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A newborn baby may develop different skin conditions. Some of them are listed below.
Baby or infantile acne: red, pimply rash on the face; disappears over time
Cutis marmorata: skin looks like pinkish-blue marble on exposure to cold temperatures; improves with age
Erythema toxicum: common, splotchy red rash; red or white pale or red raised lesions scattered all over the body , gradually disappears
Milia: tiny whiteheads on the baby’s face; disappear on their own
Birthmarks: often fade with time( Please read Birthmarks section)
Vernix: Losing vernix may cause skin peeling; subsides on its own.
Umbilical cord care: The cord should fall off within 1 to 2 weeks of coming back home. Until then, it should be kept clean and dry. Water should be used to clean it. Do not pull on the stump even when it starts to come off; it will fall off on its own. Contact your doctor if your baby has fever or if the umbilical area appears red and swollen, oozes yellow pus, produces a foul-smelling discharge, or bleeds.
Other conditions such diaper rash (caused by wet or soiled diapers or yeast/bacterial infection), cradle cap (crusty patches on a baby’s scalp or other body parts), eczema (dry, thickened, scaly skin, or tiny red bumps), contact dermatitis (on contact to allergens), heat rash (little bumps on the skin) might also be observed in infants.
General skin care tips
Daily bathing is not necessary. Wash the face and hands often, and thoroughly clean the private area after each diaper change. Bathe your baby in a warm room.
Use wipes only when extremely necessary. Dr. Divya Sharma prefers water wsh as compared to use of wet wipes. Always wipe from front to back.
A moisturizer is recommended even for babies with normal skin . If the skin is very dry, moisturize twice daily or even after every diaper change. Use one without fragrances or dyes. Please consult your Pediatric Dermatologist for recommending a skin care regimen.
An infant’s skin is very sensitive and can easily burn from sun exposure, causing real and even permanent damage. If the baby is going to be outdoors, it is important to avoid direct sunlight. Sunscreen is not recommended for infants under 6 months of age, so use protection whenever possible. For infants over 6 months of age, always apply sunscreen as well. If it's suspected that the infant has a sunburn, call the doctor for advice.
Wool, including cashmere, can be irritating. Soft cottons are the way to go. Wash anything that will be in contact with the baby’s skin.
Shield skin from spit because saliva has enzymes that can irritate their skin. The problem gets worse when skin gets wet and dry over and over. Try coating the face with petroleum jelly. Wipe it off with a soft cotton washcloth when mealtime is over and reapply moisturizer.
Baby powder and other talc-containing powder should be avoided because there is a risk of accidental inhalation and subsequent lung problems.
Babies are very sensitive to perfumes and harsh detergents. Use a gentle unscented detergent when washing infant's clothes and bedding to prevent allergies or sensitivities.
Most skincare products should not be used on very young infants because of the risk of exposure to active chemicals, which may be absorbed at higher rates in the thinner, less developed skin of infants. Always discuss with the doctor which products can be used on infants.
Most skin rashes in babies are not serious and require little-to-no treatment. Some rashes may require further evaluation. Any fever associated with a rash requires an evaluation by a physician. Rashes which involve blisters or other fluid-filled bumps (pustules, vesicles) may also need to be evaluated. In general, never hesitate to contact the doctor with concerns.
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The thickness of SC is lesser in baby skin as compared to adults. The rate of loss of moisture to surrounding skin is higher in children than in adults. Even the commensal (good bacteria) differ from adults. The pH becomes acidic like normal adult skin after 2 weeks of the birth of full-term neonate.
The major components of skin barrier are:
There are three types of moisturisers.
Coconut oil, preferably virgin coconut oil is the best in maintaining the skin barrier. Olive oil does not repair the skin barrier and may worsen eczema.
Extra virgin coconut oil not only prevent neonates and infants because their skin differs from mature adult skin in structure, function, and composition and is particularly susceptible to infection. During the late fetal period (20 weeks to birth), skin becomes functional and develops a protective barrier. Although full-term infants are born with a competent skin barrier, their skin is still developing through the first year of life. During the postnatal period, even the composition of commensal bacteria residing on the skin surface differs from that of adults and continues to evolve over the first year of life.
Given that skin continues to develop through the first year of life, the use of appropriate, evidence-based skin care practices is important. Maintaining skin barrier function is critical to preventing organ dehydration. The SC water content is involved in maintaining SC structural integrity and functionality. It is generally accepted that recommendations for infant skin care regimens should be evidence-based. Although several studies have evaluated nonprescription emollient strategies to improve barrier function or improve fluid and electrolyte balance in neonates, infants, or children with compromised skin, limited information is available on skin care regimens that enable maintenance or enhancement of skin barrier integrity in normal neonatal or infant skin.
Skin cleansing and emollient use are two simple strategies that can help keep skin healthy. Proper skin cleansing helps keep infant skin free of unwanted irritants, including saliva, nasal secretions, urine, faeces, faecal enzymes, dirt, and microbial pathogens. Exposure to such factors for long periods, especially in the diaper region, can lead to discomfort, irritation, infection, and skin barrier breakdown. In many cases, water alone is not sufficient to cleanse the skin during bathing. Epidemiologic studies and anecdotal reports have even suggested a possible link between household use of hard water and atopic eczema in children, though a causal relationship has not been found.
In addition to using cleansers during bathing, emollient use during or after bathing may have benefits. Emollients decrease transepidermal water loss (TEWL), improve skin conditions, and may even lead to reduced mortality in extremely premature infants. In adults, 7 weeks of emollient use is supposed to lead to the improvement in skin barrier function.
The thickness of SC is lesser and the skin barrier is also not fully formed in pre-term babies. They lose moisture faster compared to full-term babies. The bacteria and other microbes can grow faster as the acidic mantle is not formed.
A baby’s skin should not be disturbed much by vigorous cleansing or application of soaps. The topical agents also penetrate faster and hence even antiseptic solutions should be applied with caution.
Preferably one should choose hypoallergenic, parabens and fragrance-free product containing cholesterol, ceramides and free fatty acids in the ratio of 3:1:1. Ceramide containing moisturisers are really helpful in the prevention of eczema.
Physiologic lipids like ceramides repair the skin barrier while petroleum jelly only fills up the cracks in the skin. The latter does not prevent eczema. At DSHS, we adopt a scientific, evidence-based approach towards your child’s skin problem and spend time analyzing the causative factors and offers the safest solutions.