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When is a spot not a spot? - check out our guide; It's often tough to tell if your child's spots are just itchy and sore or a symptom of something more sinister. Here Jackie Hall, team leader of Health at Hand nurses for AXA PPP healthcare, gives the lowdown on which spots to worry about.

Byline: Jackie Hall

Any new parent will tell you that spots can make them anxious, and even the more experienced ones can still have sleepless nights over unusual rashes.

It's not easy for parents to know whether a rash or skin changes indicate a serious medical problem and whether further medical assessment is needed.

A rash can give a clue to the type of illness but other signs and symptoms are just as important in determining how serious an illness may be.

Here is a lists some of the most common spots and rashes to watch out for: | MENINGITIS What do I need to look for? A child with meningitis would normally be very unwell with reddish/purple spots which look a little like tiny fresh bruises on the skin. The key is that these do not blanch in colour when you press on them.

The glass test is a very useful way to check. This is if you press the side of a clear glass firmly against the skin and the rash doesn't fade, it's a sign of blood poisoning (septicaemia) and you should seek medical attention immediately.

The rash may be harder to see on darker skin so check for spots on the paler areas, such as the palms of the hands, soles of the feet or the abdomen.

How is it treated? If meningitis is suspected then the child must go immediately to an accident and emergency department.

Is it contagious? Bacterial meningitis can be contagious and you will be advised by the professionals looking after your child of actions that need to be taken.

| MEASLES Measles is a highly infectious, unpleasant viral illness that has some characteristic features to distinguish it from other viruses. Furthermore, it has the potential to cause serious complications.

What do I need to look for? A mass of red spots break out around the neck, behind the ears and face but can appear elsewhere too, including the inside of the mouth.

Measles can result in serious complications, but thanks to vaccination programmes the incidence of outbreaks is low.

Initial symptoms of measles can include: | A runny or blocked nose | Sneezing | Watery eyes | Swollen eyelids | Sore, red eyes that may be sensitive to light | A fever | Small greyish white spots in the mouth | Aches and pains | Cough | Loss of appetite | Tiredness, irritability and a general lack of energy How is it treated? You should contact your GP as soon as possible if you suspect that you or your child has measles.

It's best to phone before your visit as your GP surgery may need to make some arrangements to reduce the risk of spreading the infection to others.

There's no specific treatment for measles, but the condition usually improves within seven to 10 days.

If the symptoms of measles are causing discomfort for you or your child, there are some things - you can do to treat these while you wait for your body to fight off the virus. | Rest and drink plenty of fluids to avoid dehydration.

| Paracetamol or ibuprofen can be used to reduce a fever and relieve any aches or pains if you or your child is uncomfortable. (Aspirin should not be given to children under 16). Speak to your pharmacist if you are not sure which medications are suitable for you child.

Is it contagious? Stay away from work or school for at least four days from when the measles rash first appears to reduce the risk of spreading the infection.

It's important to avoid contact with people who are more vulnerable to the infection, such as young children and pregnant women.

You can avoid catching measles by having the measles, mumps and rubella (MMR) vaccine.

Measles is unlikely in people who are fully immunised or who have previously contracted the infection.

Vaccination with one dose of the combined measles, mumps, and rubella (MMR) vaccine should provide about 90% immunity.

However, vaccination with two doses of the MMR vaccine, as indicated by the UK Childhood Immunisation Programme, is thought to provide close to 100% lifelong immunity.

| GERMAN MEASLES (RUBELLA) What do I need to look for? This is usually a mild illness with small red spots appearing on the face at first and then spreading to other parts of the body.

Other symptoms include swollen glands and a cold-like illness. It's rarely seen nowadays in the UK, thanks to routine vaccination.

It is, however, of serious concern if a pregnant woman catches the virus in the first 16 weeks of pregnancy because it can cause birth defects in her baby.

How is it treated? You should always contact your GP if you suspect rubella. It's best to phone before your visit as your GP surgery may need to make some arrangements to reduce the risk of spreading the infection to others.

There's no specific treatment for rubella. The condition is usually mild and improves without treatment within seven to 10 days.

If the symptoms of rubella are causing discomfort for you or your child, there are some things you can do while you wait for the infection to pass: | Rest and drink plenty of fluids to avoid dehydration.

| Paracetamol or ibuprofen can be used to reduce a fever and relieve any aches or pain. (Aspirin should not be given to children under 16). Speak to your pharmacist if you are not sure which medications are suitable for you child.

Is it contagious? While you have rubella, it's important to reduce the risk of spreading the infection to others.

If you or your child has the condition, you should avoid work or school for four days from when you first develop the rubella rash.

In rare cases, rubella can cause serious problems in an unborn baby, so you should also try to avoid contact with pregnant women for four days from the start of the rash.

If you are pregnant and develop a rash or have been in contact with someone who has a rash, contact you GP or midwife immediately.

| NEONATAL HEAT SPOTS What do I need to look out for? These small red spots with a tiny white pimple on top appear on the face, neck and upper chest. They are the result of immature sweat glands becoming blocked when the baby gets hot.

They are very common and usually of no concern and will disappear after a few months.

| ALLERGIC WHEALS What do I need to look out for? These are blistery, reddish, raised blotches to the skin which can appear rapidly on different parts of the body.

They tend to be itchy and are usually due to exposure to an allergen eg. animal hair/dander, grasses or foods/additives.

How is it treated? Antihistamines such as Piriton can be helpful in reducing symptoms and progression.

Most often the rash settles quickly over 24 hours but if there is associated swelling of the face, lips or any breathing problems, call 999.

Is it contagious? Allergic wheals are not contagious. This is because allergic reactions are a result of the unique response of each individual's immune system to certain triggers.

Substances that cause a reaction in one person may not cause a reaction in someone else.

| SLAPPED CHEEK SYNDROME What do I need to look for? This is caused by parvovirus and causes a bright red rash on the cheeks. It is accompanied by slight fever and the child will feel mild or moderately unwell but get better after a few days.

How is it treated? Slapped cheek syndrome is usually mild and should clear up without specific treatment.

If you or your child is feeling unwell, you can try the following to ease the symptoms: | Rest and drink plenty of fluids: babies should continue their normal feeds. Dehydration poses the greater risk, particularly in the young | For a fever, headaches or joint pain you can take painkillers, such as paracetamol or ibuprofen. Aspirin should not be given to children under 16 years old | To reduce itchiness, oral antihistamines can be taken and/or emollients used Pregnant women, those who have a blood disorder, a weakened immune system or those with symptoms of severe anaemia, such as very pale skin, shortness of breath, extreme tiredness or fainting should contact their GP.

Is it contagious? The virus is spread by inhaling droplets that are sneezed or coughed out by someone infected or by touching a contaminated surface or object and then touching your mouth or nose.

It's very difficult to prevent slapped cheek syndrome because people who have the infection are most contagious before they develop any obvious symptoms. However, making sure that everyone in the household washes their hands frequently may help stop the infection from spreading.

Unless you or your child is feeling unwell, there's no need to stay away from school or work once the rash has developed.

It is however a good idea to notify your child's school about the infection so children who develop early symptoms can be spotted quickly and vulnerable people can be made aware that they may need to get medical advice.

| ECZEMA What do I need to look for? Dry or inflamed patches of skin typically form on creases of elbows and behind knees, but can occur anywhere on the body.

How is it treated? Treating eczema fundamentally involves breaking the scratch-itch cycle and replenishing the moisture content of the skin.

It will normally respond well to the regular use of emollients/moisturisers and topical steroid preparations for flare ups.

It is not possible to "overdose" on moisturisers and what may work for one person, may not for another.

Steroid preparations are useful in managing flare-ups but should be used as prescribed. There are also specific bath additives/shower gels/ soaps that are targeted to help manage eczema.

Is it contagious? Eczema is not contagious. It is a chronic skin condition, most prevalent in childhood.

| MOLLUSCUM What do I need to look for? Little crops of raised, fluid-filled blisters can occur anywhere on the body or limbs. These spots are harmless and the child will not be unwell but they are contagious and spread by person to person contact.

How is it treated? It can take up to 18 months for these to clear. Usually no treatment is needed as they clear on their own.

Is it contagious? Resolution is spontaneous but it is contagious. It can be spread through close direct contact.

If you become infected by the virus and spots appear on your skin, the virus can also spread to other areas.

It is not known how long someone with molluscum is contagious for, but it is thought the contagious period may last up until the last spot has completely healed.

| CHICKEN POX What do I need to look for? At first your child will seem a bit off-colour, they may be off their food and quite lethargic for a few days.

Then a few, itchy, red, raised spots on the neck, face, chest or back or other body parts will start to appear.

These turn into little fluid-filled blisters which can be itchy and painful.

The child can be infectious for several days before spots appear, and for five days or more after spots become visible.

How is it treated? Chicken pox is usually mild and can be self-managed from home. Most people feel better within a week or so. But some people can become more seriously ill and need to see a doctor. There's no cure but the treatment below can help relieve the symptoms while the body fights the infection. | Rest and drink plenty of fluids to avoid dehydration.

| For a fever, painkillers can help such as paracetamol. Ibuprofen shouldn't be given to children with chicken pox as it can make them very ill and do not give aspirin to children under 16.

*Always read the packet or leaflet that comes with the medicine to check it's suitable and how much to take. Speak to a pharmacist or your GP if you're unsure.

You can buy topical preparations to apply directly onto the rash or administer an oral antihistamine to help reduce itching and soothe the skin- some antihistamines are not suitable for young children, so check with your pharmacist first.

An antiviral medicine called Aciclovir may be recommended if there is a risk of severe chickenpox and you already have symptoms. It ideally needs to be started within 24 hours of the rash appearing.

Is it contagious? Chicken pox is highly contagious and can make some people very ill, so it's important to try and avoid spreading it to others.

If you or your child has chickenpox, stay away from nursery, school or work until all of the blisters have dried up and scabbed over.

This usually happens five or six days after the rash first appears. You may continue to have spots on your skin for another week or two, but you're no longer contagious if the spots are dry and scabby.

| IMPETIGO What do I need to look for? This often begins as a red patch of skin often around the nose or mouth but can occur anywhere on the body. The red patches then become a crusty/brownish colour after a few days.

It is caused by overgrowth of skin bacteria and can easily be cleared by antibiotics, although spreads easily if left untreated.

Speak to your GP if you think you or your child may have symptoms of impetigo. Impetigo isn't usually serious, but it can sometimes have similar symptoms to more serious conditions such as cellulitis so it's important to get the correct diagnosis.

How is it treated? Impetigo usually gets better without treatment in a few weeks.

However, treatment is often recommended because it can reduce the length of the illness to around seven to 10 days and can reduce the risk of spreading the infection to others.

Hygiene measures alone even for small, localised lesions are not recommended. The main treatments prescribed are antibiotic creams or oral antibiotics and duration of treatment is usually one week.

Is it contagious? During treatment it's important to take precautions to minimise the risk of impetigo spreading to other people or to other areas of the body.

Most people are no longer contagious after 48 hours of treatment or once their sores have dried and healed. It's important to stay away from school or work until then.

To help prevent the risk of infection spreading: | Don't share flannels, bedding or towels with anyone who has impetigo.

| Wash and loosely cover the sores.

| Avoid touching or scratching the sores.

| Avoid contact with newborn babies, preparing food, playing contact sports, or going to the gym until the risk of infection has passed.

| Wash your hands frequently | Washable toys should be washed.
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Publication:South Wales Echo (Cardiff, Wales)
Date:Sep 19, 2018
Words:2458
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