Baby skincare and conditions
Ever hear the phrase 'skin as soft as a baby's'? As the
parent of a newborn, you may be wondering when, exactly, this
lizard-skinned little creature's body is going to soften up. Sadie
Morgan investigates infant skin conditions and finds out what
treatment options exist to help your baby's skin go from
scaly to smooth.
When a child enters the world, his skin is usually smooth
and soft, with an almost velvety texture. For the first week
or so, your newborn's skin may feel a little bit greasy as he
sheds the vernix that he was covered in at birth. Vernix is a
curdlike, waxy, whitish substance that is secreted by the baby's
sebaceous glands while it's still in the uterus. It may be ugly,
but it serves a very important function: To protect the baby's skin
from the amniotic fluid that surrounds it. Without vernix, your
baby's skin would become wrinkled like a raisin - the same thing
that happens when you soak in the tub for too long and your fingers
and toes start to resemble dried fruit. Research has also suggested
that vernix has antibacterial properties and helps protect the baby
from infections.
Your newborn baby has spent 40 weeks inside a warm, moist
environment perfectly suited to his growth and development, so it's
only natural that when he emerges, some changes need to take place
as his body adjusts to the environment of his new habitat. From the
time newborns enter the world, their skin is in a state of flux,
trying to adjust to atmospheric conditions so different to what
they face in the womb. Once the vernix is either shed or absorbed
into the skin, your newborn's silky skin may start to develop some
not-so-nice characteristics. Cradle cap, dry and flaky skin, "baby
acne", and other skin-related conditions look awful and can be
uncomfortable.
Because infant skin is so changeable, you
need to treat it differently to your own, adult skin. Your
fantastic anti-ageing moisturiser is deinitely not appropriate for
your little one. Infant skin is more vulnerable to irritants,
changes in temperature, humidity, and other external factors. It
has not yet developed protection against potential irritants like
washing powder or scratchy fabric.
So your task as a parent is to treat your
infant's skin gently and mildly. But first, let's answer some basic
questions: What the heck is wrong with my baby's skin? How do
I know if it's dry skin, eczema, or something worse? And what
can I do about it?
What's wrong with my baby's skin?
Newborns can experience a variety of skin-related conditions. In
fact, because a newborn's skin is so thin and sensitive, they can
often experience more skin-related problems than adults do! Here
are some of the most common infant skin conditions your baby may
develop:
• Cradle cap
If your baby looks like he has dandruff (a flaky scalp), it's
probably cradle cap (also known as neonatal seborrhoeic
dermatitis). Cradle cap can be white and flaky, resembling dry
skin, or it can be yellow, greasy, and crusty - and innumerable
variations thereof. It's ugly, but fortunately it's harmless to
your baby. Cradle cap usually shows up within the first few weeks
to months of your baby's life and can be very hard to deal with as
it often emerges just when your newborn's hair finally decides to
start growing more than just peach fuzz. There's no known cause for
cradle cap, although some researchers have suggested it's a result
of the end-of-pregnancy hormone dose the baby receives from its
mother overstimulating the baby's oil-producing sebaceous glands
(the same place vernix comes from). The jury is still out on this
one, so don't start blaming yourself, Mum! There is also recent
research suggesting that a particular strain of yeast may cause the
infection of the scalp, but this is uncertain. It may also be
related to a lack of biotin (vitamin H or B7). We do know that
cradle cap isn't caused by allergies or not bathing your baby
enough, and it's not contagious.
• Baby acne
Does your baby's skin make him look like he's in the throes of
puberty, with zits sprouting everywhere? This is likely to be "baby
acne" (also called acne neonatorum). Baby acne affects about
20% of newborns, and usually shows up at around their second week
of life. Fortunately, most cases of baby acne resolve themselves by
the time the baby is three months old. But it can make getting
those gorgeous baby pictures a bit challenging! Baby acne is also
thought to be related to the mother's hormones overstimulating the
sebaceous glands, which cause the oil glands on the baby's skin to
form pimple-like bumps. Recent research points to a variety of
yeast that may cause an acne-like skin infection in infants, but
further study is needed. Baby acne is usually confined to the
cheeks and face, but can also appear on the baby's back and
shoulders near the neck.
• Milia
If your baby has tiny white bumps on his eyelids or nose,
these are probably milia (also called milk spots). They look like
little seeds and are actually benign, keratin-filled cysts that
appear just under the epidermis (outermost layer of skin). Milia
are harmless and usually disappear on their own within a
month.
• Dry skin
Dry skin in infants is common, especially in the winter
months where exposure to the extremes of temperature (cold outdoors
and warm inside) combine to dehydrate their sensitive skin. We
spend so much of our time trying to keep our babies warm and dry
that we're actually putting them at risk of developing dry skin.
When moisture is consistently drawn away from the skin, the stratum
corneum (outermost layer of the epidermis) eventually develops
cracks, which increases the risk of irritants penetrating the skin.
Even when we bathe our babies, their skin gets dehydrated because
as the water dries from the skin, it draws out natural lipids which
maintain the skin's natural moisture barrier and cause dryness.
Wiping or towelling skin dry, especially with baby wipes, can
further damage the skin.
• Infant eczema
Infant eczema (also called atopic dermatitis) is characterized by
reddened, crusty, itchy skin. In babies, it's hard to stop them
from scratching, which can make the condition much worse as it
further irritates the already fragile skin and can introduce
secondary infections. Infant eczema is an inflammation of the upper
layers of the skin. It is believed to run in families whose members
are also prone to hay fever, asthma, or eczema themselves. Eczema
usually shows up on the face, scalp, neck, chest, inside of elbows,
underarms, behind the knees, and on the buttocks. It usually
develops around two to three months of age, and is caused by an
oversensitive immune system reaction in the skin.
What's a parent to do?
Many common infant skin 
conditions will eventually resolve themselves, although
this is incredibly frustrating to new parents who want their infant
to look and feel better as soon as possible. But there are remedies
you can try to reduce the length of time your baby is suffering,
and speed up the healing process.
• For cradle cap, many parents like to try various methods
to remove the scales. A favourite method is to coat the scalp
in olive or almond oil, slip a cotton hat on overnight, and brush
off the softened scales in the morning with a soft toothbrush or
baby hairbrush. While this can provide short-term results, the
scales usually don't all go at once, so you may find yourself
repeating the process more than once - or just leaving the hat on
all the time until the scales do finally disappear. If the cradle
cap is stubbornly refusing to go after several months or the scalp
has become very red and irritated, talk to your child's GP.
• Baby acne is best treated with patience and a "less is
more" approach. With baby acne, you should avoid putting
creams, oils, or lotions on your baby's skin, as these can clog
pores and make the acne worse. Baby acne isn't caused by
dirt, so be careful not to scrub your baby's face. Wash with
mild soap and water once a day, and pat dry with a facecloth.
It should disappear within a few months of its own volition, and
meanwhile, it shouldn't bother your baby.
• Milia also require no medical treatment, and should go
away on their own within a few weeks of the baby's
birth.
• Dry skin is a bit trickier to deal with. If you've noticed
that your baby's skin feels dry, use a gentle cleansing
product with a neutral pH level, and add a few drops of bath oil to
his bath. After bathing, moisturise with baby lotion or baby oil.
Moisturisers are essential for treating dry skin because they
provide a barrier that keeps moisture in the skin from evaporating.
Infant skin is very thin, which means it doesn't hold moisture as
well as adult skin does. Increase your baby's intake of fluids, and
if you're noticing that your baby's skin feels extremely dry or is
beginning to get irritated, make sure you see your GP.
Treating infant eczema
Infant eczema is such a big issue, its treatment options
deserve a separate section! Unfortunately, there isn't a known cure
for eczema, so the goal of most parents and medical practitioners
is to find a treatment that helps the sufferer to relieve
itching, and reduce inflammation. There are lots of things
you can do to help prevent eczema from getting worse and promote
healing:
•Dress your baby in natural fibres. Cotton or silk are best,
as synthetic fabrics and wool can irritate the skin. Use
cotton sheets and blankets on your baby's bed.
• Change your washing powder. Eczema can be irritated by too
harsh a laundry detergent being used for clothing and bedding, so
try something gentle and natural.
• Skip the bubble bath, and watch the temperature. Bathe your
child in a pH-neutral cleanser only if it is necessary to remove
actual dirt; otherwise, stick to plain water, and make it lukewarm,
not hot.
• Help your child to avoid scratching. Invest in some
scratch mitts (widely available from baby clothing stores), or
slip a pair of socks over their hands and arms to discourage
scratching. Keep their fingernails short.
• Use a humidifier in your baby's room to counteract the
drying effects of using heaters.
• Dust. Keeping the house as dust-free as possible can help
to reduce eczema, as lack of dust mite and particle allergens
reduces the immune response.
• Breastfeeding your baby exclusively until at least four
months of age can help minimize eczema. But if your baby has
eczema already, look at your diet if you're breastfeeding, and your
baby's diet if he's on solids. There is research suggesting that
sensitivity to certain foods can cause eczema to flare up,
including cow's milk, wheat, eggs, soy products, nuts, and coffee.
If you're introducing solids, make sure you only introduce one food
at a time and watch carefully for reactions that manifest as
eczema.
• Moisturise. Many parents swear by emollient creams such
as aqueous cream, and paw paw ointment. Bathing in a colloidal
oatmeal bath may also help the skin to retain moisture. Apply
moisturisers to the skin directly after bathing to "lock in" as
much moisture as possible. Patch-test moisturisers on a small area
of your baby's skin until you're sure that he won't have a
negative reaction to it.
• If you're worried, don't hesitate to visit your child's
GP. Sometimes, severe eczema may need medical treatment,
although your doctor will likely suggest many of the remedies
recommended here before resorting to medication.
Fortunately, most infant skin conditions will resolve themselves
within a couple of months, as their hormones settle down and
their immune systems sort themselves out. Then you can really
enjoy that baby-soft skin, and book in for a photo shoot without
fear that you'll need to pay extra for retouching!
Sadie Morgan is a freelance writer based in Auckland. She is a
mum of six children, three boys and three girls, and has a collie
named King.
References
• "Your Baby's Changing Skin and Hair." Online at www.johnsonsbaby.com/
article.do?id=38
• Purcell, Sarah and Dr David Paige. "Managing infant dry
skin." Journal of
Community Nursing 13.4 (1999).
As seen in OHbaby!
magazine Issue 3: 2008
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