Health practitioners often field a lot of questions from friends, family, and coworkers about various symptoms that they are worried about. While it is hard, if not impossible, to diagnose a problem without a proper history and physical (as well as some diagnostic tests), there are some telltale symptoms that point to common ailments that can be identified.
Arguably the Most FAQ of All: “What Is This Rash?”
This is a question that nurses and doctors get a lot while they are off duty. It’s frustrating to the doctor or nurse to be asked this because the origin of a rash is often impossible to answer questions by just looking. Even most doctors can’t identify the exact diagnosis of a rash that crops up without the help of a specialist.
There are about three primary types of rashes. Knowing how to describe your rash in detail may help a little if you are asking a pharmacist or other health practitioner for help in how to proceed. If you can take a picture of the rash to show the person who is helping, it will help them differentiate what type of rash you are dealing with:
- Petechial/ Purpuric: Petechiae are made when tiny blood vessels called capillaries burst, leaving minuscule bruises that look like paint spatter or tiny clusters of dots that are typically red, purple, or reddish-brown. Purpura is made when those tiny, bruised petechial areas combine in patches of more extreme irritation, making larger bruised areas of red, purple, or reddish-brown.
- Maculopapular: This rash is usually made up of a combination of macules, which are flat, discolored spots on the skin, and papules, which are tiny or very small, sometimes fluid-filled bumps.
- Vesiculobullous: These rashes are a combination of vesicles and bullae; vesicles are small, fluid-filled sacs, cysts, or lesions on the skin — and bullae are larger cysts that usually contain clear fluid that is colorless, pink, or yellowish (but not pus-filled — thick, opaque fluid that can range in color from white, yellow, green, to even gray, brown or black)
- Pustules are pus or matter-filled lesions that do not usually fall under the category of a “rash”. They can be isolated or in small clusters, are generally inflamed in nature and either firm or fluctuant (squishy like a water balloon) to the touch, painful upon palpation, and may drain foul or pungent matter that can be cheesy, thick, bloody, or otherwise unpleasant fluids).
Questions to ask yourself when you notice a rash:
- Do I (or does my child) have a fever or feel ill?: This is absolutely the most important thing to find out with any rash because it immediately differentiates certain harmful/life-threatening rashes from more benign rashes. Always take your or your child’s temperature (prior to taking any kind of antifebrile medicine like Tylenol, Advil, or aspirin) if there is a rash that you are concerned about. If you or your child have other general symptoms of illness, this is also significant to point out to someone when you are asking their advice.
- Where is the rash located? Is this rash located everywhere? Is it just on the arms or legs? Is it only on the trunk? Is it inside the mouth or mucous membranes? Is it on or in the genitals? Is it on the palms of the hands or soles of the feet? Make sure to disrobe completely and find out everywhere the rash is located. Look over your child just as thoroughly, if it is them you are concerned about.
- What does it look like? (see above) The nature of the rash is important. Take a photo if you can to show the doctor or whoever you are consulting, if you cannot show them in person. Are the blisters intact, or are they popping and weeping fluid? If the rash is on your child’s chest or trunk, run your hand over it and make note if it feels rough, or like sandpaper. Little details can be very helpful in diagnosing certain rashes.
- Does it itch or burn? Is it painful in general? Has it changed over the course of several days?
The issue with rashes is that there are thousands of things that the same looking rash might be, and over the phone diagnosis (or over the internet) is pretty much impossible, and at best is a reckless way to get help for any illness that could be serious, especially if your child is the one who is suffering from it. If you have an abundance of information to give to someone you trust who is a medical practitioner, they can better steer you toward the best possible outcome.
When fevers or illnesses are attached to rashes, they are generally more worrisome. These rashes can be from various viral illnesses like scarlet fever or fifth’s disease, bacterial infections like Lyme’s disease, from parasites like scabies, from sexually transmitted diseases like syphilis, or from acutely life-threatening issues like endocarditis or disseminated intravascular coagulation (DIC) or from contagious illnesses like shingles.
Hopefully, your rash is not something life-threatening, but if you wonder why most medical practitioners are a little reluctant to diagnose you on the spot, they are worried about sending you off to premature death by misdiagnosing a rash that is a symptom of a much bigger problem.
Useful OTC Products to Try
You don’t have any healthcare coverage. This is an unfortunate and too common problem. You simply can’t afford to risk an ER bill that will possibly break you financially. This is not a circumstance that should exist in the first world, but it does exist. If you are wondering, “Do cough drops work for everything?” at this point, here are a few OTC options to try that may possibly help you with a minor rash. Having the metabolic flexibility to wait out the length of the life of a rash isn’t always an option. These various over-the-counter treatments are only safe to try if your rash isn’t making you sick in any other way, including fever.
- Diphenhydramine (Benadryl): helpful in minor allergic rashes to help itching; also useful with allergic dermatitis and other allergic reactions. If you are having a major allergic reaction, try to get some Benadryl in your mouth and down the hatch as soon as possible and get yourself to the hospital. (Don’t delay treatment by stopping to buy Benadryl, however. It is always good to keep this handy somewhere in your house.) Topical Benadryl is good for rashes caused by an allergic response.
- Tea Tree: This essential oil is made into many skin products now because it has a broad spectrum of uses for the skin. It can help with problems that are caused by bacteria, viruses, fungi, allergies, and more. It can be irritating to sensitive skin, so go easy if you have never tried it before.
- Triple Antibiotic Ointments/Creams: this is a catch-all for lots of households, and it is an amazing product for minor skin irritations in preventing infection. If you apply this to skin irritation and the problem gets no better or gets worse after 24 hours or more, then discontinue use. If it is a petroleum jelly-based ointment, it might make some rashes worse.
- Cortisone/Corticosteroid Ointment/Cream: If you are trying to get rid of a pesky rash that didn’t respond to antibiotic ointments or Benadryl, steroid-based creams might be of use. It is especially good for dermatitis caused by plants like poison ivy, and itching around the rectum or genitals.
- Antifungal Creams/Ointments: there are a number of antifungal products out there, usually marketed for things like jock itch, yeast infections, and athlete’s foot. If your rash is still causing you minor irritation, and it did not respond to antibiotic ointment, steroid-based ointment, or diphenhydramine, using an antifungal might help you. There are some fungal skin infections that can crop up in places you might not recognize. Try it for a day or two, and discontinue if it doesn’t help.
Rashes In Small Children
It is one thing to play roulette with your own health by treating it at home, but nobody should do that with their child. Any baby under six months old with a rash or a fever is considered a true emergency, and the situation should be dealt with immediately. A newborn that has rash and fever* could possibly have meningitis. It is abnormal for a child that small to have those symptoms, and very often it is a sign of a life-threatening illness that they do not have enough immune system support to fend off without help. (*Try to get a rectal temperature with tiny babies. It is the most accurate representation of the body’s core temperature. Hold a mercury thermometer in the rectum for at least two minutes before removing to get an accurate reading, and always remember to shake the thermometer to get the mercury down to baseline before you use it.)