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Warning-sign checks

Erythema toxicum: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services or go to an emergency department if the baby:

    • Has trouble breathing, pauses in breathing, or develops blue or grey lips
    • Is difficult to wake, floppy, or much less responsive than usual
    • Has a seizure
    • Will not feed or has signs of significant dehydration
    • Develops a purple or red rash that does not fade when pressed
    • Has rapidly spreading blisters, widespread skin peeling, or severe swelling

    These are not expected features of erythema toxicum.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Arrange prompt medical advice if you are unsure whether a newborn rash is erythema toxicum.

    Newborn skin conditions can be difficult to tell apart from photographs or descriptions alone.

    Contact a healthcare professional promptly if:

    • The rash is still present after two weeks
    • Spots involve the palms, soles, eyes, or inside the mouth
    • The skin becomes crusted, swollen, painful, or warm
    • Large blisters, open sores, or peeling skin develop
    • Fluid drains from the spots or has an unpleasant smell
    • The baby is feeding less well but has no emergency symptoms

    Seek urgent medical assessment for a rectal temperature of 38°C or higher in a baby younger than 3 months.

    Fever in a young baby needs assessment even when the rash looks harmless.

    They may indicate an infection or another condition that needs urgent care.

Every sign above is quoted from the sofidex article on Erythema toxicum. If you are not sure, err upward — it is always reasonable to be checked.