The emergency sign: a rash like small bruises or bleeding under the skin that does not fade when you press a clear glass against it - the meningitis pattern; call an ambulance immediately.
On brown or black skin, check palms, soles, lips, and inside the eyelids. Also emergency: rash with lip, mouth, or tongue swelling, tight throat, or breathing difficulty (anaphylaxis). Same-day: any rash plus fever with a genuinely unwell child (drowsy, floppy, not drinking), rash in a baby under 3 months with 38C or more, or a painful, blistering, fast-spreading rash. The reassuring majority: a child who is playing, drinking, and acting normal, with spots that fade under glass, can be watched for a day or two. Pymander is a free AI doctor, 24/7 by text, and can help you judge a rash tonight.
What to do
Common questions
When should you worry about a child's rash?
Most childhood rashes are harmless - heat, viruses, eczema - and the child is otherwise well. The worry line has two sides. The emergency side: a rash that looks like small bruises or bleeding under the skin and does NOT fade when you press a clear glass firmly against it - the glass test - is the meningitis pattern; call an ambulance, do not wait for other symptoms, and on brown or black skin check the palms, soles, lips, and inside the eyelids where colour changes show best. Also emergency: a rash with swelling of the lips, mouth, or tongue, a tight throat or trouble swallowing, or breathing difficulty - that is anaphylaxis. The same-day side: any rash plus fever in a child who seems genuinely unwell (drowsy, floppy, not drinking, not their normal self), a rash on a baby under 3 months with a temperature of 38C or more, or a rash that is painful, blistering, or spreading fast. The reassuring majority: if your child is playing, drinking, and responding normally, and the spots fade under glass, it is safe to watch for a day or two - viral rashes typically clear on their own. Pymander is a free AI doctor, 24/7 by text, that can help you judge a rash from your description tonight.