A Summary Of Some Common Skin Rashes In Babies (By Cecilia Koh)
- Cradle cap is a condition whereby patches of greasy yellow flakes and small pimple-like bumps appear on the scalps of healthy babies. Sometimes it may appear on the eyebrows, ears and other areas where sebaceous glands are located. It can occur in any baby, and appear during the early weeks of life and will clear by the sixth month. Some dermatologists think that high levels of maternal hormones are transmitted to the baby during the final weeks of pregnancy. This makes the sebaceous (oil) glands in the baby's skin hyperactive which trigger overproduction of sebum which not only overstimulates the growth of new skin cells but also binds the old skin cells into flakes and crusts. It often has a mild unpleasant smell and does not cause any discomfort to the baby.
- Heat rash consists of tiny blisters filled with sweat. It forms when the pores become blocked and prevent the sweat glands from releasing the sweat or when heat and humidity exceed the ability of the sweat glands to cool the body. Babies are especially vulnerable because their ability to sweat is not fully developed and they often wear or lie on waterproof materials. It normally develops around the neck, face, armpits and sometimes on the chest and back. Western medication includes applying calamine lotion and antihistamines for severe itching. Sometimes applying a light dusting of corn starch powder may help to relieve the itchiness. Chinese traditional remedy is to bath the baby with boiled dried bitter gourd vine daily for 3 days. It is best to prevent the condition from developing by dressing the baby in light cotton clothes especially in warm or hot weather. Avoid laying the baby on a plastic covered mattress or pad. Do not apply moisturizing cream or lotions or use bath oils for babies under 3 months as these products may clog the pores. Do not over wrap the baby in layers of clothes and swaddling blanket.
- Nappy rash is often due to infrequent nappy change causing irritation from ammonia which is released when bacteria starts breaking down the contents of a dirty nappy. It could be due to an allergy to your washing powder or fabric conditioner if your baby wears cloth diapers or a food/drug allergy especially antibiotics. The genital area, buttocks, groins and sometimes the upper thighs will look red and inflamed. It can be dry or moist and sometimes look pimply. Babies with nappy rash may be very fussy and cries frequently or does not seem bothered at all.
"Prevention is better than treatment" so the best defence against nappy rash is a dry bottom.
- Infantile eczema is an itchy dry scaly rash usually seen on the cheeks or chin, but may show up on the head, trunk, back of arms, or front of legs and is not contagious. It is first noticed at 2 to 5 months of age and is most common in families with history of allergies or asthma. In most cases it will settle down by the time the child reaches school age but for some it may continue to be a life long problem. The frequency and severity of flare ups can be dramatically reduced with careful daily washing using a hypoallergenic soap and applying moisturisers, topical steroids when needed. Avoid trigger factors such as excessive sweating, woollen clothing, soaps and bubble bath. Sometimes it may be necessary to give baby antihistamine if the itch is very intense and is making the baby very irritable.
- Urticaria or hives are red or pink raised areas on the skin that are very itchy and warm to the touch. It may appear on any part of the body and usually last from a few hours to a few days, but can stay for weeks or even months in some cases. Hives are usually caused by food allergies with the most frequent culprits being eggs, shellfish, chocolate, food additives, colouring or preservatives. It can also be due to allergy to certain drugs or in response to contact with animals especially cats or from insect bites.
- Hand foot and mouth disease (HFMD) is a skin rash with flat or raised red spots on the palms of the hands and soles of the feet and sometimes on the buttocks. Often the rash will form tiny blisters which look like the chickenpox rash but it does not itch. A day or two later the child may develop sores or blisters on the tongue, gums and inside of the cheeks. They begin as small red spots on the tongue, gums or mucous membranes which then develop into blisters or sores.
Treatment is to provide relief from fever or pain from the mouth ulcers and give plenty of fluids. There is no immunization for HFMD.
- Thrush or candidiasis is a fungal infection from Candida albicans. It appears as a red bumpy rash in the diaper area and the bumps are sometimes pus-filled. It may be worse in the skin folds and does not respond to diaper cream. Often the primary source of infection is in the mouth which then spreads to the nappy area from the contaminated stools. It normally starts as a couple of white patches on the sides of the mouth and if not treated quickly can spread until the tongue is coated as well. This makes it painful for baby to suckle. The creamy patches look like milk curds and therefore is easily missed. Use a cotton bud to wipe the white patches. If the patches cannot be removed it confirms that the baby has thrush therefore should be taken to the doctor who may prescribe Daktarin gel for the oral thrush and cream for the nappy area. If the infection is severe it may be necessary for the doctor to prescribe Daktacort which has a small amount of steroid in it to speed up the healing process. All feeding equipment must be boiled thoroughly for 10 minutes to prevent recurrence.