How to recognise sensitive skin conditions in baby: Symptoms to watch out

Rashes are extremely common in newborns where during the first four weeks of life, the newborn period includes various dermatologic skin problems but most of them are innocent and transient. The skin is the largest organ of the body and during pregnancy, the baby’s skin is protected in the womb while after birth, it takes time for progressive adaptation to the external world as this skin is very sensitive, thin and fragile since the barrier system is not completely formed thus, the skin is more prone to trauma, irritations, infections and it also absorbs topical medicines more than that of a mature adult skin.

In an interview with HT Lifestyle, Dr Reshma T Vishnani, Consultant Dermatologist, Trichologist and Aesthetic Dermatologist at Kokilaben Dhirubhai Ambani Hospital in Mumbai, advised, “Use of topical steroids, which are present in a lot of over the counter creams or creams prescribed by non-doctors, should be used with extreme caution! Most of the skin conditions in the new-born phase are physiological which include small white bumps on face and/or body, pigmentation over the body, temporary redness, flaky skin over the face and scalp, crusting over scalp. Most of these conditions pass off by themselves with basic skin care of using mild cleansers and moisturisers so that the skin doesn’t get aggravated.”

She revealed that the following conditions or symptoms, if they persist, should be shown to a dermatologist

• Consistently dry, rough, scaly or cracked skin, even after moisturising should raise a concern.
• Red patches over skin, they may be persistent for days in one place or temporary.
• Inflamed itchy skin which includes patches of the skin which are oozing or crusting, babies may rub or scratch their skin indicating discomfort or irritation.
• Sensitivity to temperature: babies with dry sensitive skin may react strongly to change in temperature like having dry patches in the cold weather or looking flushed when exposed to heat or even sunlight. These babies are sensitive to even mild sunlight exposure.
• Babies with sensitive skin are more prone to developing allergies from certain fabric, detergents, fragrances or even skin care products. They may develop sudden appearance of red itchy patches on by, hives, redness, swelling or itching.
• Skin reactions to products or clothing: very commonly seen in babies with sensitive skin, these babies should always be clothed in cotton loose clothes.
• These babies may sensitive to even chemicals in mild soaps or lotions or diapers, and may have persistent nappy rash not related to tightness or keeping the baby in damp diapers.

Dr Reshma T Vishnani highlighted, “There are many chronic conditions like eczema, psoriasis etc which have the above symptoms. Also, some temporary conditions like irritant dermatitis or secondary infections may present in the same way. So, if the child is uncomfortable - crying, wincing on touching or not feeding - may indicate a primary or secondary infection and should be shown to a dermatologist at the earliest. The one thing that we Indians do to aggravate sensitive skin in babies is home remedies, whether it’s using curd or milk for bath, or using gram flour or chickpea flour as a “natural exfoliant” to make the child fair or remove hair. This should be highly discouraged. Scrubbing or harsh massages to newborns is harmful in more than many ways and shouldn’t be done.”

Dr Soma Sarkar, MBBS, MD – Dermatology, explained, “Babies are born with sensitive skin which is about three times more delicate than that of an adult. The thin and permeable nature of their skin makes them more vulnerable to rapid loss of moisture. This make its critical to safeguard and take special care of baby’s skin to ensure this fragile outer layer is well protected. While most babies are born with sensitive skin and face skin irritation, some babies have or may develop extreme sensitive skin which requires special care and attention.”

She elaborated, “One such example of a sensitive skin condition is Atopic dermatitis (AD), the most common form of eczema, which is a chronic inflammatory skin disorder that has a profound impact on millions of children. The Indian Academy of Pediatrics (IAP) has put in place standardised guidelines around pediatric skin care which also encompasses sensitive conditions. According to IAP, babies with AD are normally genetically predisposed to impaired epidermal barrier function and immune dysregulation. It's a chronic skin condition with itching that tends to surface periodically with distribution of skin lesions varying depending on age.”

Given that sensitive skin conditions like eczema often run in families, Dr Soma Sarkar revealed that a baby is likely to get it if one parent has this condition. She said, “However, several other causes like environmental triggers, dry weather and over-bathing contribute or accelerate these conditions. Sensitive skin conditions in children is increasingly becoming very common. Approximately 60% of children with atopic dermatitis develop symptoms in the first year after birth, and 90% develop symptoms by 5 years of age.”

She concluded, “Dry skin is often a sign of sensitive skin. However, other symptoms of eczema or AD include chronic itchiness that often appears as a red, dry rash on the baby's cheeks, forehead, or mouth indicating a compromised skin barrier. Though eczema skin conditions can differ from one baby to another, in babies with light skin, it usually results in red patches whereas babies with darker skin tone may have a purple, brown or greyish rash. But these patches are almost always dry, itchy, and rough.”