As a pediatrician, one of the most frequent concerns we hear from parents is: “My child has a rash, what could it be?” Skin rashes in children are common and often linked to viral or bacterial infections. While most are mild and self-limited, some require medical attention.
This post will review several of the classic rashes seen in children, describe what they look like, how long they take to appear, and other symptoms you may notice.
1. Measles (Rubeola) (First Disease)
Incubation period: 7–14 days after exposure
Symptoms: Fever, cough, runny nose, red eyes, and tiny white spots inside the mouth (Koplik spots).
Rash description: Begins on the face (often at the hairline) and spreads downward to the trunk and limbs. The rash is blotchy, red, and can merge together.
➡️ Measles is highly contagious and preventable with the MMR vaccine.
2. Scarlet Fever (Second Disease)
Incubation period: 2–5 days after exposure to strep bacteria
Symptoms: Sore throat, fever, swollen tonsils, sometimes a “strawberry tongue.”
Rash description: Fine, red, sandpaper-like rash that usually starts on the neck and chest, then spreads to the rest of the body. The skin may peel during recovery.
➡️ Caused by group A streptococcus; requires antibiotics.
3. Rubella (German Measles) (Third Disease)
Incubation period: 14–21 days
Symptoms: Mild fever, swollen lymph nodes (especially behind the ears), cold-like symptoms.
Rash description: Starts on the face and quickly spreads downward. The pink, spotty rash usually clears within 3 days.
➡️ Usually mild but dangerous in pregnancy; prevented by the MMR vaccine.
4. Fifth Disease (Erythema Infectiosum)
Incubation period: 4–14 days (sometimes up to 21 days)
Symptoms: Mild cold symptoms, low fever, fatigue.
Rash description: It starts off with a rash to both sides of the face that looks like a sunburn or bilateral slapped cheek like appearance. The following day a rash develops on the extensor surfaces of the arms and legs and less often on their trunk and buttocks. Rash will start to fade proximally after a few days giving a lacy or reticulated appearance. The rash can last anywhere from 3 to 23 days with an average duration of 9 to 11 days. Even when the rash fades it often flares in response to friction, temperature changes (such as warm baths) or sun exposure. It should be noted that once the rash appears the patient is no longer contagious. Children often have no symptoms: but sometimes they can have a low-grade fever or mild joint aches.
➡️ Caused by parvovirus B19. Generally mild in healthy children.
5. Hand, Foot, and Mouth Disease
Incubation period: 3–6 days. Virus may be shed for several weeks after the infection starts. Respiratory shedding of the virus is usually limited to a week or less.
Symptoms: The most troublesome finding are the blisters in the mouth, which make it difficult for the child to eat or drink. Other signs or symptoms such as vomiting and diarrhea, can occur, but are less frequently troublesome.
Rash description: Tiny blisters in the mouth and on the fingers, palms of hands, buttocks, and soles of feet that last a little longer than a week (one, few, or all of these may be present).
➡️ Caused by enteroviruses (often Coxsackievirus). Usually mild but uncomfortable. Removal of the child will not stop the spread of the illness to other children as they can still shed the virus in their stool and secretions while being asymptomatic. Child should stay home until afebrile for at least 24 hours.
6. Roseola (Sixth Disease)
Incubation period: 9–10 days
Symptoms: High fever for 3–5 days, often without other symptoms. Children usually appear well despite the fever.
Rash description: As the fever breaks, a pink rash suddenly appears—starting on the trunk and spreading to the neck, face, and limbs.
➡️ Caused by human herpesvirus 6 (HHV-6). Most common in toddlers and is the most common rash in children 3 months to 3 years of age. Once the fever breaks and the rash appears the child is no longer contagious.
7. Impetigo
Incubation period: 1–3 days for streptococcal cause; 4–10 days for staphylococcal cause
Symptoms: Usually no fever or systemic illness; mainly skin changes.
Rash description: Red sores that quickly rupture and form a honey-colored crust. Most common around the nose and mouth but can occur anywhere.
➡️ A contagious bacterial skin infection. Treated with topical or oral antibiotics.
8. Varicella (Chickenpox)
Incubation period: 10–21 days after exposure
Symptoms: Fever, fatigue, loss of appetite, and irritability often precede the rash.
Rash description: Begins as small red spots that quickly develop into itchy fluid-filled blisters. New crops of spots appear in waves, so children may have red bumps, blisters, and scabs all at the same time. The rash typically starts on the chest, back, and face, then spreads across the body.
➡️ Chickenpox is highly contagious but preventable with the varicella vaccine.
Final Thoughts
Many childhood rashes look similar and can overlap with one another. While most are mild, some require medical care—especially if your child has a high fever, appears very unwell, or if the rash is widespread and rapidly changing.
At Bergman Pediatrics, we’re here to help parents navigate these concerns. If your child develops a rash and you’re unsure what it is, don’t hesitate to contact our office for guidance.
Quick Comparison Chart: Childhood Rashes
| Illness | Incubation Period | Other Symptoms | Rash Description | Key Notes |
|---|---|---|---|---|
| Measles (Rubeola) | 7–14 days | Fever, cough, runny nose, red eyes, Koplik spots in mouth | Starts on face/hairline → spreads down; blotchy red rash that can merge | Preventable with MMR vaccine |
| Scarlet Fever | 2–5 days | Sore throat, fever, “strawberry tongue” | Fine, red, sandpaper-like rash starting on neck/chest | Caused by strep; needs antibiotics |
| Rubella (German Measles) | 14–21 days | Mild fever, swollen lymph nodes, cold-like symptoms | Pink rash starting on face → spreads; fades in ~3 days | Mild in kids but dangerous in pregnancy |
| Fifth Disease (Erythema Infectiosum) | 4–14 days (up to 21) | Mild fever, fatigue, cold symptoms | Bright red “slapped cheeks,” then lacy rash on body | Caused by parvovirus B19 |
| Hand, Foot, & Mouth Disease | 3–6 days | Fever, sore throat, poor appetite | Painful blisters on hands, feet, mouth; sometimes buttocks | Caused by enteroviruses (Coxsackievirus) |
| Roseola (Sixth Disease) | 9–10 days | High fever 3–5 days, then improves | Pink rash starts on trunk as fever breaks | Common in toddlers |
| Impetigo | 1–3 days (strep) / 4–10 days (staph) | Usually, no systemic illness | Red sores → honey-colored crust, often near mouth/nose | Contagious bacterial skin infection |
| Varicella (Chickenpox) | 10–21 days | Fever, fatigue, irritability | Itchy red spots → fluid blisters → scabs; lesions at different stages at once | Preventable with varicella vaccine |
