Baby skin has the rep of being soft, smooth, and sweet-smelling. But as most parents of an infant can attest, bumps, blotches, and rashes are all part of baby skin territory. Your pediatrician or a pediatric dermatologist can help identify and treat your baby's skin ailments. Use the following photos to start the identification process.
What it is: Psoriasis is an inflammatory disorder of the skin that affects one to two percent of the population. More than half of cases begin in childhood or early adulthood. The disorder is believed to be caused by white blood cells (T cells) that attack the skin mistakenly.
Red, scaly areas develop anywhere, but especially on the scalp and over the knees and elbows. In infancy, the diaper area is a common site. Friction or trauma may induce new lesions, known as the "Koebner" phenomenon. Arthritis may accompany severe, long-standing psoriasis.
How kids get it: The onset of psoriasis can be seen after a strep infection; however, genetics also plays a strong role in who gets disease, especially in childhood.
How to treat it: If a strep infection is noted, oral antibiotics will be used. Gentle skin care, topical corticosteroids, ultraviolet therapy, and topical vitamin D derivatives have all been found to be helpful to relieve skln redness. Antihistamines can be used to reduce itching. Topical therapies to help alleviate scalp symptoms include tar shampoos and scalp solutions. Biologic agents, methotrexate and cyclosporine have all been tried in some severe childhood cases especially when arthritis is seen, but close monitoring by a physician is required.
What it is: Diaper dermatitis (diaper rash) is an irritation—reddening, sometimes with small pimple-like dots—of the skin normally covered by the diaper. This rash appears most obvious on the lower abdomen, genitals, around the anus, and in the folds of skin in the groin. The buttocks are less often involved. Diaper rash is often accompanied by a fungus called candida, which loves nothing more than wet, dark places.
How kids get it: Anything that irritates and has prolonged contact with the skin can cause diaper rash, including prolonged contact with urine and stools. Allergies to plastic pants, disposable diapers, detergents and fabric softeners (if you use cloth diapers), lotions, and powders can also cause diaper rash, but are infrequent causes.
How to treat it:Treating the non-yeast diaper rash is simple: eliminate the irritants to the skin. Change diapers frequently and clean your baby carefully each time with a soft cloth, plain water, and a mild soap (after a stool, not after each urination). The more you keep your baby's skin dry, the more likely the rash will go away. If you are using any lotions or powders on your baby's skin, try eliminating them for a few days. Not using fabric softeners or changing detergents also makes a difference in some babies who wear cloth diapers. (Read more about dealing with persistent diaper rash.)
What it is: Scabies is an itchy condition caused by a skin-deep mite infestation.
How kids get it: Transmitted by prolonged skin-to-skin contact with the scabies mite or with another person with scabies, it spreads easily among household contacts, in schools, and in chronic care facilities. The mite can persist in bed clothes and sheets.
How to treat it: Everyone in the household should be treated with a topical agent that kills mites (it's applied to the skin overnight and repeated the following week). Itching can last for weeks after treatment but can be alleviated with antihistamines and topical corticosteroids. Pregnant women need to consult their physician regarding their therapy.
Atopic dermatitis (eczema) is an itchy, dry, sensitive-skin condition in which patients have repeated episodes of itching. Ninety percent of cases begin by age three. In 70 percent of cases, a family history of atopy (asthma, eczema, food allergies, seasonal allergies, allergic rhinoconjunctivitis) is noted.
Infants may experience itchy, red, raised areas (sometimes oozing fluid) on the face, neck, arms, or legs. In older kids, the creases of the arms and legs, the neck, and behind the ears are common spots. Hand eczema is common in adults.
Atopic dermatitis (eczema) is primarily genetic. However, children with atopic dermatitis will have flares of itching and redness when they come in contact with irritants (wool and perfumes are common) or allergens (such as dust). Food allergies can worsen eczema, but do not cause it.
The most important eczema therapy is to use gentle, fragrance-free soaps and detergents for washing clothing. Moisturizers can replenish the skin's natural oils and hydrate dryness.
Mild to mid-potency topical corticosteroids are standardly used to clear childhood eczema and oral antihistamines can help with itching. If infections occur (as lesions often contain excess staph bacteria), antibiotics may be needed. Non-steroidal anti-inflammatory creams can help reduce disease flares that require corticosteroids, and may help when corticosteroids do not work.
What it is:Tinea faceii (ringworm) is an infection caused by a skin fungus called dermatophytes. Marked by circular red areas with scales at the edges, ringworm can occur anywhere on the body, but is most common during childhood years on the head and face. Ringworm sores are sometimes itchy.
How kids get it: The fungus is contagious: kids may get it from family members, other daycare attendees, or classmates. Shared hats, combs, brushes, and pillowcases can be a problem.
How to treat it: Topical anti-fungals may clear the lesions. Larger lesions, those resisting cream therapy, and lesions in the hair or nails usually require oral antifungal therapy.
What it is: Sometimes referred to as seborrheic dermatitis, cradle cap is a waxy, scaly, skin rash that is very common in infants. Often the rash is confined to the scalp, but occasionally it can spread to the face and diaper area.
How kids get it: A very typical rash, cradle cap affects babies between six to 12 months.
How to treat it: No need, say some doctors. While cradle cap may look scary, it doesn't hurt and doesn't really need to be "cured."
If the problem is confined to the scalp, it can usually be controlled with diluted shampoo containing selenium and by gently brushing the scalp. Applying baby oil to the scalp to loosen the scales has been recommended by some and not by others. If the cradle cap gets worse or does not improve with simple treatment, stronger medicated shampoo and other medications are available through your pediatrician.