Few kids make it out of childhood without experiencing some type of skin rash or infection. Many of these problems are contagious, so they spread quickly and easily among children in play groups, at day care or in school. Don’t be embarrassed or ashamed; it happens to many kids, and most of the problems are easily treatable.
RINGWORM (TINEA INFECTIONS)
Ringworm isn’t really a worm at all; it’s a fungus. The name comes from the characteristic rough, ring-shaped patches on the skin that the fungus causes.
Ringworm can affect all parts of the body, including the scalp, fingernails, feet and groin. The fungus is hardy, common and quite contagious. If your child is infected and touches a pet, plays in the dirt or touches a friend, the fungal spores are spread. Because fungi like moisture, ringworm is most common in the summertime when children are more likely to perspire, wear wet clothes and walk barefoot around swimming pools and locker rooms. Incubation is one week to several months.
Ringworm usually starts off as flat lesions on the skin. Some are dry and scaly; others are moist and crusty. (It’s often mistaken for eczema, psoriasis or other common skin irritations.) They may be about the size of a nickel. The outer rim may be slightly raised and composed of little bumps. As the spot enlarges, its center heals — causing the “ring” shape. On the feet, it often just causes scaling or irritation between the toes.
Your child’s physician probably will prescribe a cream to be rubbed into the skin. Follow all directions carefully. Topical, over-the-counter medications, such as Clotrimazole, Terbinafine and Butenafine, can be used to treat fungal infections, but if these don’t work, prescription creams or oral antifungal medications may be better.
Ringworm of the scalp causes small raised bumps that spread and may cause patchy hair loss, scaling and inflamed, pus-filled blisters. You may notice a funny odor to the scalp. Oral medications will be required for ringworm of the scalp, because the fungus gets into the hair roots where creams can’t reach.
To prevent recurrence:
Impetigo is a bacterial skin infection that is eaily spread to other parts of the body, as well as to other people. Incubation is one to 10 days.
It often begins around the nose and mouth, first appearing as a discolored pimple. Then small blisters form and quickly break, spreading the germs to the skin. The weeping sores form brownish-yellow crusts. The skin around them is red.
Your doctor will prescribe an antibiotic, either in pill or ointment form. (The doctor also will tell you when your child can return to school.) Follow all directions for oral antibiotics carefully.
If using an antibiotic ointment, have someone else hold your child if needed and follow these instructions three times a day:
Explain to your child that he should use only his washcloth, towel and linen — no one else’s. Likewise, no one else should use his things.
Keep his fingernails short. Remind him not to touch the sores.
Scabies or mites live in the skin — especially moist areas, such as between the fingers and around the genitals. They burrow under the skin to lay eggs, causing intense itching, especially at night. If the skin is scratched open, it may become infected.
The mites are spread through person-to-person contact. Incubation is four to six weeks for those who haven’t had scabies before.
On the skin, scabies look like tiny scratch marks — a small, wavy, threadlike line that may feel raised and appear discolored. There may be blisters at the opening of the burrow, but all of this is often difficult to see with the untrained eye.
Your child’s physician will prescribe a lotion to kill the mites. (The entire family will need to be treated, even if no one else has symptoms.) Follow all directions carefully. Apply the lotion from the hairline down and include the belly button, under fingernails and toenails, and all skin folds. Wait 10 to 15 minutes to let the lotion dry, then dress the child in clean clothes. Wait eight to 12 hours, usually overnight. Then have the child take a bath or shower.
As soon as possible, machine wash or dry clean clothes, bed linens, washable stuffed animals, hair ornaments, etc., which could have come in contact with the infection. If you use your washing machine, make sure the water temperature is set at 120 degrees F. or hotter. (Be sure to lower the temperature afterwards to avoid scalds from the hot water.) Regular detergent is fine.
Some medications may need repeated applications. It is important that you follow your doctor’s instructions. Unfortunately, the itching may persist for several weeks after treatment. If itching persists three weeks after treatment, check with your child’s doctor.
Some lotions for the treatment of scabies may be harmful to infants. Always check with your baby’s doctor first. The scabies lotion should never be swallowed.
Soak all combs, brushes and hair-care items for an hour in a mixture of Lysol and water, or boil them for five to 10 minutes.
Non-washable items should be sealed in plastic bags for two weeks to kill off the mites.
Warts aren’t caused by frogs, toads or curses. The culprit is a family of viruses, which are contagious and spread from person-to-person or through close contact, or even minor skin cuts. That’s why warts are so common among school-aged children. Incubation is unknown, but may range from three months to several years.
Common skin warts are dome-shaped and may appear rough; they often occur in groups on the hands and around the nails, and on the feet. Flat warts also may occur on the face, arms and legs. Filiform or threadlike warts may show up on the face and neck.
A doctor can speed up removal of warts using special chemicals or liquid nitrogen to freeze them until they drop off. There are a number of over-the-counter wart treatments that can be useful, especially preparations with 17 percent salicylic acid. There are some over-the-counter “freezing” treatments available, but they are not as effective as liquid nitrogen in the doctor’s office. It is stated that warts usually go away by themselves, but this can take two years or more and while they are active they are contagious. Recurrence is also common. Remember, when the wart is there, try to prevent your child from picking at it and be careful to wash your hands if you are in contact with them.
It’s best to have large, persistent or painful warts treated. The earlier warts are treated, the less likely they are to recur.
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