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CHICKENPOX (Varicella)
Common Rashes
by East Valley Childrens Center
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Acne or "zits" is a common skin problem. It usually starts in adolescence, and almost all teenagers have some problem with it at times. It is caused by the hormonal changes that occur during the teenage years and the effect of those hormones on the oil glands that are located just beneath the surface of the skin. The hormones cause these glands to become more active.
The oil glands empty onto the skin through tiny tubes, or ducts. The increased oil production sometimes causes those ducts to become "plugged". If the opening to the surface remains closed, then whiteheads appear. If the duct is open, then the plugged material will turn dark on exposure to the air and blackheads are seen. If bacteria infect the plugged material, then the result is acne.
Acne is not caused by greasy foods, lack of sleep, sex, masturbation, or not washing properly. Heredity does seem to play a role, and if one or both your parents had trouble with acne, chances are you will too. Boys have a tendency to have more severe problems with acne, because of the increased amounts of testosterone present. Some girls will notice an increase in skin problems right before their period because of hormone shifts. Some people also note that certain foods or increased stress seem to aggravate their acne as well.
Acne is treated by:
1) Keeping the openings of the oil glands unplugged
2) Keeping the bacterial count of the skin as low as possible.
If you have mild acne usually washing your face well with a mild cleanser twice daily, and using one of the over the counter preparations, such as Oxy-5 or Clearasil is enough. If this does not seem to work after a couple months, please let us know. There are many treatments for acne that are available. However, no matter what method is used, the pimples that are already present will need to heal - the treatments are primarily to prevent new pimples from forming. You have to use any treatment consistently for 4 to 6 weeks to see results. Unfortunately, there is nothing that will magically clear your face overnight.
DO:
Wash your face twice a day or more with a mild soap.
Keep hair off your face.
Keep hair free of oil by shampooing frequently.
Men should shave as lightly, and as infrequently as possible.
Women should avoid makeup, and when makeup is need use only noncomedogenic (non acne forming) makeup.
Eat a balanced diet, with fruits and vegetables to maintain a good complexion.
DON'T:
Squeeze and pick at pimples and blackheads (this can lead to scarring).
Use greasy or oily cosmetics or oil based sunscreens.
Use greasy or oily conditioners or treatments on your hair.
Acne related sites to visit: Healthy Skin Healthy Outlook
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Chickenpox is a common childhood disease nearly all of us had as children. The incubation period is approximately two to three weeks from the time of exposure. The illness consists of many small, itching blisters that quickly scab over. Chickenpox usually begins with scattered red spots that have tiny "water blisters" in the center. They spread rapidly over the next several days. There may or may not be fever. Chickenpox usually lasts one to two weeks and is contagious for the first six days or until all of the "pox" have dried scabs. Most children are out of school for a week and their skin lesions have pretty well cleared within one month. Occasionally, one or two pox will leave a scar.
Treatment consists of acetaminophen or ibuprofen for fever and discomfort, and measures to control itching such as Calamine lotion applied as often as necessary, antihistamines such as Benadryl which is available without a prescription, and corn starch or oatmeal (Aveeno) baths.
The Chickenpox vaccine, Varivax, arrived in May, 1995, after over 30 years of development and testing. It is 90 percent effective in preventing Chickenpox. About 10 percent of vaccinated children will still get Chickenpox if exposed to the "wild" virus, but their illness will be milder than if they had not received the vaccine. It is recommended for all susceptible children over 12 months of age by the American Academy of Pediatrics and the Advisory Committee on Immunizations Practices of the Center for Disease Control.
The vaccine consists of a modified, weakened Chickenpox virus which will multiply and stimulate the immune system. Occasionally, if a Chickenpox-like rash develops, there can be transmission of the vaccine-Chickenpox virus to susceptible individuals who are in close contact with the vaccinated child.
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Diaper rash is more easily prevented than treated. It is aggravated by the hot, humid environment produced by plastic covered diapers. Changing the diapers as frequently as practical is enough to prevent most rashes.
Changing the diaper soon after a bowel movement is particularly important to prevent irritation. For most children the diaper area should be cleansed with water and a wash cloth after each soiling. Baby wipes are usually fine to use, but may be irritating when there is a diaper rash. For girls it is extremely important to remember never to wipe from back to front when cleansing (try to keep the vaginal area as clear of stool as possible).
No matter how careful you are about cleaning the diaper area, some degree of diaper rash will occur in almost all children. Once it has started, determine if it is a moist, weeping type of skin rash or if it is a dry and scaly rash. The wet, weeping diaper rash is best treated by careful drying and a light application of baby powder. Once the rash is dry or scaling, heavy coatings of ointments such as Vaseline, A & D, or Desitin may be used to prevent contact of urine or stool with the skin.
It bears stressing that excessive heat and excessive moisture in the diaper area will always result in a diaper rash. Frequent diaper changes and careful cleaning of the diaper area are essential.
Occasionally, a yeast will cause or worsen a diaper rash. It is referred to as a "fungal infection", a "yeast infection", monilia, candidiasis, or cutaneous thrush. The yeast, Candida albicans, grows rapidly in the moist diaper area. The rash tends to occur in the groin area, skin folds, and above the penis or labia. The rash appears pink to red with an irregular but sharply defined border, and often the edges of the rash appear to be peeling. Occasionally, there are small blisters or pimples along the border area.
Treatment requires careful attention to hygiene in the diaper area (frequent changes, avoidance of disposable wipes, careful washing with water and occasionally with mild soap and water), and medication. LOTRIMIN, MICATIN, and MONISTAT creams may be purchased without a prescription and applied two to three times per day until the rash clears.
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Eczema is a type of chronic skin disorder known as Atopic Dermatitis. It is quite common in children, even in infancy. It is characterized by the inability of the skin to retain moisture, therefore making the skin dry out very easily. It can be aggravated by foods (typically dairy products), stress, allergies, and environmental factors. It is often associated with Allergies and Asthma.
The rash in Eczema usually starts out as dry patches that can occur anywhere on the body. The rash sometimes progresses to redness and becomes bumpy and itchy. Over time, the skin may appear to lose it's pigment, or tan, leaving pale splotches (especially on the face). The rash with eczema is not contagious, but can sometimes become secondarily infected.
Eczema is typically managed by keeping the skin moist. This means avoiding the use of soap. Soap strips away the skin's natural protective oils, but non soap cleansers such as Dove™ and Cetaphil™ may be used when needed. Frequent use of moisturizes is a must. Three to four times daily moisturizing is ideal, and more is better. The best time to use a moisturizer is right after bathing when the skin is still moist. This allows the moisturizer to trap the water in the skin. Almost any moisturizer is useful, but try and avoid those that are perfumed or scented. Aveeno™, Lubriderm™, Moisturel™, and Eucerin™ moisturizers are quite effective for eczema. Keeping nails trimmed is helpful, and in some children the itching can be helped with Benadryl™. When this treatment alone is not helping, sometimes steroid creams are used. These creams and ointments can have potential side effects and they vary greatly in potency. Do not use another family members medication without discussing it with us. If you feel that your child needs a prescription medication for eczema, please schedule an appointment.
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Fifth Disease, also known as Erythema Infectiosum, is a common childhood rash. It is caused by a virus known as Parvovirus B19, and often occurs in large outbreaks in the Spring, especially in schools. The illness typically causes only a rash with no other symptoms, but may occasionally be associated with mild runny nose, fever, and joint pains. The rash starts as a bright red rash on the cheeks, looking like a sunburn or "slapped" cheeks. The rash then appears as a lace like rash mostly on the upper arms and legs as the facial rash fades. The rash will typically wax and wane for 10 to 14 days, and becomes more noticeable when the skin warms (after bathing or sunlight exposure).
Children with the Fifth Disease rash are NOT contagious, and do not need to be excluded from school. The virus is contagious, but only before the rash begins.
Many people are aware of concerns with pregnant women being exposed to this illness. Parvovirus B19 infection can cause illness in a fetus during the 1st trimester causing problems leading to miscarriage. Miscarriage occurs in approximately 1% of infections. There is no treatment or prevention for an exposed expectant mother, and since complications are rare and only in the 1st trimester, only observation is necessary. Many other adults that get this virus experience a few weeks of joint pains, but typically they do not get the rash.
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Heat rash is caused by plugging of the sweat pores and retention of sweat. This is extremely irritating and causes a very red, prickly type of rash especially in the neck region. It may spread over the entire back and chest. Treatment consists of dressing the child less warmly, bathing your child with tepid or cool water and a wash cloth (without soap), and occasionally, especially in the neck region, a very light application of baby powder after bathing.
Hives, or urticaria, is a term that describes a common rash frequently associated (often mistakenly) with allergic reaction. The rash with hives is constantly changing, starting with small spots and quickly forming larger spots, often several inches in size. The spots have varying shapes but are usually raised and quite red, although often the center of the spots flattens and becomes pale. The rash is extremely itchy. It can be associated with swelling, especially around the eyes and mouth.
The most common cause of hives is from viral infection, but it can also be caused by certain allergic reactions such as food allergies. Usually, the cause of hives remains unknown unless a repetitive pattern develops. When hives begin while a person is taking a medication (typically an antibiotic), it may indicate the onset of an allergy to the medication.
Hives cannot be treated directly. If there is an offending allergy, the allergic culprit must be removed or discontinued. This may be difficult if the cause is mysterious. The itching can be treated with Benadryl™ (diphenhydramine is the generic term), and the use of bath products such as Aveeno oatmeal bath™. Hives are not contagious, but may come and go for as long as 10 days when caused by viral illness.
If your child is taking a medication and has developed a rash that may be hives, stop the medication and call the office during routine hours. Call us immediately if your child develops shortness of breath or labored breathing, blisters of the skin or lips, or if the rash appears to be bruising.
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Impetigo is a superficial bacterial infection of the skin. It is usually caused by bacteria known as Staph or Strep. It can occur anywhere on the body but is most common on the face and extremities. Any break in the skin can result in impetigo if the area becomes contaminated with these bacteria, which often are part of the body's normal bacteria, especially in the nose.
Impetigo causes a reddened area with then becomes oozy and crusted with a tan or honey colored material. Once infected, the area of impetigo usually becomes larger or satellite lesions will develop. Impetigo can be spread if hands are not washed.
Impetigo is treated with a topical or an oral antibiotic. Often, Impetigo will resolve with use of anti-bacterial soap and topical antibiotic ointment such as Neosporin.
If you believe your child has Impetigo, it is not urgent, but please call the office for an appointment.
Bee stings, mosquito bites, etc., are basically local reactions which result in pain, itching, redness, and swelling. Cold compresses applied immediately after a sting are often helpful. Itching and swelling can be controlled with Calamine Lotion and oral antihistamines. At times, it may take several days for such reactions to subside. Watch for signs of secondary infection such as increasing redness, swelling, pain, purulent discharge (pus), or fever. If any of these occur, please contact the office.
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Ringworm, or Tinea Corporis, is a rash resulting from a fungal or yeast infection. It is not a worm, but is called ringworm because of it's raised circular appearance. Ringworm is a growing circular rash with a raised red border and a flat scaly or silvery center. It is very itchy and can be anywhere on the body. It can be spread by direct contact, making hand washing very important.
Ringworm can be treated with any topical antifungal cream such as Lotrimin, Monistat, or Micatin. The cream should be applied twice daily for at least three weeks. If you are unsure whether your child has ringworm, he/she should be seen in the office. Ringworm of the scalp requires an oral medication and an office appointment is necessary for this.
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Copyright: East Valley Children's Center
