Don’t kid around with skin disorders

Dr Vikas Sharma

The largest organ system “the skin” undergoes dramatic visible changes in both the males and females right from birth to before the resumption of sexual development at puberty and the transition to adulthood. The skin disorders seen in children in part reflect these physiological changes, but many of the most troublesome skin problems encountered result from intrinsic genetic abnormalities conditioned by environmental influences. A child’s skin is much thinner and fragile than an adult’s, thus requiring the need for extra-care, early diagnosis and specific treatment.

Babies can develop many types of skin conditions shortly after they are born. A lot of these conditions last only a short time and go away. Others, however, are birthmarks that may not be visible at birth but will stay with babies throughout their lives.

Doctors at National Skin Hospital, Mansa Devi Complex, explained that the most common skin conditions encountered in new born babies are :

Erythema toxicum

Erythema toxicum occurs in the first 3 to 5 days after birth. It is a rash of small red dots (although some can have a central white dot) that usually appears on the chest, back, face, and arms. This is a normal reaction in babies’ skin and it goes away in a few days.

Cradle cap

This is a crusty greasy scalp rash that commonly occurs in the newborn and slightly older babies. It happens when there is a build up of sebum (an oily substance produced by glands in the skin) that, in turn, makes skin cells stick together instead of shedding normally. It can occur on the scalp alone or with a diaper, neck, or underarm rash.

Desquamation

Desquamation or skin peeling is something that affects a lot of babies in the first few days of life. It worries the parents but medically the skin change is completely normal.

Nail care

Babies play with their hands and can scratch themselves with their nails, even if they are extremely thin and tiny. As babies’ nails grow faster than adult nails, one will need to trim them every one or two weeks though taking care of the ultra-fragile skin around the nails while trimming.The spectrum of skin disorders rises as the child becomes more mobile thus becoming more exposed to potential disease triggering antigens.

Birthmarks

Many babies are born with birthmarks, some of which can be worrying for parents. Some birthmarks disappear over time, while others remain with the child for life.

Milia

These are small white bumps on the baby’s face. They look like whiteheads, but they are small cysts filled with sebum and keratin (a type of protein that makes up the outer layer of skin as well as a person’s hair and nails).

Miliaria

It has many different appearances: one could find tiny red bumps or little blisters filled with fluid or pus, usually on the baby’s chest or back, underarms, or neck. It happens when sweat ducts on the skin become blocked. It sometimes appears after intense heat or if the baby is too bundled up. So the key is to avoid too many and occlusive clothes.

Premature puberty

Signs of puberty before the age of 10 years are generally held to be abnormal. These are reflected on the skin in the form of early appearance of facial, axillary or pubic hair. This may result from an early onset of complete (or true) puberty, in which the changes are triggered by early glandular activation. The early detection and treatment of this condition is very important.

Acne

This is a very common rash for babies. It occurs mostly on the nose and forehead and looks like pimples or blackheads. Newborn acne is thought to happen when either the mother’s or the baby’s hormones cause the baby’s glands to produce more sebum.

Transient pustular melanosis

Transient pustular melanosis is a type of rash that is more common in darker-skinned babies. It appears from birth as tiny white raised bumps on a baby’s neck, chest, back, or buttocks. The bumps will go away on their own, but sometimes they leave slightly darker marks on the skin.

School years bring exposure to a wide variety of infectious and contagious conditions such as measles, chickenpox, impetigo, warts, molluscum contagiosum, scabies, fungal infections and head lice. There is also a gradual increase in contact with potential irritants: at school during lessons in sporting activities such as swimming and team games.

Furthermore, it is well known that severe skin disease of any kind in childhood can have a considerable impact on general physical development. Atopic eczema is a good example, short stature being very common in severely affected individuals.

Skin diseases in school going children are encountered more frequently and their characterisation is essential as certain not so visible but highly infectious conditions can spread rapidly like viral skin infections and fungal infections. The inflammatory fungal infections of scalp and hair can lead to permanent irreversible bald patches. Thus early detection of such cases is of utmost importance. At the same time children with certain markedly visible skin disorders like vitiligo, psoriasis, alopecia areata, eczemas and some genetic disorders  are subjected to unnecessary isolation and social boycott in spite of them being non-infectious thus affecting their mental state and development.

—The writer is Chief Consultant Dermatologist, National Skin Hospital, Panchkula