At U.S. Dermatology Partners, many of us are parents as well as healthcare providers, so we understand the many questions and concerns you might have about your child's skin. We compiled this list of frequently asked questions about pediatric dermatology to help parents — both first timers and seasoned pros — with common skincare woes faced by babies, children and teens.
Q: What is vitiligo? How common is it in children? Can it be treated safely?
A: Vitiligo is a condition that causes white patches to appear on the skin. It is common in children and adults and occurs when the immune system attacks the cells that make skin pigment (melanocytes). It can occur anywhere on the skin, but is most frequently seen on the eyelids, elbows, knees, hands, feet and genitals. Vitiligo can affect a few small spots or most of the pigment on the body.
It is important to see a dermatologist to diagnose vitiligo, since other conditions can also cause light or white spots on the skin. If your child does have vitiligo, there are several treatment options to consider including topical medications, ultraviolet light treatment and the excimer laser. All of these can take time to help (usually two to three months), so it is important to continue with treatment until you see results.
Q: How should I wash my baby’s skin?
A: Babies have delicate skin that is not fully developed. You should take special care bathing your baby by always using a small tub built for that purpose and staying with your baby during the bath. Use warm water and a gentle soap (like Cetaphil Gentle Cleanser or Cerave Cleanser).
At the end of bathtime, rinse your baby with warm water from the tap and then pat dry. Immediately apply a fragrance-free moisturizer such as plain Vaseline, Aquaphor or Cerave Cream. Over-bathing can lead to flares of eczema, so keep baths short (five minutes or less) and use only the minimum amount of soap needed.
Q: What are those little clear bumps on my child’s skin? Do they need to be treated?
A: Small, clear bumps that develop in groups on a child's skin are called molluscum (sometimes called molluscum contagiosum). They are caused by a skin virus and can easily and rapidly spread to other areas on the child's body or to other children. Although molluscum are not dangerous, they can itch or irritate the skin. Adults are usually immune unless they have a chronic illness or immune system problem.
Molluscum do not have to be treated and will often go away on their own after one to two years. They can, however, spread during this time, creating dozens or even hundreds of spots. Treatment involves destroying individual lesions. This can be accomplished with liquid nitrogen (freezing), cantharone (a chemical that causes small blisters) or prescription topical medication. Since molluscum are constantly trying to spread, repeated treatments are often needed to get them all.
Q: Should open wounds be covered or left open to dry out? Is antibiotic ointment necessary?
A: Wounds that are kept moist heal up to 50% faster than wounds that dry out and develop scabs. Keep wounds out of contaminated water and clean them daily with soap and water. Avoid using alcohol or hydrogen peroxide. After cleaning, apply a thin layer of antibiotic ointment such as Polysporin (Neosporin has a high rate of allergic reactions) and cover with a clean bandage. After a few days, switch to plain Vaseline until the wound heals.
Q: Can children get skin cancer? Should they get skin cancer screenings?
A: Skin cancers are malignant tumors that grow in skin cells, but they are quite rare in children. Excess sun exposure or blistering sunburns in childhood significantly increase the risk of developing serious skin cancers later in life. Limiting your child or teen's exposure to the sun can pay large dividends later when it comes to their lifetime skin health.
Moles often grow proportionately with your child, but it is possible for childhood moles to become malignant. Any child or adult should always see a dermatologist if they have a mole that is suspicious or changing.
Remember the ABCDEs of melanoma:
- Border irregularly
- Color is uneven
- Diameter is large
- Evolution (change) occurs
Q: Is dandruff normal in children? Which shampoos do you recommend?
A: Seborrheic dermatitis (called cradle cap in infants) may appear with symptoms ranging from mild dandruff to severe redness, crusting and itching of the scalp, ears or even face. A normal skin yeast, Pityrosporum ovale, may overgrow in some children and can be controlled with regular use of medicated shampoos. More severe symptoms may require prescription creams. Eyelid involvement can be managed by gently cleaning the skin near lashes with baby shampoo.
Q: Are warts contagious? What causes them? How do you prevent them from spreading?
A: Warts are caused by a virus, so they are contagious through contact to both the individual who has them and others. Warts may go away without treatment and most are harmless, but dermatologists do treat them, especially if they are spreading or painful. Treatments include regular use of topical and/or destruction methods.
Warts can be persistent. To prevent warts from spreading, dermatologists offer these recommendations:
- Do not pick or scratch at warts.
- Wear shoes on common floors (such as the pool or gym).
- Avoid touching warts.
- Keep foot warts dry (moisture allows warts to spread).
Q: Should tweens be treated for mild acne?
A: Acne is a common problem for pre-teens, teenagers and adults. It is a condition caused by teenagers' normal hormonal changes. If mild, it does not have to be treated. If more severe or bothersome to the patient, there are many good treatments for acne. Pre-teens often have comedonal (blackhead and whitehead) acne, which is usually best treated with prescription topical medications. More severe acne in older teenagers can leave scars, so it is often treated with antibiotics, birth control pills (for girls and women) and in the most severe cases, Accutane. These medications require the supervision of an experienced dermatologist.
Q: How often should teenagers wash their face?
A: Teenagers should wash their face in the morning and evening with a gentle cleanser such as Cetaphil Cleanser or Dove. Over-washing does not improve acne and can lead to irritation and more redness. Over-the-counter medicated washes containing benzoyl peroxide or salicylic acid may help mild acne but can be drying.
Q: Should some foods be avoided to prevent breakouts or worsening of acne?
A: For most people, diet changes do not help much with acne. For a small portion of the population, a particular food (especially dairy) may exacerbate acne and should be avoided. If you have avoided a food completely for two months and your acne has not considerably improved, it is unlikely that your acne is related to it. It's always a good choice to eat a healthy diet with a variety of fresh fruits and vegetables and to avoid processed foods and simple sugar.
The experienced dermatologists at U.S. Dermatology Partners can help with these and any other pediatric skin care concerns you may have. Contact your local dermatologist to help keep your family happy and healthy.