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Most rashes on a baby's skin will fade on their own while some may require minor treatment.
We just brought our new baby home. What should we know about caring for his skin?
Although your newborn may have some skin conditions that seem unusual to you, most are fairly common and do not need any treatment. Here’s a list of some conditions your baby may have:
Milia are tiny whiteheads on your baby’s face, most frequently on the chin and the nose. They will gradually disappear on their own.
Baby acne is a red, pimply rash on the face that usually appears after the first two to three weeks of life. This rash is generally gone by the time the baby is two to three months old.
Cutis marmorata is a condition where the skin looks like pinkish-blue marble when exposed to cold temperatures. It is not serious and will improve as your baby gets older.
Erythema toxicum is a common, blotchy red rash that can affect many newborns. Most of the lesions have firm yellow or white bumps surrounded by a flare of red. The rash tends to come and go on different parts of the body. It is most common on the second day of life, but can appear at birth or within the first two weeks. The individual blotches may stay for only a few hours or for several days. There is no treatment – it will gradually disappear.
Mongolian spots are flat birthmarks that can be deep brown, slate gray, or blue-black in colour. They sometimes look like bruises and are often found on the lower back and buttocks. Mongolian spots are present at birth and most of them fade (at least somewhat) by age 2 and are usually completely gone by age 5. They are very common in babies of African, Asian, Hispanic, Aboriginal and bi-racial descent.
There are two other skin conditions that, while very common, may require some intervention.
Diaper rash
Diaper rash, also called diaper dermatitis, is caused by wet or soiled diapers. It occurs when urine or stool in the diaper irritates baby’s skin, making it tender and red.
How should it be prevented or treated?
The best way to prevent diaper rash is to change your baby’s diaper often, especially if your baby has diarrhea. When you change your baby’s diaper, wash his bottom with mild soap and warm water (just water if there is no stool), rinse and pat dry. If the skin is very sore and red, it may be less painful to wash the area in a warm bath.
Use an unscented barrier ointment, such as petroleum jelly to protect and lubricate the area after each diaper change or a cream with zinc oxide if the skin is irritated. If you use a cream, clean it off with soap and water after each change and reapply. Do not share creams and ointments with other children and don’t touch the affected skin and then put your fingers back into the jar. Use a different finger if you need more ointment.
Using wipes can dry out your baby’s skin. If you use wipes, be sure they are alcohol-free and unscented. Do not use baby powder or talc.
If possible, remove your baby’s diaper for short periods to expose his skin to open air. This can help your baby feel better and the rash will heal faster.
If the diaper rash is severe or persistent, it may be caused by Candida, which is a type of yeast that causes an infection on the skin (usually the genitals and buttocks) or in the mouth. Candida infections are usually very red with small red spots close to the large patches. When Candida is in the mouth, it’s called thrush. If you think that your baby has a Candida infection, contact your doctor. It will be treated with an antifungal cream.
Cradle cap
Cradle cap appears as crusty patches on a baby’s scalp. There may be some redness around the scales. You may also notice redness on other parts of the body, including the creases of the neck, armpits, behind the ears, on the face and in the diaper area. When it involves these other areas it is called seborrheic dermatitis.
How should it be treated?
Cradle cap will disappear on its own and does not usually need to be treated. If you want, you can wash the hair with a mild baby shampoo and gently brush out the scales to help control this condition. However, shampooing your baby’s hair too often will also cause dry scalp. Baby oil or mineral oil may help soften the scales. When applying the oil, rub only small amounts into the scales. Then shampoo and brush out the oil a few hours later to avoid more build-up. If your baby has seborrheic dermatitis, your doctor may prescribe a mild hydrocortisone cream (0.5 per cent), which is safe and usually effective.
Dr. Denis Leduc is a general pediatrician in the Montreal area. He is a Past President of the Canadian Pediatric Society. For more information on your child’s growth and development, visit the Canadian Pediatric Society’s website at www.caringforkids.cps.ca or www.soinsdenosenfants.cps.ca.
