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5 Baby Skin Problems That Look Worse Than They Really Are

By Laura Flynn McCarthy

babyskinFrom the moment your baby is born, he will probably look perfect to you, but the truth is, babies rarely have flawless skin. Acne, scalp scale, rashes and other imperfections can pop up on an infant’s skin. Summer’s heat can bring on prickly heat, a.k.a. heat rash.

Most of the time, baby skin problems are harmless and disappear quickly.

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“Two-thirds to three-quarters of babies develop rashes and most are benign,” says Dawn Davis, M.D., pediatric dermatologist at the Mayo Clinic in Rochester, Minnesota. Call the doctor if, in addition to a rash, your baby has a fever or looks sick, or if the rash looks particularly severe, doesn’t fade when you press on it, or doesn’t clear up in a week.

Here, common infant skin problems and what you should—or should not—do about them:

1. Rash remarks More than half of all babies develop a rash with unknown cause during the first few days after birth that doctors call erythema toxicum, which, despite its scary sounding name, is harmless. It looks like pinpoint white or yellow pustules surrounded by redness, along the trunk of the body, and possibly also the face, arms, and legs. “It’s often the reason doctors get a call just before a mom and newborn are discharged from the hospital,” says Dr. Davis, “but usually nothing needs to be done. The rash disappears on its own in a week or so.”

2. Baby, it’s hot inside Your baby is more prone to heat rashes than you are, especially when the mercury rises. Parents often cover up a baby too much. “Babies’ sweat glands and ducts are not as mature as adults’ are, so they do not sweat as efficiently as adults do,” says Dr. Davis. “When babies get hot they often develop miliaria, which looks like little water bubbles on the top of the skin where the salty sweat gets stuck, or skin can get red and inflamed.” A good rule of thumb is that a baby should wear one layer extra than an adult is wearing. If you’re wearing a tee shirt and shorts on a summer afternoon, your baby would probably feel comfortable in a cotton onesie, perhaps covered by a lightweight cotton long-sleeved pajama set—not two onesies topped by a heavy pajama sleeper and a blanket. If your baby does get a heat rash, just loosen up her clothes or remove a layer or two. The rash should clear up quickly.

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3. The bottom of the matter Diaper rash—red, sometimes swollen skin on your baby’s bottom—usually results from exposure to urine and feces which can act as corrosives to your baby’s soft skin, causing it to become inflamed and painful. The best prevention and cure? Frequent diaper changes, a few minutes to “air out” the area, and applying a barrier cream, such as zinc oxide ointment, to the skin at every diaper change. Diaper rashes may also occur when you introduce new foods into your baby’s diet, or change baby wipes or other products to those that may irritate your baby’s skin. A diaper rash that looks particularly inflamed with red dots that spreads into the creases of skin may be due to a yeast (fungal) or bacterial infection. Your baby’s doctor can prescribe medicine, usually a medicated topical cream, to clear it up. (If your baby has a scaly red rash in the diaper area and around her mouth she might have a zinc deficiency. See the doctor. Zinc supplements may clear up the rash.)

4. Cradle Cap An alliterative term for seborrheic dermatitis that occurs in infants, cradle cap looks like a scaly, reddish-white rash, or white-yellow thick scales on the scalp—and sometimes also the sides of the nose, eyebrows, eyelids and behind the ears. Doctors aren’t sure of the cause but point to the stimulating effects of Mom’s hormones on a baby’s oil glands. Cradle cap usually clears up on its own within the first few months of life. You can help it along with regular shampoos, gentle brushing, and in some cases, using a dandruff shampoo that contains zinc pyrithione. “Keep dandruff shampoo away from your baby’s eyes,” warns Dr. Davis. “If scalp flakes get very thick and cause hair breakage, or your baby seems uncomfortable or if cradle cap spreads to the face and neck, consult your doctor who may want to rule out other problems such as an overgrowth of yeast, eczema, or tinea capitis (ringworm of the scalp).”

5. Baby breakouts In teenagers, acne occurs when increased hormones stimulate the skin’s oil glands to produce more oil; combined with cells sloughing off inside the skin’s hair follicles, causes clogged pores or pimples. Acne in babies is a reaction to hormones, too. “In newborns, it’s usually because the mom’s hormones have crossed over to the baby and are still circulating, causing acne,” says Dr. Davis. “For slightly older infants, acne can occur because their adrenal glands have secreted hormones. Most babies with acne have superficial red dots and pustules, similar to mild acne in teens. Time will take care of those and you don’t need treatment. However open comedones (blackheads) or deep nodules and cysts, though uncommon, can become infected and possibly cause scarring; consult your baby’s doctor.”

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Laura Flynn McCarthy is a New Hampshire-based writer who specializes in health and parenting topics.