Eczema, Food Allergy Hives And 6 Other Common Baby Rashes: How To Tell The Difference

October is Eczema Awareness Month. Here at Ready, Set, Food!, we're dedicating the month to answering common questions about eczema and sharing eczema care tips.

Today, we're covering how to identify whether your baby's rash is eczema, or whether it has another cause.

Is baby's rash eczema? There are many reasons your baby could have a rash. Eczema is one reason, but allergies, viral illnesses, and even heat can cause rashes as well. 

How can you tell the difference? Today, we'll cover how to identify 8 common baby rashes.

If you're not sure what's causing baby's rash, your pediatrician is your best source of guidance. 

Be ready to tell your pediatrician about any other symptoms that came with the rash, as well as any food or environmental triggers that could have caused the rash. 

They may refer you to a dermatologist or allergist if the rash is suspected to be from eczema or a food allergy.

How to tell the difference between baby rashes? 

Chart with eight common baby rashes and how to tell the difference based on appearance and color

1. Eczema rash (atopic dermatitis rash)

What causes it: Eczema is a chronic condition that weakens a child's skin barrier. It causes baby's skin to "flare up," or develop a rash, when exposed to certain irritants. 

Some irritants that may cause flare-ups include dry skin, dry air, rough fabrics (like polyester, nylon, or wool), fragrances, dyes, chemicals and metals. 

Food allergens and environmental allergens can also cause eczema to flare up. 

What the rash looks like: Eczema rash is a dry, rough, flaky, and itchy rash. It can cause patches of rough, itchy skin, dry and inflamed skin, or crusty, scaly bumps that can sometimes leak fluid.

On children with lighter skin, eczema rash will be red.

Baby with eczema rash on its face

 

Baby holding someone's finger with eczema on its arm

On children with darker skin, eczema rash is usually brown, purple, or gray. The rash may be harder to see, but the skin will still seem dry.

Baby with eczema on the side of its face

Source: Eczema Foundation

Eczema rashes can appear anywhere on the body. But they will most often appear on the elbows, knees, arm joints, leg joints, forehead, or cheeks.

Eczema rashes are never raised.

Other symptoms of eczema: Eczema will make your child's skin itchy. Mild eczema itching won't interfere with daily life, but moderate eczema may disrupt sleep or other activities, and severe eczema will cause constant itching.

What else to know: There's no cure for eczema, but you can help keep your baby's eczema under control with a daily bath, regular moisturizing, and other parts of an eczema care routine.

Chart with eight common baby rashes and their most common symptoms

2. Contact dermatitis rash

What causes it: Contact dermatitis is another type of eczema. When the skin reacts to certain irritants that come in contact with it, contact dermatitis flares up. Common irritants that can cause these flares include fragrances, soaps, detergents, lotions, spit, urine and feces, and poison ivy. 

(Food will not cause a contact dermatitis flare-up.) 

What the rash looks like: Contact dermatitis can show up as an inflamed rash, a blistery rash, or dry skin. It can sometimes swell up, crack, or peel the skin. Sometimes, the blistery rash can ooze, drain, or crust.

Close up of arm with contact dermatitis

Source: North Texas Allergy and Asthma Center

The rash will be red on lighter skin, and can be purple, dark brown, or gray on darker skin.

When you remove the irritant, contact dermatitis usually clears up.

Other symptoms of contact dermatitis: Contact dermatitis can cause itchiness, pain, and bleeding in rash areas. 

What else to know: Diaper rash is often caused by a type of contact dermatitis, where urine and feces irritate the areas of skin where baby wears their diaper. 

Learn more about how to identity rashes in newborns and babies in this video featuring Dr. Richter, a Children's Hospital of Wisconsin pediatrician at Southwest Pediatrics. 

 

3. Food allergy rash (food allergy hives) 

What causes it: When someone has a food allergy, their immune system treats the proteins in certain foods like harmful invaders. When someone eats a food they are allergic to, their immune system over-defends the body against that food's proteins, and triggers symptoms of an allergic reaction.  

A food allergy rash is one of the most common food allergy symptoms, and is often the first symptom to appear.

What the rash looks like: A food allergy rash is raised, very itchy, and often rounded. It can appear anywhere on the body.

 On children with lighter skin, the bumps will be red. These raised bumps will often have rash flares around them. 

Baby with a food allergy rash on its body

Source: https://foodallergyeducation.org.au/basics


Baby with food allergy rash on its face

On children with darker skin, the raised bumps will usually be the color of the person's skin, but can sometimes be subtly red or darker red. 

Back with hives

Source: Healthline 

 A food allergy rash could appear anywhere on the body. 

Like other symptoms of a food allergy, it will usually appear seconds to hours after someone eats a food that they are allergic to.  

When a  food allergy reaction is mild, the rash will be concentrated on one area of the body.

When a food allergy reaction is severe, the rash will spread all over a person's body. Severe food allergy reactions require immediate emergency attention and an Epi-pen injection.

The rash will usually clear up within several hours to a day, and will almost always last no longer than 48 hours. 

Other symptoms of food allergies: Besides the raised rash, the most common food allergy symptoms in babies are vomiting and swelling. 

Itchy, red, and watery eyes, congestion, coughing, and stomach pain are some of the other food allergy reaction symptoms.

You can find our full breakdown of the mild and severe symptoms food allergies can cause here. 

What else to know: Food allergy reactions cause swelling and vomiting, and eczema flares don't cause those symptoms.

Food allergy reactions are also reliable and timely. Someone who is allergic to a food will develop an allergic reaction every time they eat that food. Reaction symptoms may vary, though, and may not always include a rash.

For more on identifying a food allergy rash, don't miss our essential guide.

We also break down all the differences between a food allergy rash and eczema flare-up in another article.

 

4. Fifth disease

What causes it: Fifth disease is a mild viral infection caused by parvovirus B19.

What the rash looks like: Fifth disease is often called "slapped cheek disease" because it causes a flushed-looking rash to appear on baby's cheeks.  

This flushed rash is the rash's first stage. It looks bright red on lighter skin. On darker skin, it looks subtly red, reddish-purple, or slightly lighter than the person’s skin color.

A few days later, a different type of fifth disease rash may appear. This rash will be purplish-red or reddish-brown, and appear laced and flat. It may spread to baby's trunk, arms, and legs. Sometimes, it can get itchy. 

This rash may last a few days, but may also come and go for a few weeks. Heat, cold, injury or sunlight could make the rash reappear.

Baby with fifth disease rash

Source: Andrew Kerr/Public Domain

For an example of fifth disease on darker skin, see the image here from Brown Skin Matters.

Other symptoms of fifth disease:  Even though the "slapped cheek" rash is the most well-known symptom of fifth disease, other symptoms usually appear first: 

  • Low fever
  • Congestion
  • Runny nose
  • Sore throat
  • Headache
  • Nausea
  • Fatigue

What else to know: Viral illnesses like fifth disease cause rashes and fever. Food allergies and eczema cause rashes, but don't cause fever.

For our complete guide to fifth disease, please click here.

 

5. Sixth disease (Roseola)

What causes it: Sixth disease (roseola) is another viral illness that is usually mild. Usually, it’s caused by human herpesvirus 6. Less often, it’s caused by human herpesvirus 7 or another virus.

What the rash looks like: Roseola rash is dotted. It's usually raised, but could be flat. It is usually not itchy.

The rash appears rose-colored on children with lighter skin, and darker red, purple, or the color of the skin on children with darker skin.

It starts out on baby's stomach, then spreads to the torso, neck, back, and other parts of the body.

It usually lasts for a few hours to a few days.

Roseola rash on baby's stomach

Source: DFTB Skin Deep

For Roseola on darker skin, see the image here, from Brown Skin Matters.

Other symptoms of roseola: Usually, a baby with roseola will experience a sudden, high fever (102-105 degrees Fahrenheit) before the rash or any other symptoms.

Roseola may also cause congestion, sore throat, coughing, runny nose, swelling of the neck, and other cold-like symptoms.

What else to know:

About 10-15 percent of children with roseola experience seizures from the sudden, high fever. They aren't harmful, but may cause arm and leg twitching and loss of consciousness. Seek medical attention immediately if your baby has a seizure.

For everything else you need to know about sixth disease (roseola), our guide has you covered.

 

6. Hand, foot and mouth disease 

What causes it: Hand, foot, and mouth disease is a mild, common and very contagious viral illness. It is caused by the coxsackievirus.

What the rash looks like: Like the name describes, the illness causes a rash that clusters on the palms of hands and soles of feet. It also causes sores (rashes) inside the mouth.

But sometimes, the rash can also show up on baby's knees, elbows, and behind. 

On babies with lighter skin, the rash appears dark red. On babies with darker skin, the rash appears skin-colored, reddish-purple, or white.

It's not an itchy rash, but it often gets blistery. 

Hand, foot, and mouth rash on the palm of a baby's hand

Source: DFTB Skin Deep

For Hand, Foot, and Mouth on darker skin, see the image from Brown Skin Matters here.

Other symptoms of hand, foot and mouth disease: With hand, foot and mouth disease, a fever usually starts a few days before the rash.

Hand, foot and mouth disease may also cause a sore throat and a loss of appetite. 

What else to know: Viral illnesses like hand, foot and mouth disease cause rashes and fever. Food allergies and eczema cause rashes, but don't cause fever.

For more on identifying and treating viral rashes like hand, foot and mouth disease, please read this guide.

 

7. Baby acne (neonatal acne)

What causes it: We don't yet know what causes baby acne. But it's thought to be the presence of the mother's hormones in their bloodstream, left over from their time in the womb.

What the rash looks like: Baby acne looks very similar to teen and adult acne. It causes pimples (small, hard, raised, often red bumps) to develop on baby's face, neck, back, and chest. Sometimes, the pimples are surrounded by small inflamed areas, and sometimes, whiteheads appear on the bumps.

Baby's face with baby acne

Other symptoms of baby acne: There are no other symptoms of baby acne.

What else to know: Baby acne usually appears between 2 and 4 weeks of age, but could develop any time before 6 weeks of age. 

For more details about baby acne, please read our guide.

 

8. Heat rash

What causes it: Heat rashes suddenly appear on baby's skin when it's exposed to heat on hotter days.

What the rash looks like: Heat rash is a prickly rash that looks a lot like acne. It can be red, gray, or white. It usually appears on the face, armpits, wrists, and legs, as these parts of the body heat up most quickly.

 Arm with heat rash

Source: NHS

 Other symptoms: The only other symptom of heat rash is itchiness.

What else to know: Besides causing heat rash, heat can also sometimes be a trigger of eczema rash.

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