What's that RASH?
Baby’s skin – perfect one day, spotty the next. See what’s causing your bub’s blemishes with our guide to all things red and irritated
Anewborn’s skin is often far from being as ‘smooth as a baby’s bottom’. Rather, it can be spotty, flaky, red, bumpy and itchy, as your bub adjusts to life outside the womb.
Often these skin ailments will clear up on their own and are nothing to worry about, even though they are unsightly – and likely to appear just as the relatives come to visit the new baby! However, it’s helpful to know what these problems are, and be aware of when you might need to see a GP and how to choose products that promote, rather than hinder, healing.
Dr Hope Dinh, from Hope Dermatology in Melbourne, says newborns are particularly susceptible to rashes and other skin issues in those early weeks as they adapt to their new world.
“Most newborns are prone to rashes, but fortunately most of these do resolve spontaneously,” she says. “Babies have been insulated in the warm, protective and hydrating environment of mum’s womb for so long. They do get a bit of a shock when they are introduced to the world.”
You don’t need to do anything too special to care for your baby’s skin. But it’s best to use products that are as mild as possible, avoiding colour, fragrance, lanolin and soap.
“The best thing parents can do for their baby’s skin is to keep the skincare regimen simple and regular,” says Hope. “A good-quality bath oil that is nonfragranced should be used at bath time, and a close eye should be kept on the bath temperature to ensure it is not too warm.
Most newborns are prone to rashes, but fortunately most of these do resolve spontaneously.
“Regular application of a good fragrancefree moisturiser is recommended after bath time and thoughout the day as needed.”
So what are these irritating ailments, how can you help and when do you need to be concerned about them?
CAP it off
It’s unsightly, usually harmless and bound to appear in those weeks when your relatives and friends are keen to meet your little one. Cradle cap, or infantile seborrhoeic dermatitis, is that greasy, scaly, crusty rash that occurs on the scalp of newborns. It’s very common, and usually appears within the first six weeks after birth, eventually disappearing on its own, although it can occasionally persist for six to nine months.
“The exact cause of cradle cap is not known but is possibly due to overactive oil glands in the skin of newborn babies, due to the mother's hormones still in the baby's circulation,” says Hope.
“The overactive oil glands do not allow skin to naturally slough off, and instead we see dead skin cells ‘stuck’ to the scalp as an adherent crust. There may be an association with yeast overgrowth in
the skin, too.”
WHAT YOU CAN DO
You can either leave the crusts to eventually fall off or you could soften them with a lotion overnight that may loosen them a little, before using a soft brush to remove. However, try not to pick at them, as this could cause infection. If it looks like the scalp is becoming infected, which is rare, get in touch with your GP. MILKY spots Teens aren’t the only ones to be afflicted by pimples – new babies suffer, too. Milia, also known as milk spots, is caused by excess sebum production in the skin, and they appear as a pimple-like rash that dots the chin, cheeks and nose.
Milia occurs when sweat ducts become blocked – the condition is also known as heat rash or prickly heat. Not all babies are affected, but it is very common. The rash can be itchy, and is best treated or prevented by ensuring baby does not get too hot.
WHAT YOU CAN DO
Most babies’ spotty skin will go away by itself. Try to avoid touching and never squeeze the pimples.
Milk spots are normal and should clear up by themselves but if you are concerned about changes to your baby’s skin, you should consult your doctor.
All babies need nappies, and nearly every baby will end up with a red, sore and angry-looking rash around their bottom at some time. Keeping nappy rash under control can be challenging as it is caused by the skin being in contact with urine and faeces, trapped under a nappy.
WHAT YOU CAN DO
“Treating nappy rash is best done by changing the nappy frequently, applying a good barrier cream and implementing regular nappy-free time,” says Hope. Nappy rash can become more serious if it gets infected. Fungal infection is common and will appear as a very angry rash with distinct margins. If the nappy rash gets worse, despite care and treatment, or it does not seem to be getting better, then it is advisable to see your GP.
Some babies are born with red discolouration on their skin, which is usually mild and likely to fade over time.
A stork bite, or salmon patch, is a type of birthmark that is seen in about onethird of newborns. “These are small, flat patches of pink or red skin with ill-defined borders. Usually found on the back of the neck, forehead or between the eyes, they can become redder when the baby is crying. Most stork bites will disappear within the first year of life,” says Hope.
WHAT CAN YOU DO
Wait it out – most will fade by the time your bub turns two. If you are worried about a birthmark, see your GP. If a stork bite lasts longer than three years, it may be removed to improve the skin’s appearance.
An estimated one in five children will develop eczema before the age of two, according to the Australasian Society of Clinical Immunology and Allergy. The good news is that infantile eczema, which appears in the first six months of life, often improves between the ages of two and five.
The skin barrier of those who suffer from eczema is impaired, and has less water-retaining properties, so moisture is lost from the skin, causing it to dry out.
“There are a few reasons why eczema occurs, including environmental factors and genetic tendencies,” says Hope.
If your baby has eczema, she will have noticeably dry and itchy patches of red skin, usually in the folds of the arms and legs, or around the mouth and nappy region, as well as other areas of skin.
“Dress your baby in light, breathable clothing, use a shower wash or bath oil instead of soap, and keep showers and baths lukewarm to avoid drying out the skin,” says Hope.
WHAT YOU CAN DO
Make sure you always keep your baby’s skin well moisturised, place mittens over her hands to prevent scratching and bathe her daily, gently patting her skin dry.
If you suspect your baby has eczema, see your doctor for strategies to manage this skin condition. Eczema can easily become infected, especially if your bub scratches to relieve the itch, so visit your GP if you are at all concerned.
An estimated one in five children will develop eczema before the age of two.