Causes

• Main cause: Skin contact with some irritant.
• Other common causes: 8 rashes that you may be able to recognize. These are listed in the "See Other Care Guide" section. If you suspect one of them, go there. If not, use this guide.

Localized Versus Widespread Rash: How to Decide

• Localized means the rash occurs on one small part of the body. Usually, the rash is just on one side of the body. An example is a rash on 1 foot. Exceptions: Athlete’s foot can occur on both feet. Insect bites can be scattered.
• Widespread means the rash occurs on larger areas. Examples are both legs or the entire back. Widespread can also be on most of the body surface. Widespread rashes always occur on matching (both) sides of the body. Many viral rashes are on the chest, stomach and back.
• The cause of a widespread rash usually goes through the blood stream. Examples are rashes caused by viruses, bacteria, toxins, food or drug allergies.
• The cause of a localized rash usually is just from contact with the skin. Examples are rashes caused by chemicals, allergens, insect bites, ringworm fungus, bacteria or irritants.
• This is why it's important to make this distinction.

Contact Dermatitis

Contact dermatitis is a common cause of a rash in one area. This is especially true of a small rash that will not go away. Contact dermatitis usually starts as raised red spots. It can change to blisters, as in poison ivy. The rash is itchy. Contact dermatitis is an allergic skin rash. The location of the rash may suggest the cause:

• Poison ivy or oak: exposed areas, such as the hands.
• Nickel (metal): anywhere the metal has touched the skin. (Neck from necklaces, earlobe from earrings, or fingers from rings. Stomach from metal snap inside pants, wrist from watch, or face from eyeglass frames.)
• Tanning agents in leather: tops of the feet from shoes or hands from leather gloves
• Preservatives in creams, lotions, cosmetics, sunscreens, shampoos: where applied
• Neomycin in antibiotic ointment: where applied

Return to School

• Children with localized rashes do not need to miss any child care or school.

1. What You Should Know:
   • Most new localized rashes are due to skin contact with an irritating substance.
   • Here is some care advice that should help.
2. Avoid the Cause:
   • Try to find the cause.
   • Consider irritants like a plant (such as evergreens or weeds). Also, chemicals (such as solvents or insecticides). Irritants also can include fiberglass or detergents. A new cosmetic or new jewelry (such as nickel) may also be the cause.
   • A pet may carry the irritant, as with poison ivy or oak. Also, your child could react directly to pet saliva.
   • Review the list of causes for contact dermatitis.
3. Do Not Use Soap:
   • Wash the red area once with soap to remove any remaining irritants.
   • Then, do not use soaps on it.
   • Cleanse the area when needed with warm water.
4. Cold Pack:
   • Use a cold wet washcloth or soak in cold water for 20 minutes.
   • Do this every 3 to 4 hours as needed. This will help with itching or pain.
5. Steroid Cream:
   • If the itch is more than mild, put 1% hydrocortisone cream on the rash.
   • No prescription is needed.
   • Use it 3 times per day.
   • Exception: Do not use for suspected ringworm.
6. Try Not to Scratch:
   • Help your child not to scratch.
   • Cut the fingernails short.
7. Return to School:
   • Children with localized rashes do not need to miss any child care or school.
8. What to Expect:
   • Most of these rashes go away in 2 to 3 days.
9. Call Your Doctor If:
   • Rash spreads or gets worse
   • Rash lasts for more than 1 week
   • Your child becomes worse