A newborn baby is a big responsibility for young parents. When visiting a pediatrician, parents usually ask a lot of questions. Especially if the child is the first. In my personal top list, feeding and colic take first place. Second - rashes!
In photographs on social networks, babies have clean, rosy cheeks and an angelic smile. And in life, redness, pimples, peeling and other unexpected things appear on the skin. Moms are not ready for this. They get scared and start looking for the reason. Neighbors advise you to follow a diet, grandmothers complain about “bad milk.” If you are unlucky, the doctor will scare you with allergies or prescribe tests, half of which will turn out to be unnecessary.
Let's try to figure out which skin problems in infants do not require treatment and are normal in infancy, and which do not. Let’s agree right away: any rash should be examined by a doctor in person. A diagnosis cannot be made from a photograph, because the doctor examines the elements of the rash, touches it by touch, and sometimes special diagnostic tests are needed. In doubtful cases, the pediatrician gives a referral to a dermatologist.
The information below is given so that young mothers stop being afraid of every pimple, understand conditions that do not require medical attention, and understand when to take their child to the pediatrician.
What does a newborn look like?
If the birth goes well, immediately after the birth of the newborn baby, the mother is placed on her stomach. His skin can be bright pink, or it can be pale, his hands and feet have a bluish tint. This scares young mothers if they have heard or read something about hypoxia and cyanosis before. But if the doctors in the delivery room are calm and do not provide resuscitation measures, then this is a variant of the norm. A healthy child can be like this in the first minutes of life. In addition, the newborn's body is covered with vernix - the baby looks as if it has been smeared with cream cheese. And this is also normal, although unattractive. Lubricant plays an important role in protecting the skin from germs, so the baby’s skin is only lightly blotted without being completely wiped.
5-10 minutes after birth, the newborn’s skin becomes bright pink, almost red. This is a normal condition - physiological erythema . The air pressure is less than the pressure of the fluid in which the baby was in utero. When the skin ceases to experience resistance, blood actively flows to it. The body gets used to the new form of life. Gradually, the blood vessels will narrow, and the skin will become its usual pink color by the end of the week in full-term babies and after 2-3 weeks in premature babies.
Marbled leather
During the first month of life, a baby's skin sometimes looks marbled. A uniform mesh pattern of white, purple, and reddish spots is the reaction of skin vessels to cold. Therefore, this phenomenon is most often noticed during swaddling. If the marbling is symmetrical and disappears when warmed, then there is no cause for concern. In other cases, it is worth discussing this symptom with your pediatrician so as not to miss the early diagnosis of diseases of the heart, lungs or skin itself.
White pimples on the genitals
Sometimes milia appear on the labia or on the penis of infants. This is also explained by blockage of the sebaceous glands and goes away with the normalization of their work. To prevent their occurrence, monitor your baby’s intimate hygiene:
- Wash after bowel movements in warm water. You can do this under the tap, placing the baby's tummy in the palm of your hand. With your free hand, wash from the pubis to the anus so as not to provoke an inflammatory process. This is especially true for girls
- Change diapers or nappies promptly
- Do not keep your baby in diapers all the time, give him air baths so that the skin can breathe
Important: If white pimples appear on your baby’s genitals, be sure to show him or her to a pediatrician or dermatologist. Sometimes they indicate the presence of a disease. For example, mycoplasmosis, a urogenital infection, can manifest itself this way.
Peeling
On the second or third day after birth, the newborn’s skin begins to peel off. Peeling is observed in everyone, but to varying degrees of severity. Most severe if the baby is post-term. The reason is the same restructuring of the body to exist in the air. The skin loses moisture, and the top layer gradually peels off. Physiological peeling does not require treatment and goes away on its own within a few days.
If the peeling is profuse and leads to deep cracks, the skin is lubricated with special moisturizers - emollients. In case of pronounced peeling, it is necessary to exclude congenital skin diseases such as ichthyosis, hyperkeratosis and others.
Erythema toxicum
By the second or third day of life, 70% of full-term newborns develop a small red rash on the skin. Rarely, this condition occurs in premature babies. First, spots appear, and within an hour a yellow bump 1-2 mm in size forms in the center. Elements of the rash are located on the face, torso, arms and legs, and can merge with each other. The cause of erythema toxicum is unknown, but the rash goes away without treatment in 1-7 days and is not dangerous.
If the clinical picture is atypical or other symptoms are present, the doctor will prescribe additional examination to rule out other causes of the rash, such as infection.
White pimple on eyelid
Infants often develop white pimples on the upper or lower eyelid. These are milia or so-called millet. The main reasons for their appearance on the eyelid:
- Reaction to allergens
- Rarely, this is a consequence of prolonged exposure to ultraviolet radiation.
- Calcium deficiency (for example, when teething)
- Blockage of the sebaceous gland ducts
Important: In case of pimples on the eyelids, the main treatment is hygiene, but it is worth determining the cause of their appearance.
Pimple on the eyelid
Newborn acne
20% of newborns develop a rash similar to teenage acne from the third week of life. Small pustules surrounded by a red halo. They are located on the face, head, chest, shoulders, and less often on the stomach. The condition is called “acne,” although in the literature the term “cephalic pustulosis” (from the words “cephalo” - head and “pustule” - abscess) or “neonatal pustulosis” is more often used. The main two reasons are the influence of maternal hormones during breastfeeding and the colonization of the skin by microorganisms. Elements of the rash resolve without treatment after 1-3 months. This condition is not dangerous, does not cause discomfort to the child and leads to independent recovery, so there is no need to prescribe medications. The exception is severe cases when the rash is profuse, leads to secondary infection or heals with the formation of scars.
Diet of a nursing mother
Small pimples on the face of a newborn can be prevented if the nursing mother has only healthy and safe foods in her diet.
To do this, you should follow the basic rules for eating in the last month before childbirth and the first month after:
- vegetables are exclusively boiled;
- stewed fruits, the best option is baked apples;
- porridges from types of cereals that do not contain gluten, namely: rice, buckwheat, corn, oatmeal.
- dried fruits in small quantities;
- the greens should be slightly stewed or boiled; they can be consumed fresh when the baby is 3-4 months old;
- cooked meat.
In the second month of the child’s life, the mother should expand her diet to include fresh fruits and vegetables, meat, and baked goods. You should not eat legumes to avoid bloating. Each new product should be consumed in small quantities, then you need to monitor the baby’s reaction after feeding.
Infant acne
The same rash in children after three months of age is called infant acne. It persists as persistent acne of newborns or reappears at 2-3 months. It differs from newborn acne only in the age of the children and the duration of the rash. Self-resolution occurs within 6-12 months. Infantile acne may be a risk factor for acne during adolescence.
Prickly heat
Develops in children from the second week of life when overheated. The rash has different manifestations: small red spots, nodules, pustules or blisters in the thickness of the skin. Miliaria can occur on any part of the body: in the folds, on the face, scalp, torso, arms and legs. The cause of the rash is blockage of the sweat glands.
There are several factors contributing to this:
- high room temperature;
- increased body temperature in a child;
- thick clothing, non-breathable fabric, for example, an oilcloth mattress cover;
- lying in one position for a long time.
Treatment consists of general care:
- daily bathing without soap and other chemicals;
- using lighter and looser clothing;
- maintaining the air temperature in the room at 22-24 degrees C;
- ventilation.
When these conditions are met, prickly heat disappears within a few hours. The recommendations listed above also apply to prevention.
For walks outside, the child is dressed like an adult plus one layer of clothing. No need to re-wrap. There is also no need to wear a cap in warm weather.
During the cold season, undress your child during a long stay in a store, shopping center or other premises. While awake, place your baby on his stomach and hold him vertically in your arms to diversify his movements.
Chickenpox
A viral disease transmitted by airborne droplets. It occurs infrequently in infants and is very severe. Occurs if the mother became infected with chickenpox during pregnancy, or never had chickenpox, and the baby was in contact with a sick person. This occurs due to the lack of necessary antibodies.
Congenital pathology manifests itself during the first week and a half of life. The baby's temperature rises, vomiting occurs, and convulsions are possible. The child loses appetite and becomes lethargic. Apathy abruptly gives way to irritability. After a couple of days, rashes appear in the form of red spots and blisters filled with liquid. Sick children are advised to drink plenty of fluids and breastfeed frequently.
At high temperatures it is necessary to take antipyretics. Rashes are treated with brilliant green, rashes in the mouth are lubricated with sea buckthorn oil. The use of antipruritic ointments is also useful.
Diaper rash
A more serious skin reaction to overheating is diaper rash. Occurs in natural folds. It looks like redness, sometimes with weeping and erosion. With a long process, a bacterial or fungal infection may develop, then the surface of the affected skin is moist, bright red, with clear or purulent discharge. Prevention measures are the same as for prickly heat.
The skin in the folds is treated with powders. If normalizing the microclimate and caring for the newborn does not lead to a reduction in diaper rash, you should see a doctor. If complications occur, antibiotic therapy or topical steroid ointments may be needed.
Diaper dermatitis
The distinctive feature of this rash is that it appears only in the area under the diaper, other areas of the body remain clean. The reason is increased humidity and irritating feces.
The rash is found in the buttocks, thighs, lower abdomen in the form of individual elements or continuous areas of changed skin. The elements of the rash are varied: red spots, bumps, pustules or peeling.
To alleviate the condition, you need to change the diaper and wash the baby immediately after bowel movement. While changing clothes, you can arrange air baths, that is, leave the child to lie naked, you can cover it with a regular dry diaper. Lubricate the skin with a special diaper cream.
Change the diaper every 3 hours, even if it is only slightly full. More often when very full. If these measures are ineffective, you should consult a doctor. Local glucocorticoid agents may be needed.
Preventive measures
Almost all acne in babies is not dangerous. Their occurrence can be easily avoided if you follow a number of measures:
- watch your diet;
- if there is a reaction to the mixture, replace it;
- properly care for your baby and maintain hygiene;
- give the baby air baths;
- wash your baby’s underwear with specially designed powders.
If acne does not go away for a long time and bothers the newborn, doctors usually prescribe medications: Panthenol, Bepanten or Zinc ointment.
Seborrheic dermatitis
Appears in infants soon after birth and lasts up to a year. Yellow scales and peeling are most often located on the scalp and behind the ears, but can also be in other folds - axillary, elbow, inguinal. In everyday life they are called “milk crusts”. Because of its similarities to atopic dermatitis, seborrhea is sometimes considered a manifestation of allergies. The causes of this condition are not fully understood, but the relationship with allergies has not been identified.
Seborrhea goes away without treatment, in most cases in the first year of life. Unlike atopic dermatitis, the rash does not cause itching and does not cause discomfort to the child. If for the sake of aesthetics you want to get rid of seborrheic crusts, before bathing the baby’s head is lubricated with oil and then combed out with a soft comb.
In doubtful cases, when seborrhea is located on the body, it makes sense to consult a doctor to clarify the diagnosis.
White pimples on the gums and tongue
- Often appear simultaneously with pimples on the eyelids due to incompletely formed sebaceous glands.
- May be the result of stomatitis due to untreated feeding utensils or pacifiers. Stomatitis can also appear due to numerous kisses from the baby.
- If, in addition to pimples on the gums and tongue, you notice their appearance on the palate of a newborn, they may be a symptom of dysbiosis
- Bon's nodules on the gums are small cysts that look like pearls. They pose no danger and disappear without a trace over time.
- Teeth - neonatal (congenital) teeth. They can be included in a set of baby teeth or be extra in a row. In the second case, they need to be removed, so you need to consult a dentist
- Thrush - differs from other types of pimples by the manifestation of other symptoms: rising temperature, child anxiety, increase in the number of pimples
White pimple on the gum
Atopic dermatitis
This is a chronic inflammatory skin disease. It occurs in 15% of children, of whom two thirds experience the first symptoms before one year of age, sometimes even in infancy. The rash appears on the face, torso, and extensor surfaces of the arms and legs. There may be redness, peeling, crusts, and when scratching, infection and the presence of pustules may occur. Elements of the rash itch and bother the child.
Only 30% of children have atopic dermatitis associated with food allergies. Therefore, a nursing mother does not always need a diet.
The cause of atopic dermatitis is increased skin permeability. For treatment, first of all, creams that restore barrier function are used. They are called emollients. There are quite a few brands that produce such products. The choice is based on personal preference. From a medical point of view, there is no advantage to any particular drug.
If you suspect atopic dermatitis, you need to see a doctor to clarify the diagnosis and receive recommendations for treatment. You can contact your pediatrician or dermatologist. If the diagnosis is confirmed, keep in mind: treatment will be long. It includes skin care and constant use of emollients; in more severe cases, hormonal ointments may be needed; for food allergies, a diet. It is important to understand that with strict implementation of the recommendations, stable long-term remission can be achieved.
Prevention
You can wipe your skin with chamomile infusion. The baby should be dressed according to weather conditions. Clothes should be made from natural materials. Dry air in the apartment is also undesirable; if necessary, you should use a humidifier.
Be sure to read:
Onycholysis or separation of the nail from the nail bed: how to treat at home
Bathing should be regular, and the skin should be wiped daily with wet wipes. It is also important to avoid sweating and overheating your baby.
Recommendations for maternal nutrition are similar to those for diagnosing allergies. The same rules apply to artificial feeding - the formula should be selected by a doctor, taking into account all the characteristics of the baby.
Mastocytosis
A rare disease that can appear at an early age, sometimes even from birth. Outwardly, it resembles allergic urticaria, but spots and blisters last longer, and when the exacerbation subsides, pigmentation remains. A typical diagnostic test is the appearance of blisters on the skin due to mechanical irritation of areas of pigmentation.
Treatment for childhood forms of the disease is not required; recovery occurs spontaneously within several months, sometimes several years. If itching is present, antihistamines are used.
Infantile hemangioma
Hemangioma is a benign tumor of endothelial cells (endothelium is the inner lining of blood vessels). It may be congenital or appear at 1-2 weeks of life. Superficial hemangiomas are bright red and protrude above the surface of the skin. Deep - blue-purple, sometimes warm to the touch. The element size ranges from a few millimeters to an entire anatomical area (hand, buttock, etc.). In the first 5-6 months, the hemangioma may increase in size and become brighter, then the growth ends and spontaneous regression begins.
Up to 90% of hemangiomas can resolve without treatment.
In this regard, surgical treatment is no longer used routinely. The child is observed by a pediatrician and a surgeon; if hemangiomas are located on the face and neck, in the genital area and near large vessels, conservative treatment is prescribed. The operation is indicated only if it is ineffective.
Vascular abnormalities
Congenital anomalies of vascular structure are varied
- A simple nevus is a capillary anomaly. It appears as a pale pink spot or several small spots. The common name “stork bite” or “angel kiss” arose due to its location on the back of the neck and head, on the forehead, bridge of the nose and upper eyelids. The spots fade by the age of two, but can appear when crying or physical activity. No treatment required.
- Port wine stain or flaming nevus. A dark red spot that looks like a hemangioma. It may be one of the manifestations of pathological syndromes. Lasts for a long time. Treatment is not necessary, but can be done if the spot creates a cosmetic defect.
- Venous anomaly - blue-violet painful nodules under the skin. They can also masquerade as a hemangioma. Occur alone or in combination with other anomalies. The danger lies in the possibility of thrombosis of the altered veins. Treatment consists of wearing compression clothing and using aspirin to prevent blood clots. Surgical excision is possible.
- More rare lymphatic, arteriovenous and combined anomalies are found as part of various pathological syndromes.
