Rashes and Skin Lesions

Skin rashes and lesions can be very difficult to diagnose without seeing in person.  However, the Society for Pediatric Dermatology has a lot of helpful information, photos and handouts that inform on the most common childhood dermatologic issues.  If you are concerned about your child’s rash or lesion, please call for an appointment so we can see it in 3-D!


The medical term for “pimples” is acne or acne vulgaris (vulgaris means “common”). Most people get some acne. Acne does not come from being dirty; rather, it is an expected consequence of changes that occur during normal growth and development. Hormones, bacteria, and your family’s tendency to have acne may all play a role.  For more information:


Isotretinoin (Accutane)

Isotretinoin is a retinoid medication that is taken by mouth to treat severe nodular acne. Typically, it is used once other acne treatments have not worked, such as oral antibiotics. Usually isotretinoin is taken for 4 to 6 months, although the length of treatment can vary from person to person.


Alopecia Areata

Alopecia means hair loss, and there are several types. Alopecia areata is one of the most common hair loss disorders characterized by loss of hair in round patches, usually on the scalp.


Allergic contact dermatitis

Contact dermatitis is an itchy rash that is caused by something touching (contacting) your skin. The rash is usually red, bumpy, and itchy. Sometimes there are blisters filled with fluid.



Atopic dermatitis, also called eczema, is a common and chronic skin condition in which the skin appears inflamed, red, itchy and dry. It is common in thin areas of the skin such as around the eyes, and the flexural aspect of the elbows and knees.
Atopic dermatitis is most likely caused by a combination of genetic and environmental factors. Genetic causes include differences in the proteins that form the skin barrier. When this barrier is broken down, the skin loses moisture more easily, becoming more dry, easily irritated, and hypersensitive. The skin is also more prone to infection (with bacteria, viruses, or fungi). The immune system in the skin may be different and overreact to environmental triggers such as pet dander and dust mites.


Infantile hemangiomas are collections of extra blood vessels in the skin. They are benign (i.e., they are not cancerous) and most often appear during the first few weeks of life.


Propanolol for Hemangiomas

Most hemangiomas do not require any treatment; however, a small number do require treatment because of complications potentially caused by the hemangioma. Sometimes treatment is needed if the hemangioma is growing too large or if there is a risk of permanent scarring or disfigurement (damage to the appearance). Treatment may also be necessary if the hemangioma is affecting a vital function, such as vision, eating or breathing, or to help with healing when the skin overlying the hemangioma starts to break down; this is called ulceration. Propranolol has become the most widely used medication for the treatment of serious complications from hemangiomas.


Moles and Melanoma

“Moles” (melanocytic nevi) are common, raised or flat skin lesions that contain an increased number of melanocytes. Melanocytes are the cells in our skin that make pigment (melanin), which accounts for our skin color. Moles are most often tan or brown in color, but sometimes they can be skin-colored, pink, or even blue.

Moles may be present at birth (congenital melanocytic nevi; see below) or may develop during childhood or young adulthood (acquired melanocytic nevi). Moles tend to increase in number during the first two decades of life, and teenagers often have a total of 15-25 moles. Sun exposure can stimulate the body to make more moles.


Hidradenitis suppurativa

Hidradenitis suppurativa is a chronic condition of painful bumps and draining sores of the skin. It usually affects the skin folds, such as the underarms, buttock crease, and groin area.



Sweating is a normal body function that helps control temperature. Sweat evaporates from the skin and cools the body. Heat and emotion will make most people sweat. Hyperhidrosis is too much sweating. It is more than what is needed to control body temperature.


Infections of the skin

Staphylococcus aureus (“Staph”) and Streptococcus pyogenes (“Strep”) are the bacteria that cause most skin infections. Examples include:

  • Impetigo
  • Folliculitis and furuncles
  • Abscesses
  • Cellulitis


Keratosis pilaris

Keratosis pilaris (KP) is a common bumpy rash. It is usually found on the outer upper arms, upper thighs, and cheeks. It looks like small bumps that are skin colored or red, caused by a build up of extra skin protein (keratin). The bumps can feel like “goose bumps” or sand paper. KP can be itchy for some people, but usually there are no symptoms. The skin can become irritated if it is very dry or if the bumps are picked or scratched. A moisturizer (lac-hydrin or am-lactin) containing urea or lactic acid (to break down the extra skin protein) can help.



Molluscum contagiosum is a viral skin infection seen most commonly in young to school-age children. It typically causes small bumps on the skin, which can occur anywhere on the body. Molluscum are usually small, flesh-colored to pink bumps with a shiny appearance and slightly depressed center. We can treat these in the office with a painless chemical called canthridin.


Nevus Sebaceus

A nevus sebaceus (also known as “nevus of Jadassohn”) is an uncommon type of birthmark seen in about 0.3% of newborns. This type of birthmark is a small area of skin that has too many oil glands that grow larger than normal. Most of the time a nevus sebaceus is noticed right at birth, but sometimes it might be subtle and not noticed until later in childhood.


Perioral dermatitis

Perioral (or periorificial) dermatitis is a common acne or rosacea-like rash that develops around the mouth, nose and eyes of children and young adults. While steroids are sometimes used to treat this condition, they can also make it worse; it is often treated with antibiotics such as metrogel instead.


Papular urticaria

Papular urticaria is an increased sensitivity to bug bites that causes long-lasting bumps.



Pilomatricoma or pilomatrixoma is a benign (non-cancerous) bump under the skin. Pilomatricomas grow from cells in the hair follicle (where the hair forms) They feel like a small, hard lump (like a pebble) under the skin.


Port Wine Stain

A port-wine stain is a type of birthmark made of dilated small blood vessels in the skin. It is also called a capillary malformation. This type of birthmark is usually present at birth. It can appear as light red or darker red to purple discolorations on any part of the body but is most common on the forehead, nose, cheek and chin. Port-wine stains usually grow in proportion to the growth of the child. Unlike hemangiomas, a more common type of vascular birthmark in children, port-wine stains are flat, do not grow quickly, and do not go away on their own.


Psoriasis is a common, chronic condition in which red plaques with thick scales form on the skin. We do not yet know what causes psoriasis, but we do know that the immune system and genetics play major roles in its development.


Pyogenic granuloma

A pyogenic granuloma (PG) is a benign (not cancerous) red bump made of newly formed small blood vessels.



Scabies is a common skin problem caused by the human itch mite. People of any age, race and social group can get scabies, regardless of personal hygiene.


Skin cancer

While skin cancer is the most common type of cancer in adults, it is rare in children. Some children are more likely to get skin cancer because of factors in their health or family history. Most moles in children will grow slightly as their bodies grow, but any significant growth (doubling of the lesion in a short time) or changes in its color, texture, or shape means it should be evaluated.  This handout discusses what you need to know about recognizing, treating and preventing pediatric skin cancer.


Spitz nevus

A pyogenic granuloma (PG) is a benign (not cancerous) red bump made of newly formed small blood vessels.



What to use, how to use it:



Tinea is a fungal infection of the skin, hair or nails. These fungal infections are named for where they occur on the body. Small areas of tinea on the skin can usually be treated with topical antibiotics like clotrimazole or Lamisil, but infections of the hair and nails often require oral antifungals.


Urticaria (hives)

Hives are itchy areas of swelling in the skin caused by a substance called histamine. Hives may be caused by many different things, but in children viral illnesses are the most common cause. Anti-histamine medications such as Benadryl and Zyrtec are most effective in treating hives.



Vitiligo is a condition where individuals develop patches of white or lighter-colored skin. This results from destruction or reduction of melanocytes, the cells that produce pigment in our skin, so that they cannot properly function. The cause of vitiligo is not clearly understood, but it appears in most cases to be an autoimmune condition limited to the skin.



Warts are common viral infections caused by the human papilloma virus (HPV). There are many different strains of this virus causing different types of warts and specific tests are usually not necessary