What are viral exanthems. How does chickenpox spread. What symptoms characterize chickenpox. How is chickenpox diagnosed and treated. What is the importance of vaccination against chickenpox. How does immunity to chickenpox develop. What precautions should be taken with chickenpox patients.

Understanding Viral Exanthems: Common Childhood Skin Rashes

Viral exanthems are eruptive skin rashes often associated with viral infections. Despite the decrease in cases due to immunizations, these conditions still require professional medical attention. The most prevalent childhood viral exanthems include:

• Chickenpox (varicella)
• Fifth disease
• Measles (rubeola)
• Roseola
• Rubella (German measles)

Each of these conditions presents a unique pattern, aiding in their diagnosis. While vaccinations have significantly reduced the incidence of measles, mumps, rubella, and chickenpox, it’s crucial to seek medical care for any viral skin infection.

Chickenpox: A Closer Look at This Highly Infectious Disease

Chickenpox, a highly contagious disease typically associated with childhood, is caused by the varicella-zoster virus (VZV), a form of herpes virus. By adulthood, over 95% of Americans have had chickenpox. Transmission occurs through direct contact or airborne routes.

The condition most commonly affects children between 5 and 9 years old. However, in areas with a high concentration of daycare facilities, it’s not uncommon to see cases in children aged 1 to 4.

Chickenpox Vaccination: A Game-Changer in Prevention

Since 1995, a chickenpox vaccine has been available for children 12 months and older, as well as for adolescents and adults who have never had the disease. The vaccine has proven highly effective in preventing severe cases of chickenpox.

Several reputable health organizations recommend chickenpox vaccination:

• The Center for Disease Control & Prevention’s Advisory Committee on Immunization Practices
• The American Academy of Pediatrics
• The American Academy of Family Physicians

These organizations advocate for all children to be vaccinated between 12 and 18 months of age, with a booster shot between 11 and 12 years. Many schools now require vaccination before entry into preschool or public schools.

Recognizing Chickenpox Symptoms: What to Look For

While chickenpox symptoms are usually mild in children, they can be life-threatening for infants, adults, and individuals with compromised immune systems. Common symptoms include:

• Fatigue and irritability (1-2 days before rash onset)
• Itchy rash on the trunk, face, armpits, upper arms, legs, and inside the mouth
• Fever
• General malaise
• Decreased appetite
• Muscle and/or joint pain
• Cough or runny nose

Are these symptoms exclusive to chickenpox? No, they may resemble other skin conditions or medical issues. Therefore, it’s essential to consult a physician for an accurate diagnosis.

The Spread of Chickenpox: Understanding Transmission and Incubation

Once infected, chickenpox may take 10 to 21 days to develop. The disease is contagious from one to two days before the rash appears until the blisters have dried and formed scabs, typically within 4 to 5 days of rash onset.

How long should children with chickenpox be kept at home? Children should be isolated until all blisters have scabbed over. This precaution helps prevent the spread of the virus to others, especially considering that family members who have never had chickenpox have a 90% chance of becoming infected when another household member contracts the disease.

Diagnosing Chickenpox: The Role of Medical Professionals

Chickenpox diagnosis typically involves a comprehensive medical history and physical examination of the child. The distinctive nature of the chickenpox rash often allows for diagnosis based solely on physical examination.

Can blood tests confirm chickenpox? While blood tests can detect the presence of the varicella-zoster virus, they are not routinely used for diagnosis due to the characteristic appearance of the rash.

Treatment Approaches for Chickenpox: Managing Symptoms and Complications

The specific treatment for chickenpox is determined based on various factors, including the child’s age, overall health, medical history, extent of the condition, tolerance for specific medications or therapies, expected course of the condition, and parents’ preferences.

Treatment options may include:

• Acetaminophen for fever (NOT aspirin)
• Antibiotics for treating secondary bacterial infections
• Calamine lotion to relieve itching
• Antiviral drugs for severe cases
• Rest
• Increased fluid intake to prevent dehydration
• Cool baths with baking soda or Aveeno to relieve itching

The Aspirin Warning: Reye Syndrome Risk in Children

It’s crucial to note that aspirin should never be given to children with chickenpox without first consulting a physician. Aspirin has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Healthcare providers recommend avoiding aspirin or any medication containing aspirin to treat viral illnesses in children.

Preventing Complications: The Importance of Proper Care

To prevent secondary bacterial infections, children should be discouraged from scratching the blisters. Keeping the child’s fingernails short can help reduce the likelihood of scratching.

How can parents soothe their child’s itching? In addition to calamine lotion and cool baths, parents can try oatmeal baths or applying cool, wet compresses to itchy areas.

Chickenpox Immunity: Long-Term Protection After Infection

Most individuals who have had chickenpox develop lifelong immunity to the disease. This immunity is due to the body’s production of antibodies against the varicella-zoster virus.

Does having chickenpox guarantee complete immunity? While most people who have had chickenpox are immune for life, in rare cases, a person may develop chickenpox more than once. However, subsequent infections are typically milder than the initial occurrence.

The Role of Vaccination in Immunity

Vaccination also provides long-lasting immunity to chickenpox. The vaccine contains a weakened form of the virus, which stimulates the immune system to produce protective antibodies without causing the full-blown disease.

Complications of Chickenpox: When to Seek Immediate Medical Attention

While chickenpox is usually a mild illness in healthy children, it can lead to serious complications in some cases. These complications may include:

• Bacterial infections of the skin
• Pneumonia
• Encephalitis (inflammation of the brain)
• Dehydration
• Reye syndrome (in cases where aspirin is used)

When should parents seek immediate medical care for a child with chickenpox? Parents should contact a healthcare provider if their child experiences:

• High fever lasting more than 4 days
• Severe cough or difficulty breathing
• Severe abdominal pain
• Stiff neck
• Frequent vomiting
• Extreme sleepiness or difficulty waking
• Rash that becomes very red, warm, or tender

Chickenpox in Special Populations: Increased Risk and Precautions

Certain groups are at higher risk for severe chickenpox and its complications. These include:

• Newborns and infants whose mothers have not had chickenpox or the vaccine
• Pregnant women who have not had chickenpox or the vaccine
• Individuals with weakened immune systems due to illness or medications
• Adults who have not had chickenpox or the vaccine

What precautions should be taken for high-risk individuals exposed to chickenpox? High-risk individuals who have been exposed to chickenpox should contact their healthcare provider immediately. They may be candidates for post-exposure prophylaxis with varicella zoster immune globulin (VZIG) or antiviral medications.

The Long-Term Impact of Chickenpox: Shingles Risk

After a person recovers from chickenpox, the varicella-zoster virus remains dormant in the body. In some individuals, particularly those over 50 or with weakened immune systems, the virus can reactivate later in life, causing a painful condition called shingles.

Can individuals vaccinated against chickenpox develop shingles? While the risk is lower, it is still possible for vaccinated individuals to develop shingles. However, the incidence and severity of shingles are generally reduced in those who have received the chickenpox vaccine.

Shingles Vaccination: A Preventive Measure

To reduce the risk of shingles, a separate vaccine is available for adults aged 50 and older. This vaccine can significantly decrease the likelihood of developing shingles and can reduce the severity of the condition if it does occur.

Global Perspective: Chickenpox Prevalence and Vaccination Policies

While chickenpox is considered a common childhood illness in many parts of the world, its prevalence and approach to prevention vary globally. Some countries, like the United States, have implemented universal childhood vaccination programs, while others focus on vaccinating high-risk groups.

How do vaccination policies affect chickenpox rates? Countries with universal vaccination programs have seen significant decreases in chickenpox cases, hospitalizations, and deaths related to the disease. However, in regions where the vaccine is not widely used, chickenpox remains a common childhood illness.

Chickenpox and School Policies: Balancing Education and Public Health

Many schools have specific policies regarding chickenpox to prevent outbreaks and protect vulnerable students. These policies may include:

• Requiring proof of vaccination or immunity for enrollment
• Excluding students with active chickenpox until they are no longer contagious
• Notifying parents when chickenpox cases occur in the school

How do these policies impact school attendance? While these measures may temporarily affect school attendance for some students, they play a crucial role in preventing widespread outbreaks and protecting those who cannot be vaccinated due to medical reasons.

Chickenpox Research: Ongoing Studies and Future Directions

Research on chickenpox and the varicella-zoster virus continues, with scientists exploring various aspects of the disease and its prevention. Current areas of study include:

• Improving vaccine efficacy and duration of protection
• Developing new treatments for severe cases
• Understanding the long-term effects of vaccination on shingles rates
• Investigating the potential link between chickenpox and certain autoimmune diseases

What potential breakthroughs might we see in chickenpox prevention and treatment? Future advancements may include more effective vaccines, targeted antiviral therapies, and improved strategies for preventing shingles in vaccinated individuals.

Chickenpox Myths and Facts: Dispelling Common Misconceptions

Despite widespread knowledge about chickenpox, several myths persist. Let’s address some common misconceptions:

1. Myth: It’s better to get chickenpox naturally than to be vaccinated.
   Fact: Natural infection can lead to severe complications, while the vaccine is safe and effective.
2. Myth: Chickenpox is always a mild disease.
   Fact: While often mild in healthy children, it can be severe or life-threatening in certain populations.
3. Myth: You can’t get chickenpox more than once.
   Fact: While rare, it is possible to get chickenpox multiple times.
4. Myth: The chickenpox vaccine causes autism.
   Fact: There is no scientific evidence linking vaccines, including the chickenpox vaccine, to autism.

Why is it important to dispel these myths? Accurate information about chickenpox helps individuals and families make informed decisions about vaccination and disease prevention, ultimately contributing to public health.

Living with Chickenpox: Coping Strategies for Patients and Caregivers

Dealing with chickenpox can be challenging for both patients and caregivers. Here are some strategies to make the experience more manageable:

• Maintain good hygiene to prevent secondary infections
• Use cool compresses or oatmeal baths to relieve itching
• Keep nails short and consider using soft mittens on young children to prevent scratching
• Provide distractions like books, movies, or quiet games to take the mind off the discomfort
• Ensure adequate rest and hydration
• Follow your healthcare provider’s recommendations for symptom management

How can parents help children cope with the emotional aspects of chickenpox? Parents can provide reassurance, explain the temporary nature of the illness, and create a comfortable, nurturing environment to help children feel supported during their recovery.

Viral Exanthems Rashes – Conditions and Treatments

What are viral exanthems?

A viral exanthem is an eruptive skin rash that is often related to a viral infection. Immunizations have decreased the number of cases of measles, mumps, rubella and chickenpox, but all viral skin infections require clinical care by a physician or other healthcare professional.  

The most common childhood viral exanthems include chickenpox (varicella), fifth disease, measles (rubeola), roseola, and rubella (German measles). 

Immunizations have decreased the number of cases of measles, mumps, rubella and chickenpox, but all viral skin infections require clinical care by a physician or other healthcare professional. Each of the viral exanthems listed here have a distinct pattern, which can aid in the diagnosis.

• 
  

  What is chickenpox?

  Chickenpox is a highly infectious disease, usually associated with childhood. By adulthood, more than 95 percent of Americans have had chickenpox.

  The disease is caused by the varicella-zoster virus (VZV), a form of the herpes virus. Transmission occurs from person-to-person by direct contact or through the air.

  Chickenpox most commonly occurs in children between the ages of 5 and 9. In the US, in areas with a large number of children in daycare settings, chicken pox in children between the ages of 1 and 4 is common.

  What is the chickenpox vaccine?

  Since 1995, a chickenpox vaccine has been available for children 12 months of age and older. Adolescents and adults who have never had chickenpox can also get the vaccine. The vaccine has proven very effective in preventing severe chickenpox.

  The Center for Disease Control & Prevention’s Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians recommend that all children be vaccinated with the chickenpox vaccine between 12 and 18 months of age.

  A booster vaccination is recommended again between 11 and 12 years of age. Many schools now require vaccination prior to entry into preschool or public schools.

  What are the symptoms of chickenpox?

  Symptoms are usually mild among children, but may be life threatening to infants, adults, and people with impaired immune systems.

  The following are the most common symptoms of chickenpox. However, each child may experience symptoms differently. Symptoms may include:

  • Fatigue and irritability one to two days before the rash begins
  • Itchy rash on the trunk, face, under the armpits, on the upper arms and legs, and inside the mouth
  • Fever
  • Feeling ill
  • Decreased appetite
  • Muscle and/or joint pain
  • Cough or runny nose

  The symptoms of chickenpox may resemble other skin problems or medical conditions. Always consult a physician for a diagnosis.

  How is chickenpox spread?

  Once infected, chickenpox may take 10 to 21 days to develop. Chickenpox is contagious for one to two days before the appearance of the rash and until the blisters have dried and become scabs, which usually happens within 4 to 5 days of the onset of the rash.

  Children should stay home and away from other children until all of the blisters have scabbed over. Family members who have never had chickenpox have a 90 percent chance of becoming infected when another family member in the household is infected.

  How is chickenpox diagnosed?

  Chickenpox is usually diagnosed based on a complete medical history and physical examination of the child. The rash of chickenpox is unique, and usually a diagnosis can be made from a physical examination.

  What is the treatment for chickenpox?

  The specific treatment for chickenpox will be determined based on:

  • The child’s age, overall health, and medical history extent of the condition
  • The child’s tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition child or parent’s opinion or preference

  Aspirin and the Risk of Reye Syndrome in Children

  Do not give aspirin to a child without first contacting the child’s physician. Aspirin has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

  The treatment for chickenpox may include:

  • Acetaminophen for fever (DO NOT GIVE ASPIRIN)
  • Antibiotics for treating bacterial infections
  • Calamine lotion (to relieve itching)
  • Antiviral drugs (for severe cases)
  • Rest
  • Increased fluid intake (to prevent dehydration)
  • Cool baths with baking soda or Aveeno (to relieve itching)

  Children should not scratch the blisters, as this can lead to secondary bacterial infections. Keep the child’s fingernails short to decrease the likelihood of scratching.

  What is immunity from chickenpox?

  Most individuals who have had chickenpox will be immune to the disease for the rest of their lives. However, the virus remains dormant in nerve tissue and may reactivate, resulting in herpes zoster (shingles) later in life.

  Occasionally a secondary case of chickenpox does occur. Blood tests can confirm immunity to chickenpox in people who are unsure if they have had the disease.

  What complications are commonly associated with chickenpox?

  Complications can occur from chickenpox. Those most susceptible to severe cases of chickenpox are infants, adults, pregnant women (unborn babies may be infected if the mother has not had chickenpox prior to pregnancy), and people with impaired immune systems. Complications may include:

  • Secondary bacterial infections
  • Pneumonia
  • Encephalitis (inflammation of the brain)
  • Cerebellar ataxia (defective muscular coordination)
  • Transverse myelitis (inflammation along the spinal cord)
  • Reye syndrome (a serious condition which may affect all major systems or organs)
  • Death

• 
  

  What is fifth disease?

  Fifth disease is a viral illness that causes a rash (exanthem). Fifth disease is also called erythema infectiosum. And it’s known as “slapped cheek” disease. This is because the rash can cause a child’s cheeks to become very red. Fifth disease is spread from one child to another through direct contact with fluid from the nose and throat. It can also be spread through contact with infected blood. It is somewhat contagious.

  What causes fifth disease?

  Fifth disease is caused by human parvovirus B19. It occurs most often in the winter and spring.

  Which children are at risk for fifth disease?

  It is most common in young, school-age children. Children often get it at school or other places where children gather. Adults can get fifth disease, too, but most infections are in children. 

  What are the symptoms of fifth disease?

  Symptoms usually show up 4 to 14 days after a child is exposed to the disease. About 4 in 5 infected children have very mild symptoms for about a week before getting the rash. About 1 in 5 will have no symptoms at all before the rash appears. Children are most contagious before the rash occurs, before they know they have the disease.

  Early symptoms are usually very mild. These may include:

  • Low fever
  • Headache
  • Runny nose
  • Sore throat
  • Itching
  • Nausea or vomiting
  • Diarrhea

  A rash is usually the main symptom of fifth disease. The rash:

  • Starts on the cheeks and is bright red
  • Spreads to the trunk, arms, and legs, and lasts 2 to 4 days. It often has a “lacey” appearance. 
  • May come back when the child is exposed to sunlight, heat or cold, or injury to the skin. This may continue for several days.

  The symptoms of fifth disease can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

  Warning

  Pregnant women who have been exposed to fifth disease need to seek immediate medical attention.

  Fifth disease is usually a mild illness. However, parvovirus B19 infection can cause an acute severe anemia in persons with sickle-cell disease or immune deficiencies. Also, there is a small risk of fetal death if fifth disease is acquired during pregnancy.

  The symptoms of fifth disease may resemble other conditions or medical problems, so consult a physician for proper diagnosis.

  How is fifth disease diagnosed?

  The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. The physical exam will include inspecting the rash. The rash is unique to fifth disease and may be enough to diagnose your child. In some cases, your child may also have blood tests.

  What is the treatment for fifth disease?

  Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The illness is caused by a virus. Antibiotics won’t help your child.

  The goal of treatment is to help ease symptoms. Treatment may include:

  • Having your child drink plenty of fluids
  • Giving acetaminophen or ibuprofen for fever and discomfort
  • Giving an antihistamine medicine for itching

  Talk with your child’s healthcare providers about the risks, benefits and possible side effects of all medicines. Don’t give ibuprofen to a child younger than 6 months old unless your healthcare provider tells you to. Don’t give aspirin to children. Aspirin can cause a serious health condition called Reye syndrome.

  Aspirin and the Risk of Reye Syndrome in Children

  Do not give aspirin to a child without first contacting the child’s physician. Aspirin has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

  What are possible complications of fifth disease in a child?

  Fifth disease is usually a mild illness. In some cases, it may cause acute severe anemia in a child with sickle cell disease or a weak immune system. In a pregnant woman with fifth disease, there is a small risk of death of the baby in the womb.

  How can I help prevent fifth disease in my child?

  The best ways to keep fifth disease from spreading include:

  • Washing hands well with soap and warm water
  • Covering the mouth and nose when coughing or sneezing

  When should I call my child’s healthcare provider?

  Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

• 
  

  What is measles (rubeola)?

  Rubeola, also called 10-day measles, red measles, or measles, is a very contagious viral illness that results in a distinct rash. It is spread from one child to another through direct contact with discharge from the nose and throat, or via air-borne droplets from an infected child. Measles is a highly contagious disease that usually consists of a rash, fever, and cough.

  What causes measles?

  The measles virus, which causes the disease, is classified as a Morbillivirus. It is mostly seen in the winter and spring, but measles is preventable with proper immunization.

  The measles vaccine is usually given in combination with the mumps and rubella vaccine. It is called the MMR and is usually given when the child is 12 to 15 months old and then again between 4 and 6 years of age.

  What are the symptoms of measles?

  After exposure to the disease, it can take between 8 to 12 days for a child to develop symptoms of rubeola. Children are contagious 1 to 2 days before the onset of symptoms and 3 to 5 days after the rash develops. This means that children can be contagious before they even know they have measles.

  During the early stages of measles (which lasts between 1 to 4 days), symptoms usually resemble those of an upper respiratory infection. Each child may experience symptoms differently, however. Common symptoms may include:

  • Hacking cough
  • Redness and irritation of the eyes
  • Fever
  • Small red spots with white centers on the inside of the cheek (these usually occur two days before the rash on the skin appears)
  • A deep, red, flat rash that starts on the face and spreads down to the trunk, arms, and legs. The rash starts as small distinct lesions, which then combines to form one big rash. After 3 to 4 days, the rash will begin to clear, leaving a brownish discoloration and skin peeling

  The most serious complications from measles include the following:

  • Ear infections
  • Pneumonia
  • Croup
  • Inflammation of the brain

  The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult a physician for a diagnosis.

  How is rubeola diagnosed?

  Measles is usually diagnosed based on a complete medical history and physical examination of the child. The lesions of rubeola are unique, and usually allow for a diagnosis simply on physical examination. In addition, a physician may order blood or urine tests to confirm the diagnosis.

  The most serious complications from measles include the following:

  • Ear infections
  • Pneumonia
  • Croup
  • Inflammation of the brain

  The symptoms of rubeola may resemble other skin conditions or medical problems. Always consult a physician for a diagnosis.

  What is the treatment for rubeola?

  Specific treatment for measles will be determined based on:

  • The child’s age, overall health, and medical history
  • Extent of the disease
  • The child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disease
  • Child or parent’s opinion or preference 

  Aspirin and the Risk of Reye Syndrome in Children

  Do not give aspirin to a child without first contacting the child’s physician. Aspirin has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

  Because measles is caused by a virus, there is no cure for rubeola. The goal of treatment is to help prevent the disease, or decrease the severity of the symptoms.

  • Increased fluid intake
  • Acetaminophen for fever (DO NOT GIVE ASPIRIN)

  Prevention of Rubeola

  Since the widespread use of the rubeola (measles) vaccine, the incidence of measles has decreased by 99 percent. About 5 percent of measles are due to vaccine failure.

  If the child was exposed and has not been immunized, the physician can give the vaccine to the child within 72 hours to help prevent the disease.

  Other ways to prevent the spread of rubeola include:

  • Children should not attend school or daycare for 4 days after the rash appears
  • Confirm that the child’s contacts have been properly immunized

• 
  

  What is roseola?

  Roseola is a contagious viral illness that is marked by a high fever and a rash that develops as the fever decreases.

  What causes roseola?

  Roseola is likely caused by more than one virus, but the most common cause is the human herpesvirus 6 (HHV-6). Roseola occurs mostly in children under the age of 3, and occurs more often in the spring and fall.

  What are the symptoms of roseola?

  It can take between 5 and 15 days for a child to develop symptoms of roseola after being exposed to the disease. Children are most contagious during the period of high fever, before the rash occurs.

  The following are the most common symptoms of roseola. However, each child may experience symptoms differently.

  • High fever that starts abruptly
  • Fever (may last three to four days)
  • Irritability
  • Swelling of the eyelids
  • Rash (as the fever decreases, a pink rash, with either flat or raised lesions, starts to appear on the trunk and then spreads to the face, arms, and legs.)

  What are the complications of roseola?

  The most serious complication of roseola is febrile seizures. As the child’s temperature rises, there is a chance that the child will have a seizure.

  The symptoms of roseola may resemble other skin conditions or medical problems. Always consult a physician for the proper diagnosis.

  How is roseola diagnosed?

  Roseola is usually diagnosed based on a medical history and physical examination of your child. The rash of roseola that follows a high fever is unique, and often the diagnosis is made simply on physical examination.

  Aspirin and the Risk of Reye Syndrome in Children

  Do not give aspirin to a child without first contacting the child’s physician. Aspirin has been associated with Reye syndrome, a potentially serious or deadly disorder in children. Pediatricians and other healthcare providers recommend that aspirin (or any medication that contains aspirin) not be used to treat any viral illnesses in children.

  What is the treatment for roseola?

  The specific treatment for roseola will be determined based on:

  • The child’s age, overall health, and medical history
  • Extent of the disease
  • The child’s tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Child or parent’s opinion or preference

  Since it is a viral infection, there is no cure for roseola. The goal of treatment for roseola is to help decrease the severity of the symptoms. Treatment may include increased fluid intake or acetaminophen for fever (DO NOT GIVE ASPIRIN).

• 
  

  Rubella is a viral illness that causes a mild fever and a skin rash. Rubella is spread through contact with fluid from the nose and throat. Learn more about rubella.

Dermatology Treatment at Children’s National Hospital

The pediatric specialists at Children’s National Hospital have the expertise to diagnose, treat and manage conditions of the skin, nails and hair common in infant and younger patients. Discover more about the treatments we offer.

Learn about treatment

Help Kids and Make a Difference

Invest in future cures for some of life’s most devastating diseases. Give today to help more children grow up stronger.

Donate

Children’s Team Departments

Children’s Team

Children’s Team

Providers

Anna Kirkorian

Chief, Dermatology
Dermatologist

Colleen Cotton

Dermatologist

Departments

Departments

Dermatology

The Division of Dermatology at Children’s National Hospital continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair and nails.

The Most Common Skin Rashes You Get as an Adult

The rashes you get often change as you age. Before you try home treatments, understand what’s behind the break-out.

Posted
by Featured Provider Tyler Olson on Tuesday, September 22, 2020

You can get a rash at any age and from almost anything. An itchy sweater. A hot summer’s day. Even something that never touched your skin.

Your skin is the largest organ in your body. And there are a number of things that can cause it to break out in blotches, bumps, blisters, scales, spots or just general redness.

Rashes are the most common skin problems for adults.

A rash isn’t a specific diagnosis. It’s just any noticeable change in the texture or color of your skin. Most skin rashes clear up as quickly as they come. They might be small and appear easy to treat. But before you consider applying a little lotion to relieve the itch, you should understand exactly what kind of rash you have.

Luckily, the most common types of skin rashes in adults are ones you can typically wait out, treat with over-the-counter medications or resolve with the help of your primary care provider. Tyler Olson, MD, a Family Medicine physician at The Iowa Clinic in Johnston, helps clear up concerns about the rashes you’re most likely to develop in adulthood.

Seeing Spots?

Talk to your doctor to end the itching and relieve the redness

Schedule Now

1. Eczema

Most people associate eczema with itchy children but you can get it as an adult, too. It’s the most common skin rash, affecting more than 31 million Americans. Eczema is evident by its itchy, red, inflamed patches of skin in light skin tones. It looks brown, purple, gray or ashen in darker skin tones.

Eczema is not something you can catch from someone else. Instead, it’s a skin response triggered by your immune system and due to genetic and environmental factors. But it can be a chronic skin condition. Atopic dermatitis is a chronic, inflammatory type of eczema that can start in childhood but reappear in adulthood. It flares up in response to stress, weather changes, poor sleep and irritating fabrics or products. Avoiding these triggers is the first step of treatment but gentle skincare, a daily moisturizer and healthy sleep habits go a long way.

2. Contact Dermatitis

The most likely source of this rash is an allergic reaction where your skin comes into contact with an irritant. You may have had a brush with poison ivy, leaving behind a line-shaped or streaking rash. Nickel and rubber are lesser known yet common causes of contact dermatitis. But you could be allergic to anything from a certain type of fabric to a chemical in your laundry detergent.

Allergic contact dermatitis typically takes a few days to show up, so it’s not always easy to identify the source. You may get itchy, red or swollen skin, and can develop blisters near the site of contact. The best remedy is to avoid the allergen or irritant altogether. You can also apply a topical hydrocortisone cream or take an oral antihistamine to ease the itching.

“One of the most common, but unexpected, causes of contact dermatitis is actually a common medication: Neomycin, found in triple-antibiotic cream,” Dr. Olson says. “Up to one in 10 patients have this type of reaction to topical neomycin.”

3. Cellulitis

While most rashes are caused by viral infections, they can result from bacterial infections too. Cellulitis is the most common skin rash brought on by bacteria, says Dr. Olson. If you experience the redness, swelling and pain it causes, you need to see your provider.

Left untreated, cellulitis can cause serious tissue damage and spread to deeper tissues like the muscles and bones. Or, more concerningly, it can cause a bloodstream infection called sepsis. Fortunately, that rarely happens because cellulitis is treatable with antibiotics.

It’s not always clear how the bacteria that causes cellulitis enters your body, but it is known to enter through breaks in the skin. Cleaning and caring for any wounds, cuts, scrapes or blisters helps prevent cellulitis and other bacterial skin infections from forming.

4. Shingles

If you had chickenpox as a kid, you’re more likely to get this painful rash after you turn 50 (although it still pops up from time to time in teens and young adults). Shingles and chickenpox come from the same virus. It stays in your body even after the chickenpox rash is gone and can be reactivated in adulthood, commonly during times of stress.

Although shingles come from the same virus as chickenpox, the resulting rash is very different. A shingles rash is characterized by its containment to one side of the face or torso. The groups of small, clear blisters aren’t itchy. They’re painful. And the pain can last for weeks and months after the rash is gone, a condition called post-herpetic neuralgia.

“This is a condition you should probably see your doctor about, especially if the rash involves the face, as it can affect vision or hearing in rare cases,” Dr. Olson advises. “If you see your doctor right away, there are often medications that can be prescribed to help limit pain and spread of the rash.”

About one in three people will get shingles in their lifetime. But just like chickenpox, there’s an effective vaccine. You can prevent a shingles outbreak by getting vaccinated at your local primary care clinic after you turn 50.

5. Pityriasis Rosea

Pityriasis rosea is a lesser known but relatively common rash that may be the result of a virus. It starts out as a large, pink or red oval. After a couple of days — or even a couple of weeks — it spreads out with smaller, scaly patches forming on your chest or back. The shape of the rash ends up looking like an evergreen, giving pityriasis rosea its nickname, “Christmas tree rash.”

You’re more likely to get pityriasis rosea in the spring or fall as a young adult, before you hit your mid-30s. It’s not contagious or permanent. It typically resolves on its own, but that can take up to 12 weeks. In the meantime, you can practice good skin hygiene, take oral antihistamines and apply topical anti-itch creams to keep from scratching.

6. Rosacea

More than 16 million people have rosacea, the skin disease that results in a red, rosy face. You may also get visible blood vessels and small, red, fluid-filled bumps on your face. A rosacea rash can appear on your cheeks, forehead, chin and tip of your nose, giving you a flush appearance.

Rosacea typically affects people with fair skin between the ages of 30 and 50. The rash comes and goes. It can disappear for years, only to erupt again. Over time, your skin may not return to its original color once rosacea goes into remission, leaving you with a pink or red skin tone.

“Mild rosacea can often be treated by avoiding triggers such as makeup, foods that make you flush or excess sun exposure,” Dr. Olson says. “If the rash persists, there are antibacterial washes, topical creams and prescription medications. If rosacea symptoms are really persistent, there are procedures and additional medications you can get from a dermatologist.”

Get help if your rash spreads or presents other symptoms.

While many skin rashes are not aesthetically appealing, most aren’t life-threatening. Your rash may resolve on its own. And you can usually help it along with a little lotion or topical treatment.

Some rashes can get out of control or be a sign of something more, like an infection or serious allergic reaction. Dr. Olson advises that if your rash shows any of these signs, you need to seek medical treatment:

• Fever – Drug reactions and serious infections from measles or bacteria can cause fevers. Any time you have both a rash and a fever, you should schedule a same-day appointment with your primary care provider.
• Rapid spread – Skin rashes that come on suddenly usually signal an allergic reaction or serious infection. Call your primary care provider. If you have breathing difficulties, call 9-1-1.
• Blistering – Many rashes blister, where bumps turn into fluid-filled pockets. Avoid scratching or popping them. If the blisters are near your eyes or mouth, it’s best to see your provider sooner than later.
• Infection – The reason you don’t want to scratch blisters is because you could spread an infection. If you notice yellow or green fluid, swelling, crusting, red streaks or warm skin, your rash may be infected.
• Pain – Outside of shingles and cellulitis, most rashes don’t cause significant pain. If your rash hurts, you should call your provider or head to Urgent Care.

Your skin is an important diagnostic tool — one of the few that you have at your disposal. Whenever you notice a skin rash or just any spot of concern, it’s worth a call to your primary care provider. They can help you quickly relieve your rash and get you well on your way to recovery — or refer you to a dermatologist, if necessary.

Facts about chickenpox (chickenpox)

1. Home

2. Public Health – Seattle & King County

3. Communicable diseases and immunization

4. Fact sheets and data

5. Varicella

6. Varicella/chickenpox facts

What is it?

• Chickenpox (chickenpox) is caused by the varicella-zoster virus (VZV). It is often mild, but can be severe in infants, pregnant women, adults, and those with weakened immune systems.
• Before the introduction of the varicella vaccine, almost everyone had already had chickenpox before adulthood, and most adults had had chickenpox in childhood.

What are the symptoms of the disease?

• An itchy rash on the trunk and face begins to appear as pink spots and tiny fluid-filled blisters (“pockets”), which then dry up and crust over after 4-5 days.
• Rash may be the first sign of illness; there may also be fever and fatigue.
• The rash may be mild with few pockmarks or severe with hundreds of smallpox sores.
• Chickenpox can have severe complications such as bacterial skin infection and pneumonia.
• Some children who have been vaccinated against chickenpox may get a mild form of chickenpox with few patches that do not blister or crust.

How is the disease spread?

• The varicella-zoster virus is highly contagious and is transmitted by direct contact with saliva or rash from an infected person, or by airborne droplets when sneezing or coughing. The illness begins 10 to 21 days after contact with an infected person.
• Infected persons are contagious from 1 to 2 days before the onset of the rash until all pockmarks have formed scabs – usually 5 days from the onset of smallpox.
• People with immune systems, weakened disease or medications may experience severe and prolonged illness.
• A person who has never had chickenpox and has not been vaccinated against it has a 90% chance of becoming infected through contact with a family member with chickenpox.

How is this condition diagnosed?

• Chickenpox is usually diagnosed by symptoms and a typical rash.
• Sometimes a doctor may use laboratory tests to diagnose chickenpox if the diagnosis is not clear or if the disease is severe.

How can chickenpox be prevented?

• Vaccination is the best way to prevent chickenpox. The chickenpox vaccine is highly effective in preventing chickenpox, especially in severe cases and its complications.
• Children are recommended two doses of varicella vaccine starting at 12 months of age. A second dose of the vaccine is usually recommended for all children 4-6 years of age.
• Two doses of the vaccine are also recommended for adolescents and adults who have not had chickenpox.
• If you are not sure if you have had chickenpox, talk to your doctor about having a blood test.

What should I do if I have been exposed to chickenpox?

• If you already have immunity to chickenpox, you probably won’t get sick.
• If you are not immune to chickenpox, the chickenpox vaccine given within 3 days of exposure may help prevent the disease. Vaccination after 3-5 days of exposure will probably not prevent the disease, but will make it easier.
• People who are at high risk for complications from chickenpox, such as immunocompromised people, pregnant women, and premature babies, should contact their healthcare provider immediately.

What is shingles?

• Shingles, also called herpes zoster or simply zoster, is a painful skin rash caused by the varicella zoster virus (VZV). After recovering from chickenpox, the virus remains in the body for life. Usually the virus does not cause any problems, although it can show up years later, causing shingles.
• Shingles rash usually primarily affects one side of the face or body. It starts with the appearance of blisters that dry up after 3-5 days and lasts from 2 to 4 weeks. Before the rash appears, there is often pain, itching, or tingling in the area where the rash appears. Other symptoms may also include high fever, headache, chills, and upset stomach.
• Direct contact with the blisters of an infected person can cause chickenpox in someone who has not yet been ill or vaccinated.
• Shingles vaccination is recommended for people over 60 years of age to prevent the disease, reduce pain and complications.

• Last Updated January 26, 2018
• Share
• Tweet
• Print

Chicken pox (chicken pox) in children and adults: treatment

Chickenpox (chickenpox) is treated by a pediatrician

Chickenpox (chickenpox) is a highly contagious disease caused by the varicella zoster virus. The infection manifests itself in the form of blisters on the skin, accompanied by malaise, fever and severe itching.

Most of the patients endure it relatively easily – 5 days of fever and a daily rash, then the temperature returns to normal, the rash begins to disappear and a gradual recovery occurs. But for newborns, teenagers, some adults, pregnant women, and immunosuppressed people, chickenpox can be serious and cause complications. The best way to prevent chickenpox is to get vaccinated against it.

Chickenpox is transmitted by airborne droplets, the virus is unstable in the environment and dies outside the host’s body in a couple of minutes, and instantly in direct sunlight. Therefore, chickenpox can only be contracted directly from a sick person.

It takes at least 10 days and no more than 21 days from the moment of infection to the onset of the first symptoms. A sick person becomes infectious the day before the rash appears and remains infectious until all elements have crusted over (that is, usually 7–10 days).

The first signs of the disease are malaise, fever, capriciousness of the child, the appearance of the first elements of a rash. The rash has a certain phasing: a spot with a diameter of several millimeters appears, then after a few hours a bubble of 1–2 mm appears on the edge of the spot (a symptom of “dew drops on a rose petal”). After about a day, this vesicle spontaneously opens (if the patient himself did not tear it off when he scratched the itchy skin), in its place there is a weeping fine erosion, which after a few hours is covered with a crust (scab). These crusts last for several days and fall off on their own, or the patient picks them up when he scratches the skin. Erosion is the entrance gate for local infections, so some elements of the rash suppurate, become covered with larger crusts, heal much longer than others and leave behind small unpleasant scars on the skin.

Rash and fever occur in “bumps” or “waves”: the temperature rises for an hour, several dozen elements of the rash appear at once, then the temperature subsides, and no new elements appear yet, and the old ones are transformed according to the scheme described above. During the day, 3-5 or more such waves can pass, and the total number of elements of the rash usually ranges from 200 to 500 pieces. New and old elements are not similar to each other at a single point in time, as they have a different “age” – this phenomenon is called “false rash polymorphism.” The rashes usually last 5 days, and the patient is considered completely non-infectious 5 days after the last fresh rash.

After recovery from chickenpox, a reliable immunity is formed, re-infections are quite rare (however, they are described). Those who have previously had chickenpox sometimes have an attack of herpes zoster (it can be called “secondary chickenpox”). After local hypothermia of a skin area (the left half of the face of drivers, for example), great stress, or simply in old age, for no reason, severe pain suddenly begins in a certain area of ​​\u200b\u200bthe skin, and after a few days or weeks of such daily pain, the same chickenpox rash appears, only locally, in this painful place, and the bubbles are located nearby, in a heap. The defeat of the face is often accompanied by partial paralysis of its half (swells and does not close the eyes) and severe pain. The pain syndrome may require narcotic pain medications and persist after recovery for several months or even years.

Treatment of chickenpox is usually symptomatic: drinking plenty of fluids, antipyretic and antipruritic drugs. It is recommended to take a shower often without a washcloth (soaping the body with a sponge or palm), this reduces itching and the risk of attaching a secondary skin infection; apply local antipruritic agents (calamine, coxclin, cindol talker), antibacterial creams to festering elements of the rash on the elements of the rash. Zelenka, fukortsin, iodine, potassium permanganate and other coloring antiseptics are not recommended, as they have a weak effect and greatly stain the patient, his clothes and bedding. In patients at risk, an antiviral drug (acyclovir or valaciclovir) can be used, but most patients are not indicated for antiviral therapy.

The best prevention for chickenpox is vaccination.

Varicella vaccine is given twice, 6 weeks apart or more. Emergency vaccination is also possible: in the first 3-5 days (the sooner, the more effective) a vaccine can be administered to a previously unill / unvaccinated person from reliable contact with a chickenpox patient – this will reduce the severity of the disease or even completely prevent it. It should be remembered that it is possible to become infected not only from a patient with chickenpox, but also from a patient with herpes zoster (although in the second case, the virus is released much less and infection is not so likely).

Chickenpox can lead to various complications, from unpleasant scars on the body and bacterial infections of the soft tissues to brain damage (encephalitis, cerebellitis). Statistically, children under 14 years of age are considered to have a milder illness than children over 14 years of age or adults. Prior to the development and introduction of the varicella vaccine, some physicians considered it appropriate to intentionally infect a small child with chickenpox to prevent the disease from occurring in adulthood, when it is more likely to cause significant harm. However, modern science has proven the facts of re-infection of those who have been ill, the facts of the severe course and complications of chickenpox even in children, so today “chicken parties” should be considered a stupid and dangerous activity and should not be encouraged.