Transcription:

Dr Allie Grither: Hi, I'm Dr. Allie Grither. I'm a pediatric emergency medicine physician with St. Louis Children's Hospital, and I'm also a mom doc.

Melanie Cole (Host): Hey, welcome to Mom Docs, the podcast from St. Louis Children's Hospital. I'm Melanie Cole. And you know, as a parent in summer, kids, we hope, spend a lot more time outside, swimming, playing in the grass, camping in the woods, going to the beach, all the things. And these activities can lead to itchy irritated skin. So we're talking about some common summertime rashes in kids and what you can do to identify and hopefully prevent them.

Dr. Grither, it's a pleasure to have you with us. Let's just start with heat rash, because it's really common during the hot humid weather. Some of us have littler kids, some of us have older kids. Maybe they're at camp and they get all sweaty and they get this heat rash. Tell us a little bit about what that is, how the kids get it and what we do about it.

Dr Allie Grither: Yeah, absolutely. I think this is a great topic because kids of all age are going to get heat rash at some point in their lives. And so it's really important to know about it. Basically, heat rash is just a reaction that occurs in your skin from these blocked sweat glands that you have, and everyone has them. It has a few different names, so you may have heard it called a couple of different things. It can go by sweat rash, prickly heat, or heat rash. They all kind of mean the same thing.

The reaction takes a couple of different forms depending on where exactly the blockage happens, whether it's by the skin surface or kind of deeper down. So it can be anywhere from just a little bit of flat redness to some small blister-looking lesions to even these like deeper, irritated, large lumps under the skin. So it's hard to sometimes know exactly what's causing it. But if you're outside in the sun and the heat, and now your kid comes in with this itchy or kind of bothersome rash, there's a good chance that it's heat rash.

Sometimes it can be painless and not bother them at all. But most of the time, it'll be a little itchy or bothersome for them. And usually, it'll happen where things rub. So think where your skin touches your clothes or where you have skin folds, so armpits, elbows, the groin, or even kind of the neck on young babies is a very common place to get this.

So you can guess, given its name, you know, heat rash generally occurs from those things that cause heat. So being outside in the hot humid air, like right now in summertime; being active, which we all want kids to do, especially in the summertime, or even just having a fever. So say your kid is sick and they've got a high fever, even a low grade fever, and they get kind of sweaty, you can get heat rash just from.

So to fix it, usually it'll just kind of go away on its own whenever the skin cools down. So the best treatment is just that, get the skin cool. So get out of the heat. If your kiddo was out and about running around, get some rest. If your child is wearing tight clothes that were rubbing, get them into some loose fitting dry clothing whenever you can. And then, it's best to avoid whatever heat or activity caused the problem until the rash gets better. So sometimes it's later in the day, sometimes it's a couple of days, but generally those measures will get that rash gone. If it doesn't get better by doing those things, then you may want to see your doctor just to make sure it's actually heat rash and nothing else. But generally, it'll get better.

Some things you can do to keep it from happening again, wear loose moisture-wicking clothes, especially in the hot weather. Stay cool whenever you can or take frequent breaks whenever you're out and about in the heat. And then when it is summertime and humid, like it is now, avoid those heavy lotions or ointments whenever you know your kiddo's going to go outside because those things can block the pores. So there are a lot of different things that you can do to fix it and to keep it from happening.

Melanie Cole (Host): That was excellent. What a great description and treatments. You covered it all so well. Now, what about sun rashes? Because some kids, and even adults, develop these rashes when they're out in the sun for even a very short period of time and sometimes even with sunblock on. All of a sudden you look and maybe there's some bumps or some discolored skin that doesn't necessarily indicate sunburn. It's just sort of a weird rash. What is that?

Dr Allie Grither: So that kind of falls into the same category of like a heat rash, basically. So the best thing, you know, get them out of the sun, get them out of the heat, cool down and see if it's still there. Most of the time, you'll find that it goes away. Now that being said, if that happens from being out in the sun in direct sunlight, make sure that your kiddo has sunscreen on, because you can get sunburned very quickly, especially in the hot heat in the summertime. And so there's all kinds of different sunscreens you can wear. But if your kiddo is going to be out in the sun for more than about 15 minutes in direct sunlight, we would recommend putting some sunblock on.

Melanie Cole (Host): Well, that's always really good advice. And now, what about we like to go camping, I know my family does, but we're always looking around at the plants when we go hiking or camping and poison ivy, poison oak, all these kinds of things are out there. They were out there when I was a little kid and they're still out there today. What do we do? How do we identify those?

Dr Allie Grither: Oh, that's a great question. And this is such a bothersome rash, and it's very easy to spot it when it happens. But this poison ivy, poison oak, poison sumac, it's all kind of the same thing, which is just basically an allergic skin reaction to certain types of plants, specifically those ones we talked about. And they are found in every state in the US, except if you're lucky enough to live in Hawaii and Alaska, you don't usually find them there. But in Missouri, they're all over the place.

It's a reaction in your skin. It gets very red, very itchy, usually causes the little blisters with some swelling. And it can even, in some cases, if for some reason the plant is burned, cause some lung irritation if you inhale the vapors from a burning plant. But that's kind of rare. More often, it's this rash that you get. And you'll usually see it in a small little line along the legs or the arms or the belly. And that's because the rash occurs in places where you rub up against the plant. So often, we're running around, kids are having fun and they just brush up against the plant without realizing it. And then one to two days later, which is how long it takes to get the rash, you'll notice those little blisters that pop up and are extremely itchy and often filled with kind of a clear little fluid.

The other thing that can happen is you may get it in one spot, but then you may notice it a little bit later in multiple other spots. What a lot of people think is that whenever the blister ruptures, that oozing can transfer the poison ivy to other places. And that's actually not what happens. The reason why we kind of notice it occurring in different spots at different times, often, it doesn't take just rubbing up against the plant to get the rash. But if you touch the plant with your shoe or your jacket or a toy or a stick, and then you touch that object to other parts on your skin, you can transfer the oil that causes poison ivy to these different places. So they'll pop up at different times if you don't get that skin nice and clean whenever you know that you've came in contact with poison ivy.

So that's really the best thing that we can do. If we can realize what poison ivy, poison oak or sumac look like and know that we came in contact with it, we can wash our skin or wash your kiddo's skin right away to try to get that oil off. And that can decrease the chance of getting that really irritating, itchy rash. It's not perfect. So you may still get a little bit of the itchy rash. But hopefully if you get it washed off quickly, that'll take care of most of it.

And then the amount of rash that your child gets is really going to depend on how allergic they are to this plant and where contact is. So we tend to think that if the rash is over large parts of the body, or if it's on the face or the genitals, that those are a bit more severe, we worry a little bit more about those. So often those can be a reason to see your pediatrician or your doctor if you notice that you have poison ivy in those places. But most of the time, it's kind of on the legs and the arms, and we're able to treat it just with some supportive care type things. So soothing lotions like calamine lotion or oatmeal baths, cool water can help whenever you notice this rash pop up. But again, if it's not getting better with just those measures, no matter where it is, you can always see your doctor and we can talk about other things like prescriptions that we can try.

The best thing is to try to prevent it from happening, because anywhere from a half to three quarters of people are allergic to this plant. Some people are lucky and aren't, but most of us are. So if you can prevent yourself or your child from getting it, that's really the best. So wearing things like protective clothing when hiking, so unfortunately, that means long shirts and pants, and then thoroughly cleaning any objects that may have been exposed to the oils on the plant are really the best things that we can do.

Melanie Cole (Host): Wow. This is such an informative podcast. Okay. On to something none of us really want to even talk about, much less think about, is bugs. Insects, bites, there's so many different ones. There's bee stings. There's mosquito bites. My goodness, the mosquitoes have been bad, especially after rains. Tell us a little bit about any of these kinds of insect bites and stings and what we're supposed to do about them.

Dr Allie Grither: That is a great question, because like you said, there are so many, so mosquitoes ticks. There's biting flies, fleas, chiggers, oh, those are the worst. It's a long list. Unfortunately, there's really not a lot of ways to avoid it. If you want your kiddo to be outside, having fun in the summertime, you probably will be exposed to at least a few of these.

So treatment of these is largely supportive. They're very annoying most of the time, but usually won't cause longterm problems, but that itching can just be really bothersome, especially at nighttime. So what we recommend is trying to keep your child comfortable. So when you notice any kind of bite or sting, we'll wash the area right away with some soap and some water. You can actually apply cold things like a cold pack or a cold rag to the bite or sting, and that helps with swelling, but also a little bit with itching. So that can actually be pretty helpful. You can try, again, any topical creams or soothing lotions, like calamine lotion for the itching works quite well. And then, you can try anti-histamines like Benadryl or Atarax, which you may have heard about and can buy over-the-counter. They're not perfect. And for some kids, they may not help, but if the itching's very bothersome, it's worth a try. There are some other medicines, but they're generally reserved for really severe cases. So if you're worried that what you're doing at home with those measures isn't helping, you should see your doctor and they can talk with you more about things you can try or medicines that you can try.

That being said, too, these are really pesky little insects, especially ticks and mosquitoes, and they can carry some other infections that you have to watch for. So if you notice at all that your kid has trouble breathing, fainting, vomiting, or fever, definitely see your doctor in those cases, and they can walk through with you what might be going on.

And then depending on what insect you're worried about, there are some specific things you can do to prevent these bites from occurring. But in general, wearing protective clothing again, whenever you're outdoors. There are specific types of repellents that you can buy at most stores and then bathing as soon as you come inside from being outdoors can help with a lot of the itching and irritation from these insects.

Melanie Cole (Host): Okay. So moving on to other things, as we're talking about bugs, another one we don't want to talk about too much is ringworm, but it is something that kids do get, and especially in the damper areas and the mositer areas, warm, so this time of the year and coming up in the summer. What is that?

Dr Allie Grither: Yeah, ringworm. It's a really interesting little infection that you can get. It's an infection. You can get it in all kinds of places, actually, on the body, but often it's on your skin and nails. It's caused by a fungus called tinea. And it has different names depending on what part of the body it's involved in. But generally, you can just call it ringworm. It usually has this itchy red scaly kind of ring shape round rash, and then you can also see it on the hands and the feet. So if you've heard of athlete's foot, that's basically ringworm, but just in a different location. And it can cause some redness and peeling between the fingers and toes and also in the groin. if you get it on a hairy surface, like the scalp, which can happen, it can cause some hair loss and also on the arms and legs. So those are some other signs that that itchy, bothersome, rash you're dealing with is ringworm. And like you mentioned, you get it kind of in the hot warm environments. And so in the summertime like this, whenever we're hanging out in the locker rooms, by the pools, that's often a place you can pick it up.

So things that you can do, particularly in the summertime, to prevent getting ringworm is whenever you're in a public shower or locker room, wear foot protection, like sandals or some kind of shoe. Use your own personal care items. So your own towels, your own sponges or rags. Not sharing those personal care items can help prevent contracting ringworm because that's how you can pick it up, is by sharing these items or direct contact with someone else that has ringworm.

It is very preventable if you get it or if your kiddo gets it. So most of the time, you can use a topical antifungal medicine that you can get at most drug stores. But also, your doctor can prescribe them and that should take care of it. If it is on your scalp or on your kiddo's scalp, you will need an oral medicine and that unfortunately you can't get over-the-counter. So you'd have to see your doctor to get that prescribed. But it can be treated fairly easily, no matter what form it's in.

Melanie Cole (Host): Wow. This is really such a great podcast, especially this time of the year. So doctor, wrap it up for us. Give us your best advice, Dr. Grither, and what you want us to know as parents for this coming up summer. All of these rashes, some are discernible, some were like, "What the heck is that that just showed up?" I mean, we've all seen those as parents, right? What would you like your best piece of advice to be for us parents when we're looking at these rashes on our little kiddos?

Dr Allie Grither: Absolutely. I mean, if you've had a kid, you know that they get rashes and they get them pretty often. And so really, the best advice is to try and have fun and enjoy being outside in the summertime, but take precautions as much as you can. So if you know, like we talked about, you're going to be out in the hot sun, use your sunscreen, try to keep your kid cool, take frequent breaks. If you know you're going to be camping, wear protective clothing and get some bug repellents, whatever kind you're most comfortable with. Just be prepared as much as you can. Know that rashes probably will happen. And if you're at all worried at any point, your doctor would love to see you, talk to you on the phone and get you through whatever's happening.

Melanie Cole (Host): Boy, I remember those days of calling my pediatrician and saying, "What is this? You see this rash? What is this?" So, yes, our pediatricians are certainly our best resource as proved here today by you, Dr. Grither. So thank you so much for such great information. And for more advice and articles, check out the Mom Docs website at childrensmd.org.

That concludes another episode of Mom Docs with St. Louis Children's Hospital. I'm Melanie Cole.