TRIGGERS OF SKIN PROBLEMS

Sun, wind, pollutants and just plain everyday life all take their toll on that delicate baby skin

B abies are not little adults, and the vast differences between their skin and ours reflects this. Babies’ skin is marginally thinner than that of adults, and it has a higher surface ph, which acts as a protective barrier and should be disturbed as little as possible to avoid develpoing skin problems.

In the first few months of their lives, babies are making the huge transition from the gentle liquid environment of the womb to the much harsher and drier outside world, and their very delicate skin can take strain.

Although toddlers’ skin is a little more robust, it can still be damaged by unsuitable products or coarse fabrics.

ECZEMA

This dry, itchy skin condition usually appears for the first time before the child is 2 years old. “Acute eczema presents as areas of redness and flakiness with tiny blisters which may not be visible to the naked eye,” says Dr Hanif Omar, a Cape Town-based dermatologist. Although eczema is not curable, most children grow out of it.

HOW TO RECOGNISE IT

Dry, itchy, red and cracked skin that sometimes oozes fluid or even bleeds. “Persistent scratching can result in thickening and colour change, which leaves the skin looking leathery,” says Dr Omar. Areas most affected are hands, face, neck, elbows and knees (back).

WHAT TRIGGERS IT

It’s not known for sure but genetics may play a role. “Contact irritants such as soaps, solvents, wool clothing, detergents, preservatives and perfumes are common triggers of eczema,” adds Dr Omar. “And skin infections, even if localised to a small area, can exacerbate eczema. In some instances a food allergy may play a role.”

CONTACT IRRITANTS SUCH AS SOAPS, SOLVENTS, WOOL CLOTHING, DETERGENTS, PRESERVATIVES AND PERFUMES ARE COMMON TRIGGERS OF ECZEMA

HOW TO TREAT IT Keeping your child’s skin moisturised is vital. “Bath your child in lukewarm water using aqueous cream as soap; avoid using standard bubble baths and harsh soaps,” suggests Dr Omar. Mild flareups can be treated with an emollient lotion, cream or ointment. More serious cases may require a steroid cream or ointment, which a doctor must prescribe.

HOW TO PREVENT IT Breastfeeding exclusively for at least four months may help to protect your baby against eczema and other allergies. Keep your baby’s nails short to prevent scratching.

WHEN TO SEEK HELP If your child’s scratching results in infected patches of eczema, see a doctor – she may need an antibiotic cream or oral medicine. “For children with repeated skin infections, bleach baths prescribed by a dermatologist may be helpful,” says Dr Omar.

NAPPY RASH Nappy rash is a very common dermatitis that affects a baby’s buttocks, genitals and thighs.

HOW TO RECOGNISE IT Red, raw looking skin on the buttocks, genitals and thighs, or skin that looks tight and papery, or shiny and bright red. A fungal nappy rash may be fiery red with tiny pusfilled pimples. “The folds in the nappy area where irritants are not in contact with the skin are often spared,” Dr Omar points out.

WHAT TRIGGERS IT The hot, humid environment inside a baby’s nappy encourages continuous irritation of the skin in the groin region. Urine and stools left too long in contact with the baby’s skin is the most common cause.

HOW TO TREAT IT Protect the skin with a barrier cream applied to dry, unbroken skin.

HOW TO PREVENT IT Change your baby’s nappy regularly and let him go without a nappy as often as possible. Make sure you dry him gently but thoroughly, including in all his skin folds, after his bath. Don’t use baby wipes that contain alcohol.

WHEN TO SEEK HELP If there’s no improvement in the condition after four days of home treatment, take your baby to a doctor.

HEAT RASH Heat rash, which often appears when your child overheats in hot and humid weather, is also known as prickly heat or miliaria.

HOW TO RECOGNISE IT “Heat rash usually presents as fragile, clear, tiny, superficial blisters, most commonly on the head, neck and upper trunk,” says Dr Omar. “Another form is uniform

red itchy pimples in the neck, armpits and groin.”

WHAT TRIGGERS IT High temperatures. If your baby sweats so much that his pores clog and sweat can’t get out, the rash develops - babies and young children are particularly prone to heat rash because their sweat glands aren’t fully developed.

HOW TO TREAT IT Cool the affected areas using cold, wet cloths, or give your baby a lukewarm bath or shower. Use calamine lotion if your baby seems irritable and cries when you touch his skin. Hydrocortisone cream may be prescribed by a doctor if the rash is severe.

HOW TO PREVENT IT Don’t let your baby overheat. Dress him in loose fitting clothes made from natural fibres that don’t trap heat.

WHEN TO SEEK HELP If the rash persists for longer than four days, or if your baby develops a fever, see a doctor.

THRUSH Thrush is a common and harmless yeast infection. It’s most common in babies two months and younger, but it can appear in older kids.

HOW TO RECOGNISE IT It looks like cottage cheese or milk curds on the sides and roof of your baby’s mouth, and sometimes on his tongue. If you can’t easily wipe off these white patches, or they bleed when you try, it’s almost certainly thrush. “A nappy rash with infection by the same organism, called Candida, may occur simultaneously,”

Dr Omar says.

WHAT TRIGGERS IT Yeast is a normal part of the digestive system, but when there’s an imbalance, thrush may set in. Thrush can develop when hormonal changes right after birth trigger an overgrowth of yeast in your baby’s mouth. Antibiotics can trigger thrush by killing off the good bacteria that keep yeast in check.

HOW TO TREAT IT Thrush often clears up on its own in a couple of weeks but you can use an oral fungal medicine that your doctor will prescribe.

HOW TO PREVENT IT If you’re breastfeeding a baby with thrush, your doctor may recommend that you apply an antifungal cream to your nipples so that you and your baby won’t pass the infection back and forth.

WHEN TO SEEK HELP “Recurrent episodes of thrush in a child older than one year with no obvious cause should be assessed by a paediatrician,” advises Dr Omar.