Children/Young People’s Health

Skin, Nail Conditions and Lumps (Children)

Some links on this page have been colour coded to make it easier to find the information you need:

Quick Read
In-depth
Clinical level

LOCAL SUPPORT - SELF REFERRAL

Your pharmacy and skin conditions

Many common skin conditions can be supported with self-care or the support of your local pharmacist. You can see your local pharmacist for advice including support with relevant creams and oral medication such as antihistamines.

From the NHS
Find a pharmacy Find a pharmacy – NHS 

For further information on the range of services offered for common skin conditions by your local pharmacist, see under

When do you need an assessment by a GP or attend A&E?

Some conditions may need a clinical assessment in a GP practice. Your pharmacist can advise you when this might be the case and this is also well explained in the NHS articles. Much less commonly you may need to attend A&E directly and this is again well explained in the NHS articles.

PODIATRY SUPPORT

Local community podiatrists treat people who have a medical/podiatric problem that puts your foot at risk of deterioration.

TREATMENT FROM A COMMUNITY PODIATRIST

Local community podiatrist treat people who have a medical/podiatric problem that puts your foot at risk of deterioration. Conditions include:

  • painful corns and callus – but not verrucae (warts)
  • ingrowing toe nails

To self-refer to the service see “podiatry” under

NATIONAL SUPPORT - SELF REFERRAL

From the British Dermatology Association
List of Patient Support Groups for many skin conditions often with helplines Patient Support Groups – BAD Patient Hub

From Changing Faces
Support for the potential emotional impact of the appearance of skin conditions including a helpline
Services and support Services For People With Disfigurements | Changing Faces

GENERAL INFORMATION

From Healthier Together – What 0 to 18
Includes simple information using a traffic light system (with red, orange and green coloured tables) when you should worry and what to do. The red table for each presentation includes features which would suggest urgent help is needed at a hospital emergency (A&E) department.

SYMPTOM CHECKER TOOLS

Remember these tools are purely designed to provide information and potentially help you understand your skin condition. These tools do not provide medical advice, diagnosis or treatment. Professional medical advice provided by a clinician such as a doctor should always be relied on to make decisions, and information provided here should not delay you in any way getting such advice.

From DermNet NZ
This site is backed up with pictures of each condition which is helpful in understanding possible conditions better. In addition, there is very detailed information on each of the skin conditions considered.
DermDiag : A tool to help you identify a skin condition. DermDiag | DermNet NZ

From Skinsight
This tool gives conditions by location which can be very helpful if you have a rash in one place (e.g., hands). It has excellent pictures for each condition which you can compare.
Insight from experts about treating and caring for your skin. skinsight | expert insights about skin care, skin health, and skin disease

From Familydoctor
Skin Rashes & Other Skin Problems Symptom Checker: Skin Rashes & Other Skin Problems

From the Primary Care Dermatology Society (PCDS) a tool intended for GPs
The Cunliffe (TP) General Dermatology Diagnostic Tool The Cunliffe (TP) General Dermatology Diagnostic Tool

From the British Skin Foundation
Explore our A-Z of skin. British Skin Foundation – Know your skin inside out

From the NHS
Thought not strictly a symptom checker explains differences between common causes of itching
Itchy skin Itchy skin – NHS

GENERAL INFORMATION

From the NHS
Some simple information on rashes, a good place to start.

British Association of Dermatologist
Excellent website with some very good leaflets Home – BAD Patient Hub

From the Primary Care Dermatology Society (PCDS)
“Our primary objective is to educate GPs, nurses, other health professionals, and the general public on skin conditions.” Though some of the information is focused on clinicians it has a good patient and carers page which includes information such as excellent patient leaflets for common conditions which replicate what a GP is likely to say and more. Patients and carers

From DermNet NZ
Excellent website on dermatology  DermNet NZ – All about the skin | DermNet NZ

From Patient info
Skincare and conditions centre Skin Conditions and Diseases | Symptoms, Treatment, Information | Skincare | Patient which includes numerous articles on skin and sections with Information on psoriasis, skin rashes viral rashes, atopic eczema and sunburn.

From NICE
Skin and nail Skin and nail | Specialities | CKS | NICE

EMOTIONAL SUPPORT

From Changing Faces
Great advice and support for the potential emotional impact of the appearance of skin conditions

From the British Association of Dermatologists
Support & Resources Support & Resources – BAD Patient Hub

Long term skin conditions

Some conditions including acne, eczema, psoriasis, and vitiligo which can be more long term are considered under the common long-term conditions section, see under

Skin rashes caused by infection

This is not an exhaustive list but provides details on some of the more common infections causing rashes. This list is divided into bacterial, viral and fungal infections which generally have slightly different common features to help identify them. Each infection, is divided up into self-care (with or without a pharmacist support), assessment by a GP practice, and attendance at A&E. There is also a link to “spotting sepsis”, which though not common is important to diagnose early.

BACTERIAL INFECTIONS

If anyone is thought to have meningitis you should phone 999 to be seen in A&E:

From the NHS and Patient info
Rash that does not fade when a glass is rolled over it in a very ill patient:
Meningitis

See your GP for Kawasaki disease
Though uncommon, any rash associated with a high ongoing fever that lasts for 5 days or more one should be assessed by your GP who will consider Kawasaki disease which always needs treatment in hospital. The cause is unknown and it is not infectious but it has been included here as it is associated with a fever.
Kawasaki disease

Normally the following conditions can be treated with self-care (with or without pharmacy support) but on occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS

From the NHS and Patient info
Stye

Anyone with the following conditions may need to see their GP practice for antibiotics as is explained further in the articles below

From the NHS
Rash maybe red, inflamed, tender, sometimes with blisters, sometimes golden-brown crust

From the NHS and NICE
Cellulitis-acute

From the NHS
Can present like a cellulitis and can develop into an abscess

From the NHS and NICE
Rash associated with a sore throat treated with antibiotics
Scarlet fever

From the NHS
A circular or oval shape rash around a tick bite which should be treated with antibiotics as soon as diagnosed
Lyme disease Lyme disease – NHS

VIRAL INFECTIONS

These very common conditions can usually be managed with self-care, only on occasions may your child need to be reviewed by a GP practice as explained further in these articles.

From the NHS and NICE
Associated with bright red cheeks
Slapped Cheek syndrome

From the NHS
Associated with blisters on hands, feet in the mouth
Hand, foot and mouth disease Hand, foot and mouth disease – NHS

Associated with a rash which often comes on after the fever resolves
Roseola Roseola – NHS 

From the NHS, Patient info and NICE
Rash with blisters which can be itchy

Cold sore

Normally the following very common conditions can be treated with self-care with the support of your local pharmacist who can advise if you need to see your GP practice.

From the NHS and Patient info
“Small, firm, raised papules (spots) on the skin with a characteristic small dimple in the middle.”
Molluscum contagiosum

“Most people have warts at some point in their life. They usually go away on their own but may take months or even years.”
Warts and verrucas

Anyone with the following should contact their GP practice/111 as soon as possible for antibiotics as is explained further in the articles below.

From the NHS

Measles: If you think your child has measles see a GP for diagnosis

As the NHS suggest
“Measles is a highly infectious viral illness that can be very unpleasant and sometimes lead to serious complications. It’s now uncommon in the UK because of the effectiveness of vaccination.”

From the NHS, Patient info and NICE
If your child is diagnosed with measles though there is normally no specific treatment it is important to be aware of the uncommon but serious complications and when to return to your GP.

Measles

Rubella is now rare in the UK because of the effectiveness of vaccination but if you think your or your child has rubella you should see your GP for reasons explained in the article.

As the NHS suggest
“It’s very unlikely to be rubella if you have had both doses of the MMR vaccine or had rubella before.”
Rubella Rubella (german measles) – NHS

As the NHS suggest
Call your midwife, maternity unit, or GP immediately if you’re pregnant

  • been in close contact with someone who has rubella
  • you think you have rubella yourself

FUNGAL INFECTIONS

Normally the following conditions can be treated with self-care (with or without pharmacy support) but on occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS

From Patient info
Fungal Groin Infection (Tinea cruris) Fungal Groin Infection (Tinea Cruris) | Symptoms and Treatment | Patient

Normally this rash does not require any treatment but you may wish to see a GP for a diagnosis. The herald patch (like ring worm) before the full rash appears makes the diagnosis more obvious.

From the NHS and Patient info
Pityriasis rosea

Balanitis: This rash on the penis is normally treated by a GP sometimes for a fungal infection, sometimes for a bacterial infection or sometimes as a mild allergic reaction.

From the NHS and NICE
Balanitis

Having some basic knowledge of the symptoms and signs of sepsis can allow you to identify when someone is becoming seriously ill and take immediate action. This is explained under

SPECIFIC SKIN CONDITIONS

INSECT BITES AND PARASITES

Your pharmacist can fully support you with head lice

From the NHS, Patient info and NICE
Head lice and nits

Normally the following conditions can be treated with self-care with pharmacy support but on a few occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS, Patient info and NICE
Scabies

Bed bugs

Insect bites and stings

Threadworms

A circular or oval shape rash around a tick bite could be lyme disease which should be treated with antibiotics as soon as diagnosed.

From the NHS
Lyme disease Lyme disease – NHS

HAIR CONDITIONS

Your pharmacist can fully support you with head lice

From the NHS, Patient info and NICE
Head lice and nits

Normally the following conditions can be treated with self-care with pharmacy support but on a few occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS
Dandruff Dandruff – NHS

From the NHS and Patient info
Yellow scaly patches on the scalp
Cradle cap

With mild hair dye reactions you may be able to self-care with pharmacy support, but you may need GP support and very rarely A&E support (if anaphylaxis) as explained further in the article.
Hair dye reactions Hair dye reactions – NHS
With this condition you may want to see a GP to discuss as explained in the articles below.

From the NHS, Patient info and NICE
Hair loss

HANDS AND FEET CONDITIONS

Normally the following conditions can be treated with self-care with support of your local pharmacist who can advise if you need to see your GP practice. Painful corns and calluses you can self-refer to an NHS podiatrist (details at the bottom of the page)

From the NHS, Patient info and NICE
Warts and verrucas

From the NHS

You can start with simple self-care as suggested in the article but may need GP support for this condition

NAIL CONDITIONS

From the NHS
Nail problems Nail problems – NHS

Normally the following can be treated with self-care with pharmacy support but on a few occasions may need to be seen by a GP practice as elaborated on in the articles below:

From the NHS
Fungal nail infection Fungal nail infection – NHS

If you do decide you want to look at oral antibiotic treatment for a fungal nail infection and meet the criteria (after microbiology lab analysis), then it is worth understanding that the drug treatment is done over a minimum of 1 month and potentially up to 6 months and there are potential side effects with both options. This is explained in more detail below.

From NICE
Fungal nail infection Fungal nail infection | Health topics A to Z | CKS | NICE

Normally for the following condition you can self-care with support from your local pharmacist who can also advise if you might occasionally need to see your GP practice for antibiotics. You can also self-refer to a podiatrist on the NHS or see a private podiatrist to provide a long-term solution.

From the NHS

Self-referral to NHS Podiatry

For information on self-referral to NHS podiatry services, including any criteria, see under

Self-referral to Private Podiatry

For information on local private podiatrists, see under

accidents and injuries

From the NHS
The following conditions can often be treated with support of your local pharmacist but on occasions will need the support of you GP practice as explained in the articles below

Some burns can be treated with self-care with the support of your local pharmacist, some will need the input of your GP practice nurse, and some you will need to go straight to A&E. This is all expanded on in the article below
Burns and scalds Burns and scalds – NHS 

Call 999 and ask for urgent help in the case of acid and chemical burns
Acid and chemical burns Acid and chemical burns – NHS

allergic reaction

An allergic skin reaction normally produces a red itchy rash, sometimes with hives.

With these conditions if mild they only require self-care with pharmacy support, but in some cases GP support may be needed and very rarely A&E support (if anaphylaxis). This is all explained in detail under

If your child has a severe allergic response, you should call 999

From the NHS and Patient info
Anaphylaxis

mouth ulcers and other oral conditions

For children

If your child is over 4 months your pharmacist can treat oral thrush
Oral thrush Oral thrush (mouth thrush) – NHS

If mouth ulcers are present less than 3 weeks they can be treated by your local pharmacist.
Mouth ulcers Mouth ulcers – NHS

Normally with hand, foot and mouth disease you can self-care with support from your local pharmacist (the article includes when you occasionally might need to see a GP for this condition)
Hand, foot and mouth disease Hand, foot and mouth disease – NHS

rashes with no clear cause

For Henoch-Schonlein purpura you will need to see your GP

Uncommon rash with raised red or purple spots often on the legs (commoner in children).

From the NHS
Henoch-Schonlein purpura Henoch-Schönlein purpura (HSP) – NHS

common rashes in young babies

Most of the common rashes in young babies without fever or itching do not need any treatment or can be supported by creams from your local pharmacist (only occasionally will you need to see your GP as explained in these articles).

From the NHS
Rashes in babies and children: see under “rash without fever or itching”  Rashes in babies and children – NHS
Which includes:

  • Tiny (White) spots on baby’s face (in first few days)
  • Red, yellow and white spots – erythema toxicum (in the first few weeks)
  • Pimples on the cheeks, nose and forehead (in the first few months)

From Patient info
Erythema Toxicum Neonatorum Baby Acne (Erythema Toxicum Neonatorum), newborn rash | Patient

From the NHS and Patient info
Yellow scaly patches on the scalp
Cradle cap

From the NHS, Patient info and NICE
Red patches on a baby’s bottom
Nappy Rash

From the NHS and Patient info
“Small, firm, raised papules (spots) on the skin with a characteristic small dimple in the middle.”
Molluscum contagiosum

birth marks

From the NHS
Birth marks Birthmarks NHS – NHS

From Patient info
Port-wine Stain Port-wine Stain | Causes and Treatment | Patient

Lumps and common benign (non-cancerous) raised lesions

From the NHS

Skin Cancer

An awareness of melanoma and sun safety is worth considering from birth though a diagnosis of melanoma is very rare in children, particularly before puberty.

Melanoma

An awareness of melanoma and sun safety is worth considering from birth though a diagnosis of melanoma is very rare in children, particularly before puberty.

From DermNet NZ
“Cutaneous melanoma in children is rare, and extremely rare before puberty.”
Childhood melanoma Childhood melanoma | DermNet NZ

From the NHS
Comparing a benign (non-cancerous) mole with a melanoma (cancerous mole)

Explaining the ABCDEs of melanoma with photographs

From Skin Cancer Foundation
This is good American dermatology website with some helpful pictures (see ABCDEs of melanoma as an example), though the information about dermatologists does not apply in the UK
Spot the Cancer You Can See When It’s Easiest to Treat. Early Detection: Overview Early Detection – The Skin Cancer Foundation

From DermNet NZ
Melanoma: see Glasgow 7-point checklist and ABCDE+EFG criteria but note
“Most melanomas have characteristics described by the Glasgow 7-point checklist or by the ABCDE+EFG criteria of melanoma. Not all lesions with these characteristics are malignant. Not all melanomas show these characteristics.” Melanoma Skin Cancer: Images, Diagnosis, and Treatment – DermNet

From Patient info
Melanoma Skin Cancer Melanoma Skin Cancer | Causes, Symptoms & Treatment | Patient

reducing the risk of skin cancer

Answers to the question: “ How can you reduce your risk of skin cancer?” can be found under

NHS 111

If you think you need medical help right now, 111 online can tell you what to do next.

Campaigns

"Pump it up" - know your blood pressure.

Your Pharmacy

Seven common infections now treated by your local pharmacist

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