SALT LAKE CITY — The world of health and medicine can be confusing to many parents. But Nurse Suzy is here to help clarify some of the issues that are important to you and your family.

Question:

How do I know if a rash is serious and needs medical attention or if I can treat it myself at home?

Answer:

This can be very complicated because a rash can be an indicator of poor skin care or a sign that something more serious is going on, and anything in between. So, let's start with the minor rash and work our way to more serious situations.

Dry, irritated skin

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If you do not keep your environment reasonably clean, bacteria can irritate your skin and cause redness and itching. At the same time, if you over clean your environment or skin, you will develop irritated skin and rashes, which crack and dry the skin — the damaged skin provides a place for bacteria to live, thus perpetuating the cycle.

To treat these conditions, first make sure you care for your skin by cleaning it regularly but not excessively. Your skin can only take so much scrubbing before its normal oils are dried up and gone.

I recommend using regular, inexpensive lotions often. In the dry air of the winter, I would say you need to lotion your body at least two times a day — some people may need more.

Also, avoid perfumed lotions because the perfume usually includes alcohol, or a similar chemical, that will dry your skin.

Eczema

The most common rash in the Mountain West is eczema, but doctors do not know its exact cause. According to MedicineNet.com, some forms can be triggered by substances that come in contact with the skin — such as soaps, cosmetics, clothing, detergents, jewelry or sweat. Environmental allergens may also cause outbreaks of eczema. In some people, changes in temperature or humidity, or even psychological stress, can lead to outbreaks.

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Eczema most commonly causes dry, reddened skin that itches or burns. “Intense itching is generally the first symptom in most people with eczema,” MedicineNet.com states. “Sometimes, eczema may lead to blisters and oozing lesions, but eczema can also result in dry and scaly skin. Repeated scratching may lead to thickened, crusty skin.”

The treatment that I find works the best is Eucerin cream, or a similar generic brand. Put it on thick, rub it into the skin just a little, and let the rest absorb on its own. You will need to do this twice a day until the eczema patch is gone.

In my experience, cortisone creams don’t work as well as the Eucerin cream, and can sometimes make the eczema worse. The price of cortisone creams can be a concern as well.

Infections

General rashes that cover the trunk of the body have several different causes, including measles, roseola, allergies, etc. These kind of rashes need to be taken more seriously because of the consequences they lead to. If you suspect one of the following rashes, you should seek medical help.

• Measles are very contagious. A typical case actually starts with a fever, runny nose, hacking cough and red eyes. After two to four days of these symptoms, the patient may develop spots within the mouth. “These spots look like little grains of white sand surrounded by a red ring, and are usually found inside the cheek toward the back of the mouth,” MedicineNet.com states. The rash appears three to five days after the cold-like symptoms begin and can last five or six days. It is red, and typically flat (not raised or rough). It begins at the hairline and slowly works its way down the body.
• Roseola infections vary depending upon the age of the patient. In infants and toddlers, roseola typically begins with a sudden high fever, runny nose and swollen glands. The red, blotchy rash appears within 12-24 hours of the fever breaking. This infection rarely occurs in adults.
• Scarlet fever also starts suddenly, but with a sore throat and fever. The rash shows up two days later, beginning on the chest and trunk and spreading to the arms and legs. It looks similar to the roseola rash, but more concentrated and pronounced. It is also rough to the touch. HivesOrdinary hives flare up suddenly and usually for no specific reason. Welts appear, often in several places. They flare, itch, swell, appear like water blisters and go away in a matter of minutes to hours, only to appear elsewhere. This sequence may go on from days to weeks. Most episodes of hives last less than six weeks. Hives which last more than six weeks are often called "chronic."

Make sure you always have Benadryl on hand if you're prone to hives. You can buy Benadryl over the counter at 25 mg per pill. If you are having an allergic reaction with hives, take two pills immediately and seek medical help. Hives often signal an allergic reaction to medication, perfumes, etc.

I have only mentioned a few skin rash conditions here. In general, if you have a rash that is not going away with lotion, cleaning or removing irritants, or using over the counter medication, you must seek medical help to make sure it is not a symptom of something more dangerous.

Suzanne Carlile, "Nurse Suzy," has been a nurse since 1982. Her main focus is critical care and nursing education. She holds a master's degree in nursing, is a Certified Emergency Nurse, and a member of NNSDO Intermountain West Chapter.

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