When a baby or toddler has a skin condition, the effects can range from annoyance for the child, all the way to panic station for the parents. We spoke to Dr Li-Chuen Wong, a dermatologist specialising in young skin, about infant skin conditions.
What happens when a baby is spotty at birth?
"The rash that comes up after birth is called erythema toxican (baby acne). It’s usually red and blotchy, sometimes scabby and pimply, and appears mainly on the face and arms, but can be all over. This new-born rash does not bother your baby (though it probably bothers you)."
Go to the doctor when: "it doesn’t resolve after two-three weeks or if skin becomes red or inflamed. A topical steroid cream may be recommended to calm the skin down."
We recommend: Employing a daily cleansing and moisturising routine for sensitive skin. Use a soap-free, fragrance-free cleanser, such as QV Gentle Wash to avoid drying out the skin while cleansing. Moisturise skin twice a day, again using a product with no fragrance additives, such as QV Kids Moisturising Cream.
How about flaky, crusty scalp?
"This is usually cradle cap and typically lasts for the first year. Resist the temptation to pick it off. Instead massage the scalp with a suitable cradle cap cream or lotion an hour before bath time, then using a warm face cloth, gently wipe over the scalp. After about a week of this daily management the cradle cap will clear but it will keep coming back, so continue on a daily basis. If the condition is stubborn ask your medical practitioner for help."
Cradle cap on face, armpits and groin
This may well be seborrheic dermatitis and appears as a yellowish, waxy scale. Like with cradle cap, massage the scales with a suitable cradle cap cream or lotion an hour before bath time, then use a warm face cloth to gently wipe over the scale.
Go to the doctor when: "It gets nasty-looking and ask about other options such as a mild topical steroid.
We recommend: Using Egozite Cradle Cap Lotion, an oil-based lotion specifically formulated to loosen and remove the crusts of cradle cap.
Sudden appearance of blistering sores
Usually starting on the trunk or face, these may be chicken pox. Even a small percentage of children who have been vaccinated can get the chicken pox virus. Isolate the child from others until the pox have dried out. If you or others in the family haven’t been vaccinated – have the vaccination because chicken pox can be unpleasant when you’re older, and if you are pregnant, consider having your partner look after your infected child because the virus can have some ramifications for your unborn baby.
When to see the doctor: As soon as possible for a diagnosis. Antihistamines should help reduce scratching which leads to scarring. For raised or keloid scarring, silicone sheeting can help to soften and flatten the scars.
We recommend: Using a Pinetarsol bath. It has been trusted for generations to soothe and relieve inflamed and itchy skin.
Red patches that are dry and itchy
This is how eczema usually appears and it can start while babies are very young. Australia actually has the highest incidence of eczema in the world. No one knows what causes it, though it is linked to certain genes, making it a hereditary condition. There is no cure but it can be managed.
Eczema flare-ups can be triggered by environmental factors such as sudden changes in the weather; wool is a common trigger, so avoid lamb skin and woollen clothing; some foods may be triggers, so note down what your baby eats. Avoid anything rough on the baby’s skin including carpet, grass and sand. Eczema commonly flares when the system is worn down by repeated viruses – which babies attract for the first few years of life.
Dr Wong says that "the best strategy to resolve the eczema quickly is to use a cortisone cream if prescribed by your healthcare professional. Children and babies with flare-ups don’t sleep properly and get irritable and everybody’s upset, so act quickly."
When to see the doctor: When symptoms first appear for a diagnosis and advice, and when the eczema flares up.
We recommend: Avoiding all perfumed products such as soaps, shampoos, bubble baths and fabric softeners. Always use bath oils or washes specifically designed to manage eczema flare-ups, such as QV Flare Up Oil and QV Flare Up Wash. Moisturise the skin, head to toe, 2-3 times a day using a fragrance free, hypo-allergenic cream such as QV Cream or QV Flare Up Cream during flare ups.
Inflamed rash in the nappy area
Nappy rash can happen to any baby but it is worse if eczema or psoriasis is involved. Ditch cloth nappies because they aren’t absorbent enough. If you must use cloth, change it every few hours and as soon as you notice the nappy is wet.
When to see the doctor: As soon as you see any ulceration or skin degradation. Babies can also get a skin condition called psoriasis which appears as a honey-glazed rash with clear demarcation lines – like wearing a pair of undies.
We recommend: Only use fragrance-free wipes and as soon as there are signs of nappy rash, use a suitable product such as Resolve Nappy Rash, every time you change your baby. To treat redness, ask your chemist for a topical steroid cream.
Fine pink rash
When a fine pink rash is accompanied by a runny nose and temperature, it’s usually a viral rash. They can be barely noticeable through to extreme and will come and go over a 7-10 day period. Every time the baby gets another virus, it will kick off the rash again so it can go on for weeks at a time.
When to see the doctor: Viral rashes of this sort do not need treatment but it is important to consult your doctor if you are in any doubt.
This usually indicates the molluscum virus – which kids pick up in heated swimming pools. They appear as pearly white raised papules, bigger than millia (or whiteheads). Stop swimming and bathing in a bath – showers are okay. Go to the doctor for advice on how to remove them. There is actually a viral particle inside each spot which needs to be rubbed to remove. Very often the doctor will actually prick each papule to resolve the problem.
Above are some of the infant skin conditions that Dr. Li-Chuen Wong helped us identify. The main take-away is this: if you have any concerns at all, always take your child to the local doctor or hospital for professional advice.