Considering how the skin surrounding our
children’s bodies is constantly exposed to injury, bacteria, and various other
irritants, it is rather incredible that children do not have more skin problems. A number
of factors account for this, including the protective keratin layer on the surface, the
chemicals in sweat and perspiration, and the internal defenses present in the bloodstream.
Nonetheless, when skin problems do occur most are fortunately a nuisance rather than a
problem. Four of the most common skin problems that afflict children will be discussed
this week and another four next week.
ECZEMA (ATOPIC DERMATITIS)
Eczema is an inflammatory skin condition that
probably results from exposure to allergens and irritants in susceptible individuals. This
common skin condition usually appears within the first five years of life and sometimes,
but not always, is accompanied by other allergic diseases such as hay fever and asthma.
The rash of eczema is often weepy (one that emits
a fluid) and is very itchy, typically occurring in the creases of joints, neck,face, and
about the trunk. Scratching may lead to bleeding and infection.
The condition often diminishes in intensity as the
child grows older and over 40
percent of children will outgrow the problem when
they become adults. The rashes of poison ivy and other poisonous plants are similar to
eczema, but are short lived and limited to the areas of contact.
Some parents find that mechanical irritation and
heat make their child’s rash worse. Dietary factors are occasionally important and
many physicians will eliminate certain food allergens (milk, eggs, citrus juices, and nuts
being the most common).
Treatment of eczema is aimed at reducing dryness,
itching and inflammation. Topical agents include wet dressings and steroid ointments and
creams provide relief from scaling and dryness. Oral anti-itching drugs such as Benadryl
and other antihistamines may be quite helpful. Secondary infections that develop when
bacteria invade the irritated skin are treated with the appropriate antibiotic.
WARTS
Warts are caused by the papilloma virus and are
very common, with as many as 10% of all people infected at any one time. They can take a
variety of appearances- the most common is that ugly little critter than looks like a
wrinkled pimple on the fingers and around the nails. Another form is the tiny round flesh
colored flat wart usually located on the back of the hands, neck or face. The third type
is the plantar wart that resembles a hard pebble like bump on the soles of the feet. Warts
are harmless, but depending on their location can be painful. They would definitely take
last place in a beauty contest of skin diseases!
How warts are actually spread is poorly
understood. It is thought to be due to a susceptible child’s direct contact with the
virus through a break in the outer layer of the skin. While your child can spread the
warts on themselves, they are not very contagious to other people. They are rare in
children under the age of two.
The "success" of folk remedies for warts
is due to the fact that warts often disappear by themselves. "Warts are harmless, so
treatment should be conservative," according to Largo dermatologist Dr. Fred Gurtman,
"and they tend to recur even after treatment that seemed successful." So when
should warts be treated? "They should be removed when the warts appear to be
spreading,, or enlarging, cause the child discomfort because of where they are located, or
the child is embarrassed by their appearance," advises Dr. Gurtman. Sometimes your
child’s physician will recommend an over-the-counter medication that contains
salicylic acid or refer to a dermatologist for surgical removal by scraping, cauterizing,
or freezing.
"ACNE" OF THE NEWBORN
Over 40% of newborns develop a rash on their face
that resembles the pimples they might get as teenagers. This newborn "acne"
begins around 2-3 weeks of age and often lasts until 4 to 6 months of age. Baby boys are
affected more often than baby girls. The whiteheads, blackheads, and pimples appear in
crops on the nose, chin, cheeks, and occasionally the forehead. It usually gets worse a
day or two before the grandparents visit or the day of baby’s first formal picture.
While no one knows the cause for sure, it is believed due to maternal hormone stimulation
of the baby’s sluggish sweat glands before the baby was born.. In most cases, no
treatment is necessary since the rash clears on its own. Wipe spit-up milk from the
infant’s face as soon as possible with a cotton ball and warm water. Avoid soaps,
even "gentle" baby soaps on the face as they are too drying. Make sure the
sheets are soft and non-irritating. Other creams, ointments, and topical steroids should
be avoided unless recommended by the infant’s physician.
MOLLUSCUM CONTAGIOSUM
Molluscum contagiosum is a harmless skin infection
caused by a virus. The rash is commonly found under the arms and the adjacent chest areas
and consists of flesh tone, waxy-looking pimples. In the center of each pimple is a small
dimple that so that rash resembles small pearls with an indented centers. With gentle
pressure from the side the molluscum discharge a firm granular white mass. There is
usually no symptoms except for occasional itching. Dozens and often hundreds of lesions
may be seen. Despite its name, the contagiousness of molluscum is generally low. Because
of the difficulty in treating that many lesions in a child, watchful waiting is usually
the best therapy. Furthermore, the molluscum naturally go away within 6 to 12 months
without treatment or scaring. Some physicians treat the molluscum with the topical
application of tretinon (Retin A), salicylic acid, or surgical removal when the rash
occurs in areas where there’s discomfort from the pimples being rubbed.
