A mother’s womb is considered to be an unassailable place for any child. It takes months of care and nurturing to transform a fetus into a human body and during the whole process, the womb acts as a shield for the child, protecting it from every possible danger of the world outside. The hard part of the journey commences when the child is delivered and exposed to the harsh elements of this world. As the two are completely different spaces, very often, the newborn babies are unable to adapt to the new environment.
From birth to the initial years, a child’s immune system is fragile and constantly under development. Generally, infants are extremely sensitive to their environment, due to which they can develop a number of common or rare skin conditions. Living in a polluted environment and living high paced lifestyles, it becomes impossible for mothers to protect their children from every type of skin condition; however, with the knowledge of these skin conditions among infants and associated preventive skincare, these skin conditions can certainly be avoided.
Let’s discuss some of the common-to-rare infant skin conditions in detail:
- Diaper rash: Perhaps one of the most common skin conditions an infant’s mother faces is a “diaper rash”. A diaper rash, or ‘diaper dermatitis’, can occur on a baby’s bottom as early as in the first week of birth, but is most commonly found between 9-12 months. A recent study by Sukhneewat et al. (2019) found that the risk factors contributing to the high prevalence of 36.1% were:
- i) diaper changing fewer than three times/night,
- ii) previous episodes of diaper rash,
- iii) using cloth diapers, and
- iv) topical application of baby talcum powder to the diaper area.”
Any of these above factors can cause a diaper rash, which is the irritation of the skin or the appearance of patches of redness on the baby’s bottom or genital areas. Basically, it is a skin condition that is identified by skin inflammation caused due to overuse of diaper holding urine or faeces for too long or skin sensitivity. Very often, the skin around the diaper region does not get proper air and the natural defence mechanism of the body gets disrupted resulting in rashes.
The best way to avoid a diaper rash is the frequent change of diapers which would reduce contact irritation. n severe cases, zinc-oxide based ointments or powders can also be applied, but seeking a medical professional’s advice here is recommended.
- Dry skin: Just like adults, even babies suffer from dry skin issues from time to time, especially during cold weather or after long hot baths. Dry skin in infants is caused when the delicate baby skin does not get enough moisture. Roughness, cracks, dry patches, fine lines, shines and flakiness are the most common symptoms; these signs are spotted anywhere, but majorly occur around the hands, feet, faces and lips. Usually, dry skin is not a big issue and can be cured at home using home remedies like proper application of oil and moisturizer on the body of the infant before and after a bath, giving them shorter baths of warm water and keeping them hydrated with enough fluids.
- Infant Acne: Research has found that acne is a common skin condition in infants, and affects 20% of infants under six weeks of age; this is not true acne, but a result of inflammation caused by a yeast Malassezia (Samycia & Lam, 2016). Some researchers also believe that an alternate cause of infant acne is maternal hormones. Their symptoms are no different than those of adults’ acne, which is the eruption of red and white blisters, usually surrounded by inflamed skin around it. The most common parts of the body which are affected by infant acne are the cheeks, neck and upper back. While this skin condition in infants clears off in a few weeks, it can also last for months in some rare cases.
- Roseola: Also known as the sixth disease or ‘roseola infantum’, Roseola is a viral illness majorly affecting infants between the age of 6-24 months old. This skin condition in infants is caused by the two common strains of closely related viruses – Human Herpesvirus (HHV) type 6 and type 7. It is accompanied by a high fever and a distinctive rash visible on the body. Usually, the fever lasts up to two weeks after being exposed to the infected person. The most common symptoms are a fever of 103 F, a runny nose, sore throat or cough with preceding fever, and rashes. The rashes occur on the chest, back, and abdomen area once the fever subsides. It also causes irritation, mild diarrhoea, decreased appetite, and swollen eyelids among the children.
- Hand, foot, and mouth disease: Caused by Enterovirus, it is a highly contagious infection. It spreads through direct as well as surface contact from person to person. Its transmitters are a person’s infected saliva, stool, and respiratory droplets sprayed into the air after coughing or sneezing. Usually, it is accompanied by painful red blisters in the mouth, sore throat, poor appetite, irritation, red rashes on the hands and feet. This infection can affect people of all age groups, but it is usually caused in children under the age of 5.
- Infantile hemangioma: An infantile hemangioma is a type of a birthmark that grows in or under a baby’s skin due to the tangling of blood vessels forming a dense clump. It can occur anywhere in the whole body of the baby, but this is mostly present on the face, chest, scalp or on the back. Initially, it grows abruptly and bumps up from the skin, and later on, it disappears when it enters the resting phase. Generally, it disappears by the age of 5, but in some cases, it can go up to 10 years.
- Nevus sebaceous: Technically classified as a hair follicle tumour, this skin condition in infants is a group of extra oil glands under the skin. Usually visible on the face, neck, forehead and scalp, it can present itself anywhere in the head region. Nevi sebaceous usually appears differently in young children than in adulthood, though at all stages of life the lesions are hairless.
Typically, only one patch of the skin gets affected, but it appears as a large plaque. It usually does not affect the child's health, but in bothersome conditions, it can be removed through biopsy.
- Tranent Neonatal Pustular Melanosis: Just like the name of the disease, its composition also involves a group of disorders classified under various forms of pustulosis, a highly inflammatory skin condition in infants. Unlike most other skin conditions, it is found in the first four weeks of life and not right after birth. Its diagnosis is a little technical but can be clinically done. A key feature of Tranent Neonatal Pustular Melanosis is Pustules (pus) without reddish skin tone around the bump. Further areas which can be involved are the forehead, posterior ears, chin, neck, upper chest, back, buttocks, abdomen, thighs, palms, and feet. Pustules might leave the hyperpigmented skin after weeks which later on lightens or completely disappears.
- Ichthyosis: Ichthyosis is a variant of a genetic disorder, which is marked by the accumulation of dead skin cells in thick scales on the skin’s surface, commonly known as Abnormal Epidermal Differentiation. In this condition, the neonatal period is the most critical; this is the period where the mortality rate is high in babies with rising complications. Although it is a fairly rare skin condition, it can become life-threatening when other critical conditions of infancy are concerned together. As it is a genetic disorder, it generally cannot be avoided by the parents. Most dermatologists recommend the use of humidified incubators for babies suffering from this disease.
- Lyme disease: Infected by a Bacteria known as ‘Borrelia burgdorferi’, Lyme disease is a tick-borne disease usually transmitted by the bite of deer ticks. Mostly active in the spring and summer seasons, it is uncommon among young babies and the symptoms are often a red circular shaped, almost bull's size rash. It can get bigger or multiply if not treated for long. Flu symptoms like fever, nausea, headache, joint pains, swollen lymph nodes, poor appetite, chills and neck stiffness are also found when infected by this disease.
This summary of skin conditions among infants is not extensive, but gives you the essential information of the most common to rare disorders. As a parent, it is important to be informed so you can seek the right medical care early on and keep your baby safe and healthy.
Samycia M, Lam JM. Infantile acne. CMAJ. 2016;188(17-18):E540. doi:10.1503/cmaj.160139
Sukhneewat C, Chaiyarit J, Techasatian L. Diaper dermatitis: a survey of risk factors in Thai children aged under 24 months. BMC Dermatol. 2019;19(1):7. Published 2019 Jul 2. doi:10.1186/s12895-019-0089-1