About Rashes
All About Rashes
Rashes can be scary, particularly when they appear on young children. Your Pocket Nurse is here to help you identify what may be causing your rash, and what to do about it.
Your rash could be bacterial, viral, fungal or allergic and the treatment for each is different. Remember, if you have a new rash, particularly on a child and you/they feel unwell, it is important to seek medical advice.
Bacterial Meningitis
Rarer than viral meningitis and more common in babies, young children and teenagers. Meningitis is when the membranes around the spinal cord, and brain (the meninges) become infected/inflamed. This can lead to septicemia and brain/nerve damage. It is important to seek urgent medical advice if you suspect bacterial meningitis. Although not always accompanied by a rash, I am putting it first due to the severity of the illness.
Symptoms of Bacterial Meningitis can be some or all of the following:
1. Fever
2. Nausea/Vomiting
3. A rash that does not fade when doing the glass test (rolling a glass over the top with gentle pressure) - not always present
4. Stiff neck
5. Photophobia (dislike and sensitivity to bright lights)
6. Fatigue/unresponsiveness
7. seizures/fits
8. Confusion
9. Cold hands and/or feet
10. Mottled skin
Infants may also present with:
1. Rapid breathing
2. Irritability
3. Refusing to drink/eat
4. Excessive crying
5. Stiff and jerking movements.
6. A bulging fontanelle (soft area on top of head)
It is important to note that a meningococcal rash can vary in appearance from person to person, and progress at different rates, if it appears at all. It may show as a red pin-prick type rash, similar to flea bites or even as red/purpleish bruising. Whether there is a rash or not, if someone is unwell and you suspect it may be meningitis, seek help immediately.
Catching bacterial meningitis can be from droplets from an infected person (coughs, sneezes, saliva/spit). Streptococcus passed from mother to baby during childbirth or even living with an asymptomatic carrier.
Successful treatment will require hospital admission and treatment with an antibiotic drip.
There are a multitude of vaccines available to help protect against bacterial meningitis, such as; the meningitisB vaccine routinely offered to babies, hib/meningitisC vaccine and meningitis ACWY amongst others. If your child has attended every routine vaccine appointment, they should be up-to-date with their vaccines. Your GP can check they have received all the vaccinations they should have had before you travel.
Viral/Fungal Meningitis
Viral meningitis thankfully does not usually require hospital treatment, and most patients will get better on their own.
Causes of viral meningitis can be measles, mumps, influenza, and chicken pox amongst others. Therefore, the chances of getting viral meningitis can be reduced by keeping up-to-date with routine vaccinations. The symptoms are often the same/similar to bacterial meningitis, so seek medical advice immediately.
Fungal meningitis is rare, and can happen after a fungal infection spreads to the brain or spinal cord. Many fungal sources come from the environment and some animals, and also normal bodily fungi such as candida can sometimes be the cause. People with weakened immune systems are most at risk such as people with: HIV, cancer, steroid use and people on anti-rejection medication after an organ transplant. The symptoms are again similar to bacterial and viral meningitis so get checked immediately if concerned.
About Rashes
My son in hospital with infected eczema
Eczema
Eczema is a condition in which the skin becomes irritated, red, itchy and inflamed in response to a trigger, which can be any number of things. Animal fur, ingredients contained in soaps, creams, perfumes to name very few of the possible causes. There are many different types of skin conditions which cause eczema such as atopic dermatitis, irritant dermatitis and pompholyx eczema to name but a few. Often people learn overtime what their personal triggers are and the treatments that best work for them and it is so important to know that what works for one person may not work for another.
I am rather passionate about the subject of dermatitis/eczema having suffered myself and watching my son suffer horrendously as a baby. It is a pretty miserable condition at the best of times and being on holiday can often put you at risk further due to the different environment. Even temperature can put you at higher risk of having an outbreak as it is often important for sufferers to stay cool. Furthermore, the application of sun-creams can further exacerbate things. I have personally found that a certain well known brand of sun-cream creates havoc with my skin, but is the only type my son can use without triggering an outbreak on his.
I could write pages and pages on the subject, and perhaps I will later, but for now I will mainly emphasise the importance of ensuring you remember to bring the creams/treatments that work best for you. Hydrocortisone and clobetasone are available to buy over the counter in the UK, and some countries will allow the purchase of higher doses of steroid containing creams over the counter. Ensure you have your antihistamines, chlorphenamine/cetirizine/loratadine/fexofenadine, whatever works for you. Wash off sun-cream whenever safe to do so, and remember to moisturise with familiar creams whilst still slightly damp from the shower. Avoid using hotel creams/soaps/shampoos and ideally take your own safer options with you. Creams/shampoos that are made for babies/newborns can be gentler on the skin if you experience an outbreak and need to purchase alternatives abroad.
Rashes that are caused by eczema usually appear after the itching starts. They can vary greatly due to the type of eczema you have. I personally struggle with pompholyx eczema which causes small fluid type blisters which itch like hell. Other rashes may appear red, dry, scaly with small bumpy areas.
It can sometimes be difficult to tell the difference between an eczema outbreak and a skin infection, but if your skin feels hot to the touch, has open areas that ooze it is worth getting checked by a medical professional.
I am happy to give personal advice if I can help, so please feel free to post on my forum.
My son yet again, with hand, foot and mouth disease.
Hand, Foot and Mouth Disease
Another misery causing condition affecting children mainly. When this virus hit my son, I thought it was chicken pox initially. Typically starting on Christmas day, I wondered why he was being so miserable, he had a low grade fever of 38.5 and wouldn't settle at night. The next morning, he had a few spots appear around his mouth and by the end of the day his mouth was covered inside and out along with his hands and lower arms - see picture. If memory serves, I believe it only lasted a couple days and he was back to his normal self.
Hand, foot and mouth is a viral condition, so antibiotics won't help. Treat with paracetamol and ibuprofen only, and offer regular fluids. Ice lollies can help soothe the blisters inside the mouth.
Shingles
A very painful rash which develops in a small cluster of fluid filled blisters. Often appearing in a stripe pattern usually on the torso, but can appear anywhere on the body. (I once knew someone who had it on her bum and she really struggled to sit down). Another person can not catch shingles from someone with shingles, but someone who has not had chickenpox could develop chickenpox after exposure from shingles. Also stay away from pregnant women.
Shingles affect the nerves which is why it can be so painful. Take paracetamol for the pain, keep the rash clean and use a cold compress/wrapped ice to help soothe. Loose clothing will also help with irritation. Some GP's may prescribe an anti-viral medication to help, but this may be difficult to obtain whilst on holiday. It is always worth trying a local pharmacy to see if they can help. if shingles appear on the face, particularly around the eyes, seek medical help.
My son with chicken pox. Scabbing over here and unlikely to be contagious.
Chicken Pox
Predominately a childhood illness but also possible in adults. Normally a once only condition, but it is possible to get it multiple times. Often accompanied by feeling generally unwell, a low grade fever and excessive itching. Small fluid filled blisters appear quickly, usually on the torso initially but can spread to every area. They itch like hell, then dry and scab over before disappearing. Antihistamines can be given to help with the itching depending on the age of the child. Paracetamol can be given for the fever and general misery.
Some countries vaccinate routinely against varicella, the virus that causes chickenpox, but the UK does not. It is possible to purchase the vaccine privately if you want to.
Spots normally appear between 10-21 days after exposure to the virus. Once the rash appears you are infectious until all the spots have dried and scabbed over, which can take many days. You are also contagious for 48hrs before spots appear, so its worth giving other parents the heads-up if your child has mixed with theirs. Stay away from pregnant women.
Keep an eye out for secondary skin infections, any meningitis symptoms above such as a stiff neck, fast heart rate etc.
Heat Rash
A common foe on holiday, often presenting with a prickly, red rash which itches like hell, sometimes accompanied with minor swelling and in combination with sunburn. It can appear anywhere to the body but is not contagious to other people. Due to excessive sweating, and also possible in babies due to their inability to control their body temperature as well as adults.
Soothe a heat rash with cool baths/showers, antihistamines for the itch and paracetamol for any discomfort and stay in the shade. Calamine lotion and even hydrocortisone can help also. Wear cotton clothing, try to avoid getting too hot and drink lots of fluids - not alcohol!
Lyme disease
Caused by the bite of an infected tick, this rash appears as a bullseye type red area to the skin. Often accompanied by fever and feeling generally unwell. It is important to seek medical advice if you suspect you have Lyme disease.
For further information, see my previous post All About Bites
Golfers Legs
Also know as golfers vasculitis/hikers vasculitis or even just exercise-induced vasculitis. A common condition, particular on cruise ships it appears and often affecting perfectly healthy people, usually over 50.
This can present as red blotches, purple patches or even small dots. Normally starting above the sock line around ankles and calves, it is caused by irritation of the blood vessels under the skin. It usually clears up well by itself, but in my experience can appear to look more worrying that it is. Hydrocortisone is not going to help you. The best thing you can do is rest, elevate the legs and use a cold compress.
If you experience a rash that you think may be ‘golfers legs’ check for any localised heat in the area, open areas of skin which are weeping. If you feel unwell at all, seek medical help.
Me this time - covered from ear to toe.
Urticaria
A raised, red, itchy rash that can appear anywhere on the skin, potentially effecting a large area. It occurs when a trigger causes your body to produce an excessive amount of histamine in response to an allergen, insect bite, heat exposure or even just the common cold. Therefore, antihistamines are the best medicine to help settle the rash.
Sometimes, like what happened in my case, no obvious source can be found. I randomly and without obvious cause, broke out in a huge urticaria rash all over my body, even my toes and ears were covered. It was itchy as hell. I went to the GP who prescribed prednisolone steroids, but the rash continued without relief for around 10 days, worse in the mornings and late nights, and particularly where skin is in contact with clothing/bedding.
Antihistamines, cool baths, and cotton clothing worked the best for me. Try not to scratch!!
If the rash is accompanied by any swelling to the face, mouth, tongue, or difficulty breathing, dizziness, abdominal pain or collapse, seek medical help immediately!
Rashes are a common ailment and reason for people to seek medical advice. They are miserable and can ruin your holiday. Please feel free to post any comments, suggestions or questions on my forum and I will get back to you and hopefully offer some further help. Remember, no question is a stupid question and it is normal to feel worried when abroad when seeking GP advice is more difficult.
Your Pocket Nurse has heard of a new sunscreen called Sun-Off which has been causing skin rashes on bellies after application
It is a real Sun-Off Ab Itch
If you have found this article helpful, I would love to hear about it. Drop a comment below and feel free to share the wisdom!