Common childhood rashes — a parent's field guide

About this guide

Children get rashes constantly. Most are harmless, many are caused by viruses and go away on their own, and a few are the visible clue to something that needs treatment. The purpose of this guide is to help you recognise the common ones, know which are infectious and what the school rules are, and above all to recognise the small number of rashes that are emergencies.

It is a field guide, not a diagnosis. Rashes are genuinely hard to identify from a description, and even from a photograph, so if you are unsure, bring your child in.

The one test every parent should know: the glass test

Press the side of a clear drinking glass firmly against the rash.

• If the rash fades or disappears under pressure, it is “blanching”. Almost all common childhood rashes blanch.
• If the spots stay visible through the glass, the rash is “non-blanching”. Small red or purple spots that do not fade (petechiae), or larger bruise-like patches (purpura), in a child who has a fever or is unwell, are an emergency: go to a children’s emergency department or call 995. This is how meningococcal disease and some other serious infections present.

A few non-blanching spots on the face after hard vomiting or coughing, in a well child, are usually harmless, but if in doubt have them checked the same day.

Rashes that come with fever

These are mostly viral infections. The pattern of the fever and the timing of the rash are often the clue.

Roseola (sixth disease). Babies and toddlers from 6 months to 2 years. A high fever for 3 days in an otherwise reasonably well child, then a pink, blotchy rash on the trunk that appears as the fever settles. The rash is not itchy and fades in a day or two. No treatment is needed beyond comfort.

Hand, foot and mouth disease. Fever, sore throat and painful mouth ulcers, then small red spots or blisters on the palms, soles, buttocks and knees. Common in preschools, notifiable, and requires staying home until the blisters dry. See our HFMD guide.

Chickenpox (varicella). Fever and an intensely itchy rash that appears in crops: red spots that become small fluid-filled blisters, then crust over, so that spots at different stages are present at the same time, often including the scalp and inside the mouth. Infectious from a day or two before the rash until every spot has crusted, usually 5 to 7 days. The varicella vaccine is part of Singapore’s National Childhood Immunisation Schedule (NCIS), and chickenpox is now much less common. Treatment is comfort: calamine, cool baths, paracetamol (not ibuprofen, which is best avoided in chickenpox), and short nails to limit scratching. Newborns, pregnant women and anyone with a weakened immune system who is exposed should seek advice promptly.

Scarlet fever. A strep throat with a rash: fever, sore throat, then a fine, red, sandpaper-textured rash starting on the neck and chest, flushed cheeks with a pale ring around the mouth, and a “strawberry” tongue. This one needs antibiotics, and the child can return to school 24 hours after starting them.

Measles. Now rare in Singapore because of the MMR vaccine, but it still arrives with travel. High fever, cough, runny nose and red, watery eyes for 3 to 4 days, then a blotchy red rash starting at the hairline and behind the ears and spreading down the body. Measles is notifiable and highly infectious; if you suspect it, phone before you come so that we can see your child without exposing others.

Slapped cheek (parvovirus B19, fifth disease). A bright red rash on both cheeks, then a lacy pink rash on the arms and body that comes and goes for weeks, especially with heat. Mild in children. Pregnant women who have been in contact should tell their doctor.

Dengue. Fever, headache, aches and a flushed or blotchy rash, sometimes with small non-blanching spots as the illness progresses. Dengue circulates in Singapore all year. Use paracetamol only, not ibuprofen, and see our fever guide for the warning signs.

Kawasaki disease. Rare. Fever for 5 days or more with a rash, red eyes, red cracked lips, a red tongue, swollen hands and feet or a swollen neck gland. Needs hospital assessment.

Itchy rashes

Eczema (atopic dermatitis). Dry, red, itchy patches, on the cheeks and outer limbs in babies and in the elbow and knee creases in older children, that come and go. The commonest chronic rash in childhood. Daily moisturising and correct use of treatment creams control it well in most children. See our guides on everyday skincare, managing a flare and children with eczema.

Hives (urticaria). Raised, pink or skin-coloured, itchy wheals like mosquito bites that appear, move and fade within hours, often over days. In children the usual trigger is a viral infection, less often a food or a medicine. An antihistamine helps. Hives with swelling of the lips, tongue or eyes, wheeze, difficulty breathing, or a child who is pale and floppy is anaphylaxis: call 995. See our hives guide.

Heat rash (miliaria, prickly heat). Very common in Singapore. Tiny red bumps or clear blisters where sweat is trapped: the neck, chest, back, skin folds and under tight clothing. It settles with cooler surroundings, loose cotton clothing and avoiding heavy creams. It is not infectious.

Insect bite reactions (papular urticaria). Clusters of itchy bumps on exposed skin, often the lower legs and arms, from mosquitoes, sandflies or bed bugs, sometimes with a small central blister. Some children react strongly. Antihistamines and a mild steroid cream help; repellent and long sleeves in the evening prevent them. Scratched bites can become infected.

Scabies. Intense itch, worse at night, with tiny burrows and bumps between the fingers, on the wrists, and in babies on the palms, soles and trunk, often with other family members itching too. Needs prescription treatment for the whole household.

Infectious skin rashes without much fever

Impetigo (school sores). Bacterial infection: spots that weep and form honey-coloured crusts, often around the nose and mouth or on scratched bites and eczema. Very contagious by touch. Treated with antibiotic cream or, if widespread, tablets. Keep sores covered and the child home from school until 24 hours after starting treatment.

Molluscum contagiosum. Small, firm, pearly bumps with a central dimple, often in clusters, spread by skin contact and shared towels or baths. Harmless and self-limiting, but slow: they can take 6 to 18 months to clear. Treatment is not usually needed; children can attend school and swim.

Warts. Rough bumps on the hands, or flat, painful ones on the soles (verrucas). Most clear on their own over months to a couple of years. Treatment is optional.

Ringworm (tinea). Not a worm: a fungal infection causing a scaly ring with a clearer centre on the body, or scaly patches with hair loss on the scalp. Body ringworm responds to antifungal cream; scalp ringworm needs tablets. Pets are a common source.

Rashes in babies

Nappy rash. Red, sore skin in the nappy area from moisture and friction. Frequent changes, gentle cleaning, nappy-free time and a barrier cream (zinc oxide) settle it. A rash that is bright red, in the skin folds, with small spots at the edges is usually a yeast (candida) infection and needs an antifungal cream.

Cradle cap. Greasy, yellow scales on the scalp of young babies. Harmless; softened with baby oil and gently brushed away.

Baby acne and milia. Small red pimples or tiny white bumps on the face in the first weeks. Clear on their own; no creams needed.

Erythema toxicum. Blotchy red patches with tiny yellow-white centres in the first days of life, in a well newborn. Harmless and gone within a week.

Drug rashes

A new widespread pink rash a few days into a course of antibiotics, particularly amoxicillin, is common and is often caused by the underlying virus rather than a true allergy. It matters for future prescribing, so please tell us about it rather than deciding on your own that your child is “allergic to penicillin”. A rash with swelling, wheeze, blistering, peeling, mouth ulcers or fever while on a medicine needs same-day assessment.

Quick reference

Go to a children’s emergency department or call 995

• A non-blanching rash (fails the glass test) in a child with fever or who is unwell
• A rash with swelling of the face, lips or tongue, wheeze or difficulty breathing
• A rash in a child who is drowsy, floppy, hard to wake, or in severe pain
• Widespread blistering or peeling skin, especially with fever or a very sore, red skin
• In a child with eczema, a sudden crop of small punched-out sores or blisters with fever (possible eczema herpeticum)
• A rash with fever lasting 5 days or more
• A stiff neck, severe headache or a bulging fontanelle with a rash

When to see a doctor

Come in if:

• You do not know what the rash is, or it is spreading or changing
• The rash is painful, weeping, crusted or hot, which may mean infection
• Your child has fever with a rash and you need a diagnosis, advice on infectiousness, or a medical certificate for school
• The rash is very itchy and disturbing sleep
• A rash has not improved after a week of the usual measures, or keeps coming back
• Your child has a rash and is on a new medicine
• Someone in the household is pregnant, newborn or immunocompromised and your child has an infectious rash

How we manage childhood rashes at our Punggol clinic

Children with rashes are seen as walk-ins, Monday to Saturday, and can be booked online. For a chronic or complicated skin problem, a longer skin appointment with Dr Kenneth Tan, Family Medicine Specialist with a special interest in dermatology, is available by appointment.

• A proper look at the whole child, not just the patch you noticed: distribution, timing, fever, mouth, hands and feet, and how the child is behaving.
• Dermoscopy where it helps distinguish one rash from another, and skin scrapings or swabs for suspected fungal or bacterial infection.
• Clear advice on infectiousness and school, with a medical certificate or clearance letter where needed, and notification to MOH for notifiable diseases such as HFMD and measles, which the clinic handles.
• Treatment that matches the cause, whether that is nothing more than reassurance, an antihistamine, a barrier or antifungal cream, an antibiotic, or a written eczema plan.
• Prompt referral to a children’s emergency department or a dermatologist when a rash is serious, unusual or not responding.

Cross-links

• Fever in children
• Hand, foot and mouth disease
• Children with eczema, and when to call us
• Hives (urticaria)
• Childhood vaccinations (NCIS): MMR and varicella prevent several of the rashes above

Get in touch

Punggol: 658 Punggol East, #01-04, Singapore 820658 · Tel 6312 4589 · Walk-ins welcome Mon–Sat

Joo Chiat: 172 Joo Chiat Road, #01-01, Singapore 427443 · Tel 6920 1952 · By appointment

Email: admin@ktmc.sg

References

• National Institute for Health and Care Excellence (NICE). Fever in under 5s: assessment and initial management. NICE guideline NG143. 2019, updated 2021. nice.org.uk
• HealthHub, Ministry of Health Singapore. Common childhood rashes, Chickenpox, Hand, foot and mouth disease, Measles. healthhub.sg
• Ministry of Health Singapore. National Childhood Immunisation Schedule (NCIS) and List of legally notifiable diseases under the Infectious Diseases Act. moh.gov.sg
• KK Women’s and Children’s Hospital (KKH). Skin conditions in children, patient information. kkh.com.sg
• Agency for Care Effectiveness (ACE). Mild and moderate atopic dermatitis (eczema): a journey from flare to care. ACE Clinical Guideline, Ministry of Health, Singapore. February 2026.
• NHS. Rashes in babies and children. nhs.uk
• Meningitis Research Foundation. The glass test. meningitis.org

This information is for general education only and is not a substitute for medical advice. Rashes are difficult to identify from descriptions; if you are unsure, please have your child seen. v1.0 · September 2026 · Review due September 2028.