Rashes are often caused by infections and are common in children. This is because their immune system is not fully developed until they reach puberty. While it’s a relief to know that most rashes are not dangerous, it’s also importa​nt to make sure they’re not caused by a more serious infection.

Dr Uma Alagappan​, Visiting Consultant from the Dermatology Service, KK Women’s and Children’s Hospital​ (KKH), a member of the SingHealth​ group, is here to answer your questions on skin rashes in children.

Question by rennyl

Hi Dr Uma. I am a first-time mum and would like to know what skin conditions in babies require urgent attention? I notice babies get rashes easily, eg nappy rash, milk rash etc and I just want to know what kind of rashes need urgent attention so that I will know to send my baby to the doctor if it happens.

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear Rennyl,
Congratulations on being a mum!  Yes, rashes are very common in infants and usually it resolves with application of over-the-counter creams. However, if there are erosions, rash is persistent or progressive, or if the child is unwell, I would urge you to seek medical attention sooner rather than later.

Question by TBL

Hi,
My son is 1year old and I notice that he is having rashes on his scalp.
It seems that he the scalp is itchy and he is scratching it often.
I have tried to use cetaphil hair wash for baby but it doesn’t help.
May I know the cause? Does it affect his hair growth? 
He does not have a lot of hair compared to other babies.  
Are there other natural remedies?
He has eczema on his skin when he was baby. The condition has improved after using cetaphil wash.
I do not see rashes on his body now.

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear TBL,
Scalp rash in babies and young children is usually due to seborrheic dermatitis or fungal infection. Although not common, severe seborrheic dermatitis and fungal infection can affect hair growth. Natural remedies for seborrheic dermatitis or fungal infection have not been shown to be tremendously useful. Although application of moisturisers will help your son’s condition, he may require anti-inflammatory topicals for seborrheic dermatitis or anti-fungal topicals for fungal infection if the rash has not resolved yet. 

Question by concerned

Hi doctor,

I read that commercial skin products are full of chemicals and can be harmful to the skin e.g. products like Johnson & Johnson etc. If this is the case, why is it that are they still sold (and especially in hospitals)? What are some of the ingredients to avoid when buying skin products for babies/children (or adults for that matter)? Thank you.

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear Concerned,
Thank you for your question. Commercial skin care products are produced for the general population and they are usually well tolerated by most people. However, patients with skin conditions such as eczema need to be careful about the products they use. They should generally avoid products containing sodium lauryl sulphate which is a foaming agent that can cause dryness. Patients with severe skin problems can undergo a skin patch test to find out the exact chemicals that they are allergic to.

Question answered by SilverOng

Hi Doc, I am also a first time mummy to coming 3 montha old baby. I noticed there is a mummy's question on seborrheic eczema. I have seen almost 3 doctors to cure this issue, however, the effects still lingers. He is having cradle cap, yellow flaky ears and flaky skin. I was prescribed with some steroid creams and body lotions. But the problem does not seem to totally go off. May I ask what should I do and how long will this be on my baby. Personally and fortunately, I do not have eczema issues, byt probably from my spouse tree line. I am worried that this would be aomething permenant. Will it? Many thanks.

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear SilverOng,
Congratulations and welcome to motherhood! Seborrheic dermatitis is a common skin condition that usually affects babies in the first year of life. I would suggest that you follow up with one doctor so that he/she may prescribe and adjust the topical medication accordingly, especially if there was insufficient improvement with the topicals prescribed earlier.

Seborrheic dermatitis in infants is not known to have a genetic component so it usually does not develop into eczema. However, if there is family history of atopy, (namely asthma, allergic rhinitis, eczema) then there is a possibility that the child may develop eczema later on.

Question by ma18

My child has asthma. Recently my child started having a red weeping patch on her legs. When I visited the doctor, I was told that she has eczema and the eczema was due to her asthma. The doctor mentioned about the link between sensitive lungs and sensitive skin. Is it really true that having asthma leads to eczema? Thank you Dr!​

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear Ma18,
Yes, it is true that there is a link between sensitive lungs and sensitive skin. Eczema is part of the spectrum of atopic diseases, the others being asthma, and allergic rhinitis. Hence, children with a family or personal history of atopy (asthma, allergic rhinitis, eczema) are at a higher risk of developing eczema.

If you are worried about the future development of eczema in your child, the best prevention is to start good skin care management (i.e. frequent application of moisturisers) now.

Question by healthblur

I’ve used Propolis (complex natural substance from bees) on myself as an adult and it really worked for a rash I had for years! Is it safe to use on a two year old? I’m thinking since he’s my child, it should work on his rash too? Appreciate your advice before I apply to my precious child!! Thanks

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear Healthblur, Propolis is a substance produced by bees and it has been widely used in over-the-counter products. As the underlying cause of your child’s rash is unknown, I would not recommend using propolis on him. Furthermore, some people may develop allergies to propolis.

Question by jenniferkjk

Dear Mdm,
My grandniece always has some eczema behind her knee at the joint. Dr will prescribe some cortisone cream. We decided to abort it and simply apply pure coconut oil n it goes away but it comes and go. 
Why is this so?
Your reply is appreciated.
Thank you.
Best regards

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear Jenniferkjk, 
Coconut oil has some moisturising properties that may help eczema. However, the rash may recur if the skin inflammation is not properly controlled or there are triggers such as heat, sweat, and infection. I would recommend the use of anti-inflammatory creams to treat the red itchy rash, and the regular and frequent use of moisturisers to strengthen the skin barrier.

Question by Florence

My grandkids are turning 4 years old and the girl turning 2 next month. Lots of mosquitoes in our garden so they use citronella stickers.

1. Are these stickers safe to use daily? Usually stick them on outside of shirt back area. They smell too strong for me. They still get bitten on the arms & exposed ankle portion
2. What to do if they are bitten & scratching crazily & cant sleep. Is baby Benadryl cream ok to use at their age?
3. Is it ok to dig into the bite to spread the toxin so it's not too concentrated itch?

Thanks

Answered by Dr Uma Alagappan, Associate Consultant, Dermatology Service, KK Women's and Children's Hospital

Dear Florence, 
Thank you for your questions.

1. Yes generally the Citronella stickers without chemicals are safe for use in children. However evidence has shown that these Citronella stickers may cause contact dermatitis in patients with eczema/sensitive skin. If you notice any rash or itch, please stop using it and consult a doctor.
2. Reactions to mosquito bites can be very itchy. Thus barrier methods (e.g. long-sleeved pants and shirts) and avoidance may be the most effective way to prevent the child from being bitten by mosquitoes. If the child has already been bitten, he/she will probably benefit from the use of anti-inflammatory topicals.
3. I would not recommend touching or scratching the affected area as that may cause further inflammation and discomfort.