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Pediatric - Rash, Localized, Cause Unknown

Rash - localized and cause unknown

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Impetigo of Left Cheek
Impetigo of Left Cheek

Diaper Rash
Diaper Rash

Fifth Disease
Fifth Disease

Ringworm Rash on Arm
Ringworm Rash on Arm

  • Rash on one part of the body (localized or clustered)
  • Red or pink rash
  • Small spots, large spots or solid red


  • Main cause: skin contact with some irritant.
  • Other common causes: 8 rashes that you may be able to recognize are listed below. If you suspect one of them, go there. If not, use this guideline.

Return to School

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

If not, see these topics

For an itchy rash:

For a non-itchy rash:

When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Not moving or too weak to stand
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Purple or blood-colored spots or dots that's not from injury or friction
  • Bright red area or red streak (but not sunburn)
  • Rash area is very painful
  • Age under 1 month old and tiny water blisters (like chickenpox)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Severe itching or fever is present
  • Looks like a boil, infected sore or other infected rash
  • Teenager with genital area rash
  • Lyme disease suspected (bull's eye rash, tick bite or exposure)
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Blisters unexplained (EXCEPTION: Poison Ivy)
  • Pimples (Apply antibiotic ointment until seen)
  • Peeling fingers
  • Rash lasts longer than 7 days
Parent Care at Home If
  • Mild localized rash and you don't think your child needs to be seen

  1. Reassurance: New localized rashes are usually due to skin contact with an irritating substance.
  2. Avoid the Cause:
    • Try to find the cause.
    • Consider irritants like a plant (e.g., poison ivy), chemicals (e.g., solvents or insecticides), fiberglass, detergents, a new cosmetic, or new jewelry (e.g., nickel).
    • A pet may be the intermediary (e.g., with poison ivy or oak) or your child may react directly to pet saliva.
  3. Avoid Soap: Wash the area once thoroughly with soap to remove any remaining irritants. Thereafter avoid soaps to this area. Cleanse the area when needed with warm water.
  4. Local Cold: Apply a cold wet washcloth or soak in cold water for 20 minutes every 3 to 4 hours to reduce itching or pain.
  5. Steroid Cream: If the itch is more than mild, apply 1% hydrocortisone cream (no prescription needed) 4 times per day. (EXCEPTION: suspected ringworm)
  6. Avoid Scratching: Encourage the child not to scratch. Cut the fingernails short.
  7. Contagiousness: Children with localized rashes do not need to miss any day care or school.
  8. Expected Course: Most of these rashes pass in 2 to 3 days.
  9. Call Your Doctor If:
    • Rash spreads or becomes worse
    • Rash lasts over 1 week
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/24/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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