Red Spots on Children's Face and Neck: Causes and Concerns

Red spots on a child's face/neck?

Hello, doctor.
My child is currently 7 and a half years old, and he is a boy.
At the end of December last year, he developed a red spot on his face.
We took him to see a dermatologist, who said it was a red spot caused by vascular dilation, likely due to estrogen during growth.
After about a week, the red spot disappeared.
This week, I noticed 2 or 3 red spots on his neck that are similar to the previous one.
I researched online and found that this could be related to the onset of puberty in children, with rising estrogen levels, and it may also indicate potential liver issues.

Doctor, given that my child is only 7 and a half years old, does this situation suggest early development or precocious puberty? As he is a boy, how could his estrogen levels be rising? Could these red spots indicate a problem with his liver? Thank you, doctor!

Alicia, 30~39 year old female. Ask Date: 2021/03/06

Dr. Xiao Kaiwen reply Pediatrics

Boys with precocious puberty may exhibit other signs, such as the development of secondary sexual characteristics, including enlargement of the glans penis, lengthening of the penis, darkening and enlargement of the scrotum, development of pubic and axillary hair, and a significant increase in height over a short period of time (but not including any skin rashes).
Abnormal liver function typically presents with jaundice in the sclera and skin, and does not manifest as skin rashes.

Reply Date: 2021/03/06

More Info

Understanding red spots on a child's face and neck can be concerning for parents, especially when they appear suddenly or resemble previous skin issues. In your case, your 7.5-year-old son has developed red spots on his neck, similar to a previous incident on his face that was attributed to vascular dilation, likely influenced by hormonal changes associated with growth.
Firstly, it’s important to clarify that the presence of red spots, particularly those caused by vascular dilation, is not uncommon in children. These spots can appear due to a variety of reasons, including benign conditions such as cherry angiomas or other vascular lesions that can be influenced by hormonal changes during growth. In children, these changes are typically not indicative of serious underlying health issues.
Regarding your concern about early puberty or precocious puberty, it is essential to understand that while boys do produce estrogen, it is in much lower quantities compared to girls. The onset of puberty in boys is generally marked by an increase in testosterone rather than estrogen. However, hormonal fluctuations can occur, and benign conditions can sometimes mimic symptoms of hormonal changes.
The appearance of red spots does not necessarily indicate liver problems. Liver issues can manifest in various ways, including jaundice (yellowing of the skin and eyes), but isolated red spots are not a typical sign of liver dysfunction. If there are no other symptoms such as changes in appetite, fatigue, or changes in stool color, it is less likely that liver issues are the cause of the red spots.

If the red spots are not accompanied by other concerning symptoms such as fever, itching, or changes in behavior, they are likely benign. However, it is always prudent to monitor the situation. If the spots persist, increase in number, or are accompanied by other symptoms, it would be wise to consult a pediatric dermatologist or your child's primary care physician for further evaluation. They may recommend a thorough examination and possibly some tests to rule out any underlying conditions.

In summary, while the appearance of red spots can be alarming, they are often benign and related to normal growth processes in children. It is unlikely that your son is experiencing precocious puberty or liver issues based solely on the presence of these spots. Regular monitoring and consultation with a healthcare provider will help ensure that any potential issues are addressed promptly. Always trust your instincts as a parent; if something feels off, seeking medical advice is the best course of action.

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