Dry, red & itchy

12th September, 2017
Pippa Naudé

Dis-Chem Mother & Childspoke to Dr Rakesh Newaj, a Specialist Dermatologistbased in Pretoria (www.dermatologistjohannesburg.com), about the most common conditions affecting babies’ skin. He outlined the following, including how to treat each of them.

Cradle Cap

  • Appearance: Flaky, dry skin on the scalp that looks like dandruff, or thick, oily, yellowish or brown scaling or crusting patches. It usually appears from the age of six weeks.
  • Cause: Maternal hormones or yeast in the baby’s skin are thought to be possible causes of cradle cap.
  • Treatment: Although it doesn’t look great, cradle cap is harmless and usually clears up naturally around six to 12 months. To speed up its disappearance, you can massage baby oils or coconut oil onto your baby’s scalp, which softens the skin and makes it easier to gently comb the flakes away. Some baby shampoos developed specifically for cradle cap are also effective at clearing it up.

Dry Skin

  • Appearance: White, scaling skin, which can also look red and inflamed.
  • Cause: Babies have very sensitive skin, so bathing your baby more than several times a week is likely to dry it out. Cold, dry outdoor weather and indoor heating in winter can also contribute to dry skin.
  • Treatment: Aside from limiting the number of baths your baby has, make sure you also use a wash or soap made for babies for the first 12 months, says Dr Newaj;

“Choose a mild, non-perfumed soap or a pH neutral liquid baby bath product. You can also add a little bath emollient to the water – just remember that it will make your baby’s skin slippery, so keep a gentle but secure grip on her.”

  • Apply a good baby moisturiser after each bath, and make sure your child is also well hydrated. A humidifier in your baby’s room at night can also help.

Eczema

  • Appearance: Dry, red, itchy skin appearing on any part of the body, but most commonly found on the face and in the bends of the elbows and knees. It can be incredibly uncomfortable. In severe cases the skin can thicken and look leathery, or crack and ooze. This can lead to infections if not treated quickly. Eczemais very common and can affect up to 40% of children. It typically presents from three months.
  • Cause: Eczemais a genetic disease that weakens the skin, allowing moisture to escape and letting germs in. Irritating substances can cause it to flare up – such as woollen and some synthetic fabrics, soap, perfume, make-up, heat and sweat, cold and dry climates, dry skin, dust and sand, chlorine, solvents, and irritants in the environment such as cigarette smoke.
  • Treatment: Dr Newajcautions it is important to seek medical advice as soon as possible, to ensure you treat your baby’s eczema effectively – especially given how uncomfortable and even painful it can be.
  • While eczemacannot be cured, it can be managed by taking especially good care of your child’s skin. This includes moisturising the skin often (special creams are available for this), having lukewarm baths (as hot baths can dry out the skin further), and possibly using topical steroids (to lessen redness and inflammation). It’s also important to prevent your child from scratching their rash, as this can make it worse and lead to secondary infections. Keep your baby’s nails short or try get her to wear mittens at night.

Dr Newaj adds, “Fortunately, roughly half of all children will outgrow eczema – although they may have occasional remissions that can last for years, and the tendency to have dry skin often lingers.”

Heat Rash

  • Appearance: A red or pink rash accompanied by discomfort and itching, and appearing on areas of the body covered by clothing.
  • Cause: The blocking and swelling of sweat ducts.
  • Treatment: Heat rashdoes not require medical attention, and will go away naturally. However, try not to overdress your baby, and keep her cool. If it persists for three or four days, appears to be getting worse, or is accompanied by a fever, contact your doctor immediately.

Milia

  • Appearance: Also referred to as “milk spots”, miliaare tiny white bumps, most commonly occurring on a baby’s face. Milia can develop at any age, but are especially common among newborns. Half of all babies develop it.
  • Cause: Primary milia are caused by dead skin cells that cannot shed properly, while secondary milia are caused by a skin condition or infection.
  • Treatment: Miliausually disappear on their own after a few weeks, and require no treatment. However cleaning your baby’s skin gently and thoroughly will help speed up recovery.

Nappy Rash

  • Appearance: A red rash in the nappy area, that causes discomfort.
  • Cause: “Nappy rashoccurs when the skin around the baby’s nappy area becomes irritated. This is often caused by prolonged exposure to urine or stools, but can sometimes be the result of a fungal infection or eczema,” explains Dr Newaj.
  • Treatment: Make sure you keep changing your baby’s nappy promptly, to keep her skin clean and dry. You can also use a nappy cream to soothe your baby’s skin, and help clear up infections. Antifungal cream may be necessary if the rash is caused by a fungal infection. Eczemashould be managed by your doctor, once diagnosed.

Roseola

  • Appearance: Roseolausually starts with a high fever which lasts three to five days, ends abruptly and is followed by a pink rash on the trunk and neck, which may spread to the arms, legs and face. The rash may have small flat spots or raised bumps, with a lighter ‘halo’ around them that will turn white if you press on them. The rash can last for a few hours or days, but isn’t itchy or uncomfortable – although your child may feel unwell and be irritable. Roseolanormally effects children between six months and three years of age.
  • Cause: A mild and common herpes virus, which is spread through saliva, respiratory droplets or faecal matter.
  • Treatment: There is no treatment; simply keep your child comfortable and well hydrated while the virus runs its course.

“About 10 to 15% of children with roseolahave a febrile seizure,” adds Dr Newaj. A febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a spike in body temperature. “If this happens, your child may become unconscious and jerk her arms, legs or facial muscles for two or three minutes. She may also lose control of her bladder or bowels. Although frightening, fever-induced seizures in young children are seldom serious or harmful. If you can, try to time the length of the seizure. Your child’s doctor will want to know how long the episode lasted.”

Take Note

“If a rash is ever accompanied by high fever, breathing difficulties, vomiting, or reduced general health (when your child is not acting right), take your child to see a doctor,” urges Dr Newaj.

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