SHARES
Dr Melanie Majaham, Damai Service Hospital, Jalan Ipoh is a well-known paediatrician in Malaysia. She gave a talk on Common Skin conditions in Childhood at an event conducted in collaboration with Applecrumby & Fish earlier this year. Here are some excerpts from the talk, in parts. In this article, we cover blisters that occur during infancy.
During consultations, paediatricians get some questions like why doesnt my baby have baby-soft skin. Soft as a baby’s bottom is unfortunately not alwasy true. Does this happen because of infection, allergy, or birthmarks or is this just normal?
Some commonly asked questions in clinical practice are:
– What is this rash?
– What can I do to make my child feel better?
– What treatment are you starting, doctor? It is the parents’ right to know what treatment and what cream the doctor is prescribing and also the side effects of using the medication
– When should I be worried?
Blisters – what are they?
Medically, blisters are basically rashes that are filled with water inside. Most blisters look similar. But it is not so. Chicken pox, Molluscum, HFMD, Shingles – these are similar looking, are also rashes filled with fluids.
The rashes need to be examined and the progress of the rash has to be discussed with the doctor, to help them come to a conclusion for the diagnosis.
In this post Dr Melanie talks about rashes that we come across during infancy such as Baby Acne, Milia, Cradle Cap, Diaper rash, Drool rash, heat rash.
Baby Acne
This condition resembles acne in adults, white with surrounding red dot. In babies, you can see it on the cheeks and the body. Medically, it is called Erythema toxicum neonatarum.
The name looks and sounds scary but it is not so. It is normal and can be seen in half of the newborns. It appears in the first few days of life or 2-4 weeks later. It is seen on the face and the body, it is harmless. Applying oil or creams can worsen it. Sometimes doing nothing is the best thing to do!
Milia
Also known as milk spots. Appears on the baby’s cheeks, chin or nose. Appears as white spots looking like tiny pearls – very smooth to touch. The cause of their appearance is unknown, it is probably appearing due to the developing oil glands. This is seen in 40-50% of the newborns. It disappears within a few weeks or months. Does not require treatment. One word of caution to parents – do not try to extract it thinking it is a whitehead, it can cause scarring.
Cradle cap
Also referred to as baby dandruff. In this case, the baby’s scalp is very oily, scales can be seen. Oily flakes can be seen on the scalp and the eyebrows. It is non-itchy, not contagious.
The occurance of the baby dandruff actually has more to do with how clean you wash your baby’s head. The cause is an overactive sebaceous/oil gland in the scalp. There is no need to do anything about it, but since we do not like to see flakes on the head, we tend to remove it. To tell you the truth, it is actually not harming the baby. If it becomes too much of a problem, you can massage the scalp with baby oil or olive oil. You can also use a soft brush to dislodge the scales gently. You can also wash with a gentle shampoo. It will persist for a few weeks or months, do not worry. These scales usually disappear after the 3rd or 4th In case the scales appear red, sticky and smelly, you need to see a doctor because at that stage it may have developed into an infection.
Drool Rash (Ruam Susu in Bahasa)
A very common sight in most of the babies. It is usually seen around the mouth and neck. It occurs due to drooling milk and saliva.
There is the presence of a chemical, an enzyme in the saliva that helps to digest the milk the baby drinks, so when the saliva leaks out, the enzyme or chemical reacts with the skin and causes irritation to the skin, causing the skin to break down a bit which results in the rashes. So essentially to treat it, all you need to do is to keep the area clean and dry, wipe gently with a soft damp cloth. If the area is not kept clean, it can develop into a secondary bacterial or fungal infection.
Prickly heat rash – Ruam Panas
Again in this case, it is not an infection nor infectious. It occurs in area that are sweaty and warm. It occurs in babies normally due to blocked sweat glands. Treatment for this is basically to keep the baby cool – in an air-conditioned room, wearing light cotton clothes, cool baths, drinking more fluids. Sometimes applying calamine lotion can help.
Diaper Rash
We are all familiar with this type of rash. When talking about diaper rash, there are two major categories depending on the cause of the rash – Irritant rash or Yeast infection leading to rash.
Irritant rash
This occurs basically when baby uses diapers and is constantly in contact with the urine and potty that has been passed, sometimes the diaper breaks and leaks and the gel comes out, this tends to affect the skin that is in contact with the leak. This causes skin irritation and creates a raw painful area, it is better to keep this area clean and dry as often as possible. This doesn’t affect the skin folds. Avoid applying talcum powder in this area because talcum powder can be dangerous for baby, if the baby breathes it in. If not taken care of, it can lead to bacterial or yeast infection.
Yeast infection
At a glance, it looks similar to the diaper rash due to irritants. There is something called Satellite lesions where you can see small red dots surrounding the main rash, it is usually quite scaly. This rash is more well defined, it can affect within the skin folds as well. It is beefy red, and very painful for the baby. The baby is usually cranky, crying, is in pain, it can be itchy and it is a yeast infection, a Candida (fungal) infection. Treatment for this is similar, to keep the area dry and clean apart from applying anti-fungal cream. Cloth diapers reduce the risk of irritant rashes. It is advisable to get the anti-fungal cream from the doctor rather than from the pharmacy directly because sometimes they may not be suitable for your baby’s skin or it might be too strong. The ones that you get from the doctor are a bit more gentle on the baby’s skin.
In our next article, we will cover infections that occur during childhood.
To make an appointment with Dr Melanie Majaham, head over to GetDoc.
by Hridya
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya.
