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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 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

Roseola is also known as the sixth disease or roseolainfantum. This is a common childhood viral illness affecting babies younger than two years. Roseola is caused by human herpesvirus 6.

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 onset and may last three to five days
  • Cough
  • Nasal congestion
  • Febrile seizures

High fever can be the cause of febrile seizures in babies. Although it is not very dangerous, babies may have twitching movements or become unconscious during the febrile seizure.

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. 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 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
  • Cough

Infection may provide lifelong immunity for the survivors. However, measles may result in serious complications or fatalities in most cases. Therefore, vaccination is the best way to avoid measles.

3. Chickenpox

Varicella-zoster virus causes chickenpox (varicella) infection. Chickenpox has become less common due to the prevalence of vaccination against it.

Skin rash in chickenpox

Skin rash in chickenpox 

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You may notice raised red bumps (papules), initially, and it may often break out in a few days. Usually, within a day, the papules may become small fluid-filled vesicles or blisters. Crusts and scabs appear after the vesicles break, and it usually takes several days to heal.

The vesicles often cause itching, and babies may try to scratch them. The rash may initially appear on the head and torso and eventually spread to other parts before it heals or crusts over.

Other signs and symptoms

  • Mild fever
  • 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 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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You may notice red blisters around the mouth along with flat red spots on the palms and soles of the baby. The rashes may also appear on elbows, buttocks, knees, and genital areas in some babies.

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. There is currently no vaccine to prevent hand, foot, and mouth disease in babies.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 fifth disease is common in children, they may have mild illness. People with weakened immune systems and pregnant women usually have severe forms of the fifth disease.

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 before resolving.

Other signs and symptoms

These symptoms are mostly seen before the appearance of rashes. The infection is contagious before the rashes appear. Most children recover from the fifth disease without any long-term compilations.

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 harmful tounborn 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 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. Vaccination may help protect a baby 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
  • 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:

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