Pediatric Skincare FAQs – Part 1
July 15, 2014 | By Evans Dermatology Staff
At Evans Dermatology, we are parents as well as healthcare providers, so we understand being a parent comes with many skincare questions and concerns. Our staff spent some time coming up with the following list of some commonly asked questions regarding pediatric skincare. We hope they help parents – both first timers and seasoned pros – with common baby, child, and teenage skincare woes.
We will be working on a part 2 with even more FAQs, including those we received from our Facebook fans, so if you have one you’d like us to address, please leave a comment!
Q: What is vitiligo? How common is it in children? Can it be treated safely?
A: Vitiligo is a condition where white patches appear on the skin. It is common in children and adults and occurs when the immune system attacks the cells that make skin pigment (melanocytes). It can occur anywhere on the skin, but is most common on the eyelids, elbows, knees, hands, feet, and genitals. Vitiligo can affect only a few small spots or most of the pigment on the body.
It is important to see a dermatologist to diagnose vitiligo, since there are other conditions which can cause light or white spots on the skin. If your child does have vitiligo, there are several treatment options to consider including topical medications, ultraviolet light treatment, and the excimer laser. All of these can take time (usually 2-3 months) to help, so it is important to continue with treatment.
Q: How should I wash my baby’s skin?
A: Babies have delicate skin that is not fully developed. You should always take special care bathing your baby, using a small tub built for this purpose and always staying with your baby in the bath. Warm water and a gentle soap (like Cetaphil Gentle Cleanser or Cerave Cleanser) should be used. At the end of bathtime, rinse your baby with fresh warm water from the tap and then pat dry. Immediately apply a fragrance-free moisturizer such as plain Vaseline, Aquaphor, or Cerave Cream. Overbathing can lead to flares of eczema, so keeps baths short (5 minutes or less) and use only the minimum amount of soap needed.
Q: What are those little clear bumps on my child’s skin? Do they need to be treated?
A: Small, clear bumps that develop in groups on children’s skin are called molluscum (sometimes called molluscum contagiosum). They are caused by a skin virus and easily spread both on the child and to other children. Although molluscum are not dangerous, they can spread rapidly and itch or irritate the skin. Adults are usually immune unless they have a chronic illness or problem with their immune system.
Molluscum do not have to be treated and will often go away on their own after 1-2 years. They can, however, spread during this time to dozens or even hundreds of spots. Treatment involves destroying the individual lesions, which can be accomplished with liquid nitrogen (freezing), cantharone (a chemical which causes small blisters), and some prescription topical medications. Since molluscum are constantly trying to spread, repeated treatments are often needed to get them all.
Q: Should an open wound be covered or left open to dry out? Is antibiotic ointment necessary?
A: Wounds heal best when kept moist, up to 50% faster than wounds that dry out and develop scabs. Clean wounds daily with soap and water, but avoid alcohol and hydrogen peroxide. Keep wounds out of contaminated water. Apply a thin layer of antibiotic ointment such as Polysporin (Neosporin has a high rate of allergic reactions) and cover with a clean bandage. After a few days, switch to plain Vaseline until the wound heals.
Q: Can children get skin cancer? Should they get skin cancer screenings?
A: Skin cancers are malignant tumors that grow in the skin cells, but they are quite rare in children. Excess sun exposure or blistering sunburns in childhood significantly increases the risk of developing serious skin cancers later in life. Limiting exposure to sunlight in children and teens may pay large dividends in lifetime skin health.
Moles may often grow proportionately with your child. However, it is possible for childhood moles to become malignant. Always see a dermatologist if a mole in children (or adults) is suspicious or changing.
Remember the ABCDEs of melanoma:
Color is uneven
Diameter is large
Evolution (change) occurs.
Q: Is dandruff normal in children? What shampoos do you recommend?
A: Seborrheic dermatitis (called cradle cap in infants) may appear as anywhere from mild dandruff to severe redness, crusting, and itching of the scalp, ears, or even face. A normal skin yeast, Pityrosporum ovale, may overgrow in some children and can be controlled with regular use of medicated shampoos. More severe symptoms may require prescription creams. Eyelid involvement can be managed by gently cleaning the skin near lashes with baby shampoo.
Q: Are warts contagious? What causes them and how do you keep them from spreading?
A: Warts are caused by a virus, so they are contagious both to the individual and to others through contact. Warts may go away without treatment and most warts are harmless, but dermatologists do treat them, especially if they are spreading or painful. Treatments include regular use of topical and/or destruction methods, but warts can be persistent.
To prevent warts from spreading, dermatologists recommend the following:
- Do not pick or scratch at warts
- Wear shoes on common floors (such as the pool or gym)
- Avoid touching warts
- Keep foot warts dry (as moisture allows warts to spread).
Q: Should tweens be treated for mild acne?
A: Acne is a common problem for pre-teens, teenagers, and adults. It is a hormonal condition caused by the normal hormonal changes of being a teenager. If mild, it does not have to be treated. If more severe or bothersome to the patient, there are many good treatments for acne. Pre-teen boys and girls often have comedonal (blackhead and whitehead) acne, which is usually best treated with prescription topical medications. More severe acne in older teenagers can leave scars and so is often treated with antibiotics, birth control pills (for girls and women), and in the most severe cases, Accutane. These medications require the supervision of an experienced dermatologist.
Q: How often should teenagers wash their face?
A: Teenagers should wash their face in the morning and evening with a gentle cleanser such as Cetaphil Cleanser or Dove. Overwashing does not improve acne but may lead to irritation and more redness. Medicated washes (over the counter) containing benzoyl peroxide or salicylic acid may help mild acne but can be drying.
Q: Should some foods be avoided to prevent breakouts or worsening of acne?
A: For most people, changing their diet does not help much with acne. For a small portion of the population, one certain food (especially dairy) may exacerbate acne and can be avoided. If you have avoided a food completely for two months and not improved a lot, it is unlikely related to your acne. A healthy diet with a variety of fresh fruits and vegetables and avoiding processed foods and simple sugar is a good choice.