Baby Skin

Redlands Daily Facts Health Section
Staff Writer

Q: We all want Skin as Soft as a Baby's Bottom. But when the Baby's skin isn't nice, what can we do?

Mimi: Cradle cap: Infantile seborrheic dermatitis, commonly called cradle cap, causes scaly patches on a baby's scalp. Though cradle cap isn't serious, it can appear as patchy scaling or thick crusts on the scalp and greasy skin covered with flaky white or yellow scales, or dandruff. There may be mild redness Similar scales may also be present on the ears, eyelids, nose and groin.

Cradle cap is most common in newborns. It isn't contagious and probably won't bother your baby. In most cases, the condition isn't itchy for infants.

Though the exact cause of cradle cap isn't known, one contributing factor may be hormones that pass from the mother to the baby before birth. These hormones cause an abnormal production of oil (sebum) in the oil glands and hair follicles.

Another factor may be a yeast (fungus) called malassezia that grows in the sebum along with bacteria. Antifungal treatments, such as ketoconazole, are often effective, supporting the idea that yeast is a contributing factor.

The following self-care tips can help you control and manage cradle cap: Gently rub your baby's scalp with your fingers or rough washcloth to loosen the scales. If the scales don't loosen easily, rub petrolatum jelly or a few drops of mineral oil onto your baby's scalp. Let it soak into the scales for a few minutes, and then brush or loosen gently with a comb, and shampoo your baby's hair as usual. Loosen the scales with a soft-bristled brush before rinsing off the shampoo. If you leave the oil in your baby's hair, the scales may accumulate and worsen the cradle cap. Once the scales are gone, wash your baby's hair every few days with a mild shampoo to prevent scale buildup.

Cradle cap usually doesn't require medical treatment. It clears up on its own within a few months. See your baby's doctor if you've tried self-care steps without success or the patches spread to your baby's face or body. Your doctor may suggest a medicated shampoo, lotion or other treatment— such as an adult dandruff shampoo containing tar, 2 percent ketoconazole or 1 percent selenium - to help dissolve the scales. Hydrocortisone cream applied daily or every other day is sometimes helpful to reduce redness and inflammation. Do not use these without a doctor's recommendation. For older babies, scalp ringworm infections may resemble cradle cap. This condition may require a prescription antifungal shampoo.

Infant milia are tiny whiteheads (Epstein pearls) under the surface of the skin. Infant acne is redness and tiny pimples seen usually just after birth. Both are a result of the hormones from the mother. They will clear up by themselves. Do not pick. Keep the skin clean.

Purple webbed veins on the legs are from poor circulation caused by cold. Put more clothes on the baby.

Diaper rash is usually easily treated and improves within several days after starting home treatment. A few simple strategies can help decrease the likelihood of diaper rash developing on your baby's skin:

Change diapers often. Remove dirty diapers promptly. If your child is in child care, ask staff members to do the same.

Rinse your baby's bottom with water as part of each diaper change. You can use a sink, tub or water bottle for this purpose. Moist washcloths and cotton balls also can aid in cleaning the skin. While your baby has a diaper rash, avoid washing the affected area with soaps and disposable, scented wipes. Alcohol and perfumes in these products can irritate your baby's skin and aggravate or prolong the rash. Pat your baby dry with a clean towel. Don't scrub your baby's bottom. Scrubbing can further irritate the skin.

Consider using ointment regularly. If your baby gets rashes often, apply a barrier ointment during each diaper change to prevent skin irritation. Petroleum jelly and zinc oxide are the time-proven ingredients included in many prepared diaper ointments. Using these products on clear skin helps keep it in good condition. These products are usually applied in a thin layer to the irritated region throughout the day to soothe and protect your baby's skin. Zinc oxide can also be used to prevent diaper rash on normal, healthy skin.

Ointments or creams may be less irritating than lotions or liquid solutions, but ointments create a barrier over the skin and don't allow it to receive air. Creams dry on the skin and allow air through. Your doctor can tell you whether a cream or ointment would be better for your child's particular rash. As a general rule, stick with products designed specifically for babies.

Give your baby's bottom a little breathing room. When possible, let your baby go without a diaper. Exposing skin to air is a natural and gentle way to let it dry. To avoid messy accidents, try laying your baby on a large towel and engage in some playtime while he or she is bare-bottomed. If the child is a toddler he can run around in the fenced back yard as a nudist. This can actually help with potty training if you put the potty chair outside. Sunshine in small doses before 11 AM and after 4 PM helps.

To aid the healing of diaper rash, do what you can to increase airflow to the diaper region. Avoid using plastic or tight fitting diaper covers. Use larger sized diapers until the rash goes away. Don't over tighten diapers. Diapers that are too tight prevent airflow into the diaper region, setting up a moist environment favorable to diaper rashes. Tight fitting diapers can also cause chafing at the waist or thighs.

In the past, it was common to use talcum powder to protect a baby's skin and absorb excess moisture. However, doctors no longer recommend this. Inhaled talcum powder can irritate a baby's lungs.

Wash cloth diapers carefully. Pre-soak heavily soiled cloth diapers and use hot water to wash them. Use a mild detergent and skip the fabric softeners and dryer sheets because they can contain fragrances that may irritate your baby's skin. They also contain oil that decreases the absorption. Double rinse your baby's diapers if your child already has a diaper rash or is prone to developing diaper rash. If you use a diaper service to clean your baby's diapers, make sure the diaper service takes these steps as well. Try diaper liners and breathable diaper covers. Diaper liners in cloth diapers may help keep your baby's skin drier. Choose breathable diaper covers instead of plastic or rubber pants over cloth diapers because they let air circulate.

Wash your hands well after changing diapers. Hand washing can prevent the spread of bacteria or yeast to other parts of your baby's body, to you or to other children.

Talk to your doctor if your baby's skin doesn't improve after a few days of home treatment with over-the-counter ointment and more frequent diaper changes. Sometimes, diaper rash leads to secondary infections that may require prescription medications. Have your child examined if the rash is severe, worsens despite home treatment or occurs along with any of the following: fever, blisters or boils, a rash that extends beyond the diaper area, pus or weeping discharge.

Cloth or disposable diapers? Many parents wonder about what kind of diapers to use. When it comes to preventing diaper rash, there's no compelling evidence that cloth diapers are better than disposable diapers or vice versa, though disposables may keep baby's skin slightly drier. Because there's no one best diaper - use whatever works best for you and your baby. If one brand of disposable diaper irritates your baby's skin, try another. Whether you use cloth diapers, disposables or both kinds, always change your baby as soon as possible after he or she soils the diaper to keep the bottom as clean and dry as possible.

Mimi Barre is the owner of International Day Spa, 325 Cajon St., Redlands. Send your skin care questions to her at MimiB@INTLdayspa.com. She and her estheticians are available for personal consultations, (909) 793-9080.