Common skin changes in infants and children

Young children can have several skin changes, which are mostly temporary, but sometimes require special care and a little more attention.

Probably the main reason is that The skin of babies and children is the same as that of adults, but it is thinner . This means that such skin is prone to greater water loss, and external influences have greater consequences. Compared to adults, the skin of children regenerates faster, but is less resistant to bacteria. Babies and young children do not yet have fully established thermoregulation through sweating, the skin is more permeable, and as a result, unwanted substances are absorbed faster.

The skin barrier is also still compromised, which is best seen in transepidermal water loss (TEWL). In newborns, the TEWL value is 4-8 g/m ² /h, and in premature babies it is even higher, and they must therefore spend their first days of life in an incubator to avoid fatal dehydration.

Why are we describing all this? Because all skin changes are related to these changes and then do not occur in adulthood, or there are significantly fewer of these cases.

Atopic dermatitis

Probably the best-known skin condition is atopic dermatitis (AD).

The prevalence of this disease has increased by 2.5 times in just over 50 years. At the same time, it is observed that AD is also more difficult to cure. It appears in more than half of children in the first year of life , and then disappears in many. By the age of 7, only a quarter still have it, and then it disappears in almost 90% of them during their teenage years. It rarely appears in adulthood.

Atopic dermatitis is an itchy, inflammatory, chronic skin disorder that is very common in children up to the age of seven. It is most commonly accompanied by itching and eczema . It can occur in mild, moderate or severe forms. In milder forms, redness is present but there is no peeling of the skin, while in severe forms, bright red erythema, papules and lichenification (densely scattered flat papules, grayish-brown in color) are present, and discharge or peeling of the skin may be present.

Eczema

In principle, eczema can appear anywhere (especially in more severe forms), but most often on the face and limbs. Frequent itching and scratching can disrupt sleep, and it can also be difficult for a child to concentrate during the day if itching and subsequent scratching are present.

Outbreaks of diseases, allergies, causes

The course of the disease is unpredictable, but it has been found that the intensity of atopic dermatitis decreases with age.

As many as 90% of parents are convinced that food allergy is the cause of atopic dermatitis, and because of this, they often neglect basic therapy, which is absolutely necessary. The fact is that cases where food allergy is to blame for the development of atopic dermatitis are very rare . However, it has been found that food allergy worsens the course of the disease, but is not the main cause.

There are several causes of AD. Genetics is responsible for about half of the cases of the disease, another common cause is the environment ( house mold, stress, polluted air, your own path... ). Sometimes, however, it is simply not possible to find a factor that causes AD.

How can we improve the situation?

There are a huge number of methods and approaches, and it is usually difficult to clearly determine which type of therapy will improve the condition, but there are some factors that should always be considered.

1. Avoiding cosmetic products that contain fragrances, olive oil, irritating surfactants (sodium lauryl sulfate), urea and lanolin (only in some cases), certain preservatives (cause allergic contact dermatitis), dyes and some emulsifiers.
2. Also avoid mechanical exfoliants and UV filters , which are organic. Instead, use physical UV filters, as they are the most suitable due to their mechanism of action.
3. Shower with lukewarm water and cleanse your skin with mild cleansers. (we have available Shower Gel and Oil Shower Gel for the body, and Shampoo for cleansing the scalp) and after showering/bathing always nourish it with ointments ( AtopicBalm ), creams ( AtopicCream ) or lotions ( AtopicLotion ), depending on the skin's needs. A combination of ointments and lotions is best, because ointments protect and nourish the skin, while lotions moisturize it.
4. Select suitable laundry detergent and buy clothes made from natural materials (preferably 100% cotton).
5. In severe forms of AD, Consult a pediatrician or dermatologist , as antibiotics, antihistamines, and other remedies will likely be needed to calm the outbreak.
6. You can make it yourself oat or bark bath .
7. Can Bandage the most problematic areas to prevent scratching and additional wounds.

You can read more about this in previously written blogs. What is atopic dermatitis? and Red skin syndrome , where we also wrote about corticosteroid creams and weaning off them. You can read more detailed descriptions of the above-mentioned products in our Plonkcu .

Diaper dermatitis

Diaper dermatitis, or diaper rash, is a non-allergic inflammation of the skin in the diaper area. It is characterized by redness and rashes. It occurs in 50-65% of infants and reaches its peak at 9-12 months, and usually disappears after 2 years of age.

Causes

The diaper has an occlusive effect on the skin, which means that the skin in this area is exposed to moisture and higher temperatures, and at the same time, the skin is also exposed to urine and feces for a short time. All of these factors lead to The skin barrier is broken , which increases the permeability to potentially irritating substances. At the same time, it is a haven for microorganisms and, in severe forms of diaper dermatitis, fungal infections can also occur. Candida albicans or to infection with bacteria such as Staphylococcus aureus and Streptococcus and others.

How do we prevent this?

Nowadays, technology has advanced so much that they have also upgraded the design, composition and performance of diapers, which is of course crucial in reducing diaper rash. In addition, Frequent diaper changes are recommended, as is the use of breathable, absorbent, and disposable diapers.

Care must be taken to restore the skin barrier, so it is important to choose the right ointments for the diaper area and apply them in thin layers, otherwise they can collect in skin folds, where microorganisms can grow .

A few more factors to pay attention to:

1. It is recommended Bathing with liquid soap-free cleansers , suitable for newborn skin.
2. Clean the skin under the diaper regularly clean with gentle cleaning agents (they should have a neutral or acidic pH, contain non-irritating substances and are suitable for babies). You can use our Shower Gel and Oil Shower Gel , which are very gentle and suitable for this type of skin.
3. Apply an ointment or cream suitable for diaper area care to the skin (it should contain zinc oxide, panthenol, etc.). Our Rash Balm / Baby It is designed specifically for the diaper area.
4. When possible, leave your baby without a diaper to let the area air dry.

What about moisturising wipes?

The study demonstrated that Using wet wipes is not harmful as long as they contain preservatives that babies' skin tolerates and do not contain alcohol, fragrances that can cause allergies, essential oils, soaps, and irritating cleaning agents.

The table below lists the causes and how to prevent them.

Seborrheic dermatitis

Skin change characterized by oily scales . Mild scaling may occur on the scalp, forehead, the rest of the face, and behind the ears, including the folds, but the areas are not itchy, which is the biggest difference with atopic dermatitis . Mild to severe erythema may also be present, which is often flaky. Stress can also cause inflammation.

In principle, the aforementioned dermatitis can occur at any age, but it most often appears in the first three months of life and resolves between the ages of 6 and 12 months. In adolescents, it mostly manifests as dandruff, which is a milder form of dermatitis.

Possible factors

Despite its prevalence, very little is known about its course, but several factors have been identified that are associated with the condition of the skin lesion. Sometimes dermatitis appears in infants due to hormones, then spontaneously disappears and reappears during puberty. A direct link has been found with the fungus of the genus Malassezia , which is a normal part of the skin flora. The study also linked seborrheic dermatitis to an immune deficiency, which in addition to the dermatitis itself is also manifested by diarrhea and poor weight gain. However, they did not find a strong link with nutritional deficiency, although it is also thought to be a cause of dermatitis.

Deficiencies in riboflavin, biotin, and pyridoxine have been linked to outbreaks of seborrheic dermatitis in infants. Co-occurring psoriasis, eczema, and fungal infections only exacerbate the resulting changes.

How do we improve the condition of seborrheic dermatitis?

In infants it is necessary regular washing of the scalp with baby shampoo , followed later by gentle brushing to mechanically remove scales. Alternatively, care with coconut oil, tea tree essential oil, borage oil, honey, glycerol, aloe vera and others . You can use our products as baby shampoo Shampoo , and for softening you can use Oil Shower Gel or ProtectBalm .

If the extent is larger, topical antifungal medications are prescribed. However, corticosteroids and keratolytics are avoided, as systemic absorption may occur more quickly.

For older children, keratolytics such as salicylic and lactic acid, urea or propylene glycol are considered, as they help remove scales. To reduce fungus Malassezia Antifungal agents (ketoconazole) or shampoo (zinc pyrithione or selenium sulfide) or various creams with active ingredients are used.

Temenca

A form of seborrheic dermatitis in infants that appears as oily, non-itchy scales on the scalp, usually without discharge. The scales can be a variety of colors (white to yellow) and usually appear in the 3rd or 4th week after birth. Tinea versicolor can be treated in the same way as seborrheic dermatitis. To soften the scales, you can use: Oil Shower Gel or ProtectBalm , which will help to remove scales more easily.

The following skin changes usually resolve on their own and do not require special treatment, unless they spread excessively or become complicated, in which case a visit to a dermatologist or pediatrician is necessary.

Toxic erythema of the newborn

Is asymptomatic skin condition that occurs in 30-70% of newborns . How it occurs is unknown. Red lesions with a central papule or pustule are usually found on the face, trunk and extremities. Clinical observation is usually sufficient. The condition does not require treatment and usually disappears within two weeks after birth. Otherwise, consultation with a dermatologist is necessary.

Milia

Milia are noticeable as small yellow-white superficial papules filled with keratin , which are the result of immaturity of skin structures. They occur in almost half of healthy babies, usually at birth . They appear on the skin of the face and disappear within a few weeks. No treatment is required.

Miliaria

It is a result of immaturity of skin structures, it is a blockage of sweat glands, which manifests as blisters, papules or pustules on the skin, usually on the trunk, but can also be on the forehead, hands and covered parts of the skin. It occurs in 40% of infants, usually in the first month of life . Sweating is the most common risk factor.

The main cause is the blockage of the sweat glands, resulting in the accumulation of skin debris or bacteria such as Staphylococcus in the epidermis. The obstruction leads to sweat leakage into the epidermis or dermis, resulting in excessive moisture in the cells, swelling and blockage of the ducts. There are different types that affect the skin in different ways.

To improve the condition, a cooler environment and wearing breathable clothing can help, and miliaria will spontaneously disappear. However, the actual treatment varies between types. Miliaria crystallina is usually not treated and usually resolves within 24 hours . Miliaria rubra has characteristic inflammatory structures that can be treated with mild corticosteroids (1–2 weeks). Miliaria pustulosis is treated with topical antibiotics such as clindamycin, as a bacterial infection is also present.

Neonatal acne

Acne in newborns appears in the first month of life. It is a transient skin condition, under the influence of androgen hormones. Acne usually consists of closed comedones on the forehead, nose and cheeks, but open comedones, inflammatory papules and pustules can also develop. Treatment is not particularly recommended, but in the case of extensive lesions that last for several months, 2.5% benzoyl peroxide in a lotion is used. Acne generally disappears within 1-3 months.

Babies and young children have many skin changes related to the imperfect functioning of the skin, but in most cases these changes are not particularly harmful. The most challenging skin conditions are certainly atopic dermatitis and diaper rash , with atopic dermatitis also present later in adulthood. Seborrheic dermatitis may also require special attention in some cases, but since it is not an itchy condition, it does not affect the quality of life.

Atopic dermatitis can, in some cases, interfere with sleep and concentration, and individuals need to be careful not to let certain factors worsen the condition. Regular care is needed, as little stress as possible, and trying to find products that really help improve the condition.

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