Dots and Spots, When Your Child’s Rash Requires Medical Attention


Let’s face it, your child’s skin is perfection. Plump, soft and smooth. So, when a rash affects your baby or child, how do you know if it’s a big deal (requiring a visit to your pediatrician) or something you can manage on your own? After years in the trenches, here are my top 10 guidelines to help you decide – and of course, when in doubt, calling or emailing your doctor for advice is certainly the gold standard!

10 Foolproof Signs You Need to Bring Your Child to the Doctor

  1. If your child’s skin looks very pale to you, or has bluish or grey undertones: this could be a sign of iron deficiency, or even an issue with oxygen supply. Don’t fool around here. Get your child evaluated immediately.
  2. If there is unexplained bruising in places that normally shouldn’t be bruised, or if there are tiny purple dots (called petechiae) – time for a call and a visit. Abnormal bruising or petechie can be signs of a clotting issue, a viral infection, a widespread infection or even a drug reaction.
  3. If a little rash becomes bigger or more widespread, especially if your child is feeling ill and/or has a fever – typically this is a no-brainer for a parent.
  4. If a rash or lesion is painful to the touch, or you see spreading redness and/or tenderness from the original lesion – this is typically a sign that a small infection has become larger.
  5. Blistering lesions or rashes – whether from a burn site or blistering from another reason, these requires a look – typically we may see chicken pox, a drug or local allergic reaction, or even shingles in some kids. Burns that blister require special care and caution.
  6. Puffy skin – if your child starts developing puffy ankles, wrists, belly, or eyes, this could be a sign of a kidney issue – and requires immediate attention.
  7. Growing or changing moles – just as we advise adults with changing moles to come in, same goes for our kids. Sometimes, albeit rare, we can see dangerous moles in children.
  8. Itchy rashes that disrupt sleep/quality of life – whether it’s an eczema flare out of control, hives, or itch that doesn’t come with a rash, typically your pediatrician can figure out the cause and a way to make your child more comfortable.
  9. When you suspect a foreign body, and you can’t get it out – so important for us to see it sooner, rather than later. Most foreign bodies may dig deeper with time, and with that comes risk of infection. Let us take a look if you are in doubt, or you see pus, spreading redness, or localized pain.
  10. When suddenly a little pimple looks like an angry spider bite – many parents think this is the case, when in fact your child may have an angry staph infection that may require opening and drainage. NEVER squeeze these….you can worsen the situation greatly.

And of course, when in doubt, go to the doctor! You’ll get the answers and peace of mind you need.



About Dr. JJ Levenstein

Dr. JJ Levenstein is a board-certified pediatrician and fellow of the American Academy of Pediatrics and in 2012 retired from her thriving private pediatric practice in Encino, California. She served on the staff of CHLA and Encino Tarzana Hospitals for 20 years and was consistently voted one of the Best Doctors in America® from 2003 through 2012. Drawing from her experience as a pediatrician and mom, Dr. Levenstein serves as president and co-founder of MD Moms, makers of Baby Silk, the first personal care line for babies developed by pediatrician moms. She serves on the board of United Cerebral Palsy LA, is an active writer and sits on the advisory boards of several child-centered websites. She is an accomplished chef and completed culinary school in 2013! She has had a lifelong interest in child nutrition and all things related to preventive health.

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