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I have a five-month-old newborn that seems to have an ongoing skin irritation problem. How do I tell if this is diaper rash, roseola, eczema or something worse?  

A. These are three very different skin conditions.

DIAPER RASH
Diaper rash is usually caused by the irritant combination of the urine, stool, moisture and the friction that occurs in a diaper. Sometimes there are bright red areas that are caused by the fungus Candida. If over-the-counter creams don’t help, you will need a prescription from your doctor.

ECZEMA
Eczema, a type of dermatitis, is usually found on the face, elbows and knees, although it can also be found on the neck, wrists and hands. The rash is generally red and scaly, and can be itchy. On occasion you might even see bumps that are filled with fluid. You may be able to identify certain triggers that can cause a flareup. A moisturizer might help, as well as avoiding harsh soaps and rough fabric. Your doctor might even give you a medicated cream. An accurate diagnosis and treatment plan is important.

ROSEOLA
Roseola is caused by a viral infection that affects children usually six months to three years. In most cases, a high fever for a few days precedes the appearance of the roseola rash, at which time the fever typically goes away. The rash is usually fine and pink and is found mostly on the middle part of the body.
While it is possible to have a fever without the rash, the rash is generally present and will clear on its own after a few days. See your physician should there be a rash.

Published in Winter 2009

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