Tuesday, August 22, 2017

Decoding Baby Skin Problems

A few weeks ago after going out for an evening walk, I noticed red spots on my little one's legs. He was still riding in his carseat/stroller travel system then so I had watched him during the walk and I knew there was no way mosquitoes had gotten my little one that many times! A few days later after another walk, more spots! Then Lucas started sleeping on his stomach and things rapidly deteriorated from there.

What to do if you notice spots on your little one...

1. Don't panic. Pediatric skin issues are very common. Often baby is not even bothered by a skin condition, but you want to make sure it is getting diagnosed properly so you can treat it properly. 

2. Familiarize yourself with the appearance of different skin problems. This Visual Guide to Children's Rashes and Skin Conditions is excellent. Measles and chicken pox are pretty rare due to vaccinations, but it can be reassuring to see that your baby definitely doesn't have them. 

3. Consider and note the circumstances just prior to the appearance of the skin condition. Were you and baby outside on a walk? Did baby just have a new food? Did you change your laundry detergent? 

4. If you can't identify a specific cause, do not jump to conclusions and make sudden changes. Changing your laundry detergent, baby's soap, etc may just exacerbate the problem and if you change multiple things you won't be sure which was causing the problem. If you are breast-feeding, absolutely do not jump to the conclusion that your diet is the cause. It is unlikely. Baby skin issues are also seldom related to poor hygiene. In fact, too frequent baths and/or too much soap use can make some problems worse.

5. Take pictures each day. If you don't head to your physician right away, take pictures so that if the skin condition worsens you can show your doctor how it progressed. Doctors LOVE pictures showing various stages of skin conditions, trust me :-)

Some baby rashes are self-limiting, meaning they will clear up eventually even without any treatment. But if the skin condition is worsening or not improving after a few days you probably want to seek the advice of your pediatrician. Watch for any signs of infection such as fever and if there are open skin areas, which are red and warm to the touch or weeping pus or developing crusts, you want to go to your pediatrician ASAP.

Some Easy Home Remedies:

Leukwarm Bath - if you're concerned something is on baby's skin which is causing irritation try a leukwarm bath, but don't let baby sit in the tub too long. 
Cool Compress (washcloth) - for angry, irritated red skin you can apply a cool washcloth to the area. 
Emollient Ointment (such as Aquaphor) or Emollient Cream (such as Cetaphil or Eucerin) - allow the skin to regain an ideal moisture balance and heal. The ointment will be more effective but is also more greasy.

Over the counter medication treatments which should be discussed with your pediatrician:

1% Hydrocortisone (Cortaid) - steroid cream/ointment, reduces skin inflammation.
Clotrimazole (Lotramin) - anti-fungal cream, treats yeast in the diaper area or ringworm on the body.
Triple Antibiotic Ointment (Neosporin) - antibacterial ointment, apply to broken skin to prevent bacterial infection.
Diphenhydramine (Benadryl) - antihistamine used to treat allergic reactions, it is not recommended for babies and should not be given without specific direction from a doctor.

So is the rash eczema??? That's the dreaded question my husband and I asked ourselves. My husband has suffered from pretty significant eczema since infancy. Eczema in children typically appears before age 2. For many children it lessens in severity with age and may go away completely by the time they are a teenager. It may be in just a few spots or it may be widespread over most of the body. 

After his first birthday, my toddler developed very mild eczema on the backs of his calves and the backs of his upper arms. This could be a result of daily baths. We used to do every other day baths, but couldn't seem to get through a day without Henry putting food in his hair. He bathes in Honest company fragrance free bubble bath and we apply Honest company fragrance free face and body lotion afterwards. This light body lotion took care of the dry areas on his legs. We also apply Aquaphor to the bumps on the back of his arms. My husband swears by Aquaphor and we get it from Amazon with subscribe and save. 

(Aquaphor is 41% petrolatum, enviornmental working group (www.ewg.org) rates it as a 2 "Low Hazard" product, but if you are avoiding petrolatum based products, this one is not for you.)

After some trial and error and a conversation with a pediatrician, we determined that the nasty red bumps on Lucas's skin are in fact eczema. It's not the standard dry, scaly skin eczema, but it's still eczema. He has developed patches on his legs and his wrists, I believe from friction since he is scooting around his crib now that he rolls to sleep on his stomach. Since he does not have head to toe symptoms and I wash his crib sheets with his clothes, I'm not concerned it is the laundry detergent. I'm almost sad about that, because it would be easier to fix. His symptoms are also exacerbated by heat/sudden temperature changes  which is common with eczema. I'm hopeful that once he starts crawling, things will improve. 

In the meantime...we have reduced his baths to every 3 days. I'm actually considering going to every 4 days if he continues to look worse the morning after his bath. We are using Aveeno Baby Eczema Moisturizing Wash and I've started applying Aveeno Baby Eczema Therapy Moisturizing Cream all over after baths and once a day. These products have a nice thick texture. The cream works great for my dry hands too, I just rub it in after I put it on Lucas. I also spot treat active areas with Aquaphor and 2.5% Hydrocortisone cream, prescribed by our pediatrician. I don't like using the steroid cream, but these angry red welts need to be treated.

Eczema in babies and young children is fairly common. Luckily, it usually changes in appearance and severity over time. My focus now is finding a regimen which works and hoping for improvement. At only five months, these particular spots should not be a chronic issue for Lucas, fingers crossed!

Useful eczema resources:

Baby Centre - Baby Eczema: Causes, Symptoms, Treatments and Creams
Web MD - Does my baby have eczema?
Dr. Sears - Understanding and Treating Eczema
National Eczema Association - The Eight Types of Eczema

Google Images provides a lot of pictures to see the many different ways eczema can appear.

Does your baby or child have eczema? What is your go-to bath routine and treatment?

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