Help for Parents in Caring for Baby’s Skin

Many parents have experienced fear and dismay upon suddenly spotting things like flecked pock marks or even skin areas that suddenly swell up on their newborn baby’s skin.They say to themselves, oh no, what disease is my baby suffering from? Could it be infectious? How can I treat it right away? Below, we will try to help parents to get a handle on some of the most common skin diseases and rashes that newborns and young children experience, and how they are treated.

Generalized rashes
Most rashes are caused by a viral infection. Viral infections, in general, are not necessarily so serious as one might believe. Often, in normal circumstances, they will disappear on their own several days or a week after entering your child’s body. It is therefore important to try to take steps to prevent these viruses before they affect your family and cause skin or other problems. The most common viral infections that affect the skin include:
• Chicken pox: The onset of chicken pox is acute. The skin normally erupts with sudden purplish brown bumps that become blisters, spreading everywhere all over the skin in only a day or two. This result is from catching the highly contagious airborne varicella zoster virus (VZV), and is usually accompanied with a low fever, headaches and other similar symptoms, none of which are normally too severe or deadly. Eventually, often with treatment, the small itchy blisters dry up and form scabs which will ultimately leave the skin. The disease is preventable with vaccinations. While not cause for major panic if your child does get chicken pox, this disease is so highly infectious that experts believe it is good if the affected child is diagnosed in the hospital and then sent home immediately, the child is effectively quarantined at home, unable to infect others until the process has nearly run its course when the blisters begin going away.

• Scarlet Fever: This highly infectious disease is caused by the streptococcal virus, known as “strep.”  It usually affects children aged 2-10. Childrenwho get this severe form of strep see their skin systemically grow splotches of sandpaper-like purplish-red rashes, thus giving the disease its name. The affected tongue normally associated with the disease is also commonly called “strawberry tongue,” as the coating becomes bright-red. Generally, the first choice for treatment of Scarlet Fever is penicillin-like medicines or other antibiotics, and you should seek help from a doctor.

• Roseola: Roseola, is also known by many names, including exanthema subitum, roseola infantum, rose rash of infants, sixth disease, baby measles, false measles, or three-day fever. It is a viral disease whose manifestations are usually limited to a transient rose-colored rash that occurs following a high fever. Typically the disease affects a child between six months and two years of age, and begins with a sudden high fever of around 39–40°C. This can cause, in rare cases, febrile convulsions (also known as febrile seizures or “fever fits”) due to the sudden rise in body temperature, but in many cases the child appears normal. After 2-3 days, when the body temperature drops to normal levels, systemic pink rashes often appear over the body. However, these rosy colored rashes normally disappear within 24 hours. There is no specific vaccine against or treatment for roseola, and most children with the disease do not get seriously ill. As the disease and skin rash is caused by 2 human herpes viruses, and tends to go away after a day or so, generally only medications that help with fever symptoms are given, such as antipyretics that help reduce baby’s temperature.

Localized rashes
The causes may vary, but most localized rashes may soon disappear with a little bit of common sense family care at home. Common local rashes include the following:
• Diaper Dermatitis: Diaper rash is generally not too severe and attributable to the friction between the diaper and the baby’s buttocks, especially when there is often a moist environment inside the diaper. The optimal preventative method to avoid diaper rash is to change baby’s diapers frequently, use safe skin creams in affected areas, and be careful to keep an eye on baby to make diaper changes as needed during the night.

• Impetigo: Impetigo is a bacterial infection that involves the superficial skin. The most common presentation is yellowish crust on the face, arms, or legs. The lesions may be painful or itchy, but fever is uncommon. Impetigo is typically due to either the Staph or Strep virus. Depending on the size of the rash, and the specific conditions, doctors will often prescribe antibiotic topical ointmentsor even oral antibiotic pills. The key to prevention of impetigo is to teach your young child to properly wash his or her hands, forming good personal sanitation habits early on.

• Heat Rash: Also known as sweat rash or prickly heat, this rash usually occurs when parents put too many clothes on their child during warmer weather. The rashes are mainly seen on the back,where perspiration occurs more frequently. Since this is a rash induced by heat, the easiest and most effective precaution is to avoid dressing your children up too much.

• Herpes simplex: Herpes has many forms and the Herpes Simplex Virus (HSV) is wide spread. Oral herpes generally appear as small blisters in groups, often called cold sores or fever blisters, around the lip ‘s edge. Or, herpes may just cause a sore throat. The rashes can also appear on the cheek or around the eyes. Although only 8-10% of affected children will experience HSV eye infection, once it occurs, it is so serious that the inflection can lead in some circumstances to blindness. In these situations, seeking immediate medical advice is critical. If parents are suffering from oral herpes and have a cold sore showing or a sore throat, they should avoid kissing their child for a while until the sores go away.

• Hand-foot-and-mouth Disease: For HFMD, your child may experience the sudden onset of fever or other discomfort, as the result of a group of viruses. Often, with HFMD, about a day or two after the fever, isolated blisters appear on the palms, finger tips, toes and/or soles of the feet, in addition to the roof of the mouth or tongue. Sometimes there are blisters present on the buttocks or groin as well. Rashes experienced during contraction of hand-foot-and-mouth disease normally are stable, lasting for around a week. However, there have been small instances of death from HFMD in recent years, normally as a result of very high fever. Parents should pay attention to this disease,and check for rashes whenever a fever strikes, seeking medical help as necessary.

• Contact Dermatitis: This refers to any skin inflammation that suddenly appears due to your child’s skin coming in contact with substances they might be allergic to, such as certain foods or soaps. These allergic skin reactions are generally not that serious, and slowly disappear right away upon avoidance of the allergy causing substance. Of course, it is recommended that parents seek medical advice for their children in cases where there is severe redness, swelling, pain, or lesions.

The following rashes may be highly infectious, needing medical advice

• Warts (Verruca vulgaris): Warts are typically small, rough, and hard growths that are similar in color to the rest of the skin and typically do not result in symptoms, except when on the bottom of the feet where they may be painful. Your child may not be overly affected by warts, but they can be a nuisance. Warts have several forms and are caused by infection from the human papillomavirus (HPV). They are commonly seen in hands and feet, but may appear in any part of the body. Warts are often treated with liquid nitrogen freezing therapy, or sometimes with topical creams or other skin ointment medications.

• Molluscum Contagiosum (MC): Sometimes called Water Warts, MC is an infectious disease attributable to a DNA poxvirus called the molluscum contagiosum virus (MCV) which affects mainly humans only. It appears as densely distributed white or yellowish blisters with concaves in the center. Molluscum lesions are most commonly found on the face, arms, legs, torso, and armpits in children. They are highly contagious, spreading through touch and to other surfaces, making children highly susceptible. It is typically recommended to remove the skin growths with a curette, liquid nitrogent, laser or other treatment as once removed from the skin often it will not affect other areas. Molluscum contagiosum does not remain in the body when the growths are gone from the skin and they will not normally reappear on their own.

• Toxic Epidermal Necrolysis (TEN): Toxic epidermal necrolysis, also known as Lyell’s syndrome, is a rare, life-threatening skin condition that is usually caused by a reaction to drugs. It is a very serious disease that causes initially red-purple, dusky, flat spots known as macules to appear on the body’s trunk, and spread out from there. These skin lesions then transform into large blisters. The affected skin can then become necrotic or sag from the body and peel off in great swaths, as if a child was severely burnt. Certain genetic factors increase the risk for TEN in negative reaction to other drugs. The initial treatment involves avoiding the drug causing the reaction, and then goes from there in terms of severity. Needless to say, parents should seek treatment immediately for their child if they see severe skin reactions to any medication.

Severe eczema
About 10-20% of infants will have severe eczema, a dry skin disease also known as “special dermatitis.” Typically, eczema will show up in babies or young children as dry, red and crusty skin near their scalps or faces. Possibly, small blisters and scabs may form on their inner elbows or innerknees.
Eczema is easily found when your child feels extremely itchy in these areas, and you can feel dry bumpy skin there. After an acute eruption, in cases of prolonged itchiness without recovery, the disease can developinto long-term chronic eczema, chronic skin dryness and other skin issues in your child. Eczema is not infectious, but unfortunately it cannot be cured. The causes of eczema are very complex. Therefore, doctors tend to try to only control and reduce the symptoms, but are unable to provide curative treatments.

The following tips can help to reduce the risk of acute eczema in your child:
• Avoid sudden changes of temperature and humidity
• Arrange outdoor activities that avoid poor air quality days
• Avoid overheating or over perspiration
• Avoid foods that may stimulate the skin and induce eczema

The most important things for eczema patients to do is use moisturizer every day to inhibit the rash. Some studies show that the protective function of the skin barrier tends to increase accordingly as skin humidity increases. Therefore it is suggested to applying moisturizer after showering (with water at 38 ℃, and shower for no more than 10 minutes). Only pat down with a towel to half dry, leaving water on the skin. Then take an appropriate amount of cream in the palm of your hand, (emulsion is not recommended), and apply it all over the child’s body evenly. Parents should help the very young to apply a mild moisturizer daily. It should be without heavy chemicals or fragrances. In many cases, continuous use of a moisturizer can relieve most eczema symptoms.