Infectious Skin Conditions in Children

Features that may suggest infection include:

• Rapid spread or worsening

• Crusting, weeping, pustules, or blisters

• Pain or tenderness

• Other family members developing similar rashes

• Fever or a child appearing unwell

Assessment helps distinguish infection from inflammatory conditions such as eczema or psoriasis.

Infectious skin conditions in children fall into four main groups:

• Bacterial infections

• Viral infections

• Fungal infections

• Parasitic infestations

Each group behaves differently and requires a different treatment approach.

Common bacterial skin infections include impetigo (school sores) and folliculitis. These are most often caused by Staphylococcus aureus (staph) or Streptococcus bacteria.

They may present as:

• Red, crusted, or weeping sores

• Honey-coloured crusts, typical of school sores

• Pustules or small boils

• Surrounding redness or inflammation

Treatment depends on severity and may involve topical or oral antibiotics.

A bacterial skin infection may be more serious if a child:

• Has fever

• Appears generally unwell

• Has rapidly spreading redness, pain, or skin breakdown

These situations require urgent medical assessment, and hospital care may be needed. Early diagnosis is important to prevent complications.

Common viral skin infections include:

• Molluscum contagiosum

• Warts

• Herpes simplex virus (HSV) – cold sore virus

Molluscum contagiosum is a common viral skin infection in children. It causes small, smooth, dome-shaped bumps, often with a tiny central dimple.

It spreads through skin-to-skin contact and is more common in young children, particularly those with eczema.

Yes. Molluscum is usually self-limiting, meaning it resolves without treatment over time. This can take several months.

Treatment may be considered if lesions are:

• Widespread or persistent

• Frequently inflamed or infected

• Causing eczema, discomfort, or distress

When treatment is required, a dermatologist can offer age-appropriate topical treatments aimed at reducing symptoms and limiting spread.

Warts are caused by the human papillomavirus (HPV) and are very common in children. They can occur on the hands, feet, knees, or other areas of skin.

Warts are benign but may spread, become painful (particularly on the soles of the feet), or cause distress.

Not always. In many children, no treatment is a reasonable option, as warts often resolve on their own as the immune system clears the virus.

Treatment may be considered if warts are:

• Painful or affecting walking or activity

• Spreading or increasing in number

• Persistent

• Causing distress or affecting confidence

Treatment is individualised based on age, wart location, number of lesions, and tolerance.

Options may include:

• Observation only (no active treatment)

• Over-the-counter wart paints or solutions for home use

• Prescription topical treatments for home use, selected based on age and site

• Clinic-based topical treatments, applied in a controlled medical setting

• Cryotherapy (freezing), which can be effective but may be uncomfortable and is not suitable for all children

A dermatologist can help balance effectiveness with comfort and guide the most appropriate option.

HSV can cause painful blisters or sores, commonly around the mouth or lips.

Urgent assessment is recommended if HSV:

• Involves the eyes (risk of herpes simplex keratitis)

• Occurs in infants

• Is extensive or associated with systemic symptoms

Some cases benefit from antiviral treatment, depending on severity and location.

Fungal infections include tinea (ringworm) and candidiasis.

They may present as:

• Scaly, red, or ring-shaped rashes

• Hair loss, broken hairs, or scaling on the scalp (tinea capitis)

• Nail or skin-fold involvement

Fungal infections are contagious and may spread through close contact or from pets, particularly cats and dogs.

Scalp fungal infections usually require oral antifungal medication, as creams alone are not effective.

Common parasitic infestations include scabies and head lice.

Scabies is caused by mites that burrow into the skin and cause intense itch, often worse at night. It spreads easily through close contact.

Successful treatment requires:

• Treating the affected child

• Treating close contacts

• Following household measures to prevent reinfestation

Management is individualised and considers:

• The child’s age and weight

• Severity and location of infection

• Ability to tolerate topical or oral treatments

• Whether investigations or escalation of care are needed

The goal is safe treatment, reduced spread, and prevention of recurrence.

At Ready Dermatology in Sydney, our specialist dermatologists provides assessment and management of bacterial, viral, fungal, and parasitic skin infections in children. Care focuses on accurate diagnosis, safe treatment, early recognition of more serious infection, and supporting families through both treatment and prevention.