Banish baby's skin problems

Your little one’s skin is prone to dryness, rashes and other conditions. Although an unsightly red rash can cause any level-headed parent to go into a state of utter panic, many of these flare-ups are fairly harmless. These are some of the most common skin conditions that affects babies, and advice on how to treat them.

Eczema

This chronic, non-contagious skin condition is common. It causes red, itchy patches of skin, which may develop blisters. Scratching only worsens things, developing thickened patches, known as lichenification. Eczema is usually caused by one of the following factors: it could be genetic, or it develops due to an immune system reaction to food and inhalant allergens, and worsens with heat and sweat. Eczema most often occurs on baby’s cheeks and at the joints of their arms and legs. 

A genetic predisposition typically occurs when there is a family history of allergies like eczema, hay fever and asthma. “In the genetically predisposed child, the immune system is hypersensitive to certain external allergens (like dust mites, for example) causing the release of various chemical modulators that result in inflammation of the skin,” says KwaZulu-Natal dermatologist, Dr Imraan Jhetam. Dry skin is a major culprit, says Dr Pieter Fourie, a Cape Town paediatrician. 

“The natural oils and bacteria living on the skin produce a protective barrier that prevents it from drying out. When the skin does dry out, it cracks, allowing harmful bacteria and fungi to penetrate the skin and resulting in an eczematous reaction. Standard soaps are largely to blame,” he says. According to Dr Fourie, food allergens are also a contributing factor towards eczema, although inhalant allergens, such as dog hair, are equally liable. Treating eczema in babies and toddlers starts with the use of fragrance-free soaps and moisturisers. 

“Often, the use of a good-quality moisturiser alone will help to clear up eczema, but in more serious cases, a topical steroid cream may be required. When used at the appropriate strength and for the recommended time period, these creams are safe and effective for babies and toddlers,” says Dr Jhetam. If your child’s eczema is severe, visit a doctor or dermatologist who will recommend a safe cream. It’s worth getting a pair of nonscratch mittens for very young children, while an antihistamine will also help to alleviate the itching.

Nappy rash

Characterised by red and swollen skin on the genitals, bottom and folds of the thighs, nappy rash is very common in babies aged nine to 12 months. It may be caused by a variety of factors, including: urea-splitting bacteria which produces acid and causes the skin to burn, sensitivity to the material that the nappy is made of, and the use of harsh cleaning agents.

 The best way to treat nappy rash is to change nappies frequently. Use fragrance and alcohol-free wipes to clean the area, pat the skin dry and apply a good barrier cream before the nappy change. Nappy-free time will help as the natural air circulation promotes healing. If these treatments do not help, your baby may have a more serious condition like thrush or bacterial nappy rash. “Thrush is caused by a fungus called candida albicans. 

It resides in baby’s gut and can overgrow and spread to the nappy area, where it develops a distinctive rash of tiny red spots around the perineum (the area between the genitals and the anus). Bacterial nappy rash causes a yellow, crusty layer around areas of redness, and the skin will usually peel off. The rash is also likely to spread to other areas outside the nappy region, such as the navel and abdomen,” says Dr Fourie. Thrush and bacterial nappy rash need antifungal creams or antibiotic treatments.

Cradle cap

Cradle cap (or infantile seborrheic dermatitis) is a harmless condition characterised by dry flakes of skin on the scalp that resemble dandruff or yellow scaly patches. The exact cause is not known, but increased oil production on the scalp, which results in inflammation and the development of scaly patches, are thought to play a role. Cradle cap is not contagious, and it typically clears up on its own but it can look rather unsightly. “Mild cases respond well to massaging the scalp with olive oil, washing out the flakes with baby shampoo and using a gentle brush. An antifungal medicated shampoo or cortisone lotion may be required in more severe cases,” says Dr Jhetam.

Baby acne

Also known as neonatal acne, it is common in babies, and may start as early as three weeks after birth. It is characterised by red pimples on the cheeks, forehead, nose and temples. “The exact cause is still unknown, but it is thought to be related to hormonal changes in the skin’s deeper layers, as well as other factors, including adaption to oral feeds,” says Dr Fourie. Baby acne does not require any treatment and will clear up within a few weeks. Do not use normal acne treatments on your baby’s skin.

Milia

Milia (or milk spots) are tiny white pimples that appear on a newborn’s face, particularly over the cheeks and nose. They can also appear on the roof of an infant’s mouth, in which case they are called Epstein’s pearls. “Milia are micro-cysts that form due to skin flakes becoming trapped under the skin. They will clear up within a few weeks, requiring no special treatment or medication,” says Dr Jhetam.

When to call the doctor

While skin conditions in those under 24 months old are usually harmless, they can be a sign of something far more dangerous.

Call your doctor if:

The rash is accompanied by other symptoms, such as a fever, vomiting, diarrhoea or irritability.

The rash is causing your child to lose sleep or feed poorly.

Simple measures, like changing nappies more frequently, or changing to fragrance-free products do not help.

To find out more, speak to your Clicks Pharmacist.