Almost right from the beginning of a child's life, parents encourage their children to be healthy eaters while being active and fit. This also is an important time to promote healthy skin care. Whether washing the delicate skin of an infant or providing effective treatment for toddlers with eczema, there are numerous ways parents and dermatologists can work together to keep children's skin clean, healthy and nourished.
Speaking today at the American Academy of Dermatology's (Academy) SKIN Academy, dermatologist Sandra M. Johnson, MD, FAAD, clinical assistant professor of dermatology at the University of Arkansas for Medical Sciences in Little Rock, Ark., discussed daily skin care for children and the treatment of common pediatric skin care conditions.
''Teaching your child healthy skin care habits and modeling these behaviors for them can be tremendously helpful in preventing and treating various skin conditions,'' said Dr. Johnson. ''A dermatologist is an important member of your child's healthcare team and if parents have concerns about their child's skin, hair or nails, I recommend that they establish a relationship with a dermatologist so that as their child grows, their skin and body care can continue to progress on a healthy note.''
Daily Skin Care for Children
The skin of toddlers is sensitive and can experience numerous changes in the first few years of life. Parents may be concerned by their child's less-than-perfect skin, but a dermatologist can evaluate and determine which conditions will resolve themselves and which may need additional treatment.
When cleaning a toddler's skin or when it's time for toddlers to learn how to wash their own skin, the use of gentle cleansers and soaps is important, stated Dr. Johnson. Fragrance-free products or those with natural ingredients work well and will not irritate sensitive skin. Emollients which will hold moisture in the skin and prevent dry skin conditions and rashes should be applied liberally.
Most important of all, recommends Dr. Johnson, is to start children with a strong foundation in sun safety. The regular use of sunscreen is one of the best "sun-smart" tips to share with children. Dermatologists strongly recommend using a sunscreen with broad-spectrum protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays and that offers a Sun Protection Factor (SPF) of 15 or higher.
If your child is prone to skin irritation or allergic reactions, choose a physical or chemical-free sunscreen made with zinc oxide or titanium dioxide because the ingredients sit on top of the skin, forming a barrier against the sun's rays. If you do use a chemical-based sunscreen, do a patch test first to make sure your child won't have a reaction to it. Apply a small amount to the inside of the upper arm. If he or she develops a rash or redness at the site by the next day, choose another formula instead.
''Early initiation of sun protection behaviors by parents and consistent use throughout life can help decrease a child's lifetime risk of developing skin cancer,'' stated Dr. Johnson. ''Modeling the use of sunscreen and other sun-protection habits, such as wearing sun-protective clothing, hats and sunglasses, and seeking shade whenever possible, is an important way to teach your children these skills.''
Pediatric Skin Infections
Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Warts occur more easily if the skin has been damaged in some way, which explains the high frequency of warts in children who are prone to cuts and scrapes, and who bite their nails or pick at hangnails. In children, warts can disappear without treatment over a period of several months to years. However, warts that are bothersome, painful, or rapidly multiplying should be treated by a dermatologist. There are many treatments for warts, including topical treatments that are applied directly to the wart such as salicylic acid, liquid nitrogen or cantharidin.
Less common, but still of concern for children, is the ''superbug'' or Community Acquired Methicillin Resistant Staphylococcus Aureaus (CA-MRSA) infection. CA-MRSA is commonly spread within families and among children in daycare centers or at local community centers. This condition presents itself as skin and soft tissue infections, such as cellulitis and abscesses or open sores. Treatment for this infection includes oral antibiotics such as clindamycin and some tetracyclines.
To prevent CA-MRSA, Dr. Johnson recommends that children wash their hands often, that cuts and scrapes are quickly cleaned, treated and bandaged, and that children do not touch other people's wounds or bandages.
As summer peaks, so do the inevitable bug bites. However, Dr. Johnson advises that parents and children can enjoy a relatively biteproof summer by following a few practical suggestions aimed at reducing the risk for bug bites.
The most common bug bites are those from fleas, mosquitoes, wasps or bees. While these bug bites can be annoying and seem fairly harmless, it is possible to have a bad reaction to a sting. Dr. Johnson recommends having an emergency allergy kit available, which can be purchased through your doctor. Some bug bites can cause bacterial infections, such as impetigo, a superficial infection of the skin characterized by yellow, crusted, well-defined lesions.
Treatment includes topical or oral antibiotics, and infected areas and lesions should be bandaged until treatment has been determined effective. ''Impetigo is highly contagious and can spread rapidly among children,'' said Dr. Johnson. ''In many states, a physician's note is required before children can return to daycare or school.''
Before going outdoors, it is important to use insect repellents on the skin and clothing to be completely protected against bug bites. The active ingredient in most commercial repellents is either the insecticide permethrin or the chemical DEET. Repellents containing permethrin should be applied only to clothing, where the agent has a residual effect through several wash cycles, providing lasting protection against bugs. In contrast, an insect repellent containing the chemical DEET should be applied directly onto the skin to ward off mosquitoes, ticks and other insects.
''While I recommend using an insect repellent with a 10 percent or lower DEET concentration for children, I do not recommend using a combination sunscreen and insect repellent because the reapplication of the product will increase the percentage of DEET on the skin,'' said Dr. Johnson. ''It also is important to note that insect repellents with DEET should never be used on a baby less than two months old, as their skin is very sensitive. To avoid irritation, I advise everyone to wash off the repellent with soap and water once they come inside.''
Pediatric Skin Inflammations
Atopic dermatitis or eczema is a common condition found in newborns and young children. This itchy, oozing, crusting rash occurs mainly on the face and scalp, but patches can appear anywhere. It is estimated that this condition affects 10 percent of the U.S. infant population. However, in nearly half of these children, the disease will improve greatly by the time they are between five and 15 years of age. Others will have some form of the disease throughout their lives.
''Children with eczema are unique patients because it may be difficult for them to resist scratching, thereby making the condition worse,'' said Dr. Johnson. ''Fortunately, for mild to moderate cases, the application of moisturizer on a regular basis can be very helpful. In the meantime, avoid as many eczema triggers as possible, such as dust, pet dander and mold."
It also may be helpful to use mild soaps, both on your child's skin and on their clothing, avoid sudden temperature changes, keep your child's bedroom and play areas free of dust, and dress your child in breathable, preferably cotton, clothing.
''Caring for a toddlers skin can be challenging at times, but a soft touch, common sense and working with a dermatologist can put parents at ease about any skin conditions that arise,'' said Dr. Johnson.