As the weather gets cooler, the air gets drier and the heaters go on, children can be exposed to irritants and illnesses that can trigger a rash. Cold weather, dry air, overheating and scratching can cause or worsen a skin rash, especially in extreme temperatures. You can care for many rashes with over-the-counter products and medications, if necessary, while observing your child at home carefully. If she seems very sick, upset or unresponsive to treatment at home, contact your healthcare provider.
To soothe dry skin during the cooler months, your child should bathe or shower in warm water. Too-hot water will overdry the skin. Pat your child dry after the bath or shower, and use an oil-based moisturizer to keep moisture next to her skin. You can use humidifiers in your home, especially if the heat is blowing dry air. To prevent dry skin and further skin irritation, have your child wear gloves. Take off wet gloves and socks as soon as possible, and give your child plenty of fluids.
Children often lick their lips when they have a runny nose or when their lips are dry. Licking lips frequently can cause skin to break down, especially when it’s exposed to cold, wind or friction from a scarf or coat. The rash from lip licking is usually a red-brown scaling or peeling patch around the mouth with varying degrees of lip dryness and irritation that can range from annoying to painful. You can use petroleum-based moisturizers or balms on the rash, which will reduce irritation and provide a barrier from the moisture from a runny nose. If age-appropriate, kids can use their own lip balm when necessary. Encourage your child to stop lip licking.
Viral infections, including roseola, can cause a rash. They usually start like the common cold with a runny nose, sore throat and fever. About two to four days after being sick, a child will develop a pinkish-red rash all over the body that lasts between a few hours and a few days. You can watch your child at home if there is a rash and viral illness with no high fever. Most viral rashes are not contagious, and kids who are well can return to childcare and school with the rash. Handwashing can help prevent spreading this illness.
The good news is these rashes go away by themselves without any specific treatment. You can use antihistamines or one-percent hydrocortisone cream if the rash is itchy or uncomfortable. Contact your child’s provider if there is a rash and high fever.
Frostnip is a mild frostbite. The exposure irritates the skin, causing redness, a cold feeling and numbness. Your child may feel pain and tingling as the skin warms, though it does not cause permanent damage. Rewarm skin after frostnip by bringing your child indoors, removing wet clothing and wrapping her in a blanket or placing her in a warm bath. Avoid heating pads or direct heat, which can damage skin.
Frostbite has degrees of severity, but superficial frostbites are the most common type in kids. If your child has frostbite, the skin can be red or turn white or pale. Your child may have some stinging or burning. After the skin has been rewarmed it can look mottled, blue or purple. Blisters may form. You can manage frostnip at home. If you suspect frostbite or fever, contact your child’s provider.
Your child can get heat rash from being bundled up and overheated. This rash looks like small red bumps and is generally found on the parts of the body covered by clothes and where your child is the warmest (e.g. stomach, armpits, neck).
In the cool weather, you should resist the urge to overdress your child and avoid excessively warm environments. Kids should wear one more layer than you do in the house. You can use yourself as a barometer. If you are too hot, your child is as well. If the rash becomes irritated or itchy, you can use moisturizers or hydrocortisone cream. It will usually clear up by itself in a few days.
Contact your child’s provider for further evaluation if the rash is accompanied by persistent fever, if there is any bleeding or drainage or if there are unexplained symptoms accompanying the rash.
Lateesa Posey, MSN, RN, PPCNP-BC, is a certified pediatric primary care nurse practitioner who has worked in primary care for the past 16 years. She currently works for GPM Pediatrics in Brooklyn, NY, and serves as adjunct faculty for Wilkes University graduate nursing program in Wilkes-Barre, PA.