Treating COVID Rash in Kids

A rash in kids is a typical COVID-19 symptom. Skin rashes are common throughout childhood and can have various causes. A rash on the toes is often associated with the COVID-19 infection. Rashes linked to the COVID virus can appear in many ways, but this toe rash—dubbed "COVID toes"—is one of the most common.

This article will explore what else to look for in a COVID-19 rash, potential complications, and how to treat COVID-19 rashes in kids.

Rash and COVID Risk in Children

Rashes with a COVID-19 infection can appear in a few different ways.

COVID toes is the most common rash among people who have tested positive for COVID-19. It can appear with or without other COVID-19 symptoms and can affect the toes, fingers, or both. It usually appears with discolored spots and may include some swelling and discharge.

Other forms of rashes that can appear include:

• Maculopapular rash appears darker than the natural skin tone with flat or raised portions. It usually appears in children's extremities (arms and legs). The skin dries and flakes off as the rash heals.
• Erythematous eruptions are raised, discolored, and scaly and are common in several inflammatory and autoimmune conditions.
• Urticaria is a raised, itchy rash that often develops with allergic reactions.
• Chilblains are small, itchy bumps that resemble blisters. They can be discolored and often appear after exposure to cold temperatures. It usually clears up without treatment in seven to 10 days.

It's difficult to estimate how many children have developed a rash with COVID-19 since children who have a rash but no other symptoms might not be tested. An estimated 20% of adults who contract COVID-19 experience some skin-based symptoms, but studies estimate that rate is closer to 15% in children.

Children with skin symptoms during a COVID-19 infection usually get rashes or other symptoms during the active infection phase. However, some may develop rashes after being treated with certain medications like hydroxychloroquine.

Complications of COVID Rash

Rashes that appear with COVID-19 typically resolve after recovering from your infection. In children, a rash can be the only COVID-19 symptom. When rashes appear with other symptoms, it may indicate a more severe illness.

In children, the most common complication of a severe COVID-19 infection is multisystem inflammatory syndrome (MIS-C). This rare condition can occur two to six weeks after the onset of COVID-19. Children who develop MIS-C during or after a COVID-19 infection experience inflammation that leads to additional symptoms like:

• Bloodshot eyes
  
• Diarrhea
• Dizziness
• Skin rashes
• Stomach pain
• Vomiting

Skin rashes are one of the more common signs of an MIS-C reaction in children with COVID-19. MIS-C-related inflammation can impact many areas of the body, like the heart, lungs, kidneys, brain, and eyes.

How to Tell If a Child Has a Rash from COVID

Children can develop rashes for all kinds of reasons, not just COVID-19. A healthcare provider can perform testing to identify some rashes, but the best way to confirm whether COVID-19 is the cause of a rash is to perform a diagnostic test.

Some children who develop rashes from COVID-19 may have a negative test result on PCR testing since rashes usually appear later in the infection. Antibody testing may give more accurate results, but most rashes will clear without treatment as the infection resolves.

Other Potential Causes

Common causes of rashes in children include the following:

• Allergies
• Bacterial infections
• Eczema
  
• Fungal infections
• Hand, foot, and mouth disease
• Overheating
• Insect bites
• Plant reactions (e.g., poison ivy)
• Viral infections
  

COVID-19 isn't the only infection that can cause a skin rash. Viral illnesses like roseola, measles, and chickenpox (varicella) can also cause skin rashes. There are few cures for viral infections, and the infections and related symptoms—like a rash—can take several weeks to resolve.

Kid-Friendly COVID Rash Treatments

There are no cures for viral illnesses like COVID-19. Healthcare providers often recommend supportive care, such as over-the-counter (OTC) fever reducers, decongestants, or cough suppressants to relieve symptoms.

Similarly, there is no specific treatment for a skin rash with COVID-19. However, moisturizing creams or anti-inflammatory ointments can help relieve symptoms like itching and inflammation. Depending on the child's age, treatments may include:

• Topical corticosteroids
• Topical antibiotics
• OTC pain relievers
• Antihistamines

How to Lower Rash and COVID Risk

Anyone can become infected with COVID-19.

Vaccinations are available to help reduce your chances of being infected—though some people have had skin reactions to the vaccine. Beyond vaccination, you can limit your risk of contracting COVID-19 by:

• Avoiding people that you know are sick
• Washing your hands often
• Wearing a mask or distancing yourself from others in crowded areas

Summary

Rashes and other skin problems are symptoms of a COVID-19 infection. Many of these rashes develop later in the infection and may even be the only symptom—especially in children. COVID-19 rashes usually resolve without treatment, but topical steroids, antibiotics, oral pain relievers, or antihistamines can help manage symptoms.