BY JAMIE LOBER
One imagines the skin of babies to be soft, smooth, and pink. In reality,
their skin is still immature, and is rarely perfect. The sensitivity of their
skin causes it to be susceptible to several skin conditions. Amidst
those little imperfections, there are sometimes more serious conditions.
When you understand a few of the most common, you will be able to
differentiate what is normal versus what warrants medical attention.
BABY’S MINOR SKIN IMPERFECTIONS
• Erythema Toxicum
This is a skin rash that affects almost half of newborns within the first week or so. The rash that looks like mosquito bites or hives. Its cause is unknown, and it resolves without treatment after a few days or weeks.
• Diaper Rash
There are two kinds of diaper rash. Common diaper rash is often caused by not changing the diaper often enough. The skin in the diaper area looks, red, raw, and burned. Balmex, Desitin, vitamin A and D ointment or Vaseline jellies can help. To prevent diaper rash, you may use Butt Butter made by Dr. Seth Bush of Middle Georgia Pediatrics in Macon. It contains cholestyramine which binds bioacid and stool to prevent them from burning the skin. “The best way to take care of the rash is to change diapers frequently when they are wet and dirty,” says Dr. Dan Stewart, pediatrician at Cornerstone Medical Associates in Perry.
The other kind of diaper rash is a yeast infection where you tend to see red bumps in the diaper area. “We all have yeast on our bodies but in the damp environment of the diaper area, that yeast can overgrow and overcolonize; so you need to use an antifungal medicine like Lotramin or cream,” says Dr. Bush. Make sure your child’s bottom is getting air.
“Sometimes you have to take diapers off and put a big towel underneath them when they take a nap and let them pee or poop on the towel to keep the area open to get well,” says Stewart.
Since the baby’s skin is most sensitive in the creases of the elbows as well as the creases behind the knees and neck, those are the most common spots for eczema. This condition is often referred to as atopic dermatitis. “Studies show that the more frequently you use lotions and creams, the better. If I have a baby with eczema, I say that every diaper change you should lube them up with some type of cream like Lubriderm to keep that moisture locked in the skin so the baby has a greasy feel to him,” says Dr. Bush. No two kids are the same.
“Treatment is individualized based on severity, degree of involvement, and how much it impacts their life. Most parents feel it is external or something the baby is allergic to but in most cases it is not at all; it is innate,” clarifies Dr. David Cohen, dermatologist at Dermatologic Surgery Specialists in Macon. According to the American Academy of Pediatrics, forty percent of children outgrow eczema while others learn to live with it.
Some babies have allergies or asthma that causes their skin to act up and get infected. To decrease the chance your baby will develop allergies, the American Academy of Pediatrics recommends breastfeeding for the first four months. “To help eliminate bacteria from the skin, you can add a little Dixie cup of bleach to the bathtub or treat them with antibiotics,” says Cohen.
• Birth Marks
Birth marks are not usually a concern. In fact, some go away over time without any intervention at all. “Strawberry hemangiona is a red lesion that we call an angel kiss. It is like where the angel came and kissed the baby but it clears on its own in time such that fifty percent are gone by five years of age,” says Bush. Your pediatrician can determine whether the birth mark should be treated or left alone.
Milia are common but do not require intervention. A lot of babies get these white bumps on their nose or chin but it goes away. Milia is caused by blocked oil glands. When baby’s oil glands enlarge and open up in a few days or weeks, the white bumps disappear.
“Others get miliaria rubra which is a prickly heat rash that requires nothing more than bathing and soapy water,” says Stewart. In cases where acne persists, a medicated cream may be necessary to clear up the skin.
• Molluscum (Molluscum contagiosum)
Molluscum are warts caused by viruses. “They are smooth, dome-shaped warts that have a tiny volcano area,” defines Stewart. Spending time at daycare centers or sharing personal items are the two most common causes. This painless condition goes away by itself over time but if you have a bunch of them on conspicuous areas, you have to deal with them to get rid of them as best you can. Scraping or freezing are two popular methods.
• Cradle cap
Cradle cap is an excessive dandruff condition that your baby may be born with. It can last between several months and a year. “Usually it is due to the hormones achieved from the mother through the placenta during delivery that activates the dandruff and then it goes away until they hit puberty,” says Cohen. The same hormones can cause acne in babies. Treatment for the appearance can be topical such as benzoyl peroxide cleaners or creams to dry it up. In severe cases, a course of antibiotics are given to be taken topically or orally. (See page 10 for info on the Bean-B-Clean brush—a cradle cap treatment free of toxic chemicals).
• Bug Bites
In Central Georgia, mosquito bites are the most common. Children are more likely to get bigger reactions because of the immaturity of their skin. The use of a baby-safe mosquito repellent or Skin-So-Soft by Avon must be applied when necessary. It is effective against red bugs as well. Spider bites are also common in this area, and the bites can be more long-lasting. Fleas can be a problem as well, particularly if dogs and cats are in the household.
he majority of skin conditions in babies are not a concern and go away in time. “Most kids, fortunately, have healthy skin that requires minimal to no attention except for perhaps using sunscreen and avoiding the sun at an early age,” says Cohen.
WHEN TO WORRY
In the first few months of a baby’s life, any rash associated with other symptoms (such as fever, poor feeding, lethargy, cough) needs to be evaluated by a doctor as soon as possible.
• Fluid-filled blisters (especially ones with opaque, yellowish fluid) can indicate a serious infection, like a bacterial infection or herpes.
• Small red or purplish dots over the body (petechiae) that don’t lighten with pressure. They can be caused by a viral infection or a potentially very serious bacterial infection. Any infant with possible petechiae should be evaluated by a doctor immediately.