​Sunny days and starlit evenings spent playing, splashing, and exploring can leave kids with more than warm summertime memories. But unfortunately, balmy weather also can lead to itchy, irritated skin.

We’ve provided a list to help prevent, identify, and soothe typical skin rashes found in the Cayman Islands.

Heat rash (also known as prickly heat or miliaria) is often seen in babies and young children when sweat gland pores become blocked, and perspiration can’t escape. The rash looks like patches of small pink or red bumps or blisters under clothing or spots where skin tends to fold—on the neck, elbows, armpits, or thighs—although heat rash can occur on other covered areas.

What parents can do:

  • Keep kids cool. Dress your child in clothing that keeps the skin cool and dry. If possible, use fans and air conditioning to avoid overheating.
  • Pay attention to hot spots. Wash areas of the skin that stay wet with sweat, urine, or drool with cool water. Pat them dry.
  • Keep skin bare. Leave skin open to the air without clothing, and do not apply skin ointments.

Maiden Plum & Other Plant Rashes. Many children get a burning, intensely itchy rash where their skin touches plants—such as Maiden Plum, Manchineel, John Crow Bead and Cow Itch. An allergic skin reaction causes redness, swelling and blisters.

What parents can do:

  • Prevent exposure. Teach your child what these plants look like and how to avoid them. Distinctive glossy, waxy leaves with serrated edges will identify Maiden Plum. The Manchineel tree will be close to wetlands, and the bark will have vertical and horizontal fissures that break the bark into a crazed pattern. The leaves can be heart-shaped and somewhat glossy. The bark, leaves, sap and fruit of the Manchineel are very dangerous, and if it rains, never take shelter under a Manchineel tree, as water dripping from the leaves will carry the sap with it, causing blistering of the skin. John Crow Bead, also known as Licorice, Rosary Pea and Crab’s Eyes, includes a red seed with a black spot covering one end and is highly poisonous if eaten. Cow itch is a climbing shrub with long vines. The sides of the leaves are often heavily grooved, and the tips are pointy. Cow itch bears hanging purple flowers with pods (5-10cm long) and covered in loose orange hairs resembling furry caterpillars. Cow itch hairs are fragile, and the slightest touch will release them into the air or onto clothing. The hairs cause a severe, almost unbearable itch if they contact the skin.
  • Wash and trim. If your child comes into contact with these plants, wash their clothes, shoes, hats, backpacks etc., in soap and water. Also, wash the skin area exposed with soap and water for at least 10 minutes after the plant or the oil is touched. To discourage scratching and further damage to the skin, keep your child’s fingernails trimmed, which will prevent the rash from spreading if there is still a tiny amount of oil under the fingernails. If you suspect your child has come in contact with Manchineel, you should seek immediate medical attention.
  • Soothing salves. If the rash is mild, apply calamine lotion to cut down on the itching. Avoid ointments containing anesthetics or antihistamines—they can cause allergic reactions themselves. Another good option to reduce skin inflammation is 1% hydrocortisone cream.
  • Talk with your Pediatrician. While mild cases may be treatable at home, you should talk with your pediatrician if your child appears uncomfortable or the rash is severe and not going away. If there is inflammation on your child’s face or groin area, or you notice signs of infection (i.e., fever, redness, swelling beyond the lesions, seek medical attention immediately).

Eczema (also called atopic dermatitis or AD) is a chronic condition common in children that causes patches of dry, scaly red skin and tends to flare up during colder months when there’s less moisture in the air. But dryness caused by air conditioning and pressurized planes during summer travel can cause problems, too. Overheating, sweating and chlorine in swimming pools also can trigger eczema.

What parents can do:

  • Moisturize. Apply fragrance-free creams or ointments at least once a day or more often if needed. After a bath or swimming, gently pat your child’s skin with a towel and then apply moisturizer to their damp skin.
  • Dress wisely. Choose clothing made of soft, breathable fabrics like cotton when possible—Wash clothes in a detergent free of irritants such as perfumes and dyes.
  • Don’t scratch. Keep your child’s fingernails short and smooth, and remind them not to scratch. Scratching can make the rash worse and lead to infection.
  • Talk with your Pediatrician. Ask your child’s pediatrician if allergies, sometimes triggered by trees and plants that bloom during summer, could cause eczema. Your child’s pediatrician may recommend medicines to help your child feel better and keep the symptoms of eczema under control.

Insect Bites & Stings such as bees, wasps, mosquitos, fire ants, and ticks can cause itching and minor discomfort where they prick the skin. However, insect bites and stings can cause a severe allergic reaction called anaphylaxis for some children, which includes a rash or hives and life-threatening symptoms such as airway swelling. (For children with a known allergy to insect bites and stings, it is essential to have an anaphylaxis emergency care plan in place). Other times, diseases spread by insects such as Zika Virus can cause rashes and other health problems.

What parents can do:

  • Avoidance. When spending time outdoors, avoid scented soaps and shampoos and brightly coloured clothing—they can attract insects. If possible, steer clear of areas where insects nest and gather (i.e., stagnant pools of water, uncovered food, and blooming flowers).
  • Use insect repellent. Products with DEET can be effective on the skin but look for family-friendly products containing no more than 30% DEET concentrations. Wash the insect repellent off with soap and water when your child returns indoors.
  • Cover up. When in bush areas or in or near tall grass, stay on cleared trails as much as possible. Have your child wear a long-sleeved shirt, pants, and hat. Avoid wearing sandals in an area where ticks may live.
  • Look closely. Wear light-coloured clothing to make it easier to spot ticks. After coming indoors, check for ticks on your child’s skin—they often hide behind the ears or along the hairline.
  • Remove stingers and ticks. To remove a visible stinger from the skin, gently scrape it horizontally with a credit card or your fingernail. If you find a tick, gently grasp it with fine-tipped tweezers as close to the skin. Slowly pull it away from the skin without squeezing the tick’s body.
  • Clean the skin. After the stinger or tick is out, clean the bitten area with rubbing alcohol or another first aid ointment.
  • Treat swelling. Apply a cold compress or an ice pack to any swelling for at least 10 minutes.
  • Help relieve the Itch. Applying ice and calamine lotion or 1% hydrocortisone cream can also help relieve itching.

Impetigo is a bacterial skin infection that’s more common during hot, humid weather. It causes a rash that may have fluid-filled blisters or an oozing rash covered by crusted yellow scabs. Impetigo is more likely to develop where there is a break in the skin, like around insect bites.

What parents can do:

  • Clean and cover. Clean the infected area with soap and water. Cover the infected area loosely to help prevent contact that could spread the infection to others or other body parts. Wash your own hands well after treating your child’s sores.
  • Avoid scratching. Trim your child’s fingernails and discourage scratching. A child can spread the infection to other parts of their body by scratching. You can cover the rash loosely with a bandage to prevent your child from touching the rash, but make sure air can flow through so the skin can heal.
  • Talk with your Pediatrician. Mild cases of impetigo may be treated with over-the-counter antibiotics; however, it is advisable to speak with your pediatrician, who will treat the rash with prescription antibiotics—either a skin cream or oral medication. Your pediatrician may order a skin culture (test of your child’s skin) to determine which bacteria are causing the rash.

Swimmer’s Itch (also called sea itch) is caused by the microscopic larvae of thimble jellyfish, which are too small to see in the water. Experts say sea itch outbreaks can happen anytime between March and August, although it is usually at its worst between April and early July.

Sea itch symptoms usually begin four to 24 hours after exposure and include an itchy and painful stinging sensation and slight blistering in affected areas. In rare but severe cases, usually with young children, it can lead to vomiting, nausea, diarrhea, fever, headaches and muscle spasm.

What parents can do:

  • Protection. You can protect your child to some degree by smearing thick sunscreen on the skin before swimming. Dive experts recommend lathering up with baby oil before hitting the water. The Central Caribbean Marine Institute on Little Cayman suggests using fabric softener to repel the tiny larvae.
  • Shower or towel dry. Shower or briskly rub the skin with a towel immediately after getting out of the water. The parasites start to burrow when the water on the skin begins evaporating. If your child’s skin stings with rubbing—and the rash appears under the swimsuit, stop rubbing and head for the shower.
  • Don’t scratch. Trim your child’s fingernails and discourage scratching. Home treatments such as cool compresses on the affected areas, Epsom salt or oatmeal baths, or baking soda paste may help to relieve the discomfort. If itching is severe, talk with your pediatrician, as they can suggest prescription-strength lotions or creams to reduce your child’s symptoms.

Hookworm is a skin infection primarily caused by Ancylostoma braziliense hookworms. It is acquired by walking barefoot or sitting on soil or sand contaminated with dog or cat feces containing hookworm larvae. The hookworm eggs hatch in the ground, and the larvae migrate through a person’s skin, forming red burrows or tracks underneath the outer skin layer.

Symptoms include itching (which can cause a secondary bacterial infection), mild swelling, and redness at the place of larval penetration, typically on a person’s feet or buttocks. The burrows or tracks usually appear 1 to 5 days after exposure but sometimes can take weeks to show up. In most cases, the infection suddenly disappears after a few weeks. Treatment includes applying anti-itch creams and taking anthelmintic drugs.

What parents can do:

  • Keep shoes on. Don’t let your child play on beaches where people walk their dogs. If your family goes on an outing to a designated pet-friendly beach, make sure your child keeps shoes on and doesn’t sit in the sand without a blanket or towel. Always wash the towel or blanket after each use.
  • Wash your hands and feet with soap and water, or if not available, use an alcohol-based hand sanitizer after touching sand or soil.
  • Talk with your Pediatrician. Your pediatrician can prescribe anti-parasitic medications to treat the rash. Without treatment, the larvae usually will die off in 5 to 6 weeks. Your pediatrician may suggest a cream to help relieve itching.

Folliculitis (Hot Tub Rash) is an itchy, pimply rash that occurs when bacteria in unclean pools and hot tubs get into hair follicles on the skin. As a result, the area where hairs grow from the skin becomes infected and inflamed, sometimes forming small, pus-filled blisters. A similar rash may come from wearing a damp swimsuit that wasn’t washed and dried well after previous use. Hot rub rash typically starts 12-48 hours after being in a hot tub.

What parents can do:

  • Avoid dirty pools. If you’re unsure whether the acid and chlorine levels are being controlled adequately, don’t allow your child to go in.
  • Don’t allow young children in spas or hot tubs. In addition to the risk of drowning and overheating, young children are also at higher risk of bacterial skin infection because they spend more time in the water than teens or adults. 
  • Talk with your Pediatrician. Hot tub rash usually clears up without medical treatment. In the meantime, warm compresses and an over-the-counter anti-itch cream recommended by your pediatrician can help your child be more comfortable. If your child’s rash lasts more than a few days, talk with your pediatrician.

Ringworm. Despite having “worm” in its misleading name, ringworm is an infection caused by a fungus that thrives in warm, damp conditions. It is similar to athlete’s foot or jock itch and can appear on a child’s scalp or other body parts. It’s called ringworm because the rash from the infection tends to form round or oval spots that become smooth in the center as they grow while the border remains red and scaly. The fungus can spread quickly among student-athletes, especially during sweaty summertime practices and games, when they share sports equipment and locker rooms.

What parents can do:

  • Stop the spread. Check and treat any pets that may have the fungus—look for scaling, itchy, hairless areas on their fur. Family members, playmates, or schoolmates who show symptoms also should be treated. Do not allow your child to share combs, brushes, hair clips, barrettes, or hats. Make sure mats used in sports like wrestling and gymnastics are disinfected adequately after use.
  • Talk with your Pediatrician. A single ringworm patch on the body can be treated with an over-the-counter cream. However, if there are patches on the scalp or more than one appears on the body, or if the rash worsens while being treated, you should consult your pediatrician.

Hand, Foot & Mouth Disease is more common during summer and early fall. Outbreaks are most common in younger children and spread in child care centers, preschools, and summer camps. Caused by Enterovirus coxsackie, the illness starts with a fever, sore throat, and runny nose—much like the common cold—but then a rash with tiny blisters may appear on any or all the following places on the body:

  • In the mouth (inner cheeks, gums, sides of the tongue or back of the mouth)
  • Fingers or palms of hands
  • Soles of feet
  • Buttocks

Symptoms are the worst in the first few days, but they are usually gone within a week. Peeling skin on the fingers, toes, and nails may begin after a week or two, but it is harmless. However, parents of children with a history of atopic dermatitis or eczema should be aware that their children may be prone to a more severe outbreak.

What parents can do:

  • Monitor symptoms. Be sure to call your pediatrician if your child’s fever lasts more than three days or if they are not drinking fluids. If symptoms are severe, your pediatrician may collect samples from your child’s throat for lab testing.
  • Ease the pain. For fever and pain, the pediatrician may also recommend acetaminophen or ibuprofen. Liquid mouth-soothing remedies may help alleviate mouth ulcer pain. Do not use regular mouthwashes because they sting.
  • Avoid dehydration: Children with hand, foot, and mouth disease need to drink plenty of fluids. Call your pediatrician or go to the ER if you suspect your child is dehydrated. 
  • Inform others. Tell child care providers and playmates’ parents to watch for symptoms of the illness. Children with hand, foot, and mouth disease may spread the virus through the respiratory tract (nose, mouth and lungs) for 1-3 weeks and in the stool for weeks to months after the infection starts. Once a child’s fever has gone away, and they are feeling better, there is no need to keep them home unless there are still open and oozing blisters.


Protecting your child’s skin is a year-round concern, especially in the Cayman Islands, where the skin is exposed and vulnerable. Fortunately, many tropical rashes clear up quickly on their own. However, talk with your pediatrician about any rash you’re unsure about, especially if you don’t know what has caused it. If it’s making your child feel miserable or doesn’t clear up quickly, or if it shows signs of infection or shortness of breath, consult medical attention immediately.