in chickenpox

Skin rash in chickenpox 

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Before the rash appears children usually have moderate fever, loss of appetite, and a general feeling of illness. You may notice raised red bumps (papules), initially on the trunk and face, and it may often break out on the arms and legs in a few days. Usually, within a day, the papules may become small fluid-filled vesicles or blisters. The vesicles often cause itching, and babies may try to scratch them. Crusts and scabs appear after the vesicles break, and it usually takes several days to heal. Also, characteristically in chickenpox, the rash develops in crops so that spots are seen in different stages of development in different areas. When they are scratched, there is a risk of infection which may rarely become severe such as cellulitis.

Many children also have associated oral ulcers, even rectal and vaginal ulcers. New spots usually stop appearing by the fifth day, the majority are crusted by the sixth day and most disappear in less than 20 days. The blisters tend to leave a scar only when they are scratched.

Other signs and symptoms

  • Fever
  • Headache
  • Lack of appetite
  • Tiredness

Chickenpox may last up to a week in most cases. It can be prevented in babies by routine immunization.Parents who were neither vaccinated nor had a chickenpox infection should get immunized, as well.

4. Hand, foot, and mouth disease

Hand, foot, and mouth disease (HFMD) is a viral disease due to enterovirus (coxsackievirus). This usually affects children under five years of age. However, older children and adults can also get this disease.

Skin rash in hand, foot, and mouth disease

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The rash affects the skin of hands and feet and sometimes arms, upper legs, buttocks. or genitals and less commonly face and trunk. Painful sores develop on the mucosa of the mouth and throat.

Other signs and symptoms

  • Fever
  • Mouth sores (blisters in the mouth)
  • Sore throat
  • Lack of appetite
  • Irritability

Mild symptoms mostly last up to a week to ten days. Treatment focuses on symptomatic relief. There is currently no vaccine to prevent hand, foot, and mouth disease in babies.

The infection can spread by bodily contact, through droplets, from feces, through contaminated objects and surfaces. It is recommended to practice adequate hygiene measures to avoid the illness.

5. Fifth disease

The fifth disease, also called erythema infectiosum, is a viral illness due to parvovirus B19. Although the infection is common in children, they usually remain asymptomatic or have mild illness. Children with weakened immune systems or red cell disorders like sickle cell anemia may have severe disease if the bone marrow is affected. Rarely infection in pregnant women leads to stillbirth or swelling of the fetus (hydrops).

Skin rash in the fifth disease

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Skin rash may develop after other symptoms are cleared in the fifth disease. Baby’s cheeks may turn red as if slapped, thus the disease is also called slapped cheek disease.Skin rash may have a lacy or net-like appearance while spreading or resolving. The rash may spread to arms, legs, and trunks but never to palms and soles before resolving. The rash is worsened on exposure to sunlight. Adolescents may suffer from mild joint pain which comes and goes for several weeks post infection.

Other signs and symptoms

The infection is contagious before the rashes appear. Most children recover from the fifth disease without any long-term complications. Treatment is therefore symptomatic for management of fever and itching.

6. Rubella

Rubella, also called German measles or three-day measles, is caused by the rubella virus. Although this can be a mild infection in most people, it can be devastating for unborn babies if mothers get an infection during pregnancy. Congenital rubella may cause cataract, heart defects, developmental issues, and hearing loss (deafness) in newborns.

Skin rashes in rubella

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You may notice a red rash or pinkish spotted rash on the face and roof of mouth or other parts of the body. Rashes may merge and may appear like a more extensive rash. Babies may try to scratch the rashes since it can cause itching.

Other symptoms and signs

  • Low fever
  • Runny nose
  • Eye redness
  • Cough
  • Swollen lymph nodes on the neck, especially behind the ears

Sometimes, rubella infections can be asymptomatic. Most infected people spread the virus to others before and after the appearance of the skin rashes. Treatment is symptomatic. Once infection occurs it provides lifelong immunity. Vaccination helps protect from rubella.

Are Viral Rashes Contagious?

Some of the viral rashes can be contagious, which means that direct contact with the fluids from the rashes could spread the infection. However, most viral diseases are spread from mucus and saliva via direct contact or airborne droplets expelled by an infected person.

Although viral illnesses are contagious, the contagious period may vary for each virus. Viral spread may happen certain days before, during, or after the appearance of the skin rash.

The contagious periods for the common viral infections in babies are the following.

IllnessContagious period
RoseolaMost contagious during fever.Once the fever is gone for 24 hours, it is no longer contagious,even if the rash is present (2).
 

Rubella

One week before the appearance of the rash. It continues to be contagious for seven days after the disappearance of the rash (3).
ChickenpoxOne to two days before the rash and until all rashes are crusted. In case of a vaccinated baby,until no new rash appears for 24 hours(4).
Fifth diseaseContagious during fever or cold and not after the appearance of the rash (5).
RubeolaFour days before and four days after the rash (6) .
Hand, foot, and mouth diseaseMost contagious during the first week of illness. Infection may spread up to one week after the symptoms resolve (7).

Contagious periods may vary in individual cases and depend on other factors, such as compromised immunity.

Diagnosis Of Viral Rashes In Babies

Pediatricians can diagnose viral rashes by observing the rash and the history of signs and symptoms in the babies. Doctors may also ask for health history and vaccination details for diagnosis.

Although it is rare, blood tests, imaging tests, or other evaluations are ordered for confirming the diagnosis. These additional tests may also help identify any possible complications of viral rash in babies.

Treatment For Viral Rashes In Babies

Viral rashes may resolve on their own without any treatment in most cases. The following treatments are often given to reduce the severity, duration, and complications of illness in babies (8).

  • Pain relievers, such as acetaminophen,can be given
  • Give plenty of fluids or breastmilk
  • Encourage more rest
  • Use ointments, creams, or lotions, such as calamine lotion, as per doctor’s recommendation to soothe itching
  • Bathe baby in lukewarm water with mild soap
  • Avoid scrubbing baby skin; pat dry instead
  • Keep the child’s nails cut
  • Use loose-fitting dresses
  • IV fluids and antivirals are given in severe cases

If your baby tries to itch the rash, it is better to cover the rash to avoid secondary bacterial infections due to scratching. Antibiotics are not effective against viral rashes, and you should avoid giving them to the babies without prescription.

Prevention Of Viral Rashes In Babies

It may not always be possible to prevent exposure to viruses. However, the following precautions may reduce the risk of contracting viral illness in babies.

  • Observe routine vaccinations for babies as per the recommendations.
  • Caregivers, parents, or anyone who is handling babies should maintain good hand hygiene.
  • Do not cough or sneeze near babies. You may cover your mouth and nose while coughing or use a mask during respiratory illnesses.
  • Ensure there is adequate good hygiene at the baby’s daycare facility.

If your baby is sick with any viral rash, it is recommended to keep them at home to avoid spreading the illness to other children.

You may call or visit a pediatrician if your baby has viral rashes. Babies born prematurely or with compromised immunity require immediate medical care. Vaccination and good hygiene can help protect the baby from viral illnesses in the long-term.

References:

MomJunction's health articles are written after analyzing various scientific reports and assertions from expert authors and institutions. Our references (citations) consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Viral Exanthems (Rashes); Children’s National Hospital
2. Roseola; St. Clair Hospital
3. Rubella; The Centers for Disease Control and Prevention
4. Chickenpox; The Centers for Disease Control and Prevention
5. Parvovirus B19 and Fifth Disease; The Centers for Disease Control and Prevention
6. Measles (Rubeola); The Centers for Disease Control and Prevention
7. Hand, Foot, and Mouth Disease (HFMD); The Centers for Disease Control and Prevention
8. Viral Rash (Child); Fairview