Tag: skin rashes

30 Uncommon Diseases Parents Should Learn to Recognize

Did you know that just because your younger child is pulling at their ears, it doesn’t automatically mean that they have an ear infection?

It could be teething, an over-tired infant or toddler, or a kid with a cold and their ears are popping because of congestion.

Understanding common, and some not so common symptoms of pediatric diseases can help make sure that your kids get diagnosed and treated quickly.

Symptoms of Classic Pediatric Diseases

Most parents are familiar with the more classic pediatric diseases and the signs and symptoms that accompany them, such as:

  • Appendicitis – classically, it starts with pain near the belly button, which quickly worsens and moves to the lower right side of your child’s abdomen. Appendicitis is not always classic though
  • Croup – often starts in the middle of the night with a seal bark cough, heavy breathing that sounds like wheezing, and a hoarse voice
  • Diabetes – type 1 diabetes is classically associated with polydipsia (drinking a lot), polyuria (frequently urinating large amounts), and weight loss
  • Ear infection – in addition to ear pain, fussiness, or tugging at their ears, kids with an ear infection will usually have cold symptoms, or at least might have had a recent cold, with a cough and runny nose
  • Fifth disease – red cheeks that appear to be slapped followed by a pink lacy rash on a child’s arms and legs that can linger for weeks
  • Hand, foot, and mouth disease – caused by the coxsackievirus A16 virus, kids with HFMD classically have ulcers in their mouth and little red blisters on their hands and feet. They might also have a fever and a rash on their buttocks and legs.
  • Hives – hives or whelps are raised, red or pink areas on your child’s skin that come and go, moving around over a period of three to four hours and are a sign of an allergic reaction. Unfortunately, unless your child is taking medicine or just eat something, it can be hard to find the allergic trigger. You often don’t need to though, as hives can also just be triggered by viral infections and might not come back.
  • Impetigo – honey colored crusted areas on your child’s skin that are a sign of a bacterial infection
  • Ringworm – a fungal infection that can appear on a child’s skin (tinea corporis), feet (tinea pedis), groin (tinea cruris), nails (tinea unguium), or scalp (tinea capitis)
  • Roseola – another viral infection, this one is caused by human herpesvirus 6 (HHV-6) and 7 and causes a high fever for three or four days, and then, as the fever breaks, your child breaks out in a pinkish rash. The rash starts on their trunk, spreads to their arms and legs, and is gone in a few days.
  • Swimmer’s ear – the tricky part about recognizing swimmer’s ear is that you can get it anytime you get water in your ear, not just after swimming, leading to pain of the outer ear, especially when you push or tug on it.

Symptoms of Uncommon Pediatric Diseases

Although not necessarily rare, it is often uncommon for the average parent, and some pediatricians, to be familiar with all of the following conditions unless they have already been affected by them.

Having dark, brown or Coca Cola-colored urine is a classic sign of acute post streptococcal glomerulonephritis.
Having dark, brown or Coca Cola-colored urine is a classic sign of acute post streptococcal glomerulonephritis. Photo by Vincent Iannelli, MD

Why should you know about them?

Some are medical emergencies. Missing them could lead to a delay in seeking treatment.

Others, while they might not be emergencies, often lead parents to seek treatment, but it might not necessarily be the right treatment if someone doesn’t recognize what is truly going on with your child.

  1. Acanthosis nigricans – dark thickened (velvety textured) skin often found on the back of an overweight teen’s neck, and sometimes in their armpits and other skin folds, and which can be a sign of type 2 diabetes
  2. Anaphylaxis – while a severe allergic reaction like anaphylaxis is not easy to miss, getting proper treatment is sometimes difficult. This life-threatening reaction requires an epinephrine injection as soon as possible, something that some parents and even some emergency rooms seem hesitant to do.
  3. Bell’s Palsy – children with Bell’s palsy develop a sudden weakness or paralysis of the muscles of one side of their face. Fortunately, the symptoms usually begin to resolve in a few weeks.
  4. Breath holding spells – a young child having a breath holding spell will actually pass out! While it sounds scary, since they follow a typical pattern, either the child is crying forcibly (cyanotic breath holding spell) or something painful happened suddenly (pallid breath holding spell), and they quickly wake up and are fine, you hopefully won’t panic if you ever see one.
  5. Cat scratch disease – after a bite or scratch from an infected cat or kitten, a child will develop a few lesions at the scratch site, but will also develop enlarged lymph nodes nearby – typically their armpit or neck if they were scratched on the arm.
  6. Cyclic vomiting syndrome – possibly related to migraines, children with cyclic vomiting syndrome have repeated episodes of intense nausea and vomiting, sometimes leading to dehydration, every few weeks or months
  7. Diabetes insipidus – like type 1 diabetes, kids with diabetes insipidus urinate a lot and drink a lot, but it has nothing to do with their blood sugar. It can follow a head injury or problem with their kidneys.
  8. Encopresis – kids with encopresis have soiling accidents, sometimes leading parents to think that they have diarrhea. Instead, they are severely constipated and have small amounts of liquidy stool  involuntarily leaking into their underwear after getting passed large amounts of impacted stool.
  9. Erythema multiforme minor – triggered by infections and sometimes medications, kids with EM have a rash that looks like hives, but instead of going away, they just keep getting more spots, some of which look like target lesions. The severe form of EM, erythema multiforme major is fortunately rare.
  10. Geographic tongue – a curiosity more than a condition, children with geographic tongue have bald areas on their tongue where the papilla have been lost (temporarily). The name comes from the fact that the shapes of the bald areas vary in size and shape and they move around. They are not painful, although parents typically don’t notice them until they look in their child’s mouth when they complain of a sore throat or other problem.
  11. Henoch-Schonlein Purpura (HSP) – episodes of HSP typically follow an upper respiratory tract infection, when kids develop a rash (palpable pururpa), stomach aches, arthritis (joint swelling and pain), and more rarely, kidney problems. The rash is distinctive – red dots (petechiae) and a hive-like rash that looks like bruises.
  12. Hemolytic Uremic Syndrome (HUS) – follows a diarrheal illness with E. coli, in which toxin from the bacteria causes bleeding (from low platelets) and anemia (destruction of red blood cells) and can lead to kidney damage.
  13. Intussusception – colicky abdominal pain (severe pain that comes and goes) and loose stools that are filled with blood and mucous (red currant jelly stools) in young kids, typically between the ages of three months and three years
  14. Kawasaki disease – it is important to recognize when a child might have Kawasaki disease, because early treatment might help prevent serious heart complications from developing. The initial signs and symptoms of Kawasaki disease can include a prolonged fever (more than five days), swollen lymph glands, pink eye (without discharge), rash, strawberry tongue, irritability, swelling of hands and feet, red and cracked lips, and as the fever goes away, skin peeling.
  15. Nephrotic syndrome – kids with nephrotic syndrome have swelling (edema), around their eyes, on their legs, and even their belly. All of the swelling causes them to quickly gain weight. Because, at first, the swelling is worse in the morning and gets better as your child is up and about, it might be mistaken for other things that cause swelling, like eye allergies. Nephrotic syndrome won’t get better with eye drops though.
  16. Night terrors – most common in preschoolers and younger school age children, kids with night terrors ‘wake up’ in the early part of the night screaming and are confused and impossible to console, because they are really still asleep. The episodes are not remembered the next morning and are often triggered when kids are off their schedule or under extra stress.
  17. Nursemaid’s elbow – you are walking with your toddler and all of a sudden he gets mad, drops to the ground while you are holding his hand, and then he refuses to move his arm or bend his elbow. Did you break his arm? It’s probably a radial head subluxation, which your pediatrician can usually easily reduce.
  18. Obstructive sleep apnea – although many kids might snore normally, with obstructive sleep apnea, the snoring will be loud, with pauses, gasps, and snorts that might wake your child up or at least disturb their sleep.
  19. PANDAS – Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections is characterized by OCD and/or tics that appear or suddenly worsen after a strep infection.
  20. Peritonsillar abscess – a complication of tonsillitis, it can cause fever, severe throat pain, drooling, a muffled voice (hot potato voice), and swelling on the side of one tonsil, pushing the uvula towards the other side
  21. Pica – while many younger kids put things in their mouth, kids with pica crave and eat all of those non-food things. Since it can be a sign of iron-deficiency, talk to your pediatrician if you think that your child might have pica.
  22. Pityriasis rosea – kids with pityriasis rosea have a rash that starts with a herald patch (looks like a ringworm) and is then followed by a lot of small, oval shaped red or pink patches with scale on their trunk. The rash, which may be a little itchy, can last for up to 6-12 weeks.
  23. POTS – teens with Postural Orthostatic Tachycardia Syndrome have dizziness, fatigue, headaches, nausea, difficulty concentrating and other symptoms related to alterations or dysfunction in the autonomic nervous system (dysautonomia).
  24. Pyloric stenosis – since so many infants spit up, it is not uncommon for the parents and pediatricians to sometimes delay thinking about pyloric stenosis when a baby has it. Unlike reflux or a stomach virus, with pyloric stenosis, because their pylorus muscle becomes enlarged, no food or liquid is able to leave their stomach and they eventually have projectile vomiting of everything they try to eat or drink. It is most common in babies who are about three to five weeks old.
  25. Scalded skin syndrome – unlike typical bacterial skin infections, with scalded skin syndrome, exotoxins that certain Staphylococcus aureus bacteria cause the skin to blister and appear burned, with eventual skin peeling
  26. Stevens-Johnson Syndrome – a rare skin reaction that can be triggered by medications, beginning with flu like symptoms, but then progressing to a blistering rash that includes their mouth and eyes.
  27. Testicular torsion – if one of the testicles twists around the spermatic cord, it can cut off blood flow and quickly lead to permanent damage. Sudden, severe pain and swelling often make it easy to recognize this medical emergency, but sometimes the pain comes on more slowly or the pain is dismissed as happening from trauma, epididymitis, or torsion of the appendix testis.
  28. Toxic synovitis – typically following a viral infection, kids with toxic synovitis have hip pain and limping for a few days, but otherwise seem well, without high fever or other symptoms
  29. Vocal cord dysfunction – often misdiagnosed as asthma, especially exercise induced asthma, and other things, kids with vocal cord dysfunction often have episodes of repeated shortness of breath, chest tightness, wheezing, and coughing – just like asthma. They don’t improve though, even as more asthma medicines are added, which should be a red flag that they don’t have asthma and could have vocal cord dysfunction instead.
  30. Volvulus – a volvulus occurs when the intestines twists on itself, cutting off blood blow. In addition to severe abdominal pain, these kids often having vomiting – typically of a green, bile looking material (bilious vomiting). Green vomitus can also be a sign of other intestinal obstructions, but all would be a medical emergency.

Is knowing about these conditions always helpful?

No, especially if you don’t know what a ‘seal bark’ or ‘hot potato voice’ sounds like or what ‘red currant jelly’ looks like, but it likely shouldn’t hurt to get a little more educated about the diseases that could be causing your child’s symptoms.

What to Know About Recognizing Symptoms of Pediatric Disease

Having the internet and access to Google doesn’t make you a doctor. Get real medical advice if you think that your child is sick and has symptoms that have you concerned. It does help to know which symptoms to be concerned about though.

More on Recognizing Symptoms of Pediatric Disease

 

Molluscum Contagiosum

Molluscum contagiosum is a very common childhood skin rash, that surprisingly, few parents seem to have ever heard of.

While most parents have likely have heard of eczema, ringworm, and impetigo, a diagnosis of molluscum might leave them with their head scratching. Hopefully their kids won’t be scratching too.

Molluscum is contagious!

Symptoms of Molluscum Contagiosum

Molluscum contagiosum lesions are typically small and dome shaped, with a small dimple in their center. Although often flesh colored, they can also be pink.

They are usually found alone or grouped on a child’s chest or back, arm pit, or around the skin folds of their elbow and knees.

For many children, molluscum don’t cause any symptoms and the rash is simply a cosmetic problem. Others can get redness and scaling on the skin around the molluscum rash, and it may be itchy.

Another characteristic is that molluscum will sometimes have a plug of cheesy material coming out of the central part of the lesion.

Spotting Molluscum Contagiosum

The diagnosis of molluscum is usually made based on their classic appearance.

Three molluscum lesions on a child's arm.
Three molluscum lesions on a child’s arm. Photo by Vincent Iannelli, MD

The diagnosis can be confusing at first though, when the molluscum are still very small. It may take a few weeks for the lesions to grow before they look like more typical molluscum lesions.

Molluscum might also be confused with other rashes if they are red and inflamed when you go see your pediatrician, or if there is a lot of redness around the rash. That might make your pediatrician think that your child has a small abscess or simple eczema.

Getting Rid of Molluscum Contagiosum

Since molluscum usually goes away in about six to nine months on its own, some pediatricians advocate not treating it. Keep in mind that it can sometimes last for two to four years and may spread aggressively, which is why others do recommend treating molluscum with:

  • Direct removal with a curette
  • Cryosurgery – freezing
  • Cantharidin – a blistering agent
  • Aldara cream (Imiquimod) – also used for genital warts, although they are not related to molluscum
  • Retin A cream (Tretinoin) – also used for acne

All of these treatments have their shortcomings though.

Direct removal and cryosurgery are painful. Cantharidin can cause large blisters. Aldara is expensive. And Retin A doesn’t always work well when used by itself. Also, both Aldara and Retin A can be very irritating to the normal skin that surrounds the molluscum rash.

More About Molluscum Contagiosum

So what should you do about your child’s molluscum?

Talk with your pediatrician or a pediatric dermatologist about your options, which might include:

  • Leaving the molluscum alone, especially if your child has already had them for several months and they are not spreading. Just avoid sharing towels and skin-to-skin contact with others, because they are contagious. It is not a reason to stay out of school or daycare though.
  • Trying direct removal with a curette or cryosurgery if your child only has a few lesions. Although it can be painful, your pediatrician can consider using a topical anesthetic.
  • Using cantharidin if your child doesn’t have a lot of lesions. It is not FDA approved in the United States though, so not all doctors have it, and it can sometimes produce large blisters.
  • Using Aldara cream or Retin A cream – either alone or together on alternate days.

Most importantly, if you do treat your child’s molluscum, watch for new lesions during treatment. They are contagious and start spreading the infection again, even if the initial treatment was successful. And molluscum has a very long incubation period – up to about two months!

Other things to know include that:

  • Molluscum contagiosum is caused by a double-stranded DNA poxvirus.
  • Molluscum can be spread by direct contact with an infected person, touching contaminated objects (such as towels, toys, or clothing), and on a child when they scratch a lesion and then scratch other areas of their skin (autoinoculation). So encourage your child to not pick at them.
  • Molluscum can grow aggressively in children who have a weakened immune system.
  • Molluscum can be a sexually transmitted infection in older teens and adults. It is so common in young children though, that unless there are other signs or suspicions, it is usually not considered a sign of abuse, even if you find an isolated lesion in the anogenital area.

Also keep in mind that a pediatric dermatologist can be helpful if your child has molluscum that isn’t responding to standard treatments.

What to Know About Molluscum Contagiosum

Molluscum contagiosum is a very common viral infection that can cause a skin rash in children. Although difficult to treat, it does typically go away on its own – eventually.

More Information on Molluscum Contagiosum

What to Do If a Tick Bites Your Child

Lyme disease.

That’s usually what comes to mind when people find a tick on their child or if they simply think about tick-borne diseases.

It is important to know that there are many other diseases that can be caused by many different types of ticks though, from anaplasmosis to tularemia. And since these ticks and the diseases they transmit are fairly regional, it is easy to be unfamiliar with them if you don’t live in their specific habitats.

That can especially be a problem if, for example, you are from Hawaii, where tick-borne diseases aren’t a big issue, and you travel for a camping trip to Oklahoma and your child is bitten by a tick. Will you or your doctor know what to do if your child develops symptoms of Rocky Mountain spotted fever?

How To Remove a Tick

Fortunately, if you find a tick on your child, you can decrease their chance of getting sick if you remove it quickly. That makes doing daily full body tick checks important.

 

Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure.
Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure. A special tick-removal spoon can make it even easier!

How quickly?

At least 36 hours.

“Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.”

CDC on Preventing Tick Bites

After removing the tick, wash the bite area and your hands with soap and water and observe your child over the next few weeks for symptoms of a tick-borne disease.

Symptoms of a Tick Bite

Although some of the symptoms of tick-borne diseases are specific to the tick that bit your child, some other symptoms are common to all of them, including:

  • fever
  • headache
  • fatigue
  • muscle aches and joint pains
  • skin rashes
  • chills

Like spider bites, tick bites are usually painless. That often leads to a delay in actually figuring out that a tick has bitten your child, which makes it important to do frequent tick checks if they are doing anything that could expose them to ticks.

Many people are also surprised at how many different diseases can be transmitted by ticks, including:

  • Anaplasmosis – transmitted by the black-legged tick (northeast and upper midwestern United States) and the western black-legged tick (Northern California). May not cause a rash.
  • Babesiosis – transmitted by the black-legged tick (northeast and upper midwestern United States). Can cause severe hemolytic anemia.
  • Colorado Tick Fever – a viral infection that is transmitted by the Rocky Mountain wood tick (western United States, especially Colorado, Utah, Montana, and Wyoming). Can cause meningoencephalitis.
  • Ehrilichiosis – transmitted by the lone star tick in southcentral and eastern US.
  • Lyme disease – transmitted by the blacklegged in the northeastern U.S. and upper midwestern U.S. and the western blacklegged tick along the Pacific coast. Erythema migrans rash or Bull’s eye rash.
  • Powassan disease – a viral infection that is transmitted by the black-legged tick (northeastern United States and the Great Lakes region). Can cause biphasic illness, with children appearing to get better and then the symptoms reappearing again.
  • Rocky Mountain spotted fever – transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. Causing a classic petechial rash on the wrists, forearms, and ankles, which can then spread to the trunk.
  • Rickettsia parkeri Rickettsiosis – transmitted by the Gulf Coast tick in the eastern and southern United States.
  • STARI (Southern Tick-Associated Rash Illness) – “transmitted” by the lone star tick (central Texas and Oklahoma eastward to the the whole Atlantic coast). Children have an expanding “bull’s eye” lesion at the tick bite, like Lyme disease, but the cause is unknown.
  • Tickborne relapsing fever (TBRF) – spread by multiple soft ticks in the western United States which live in rodent infested cabins and can cause relapsing fever – 3 day episodes of fever, in between 7 days stretches in which a child might be fever free, over 3 to 4 weeks.
  • Tularemia – transmitted by dog ticks, wood ticks, and lone star ticks or by handling a sick animal, including wild rabbits, muskrats, prairie dogs, and domestic cats. Can cause an ulcer at the site of infection.
  • 364D Rickettsiosis – transmitted by the Pacific Coast tick in Northern California dn along the Pacific Coast.

And although it can be helpful to know about all of the different tick-borne diseases and their symptoms, you should basically just know to seek medical attention if your child gets sick in the few weeks following a tick bite.

What to Know About Ticks and Tick Bites

Of course, it would be even better to reduce your child’s risk of getting a tick-borne disease by avoiding ticks in first place, including limiting his exposure to grassy and wooden areas, wearing protective clothing, using insect repellent, treating your dogs for ticks, taking a shower within two hours of possibly being exposed to ticks, and doing frequent tick checks.

In addition to avoiding ticks, it is important to know that:

  • The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.
    The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.

    Tick activity is seasonal, with adult ticks most active in spring and fall, and the smaller nymphal ticks more active in late spring and summer.

  • Tick bites that lead to tick-borne diseases are often not noticed because they are usually painless and are often caused by nymphs, the immature, smaller forms of a tick. So while you might be thinking about a large, adult tick when you are asked about a recent tick bite, a nymph is tiny (about 2mm long) and might even be missed.
  • Testing (on your child), including antibody tests, can be done to confirm a diagnosis of most tick-borne diseases, but keep in mind that testing can be negative early on. You also shouldn’t wait for results before starting treatment in a child with a suspected tick-borne disease. Testing is usually done with either indirect immunofluorescence antibody (IFA) assay or enzyme immunoassay (EIA) tests.
  • It is usually not recommended that you have a tick that has bitten your child be tested for tick-borne diseases. Even if the tick was positive for something, it wouldn’t mean that it transmitted the disease to your child.
  • Experts don’t usually recommend that people be treated for tick-borne diseases after a tick bite unless they show symptoms. The only exception might be if the tick was on for more than 36 hours and you were in an area with a high risk for Lyme disease.
  • Although doxycycline, one of the antibiotics often used to treat tick-borne diseases, is often restricted to children who are at least 8 years old because of the risk of side effects, it should still be used if your younger child has Rocky Mountain spotted fever, ehrlichiosis, or anaplasmosis.

You should also know that most old wives tales about ticks and tick bites really aren’t true. You should not try to burn a tick that is biting your child with a match, paint it with nail polish, or smother it with vaseline, etc. Just remove it with tweezers and throw it away in a sealed bag or by flushing it down the toilet.

What to Do If a Tick Bites Your Child

Don’t panic if a tick bites your child. You have up to 36 hours to remove it, before it is can likely transmit any diseases to your child, like Lyme disease or Rocky mountain spotted fever.

More About Ticks and Tick Bites

What to Do If a Spider Bites Your Child

It can often seem like spiders are everywhere, and when you consider that more than 100,000 species of spiders have been identified, they probably are.

A black widow spider is typically easy to identify because of the classic markings on its body.
A black widow spider is typically easy to identify because of the classic markings on its body. Photo by Vincent Iannelli, MD

Even with only 4,000 species of spiders in North America, that’s a lot of spiders.

And believe it or not, that’s a good thing. All of those spiders eat up to 800 million metric tons of insects each year!

Fortunately, very few of these spiders are dangerous.

In the Unites States, just two species of spiders are poisonous enough to cause harm. They include the black widow spider (Latrodectus mactans) and the brown recluse spider (Loxosceles reclusa).

Even in other parts of the world that have more of a variety of venomous spiders, like Australia, that “reputation is bigger than its bite.”

It is important to remember than even venomous black widow and brown recluse spiders aren’t wandering around your house trying to attack your kids. They usually like to live in places where they won’t be disturbed. So unless your child was crawling through boxes in a closet or attic, or some other place where they might have disturbed a spider, it is unlikely that any bites on their skin were caused by a “bad spider.”

And in most cases, any “bite marks” probably weren’t caused by a spider at all, as many experts think that spider bites are over-diagnosed. Many other conditions, including other insect bites and skin infections can mimic spider bites.

Symptoms of a Spider Bite

Surprisingly, most spider bites aren’t that painful. Although it may feel like a pin prick, many bites often go unnoticed, making it hard to know if you have been bitten.

Common spider bite symptoms can include a single bite mark with:

  • swelling
  • redness
  • itching
  • pain

In fact, most spider bites will resemble a bee sting. Your child may also develop hives and other allergy symptoms if they are allergic to the spider bite.

Symptoms of a black widow spider bite cold include severe muscle pain and cramps, which develop within a few hours of the bite. Other symptoms might include weakness, vomiting, trouble breathing, abdominal pain, and high blood pressure.

Brown recluse spider bites can be painful. In addition to pain, these spider bites might cause burning and itching. Another characteristic finding is that the spider bite may look like a bull’s eye, with a red ring around a white center that turns into an ulcer.

Was Your Child Really Bitten By a Spider?

The most obvious way to diagnose a spider bite is to see the spider biting your child.

Keep in mind that since many of us have spiders in and around our homes, simply seeing a spider and then noticing a bite on your child doesn’t necessarily mean that your child has a spider bite.

As hard as it sometimes is to tell if a child even has a spider bite, it can be even harder to determine what type of spider actually bit him. Again, seeing the spider can help, as “bad spiders” have very characteristic features.

The black widow spider is jet black, with a red hourglass marking on the underside of their abdomen. Brown recluse spiders are smaller, are yellowish-tan to dark brown, and have a violin shaped marking on their back.

Should you try to catch a spider to help your doctor identify it? Probably not, as you are more likely to bring your pediatrician a crushed spider that is impossible to identify than anything useful. And you should likely be concentrating on taking care of your child after he has been bitten, instead of chasing after the spider.

What to Do If a Spider Bites Your Child

For most spider bites, you can follow some simple home treatments, including:

  • washing the spider bite with soap and water
  • apply an ice cube to the bite for about 20 minutes
  • giving your child a pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil)
  • applying a topical antibiotic ointment to the bite two or three times a day
  • applying a topical steroid cream to help control itching and redness a few times a day
  • continuing home treatments for one or two days, the typical time that it takes a spider bite to go away

Of course, you should seek medical attention if you think your child was bitten by a black widow spider or brown recluse spider, or if any spider bite seems like it is getting infected, with increasing redness and pain after a few days.

Don’t overlook the fact that your local poison control center (1-800-222-1222) can be a good resource if you think your child was bitten by a poisonous spider.

What to Know About Spider Bites and Kids

Other things to know about spider bites include that:

  • Even the poisonous black widow spiders and brown recluse spiders rarely cause life-threatening symptoms or death.
  • In addition to seeking medical attention for a black widow spider or brown recluse spider bite, see your pediatrician if a spider bite isn’t getting better in a few days.
  • Kids may need a tetanus shot after a spider bite.
  • Spiders usually bite just once, so if a child has multiple bites, then it likely isn’t from a spider.
  • Although parents often look for the double fang marks in trying to identify a spider bite, they usually aren’t seen, and even when you see “fang marks,” it doesn’t mean that your child was bitten by a spider.
  • Instead of a black widow or brown recluse, it is more likely that you will come across a more harmless spider in or around your home, like a grass spider, wolf spider, orb weaver, or daddy-long-legs.

Most importantly, teach your kids to avoid spiders by shaking out shoes and clothing that are lying on the floor and not storing boxes or other items on the closet floor or underneath your child’s bed. You can help keep spiders out of your child’s crib or bed by making sure any bedding doesn’t touch the floor.

And remember that spiders eat insects, so might help keep your kids free of other types of bites.

More About Spiders and Spider Bites

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Treating Hard to Control Warts

Unfortunately, there are no quick and easy ways to treat warts.

In fact, because there are no quick and easy ways to treat warts, many pediatricians suggest that parents simply wait it out, and let the warts go away on their own.

Common Wart Treatments

If you don’t have the patience to wait for a wart to go away on its own, which can take months to years, you can try:

  • OTC topical liquid or gel wart remover treatments with salicylic acid
  • OTC wart remover treatments with salicylic acid on a pad
  • OTC wart remover treatments that freeze warts
  • duct tape

Your pediatrician might also try:

  • cryotherapy – “prescription strength” wart freezing, which may have to be repeated multiple times
  • cantharidin – not FDA approved in the US, but this blistering agent is often applied to warts to induce them to go away

And of course, your pediatrician might also simply recommend that you wait it out for a few more months or years, as the warts should eventually just go away.

But why not treat the warts if treatments are available? Many experts say that at best, standard wart treatments only work half of the time. And they can be painful or leave scars.

Treating Hard to Control Warts

Again, treating warts is often hard, even in the best of circumstances. Warts can be even harder to treat if they are around your child’s nails (periungal warts) or on the bottom of their feet (plantar warts).

Plantar warts can be hard to treat.
Plantar warts can be hard to treat. Photo by happyfeet34 (CC BY 2.0)

Still, if you are not getting anywhere, you should ask yourself these questions and share the answers with your pediatrician:

  • Does your child really have warts?
  • Did you follow the directions on the label carefully?
  • Are you gently rubbing away hard skin from the surface of the wart with a pumice stone or emery board each week?
  • Are you softening the skin on and around the wart by soaking the area in warm water for at least 5 minutes before your wart treatments?
  • Did your child’s wart mostly go away and then come right back in the same spot?
  • Did your child’s wart completely go away, but new warts came up in different places?
  • Did your child get a much bigger wart around the site of a previously treated wart (a ring wart)?

A dermatologist can treat your child’s truly resistant warts with cryotherapy, cantharidin, higher strength salicylic acid paste than is available OTC, yeast injections, electrosurgery, or pulsed dye laser therapy, etc.

What To Know About Treating Hard to Control Warts

Although multiple wart treatments are available, warts are not easy to treat and so it is not unreasonable to just leave them alone if they aren’t bothering your child.

More Information About Treating Hard to Control Warts

Treating Hard To Control Eczema

Eczema or atopic dermatitis very commonly affects kids.

Few conditions are as frustrating for parents and pediatricians, because even when properly treated, you can expect eczema to flare up from time to time after it gets better. Eczema is even worse when it isn’t properly treated though.

What Triggers Your Child’s Eczema?

Like other things that are supposed to have triggers, like asthma and migraines, it is often hard to figure out what triggers a child’s eczema.

Dress in soft, breathable clothing and avoid itchy fabrics like wool, that can further irritate your eczema.

National Eczema Association

Common eczema triggers to avoid might include:

  • harsh soaps and cleansers, shampoos, and body washes, including those with fragrances
  • food allergy triggers – milk and eggs
  • environmental allergy triggers – dust mites and animal dander
  • low humidity
  • temperature extremes – either getting too hot or too cold
  • skin infections

And anything else that might make your child’s skin dry and itchy.

Eczema Treatments for Kids

Although there is no cure for eczema, it is usually possible to control your child’s eczema, including getting rid of all or most of her eczema rash and decreasing how often your child has eczema flares.

These basic treatments include:

  • using lukewarm water for daily baths and showers
  • using a soap substitute or cleanser that is unscented, fragrance-free, and dye-free – Cetaphil, Dove, Aveeno
  • using a tar-based shampoo if your child’s scalp is red and itchy – T-Gel
  • daily use of moisturizers, especially within a few minutes of taking a bath or shower (soak and seal therapy)
  • prompt use of a moderate strength prescription topical steroid (like traimcinolone acetonide 0.1% cream) as soon as your child has a flare, with red, rough itchy skin
  • as needed use of oral antihistamines to help control itching during flares – Benadryl
  • keeping your child’s finger nails short to minimize damage from scratching

A written eczema action plan can make sure that you understand how and when to do each of these treatments.

Best Moisturizers for Eczema

Everyone seems to have their favorite eczema moisturizer.

Which is best?

The best moisturizer is probably the one that your child will use and which works to keep his skin from getting dry. In general though, ointments are better than creams, which are better than lotions.

Some favorites include Aquaphor (too thick and greasy for some people), Vanicream Moisturizing Skin Cream, CeraVe Moisturizing Cream, Eucerin Original, and Cetaphil Moisturizing Cream.

Whichever moisturizer you use, be sure to apply it to your child’s skin within three minutes of his soaking in a bath or shower so that you can seal in the moisture (soak and seal therapy).

Treating Hard To Control Eczema

What to do you do when basic treatments aren’t working?

Although a pediatric dermatologist can evaluate your child to see if she needs a systemic medication, phototherapy, or other treatment, most kids with hard to control eczema simply need more education to make sure they are using standard treatments correctly.

  • Is your child bathing correctly?
  • Are you putting on the right moisturizer, using enough moisturizer, and using it often enough?
  • Is your soap too harsh?
  • Are you afraid to use a topical steroid?
  • Are you applying a steroid over a moisturizer, which can make it less effective?
  • Could you be doing more to avoid triggers?
  • Could stress be triggering your child’s eczema?

What’s next?

A Staph skin infection might be a problem. In addition to oral antibiotics, weekly dilute bleach baths might help if this is an issue for your child.

Your child with hard to control eczema might also benefit from:

  • using more moisturizer over his entire body – don’t spot treat the areas that you think are a problem
  • using a thicker moisturizer – put your jar of Aquaphor in the freezer or refrigerator if your child doesn’t typically like using a moisturizer or complains that it stings or burns
  • a prescription barrier cream to control itching – Atopiclair, MimyX
  • a prescription topical Clacineurin Inhibitors – Elidel, Protopic
  • a 504 school plan
  • changing your laundry routine – wash new clothes, use mild, dye free laundry detergent and rinse twice after washing
  • using sunscreen and rinsing after swimming in a pool or excessive sweating, applying a moisturizing quickly afterwards
  • allergy testing to better identify triggers

You might also talk to your pediatrician about wet wrap therapy. With this treatment, you have your child take a bath or shower, applying a topical steroid to the affected areas and a generous amount of moisturizer to the rest of your child’s skin. Next, cover the area in wet cotton clothing or a wet dressing, and lastly, dress your child in dry cotton clothing, removing them all once the clothing dries out. You can then repeat the whole process or start again the next night, continuing until your child’s eczema is under better control.

Wrap therapy can be done with wet pajamas if you have to cover a big area, tube socks with the end cut off if you just have to do his arms, or cotton gloves for hard to control hand eczema. Some experts even recommend using a chilled wet dressing, putting the wet clothes in the refrigerator for a short time before using them on your child.

If you are at the point of considering wet wrap therapy, seeing a pediatric dermatologist might also be a good idea.

What To Know About Treating Hard To Control Eczema

While eczema can usually be controlled and most kids eventually outgrow having eczema, you may need some help to really understand how to really manage your child’s eczema effectively.

More Information About Treating Hard To Control Eczema