Baby Blemishes

by Christine Haran

Everyone wants to have skin like a baby -- soft, clear, smooth and rosy. In reality, even infants can break out like teenagers. While the tiny blemishes and rashes can be upsetting to parents, they are usually harmless and require minimal treatment, if any.

It's often worthwhile to talk to your pediatrician about a given skin condition, however, as they can offer prevention and treatment guidance. Below, Daniel Krowchuk, MD, a professor of pediatrics and dermatology at Wake Forest University Health Sciences in Winston-Salem, North Carolina, reviews conditions that commonly affect infants, from cradle cap to diaper rash.

Are skin conditions common in newborns?
Yes, these may be divided into two categories. There are skin conditions that represent normal variations, meaning that lots of babies get them and they are of no consequence in the long term and usually resolve on their own. Then there may be other skin conditions that will persist and require evaluation and treatment.

What should routine skin care involve?
Parents should be aware that there is no one and only one way of caring for your baby's skin. Many of the skin care recommendations rely on common-sense regimen. There is some science behind recommendations, and then there's a lot of personal preference. For example, a baby -- a newborn, in particular -- may not need a bath every day, and therefore it's not necessary to give one. Obviously you're cleansing the diaper area, which gets dirty on a regular basis. There may be times, for example, during the winter in colder climates, when a baby's skin becomes dry and a moisturizer might be useful. It may be applied after bathing and at other times during the day, if needed.

Baby powders are often used, but they are not routinely needed. Some people apply them in areas where there's moisture, like in the diaper area or in the folds of the neck. The difficulty with powders is that they can be inhaled. Generally we recommend that parents stay away from them if they can. If you're going to use power, choose one that contains cornstarch rather than talcum power. Dispense a small amount on your hand, well away from the baby, and then just gently rub that on the area of skin you wish to treat.

In general, it's wise to choose products that are designed for infants, which often do not contain alcohol or fragrances that may be irritating to the infant's skin. I think most parents are pretty savvy; most know to use products that are designed for infants.

What is cradle cap?
Cradle cap is a form of seborrheic dermatitis and most commonly appears in babies as a scaling on the scalp. It can be mild or it can be fairly widespread. Seborrheic dermatitis is a self-limited condition, so by the time a baby gets to be eight or nine months of age, typically, it's quieting down.

If cradle cap is mild, a standard baby shampoo may be sufficient to help remove the scale. Some parents find that if they, when shampooing, use a soft brush designed for the scalps of babies, that will help lift off some of that scale. Some people prefer to apply a small amount of mineral oil to the scalp and then use the brush to loosen the scale. An antiseborrheic shampoo -- that's one of the dandruff shampoos -- could be used to help lift off the scale if other measures weren't effective. Generally, if you're at this point, it might be worth talking to your health care provider about selecting of one of these shampoos. Parents should use the shampoo on an as-needed basis. Once the scale is gone you can return to your infant's routine scalp care.

Do parents need to treat the flaky skin some infants are born with?
Flaking skin is a normal and temporary finding. No treatment is necessary. If the skin seems excessively dry or there's a little bit of cracking, which sometimes can happen in the skin folds -- for example, in the ankle -- then, a moisturizer may be helpful.