Acne in the newborn on the face

Acne of newborns or the scientific term "milia" are white or yellow pimples on the baby's skin, which are located mainly on the face and cause parents' anxiety because of their appearance. Outwardly, they resemble pustules, but this is not at all and should not be feared at once. It is necessary to distinguish, when such pryshchiki do not entail danger, and when it is necessary to address to the doctor.

[1], [2]

Epidemiology

The epidemiology of manifestations of a sexual crisis in a child is such that only 76% of all children have these or other manifestations. About 19% of cases of sexual crisis correspond to the development of milia or eels of newborns. This is not as common as other manifestations and more common in preterm babies. To date, less than 3% of all cases of milia are complicated by infection, which indicates an increase in the parents' knowledge of skin care for an infant.

[3]

Causes of the eels in newborns

In most cases, infantile eels are caused by occlusion of the outflowing parts of the sebaceous duct. Such a condition in a newborn child is considered normal, if the cause of the occurrence is just that. But we need to understand what features of the skin of a newborn child contribute to the development of acne.

First of all, it should be noted that the baby's skin is very thin and the sweat and sebaceous glands do not fully develop until the moment of birth. This is a certain mechanism of danger, since a child can not eliminate pathogens that accumulate on the surface of the skin. Sebaceous glands of the newborn are laid in the dermis, but they do not have branching and there is no exit to the surface of the epidermis. During the growth of the skin, the cells multiply and form full-flowing outflow ducts, as in an adult. This happens by the end of the first month of the baby's life. Reproduction of cells and development of the excretory duct occurs under the influence of the sex hormones of the mother. At their normal level, everything safely ends and at the end of the neonatal period the glands develop. One of the causes of blockage of the glands is the excess of sex hormones in the mother. During pregnancy, for a normal fetal development, it is necessary that there is a sufficient amount of estrogens and progesterone, regardless of the sex of the child. This is necessary for the development of the genitals, but also for the bookmarking of many glands and their normal function. Therefore, during pregnancy, the level of maternal hormones increases to provide both the mother and the fetus. Excess sex hormones can also give clinical manifestations in the form of a sexual crisis. This leads to premature closure of the glands and the accumulation of secret before birth. Over time, the normalization of the level of hormones after birth and the gradual growth of the skin leads to the opening of the duct and the whole secret comes out. The pathogenesis of the formation of the acne process itself testifies to the physiological changes in the skin and proves that there is no need for external intervention.

Such acne is one of the elements of the newborn's sexual crisis. Sexual crisis is characterized by the fact that after birth, the baby can have some manifestations from the genitals, skin, mammary glands. This is considered quite normal and does not require any medical measures. Along with acne can be engorgement of the mammary glands, discharge from the vagina of girls, which is also often expressed with clogging of the glands.

There are pathological causes of the development of acne with external infection of the duct. Then the direct cause is the microorganisms that get through the thin skin of the baby and contribute to the development of the inflammatory process. Normally, if you do not touch the eels, they open themselves after a while. But if they are squeezed out or something to do, then they can become infected. The child's thin skin can easily be injured and this is the reason for the infection of acne and the formation of infected acne. Therefore, it is important that parents do not apply any methods for treating or traumatizing the skin.

Speaking about the excess of hormones it is important to remember that this happens not in every woman and not all newborns have manifestations of sexual crisis and acne in particular. Therefore, it is necessary to identify the risk groups for this pathology in order to be aware of the possibility of such manifestations on the skin. If the pregnancy was pre-planned, then hormonal screening is carried out and if the problems are detected, hormone levels are corrected. In such cases, with a planned pregnancy, no problems usually arise. The risk group includes women who have miscarriage or a threat of miscarriage, which requires external intervention. The reason for this condition in most cases is the lack of sex hormones of the mother for implantation of the embryo and normal blood circulation. Therefore, when a threat is carried out additional hormone replacement therapy. If the amount of such therapy exceeds the norm, the hormones act on the baby and cause the appearance of symptoms. Women with concomitant pathology also belong to the risk group. If there is a late gestosis, it can also cause the appearance of symptoms of a sexual crisis. In women with an initial increase in testosterone or hormone therapy for any other reason, hormonal imbalances that lead to the appearance of acne can develop.

Proceeding from the possible reasons, it is necessary to distinguish two states - the physiological eels of newborns and acne during their infection. The first condition is not even a pathology, but the second develops with the wrong care of the baby's skin. Therefore, it is very important to know the clinical manifestations of certain conditions and to properly treat, if necessary.

[4], [5], [6], [7]

Symptoms of the eels in newborns

The first signs of milia appear more often in the first-second week of a child's life. It all starts with the appearance of small white dots on a red background. Localized rashes on the cheeks, chin, forehead. Sometimes the process can spread to the torso, but this is rare. Symptoms of acne are characterized only by a specific appearance. They appear against the background of light reddening of the skin and have the appearance of white dots, which in the center have a white rod. This is very similar to the appearance of the eel, which is why it is called, but there is no inflammatory basis in the gland itself. Therefore, the name justifies the appearance. A characteristic feature of acne is that there are no other symptoms in the child. These pimples do not cause itching, pain or discomfort. The child sleeps well, takes a breast, does not act up more normal and the temperature is within the norm.

Sometimes there can be an infection of such acne, even in the absence of interventions from outside. Then there are symptoms of fever - in infants it can be a temperature reaction up to 38 degrees and not higher, which at first glance does not seem like a serious temperature, but it is not so. At such children the center of thermoregulation is not sufficiently developed, therefore such hyperthermia is considered already serious. There are changes from the general condition - capriciousness, crying, refusal of feeding, sleep disturbance. Acne itself can also change its appearance when infected - they become larger, have a more yellow color and some can be opened with the release of pus and the formation of sores. These are serious symptoms that require immediate action.

[8], [9], [10], [11]

Stages

The stages of milia development do not have a particular dynamics, because the process itself passes, when the ducts open and the secret of the sebaceous glands exits. If it is a case of infected acne, then everything begins with the process of infiltration, and then goes into the stage of abscessing.

Whiteheads in a newborn are manifestations of milia, but other species, such as infantile inflammatory acne have an inflammatory mechanism of education. They develop with the persistence of the infection and last until the third fourth month of the child's life. Such acne requires a thorough differential diagnosis.

[12], [13]

Complications and consequences

The most frequent and serious complications that can be caused by acne are their inflammation with the rapid spread of infection throughout the skin. With external skin defects, microorganisms rapidly spread into the interior and from there already infect tissues. This leads to a pronounced and rapid inflammatory reaction of the entire skin, which threatens the sepsis of the newborn. The expressed inflammatory reaction entails intoxication and the rapid development of toxic shock. Speaking about the consequences of acne, they can be very serious, as any skin changes are very dangerous in terms of rapid spread of infection. This proves the importance and the extreme need for proper care of the infant's skin in the first month of his life, and especially when acne occurs.

[14], [15], [16], [17]

Diagnostics of the eels in newborns

Diagnosis milia provides not only the diagnosis, but also adequate differential diagnosis, which allows you to calm your mother or vice versa you need to worry. First, for the mother, you need to determine when acne is normal, and when you should contact a doctor. Diagnosis of such dangerous for the child states is to determine the general condition of the child. First, if the child has a normal temperature, he sleeps well, suckles and behaves normally, then most likely such acne is milia. Then do not worry. If something is wrong, the child screams or acne bothers mom, then you should definitely seek advice. Very often, the peak of the blackheads falls on the third week of the child's life, when he starts colic and the daily strong cry for several hours coincides with the appearance of the milia. Then it is very difficult to determine what exactly the child is worried about and need an experienced look.

The main method of diagnosing acne in newborns is an objective examination. Any pediatrician or neonatologist with a simple examination of the basis of experience can say that it is for the dehydration. If the diagnosis of a milia is objectively confirmed, then no analyzes and other studies should be performed, remembering that any methods of invasive intervention are dangerous for causing even greater harm to the child.

It is very important to conduct differential diagnosis between newborn eels and allergic rash, especially if there are both together. Allergic rash, as well as acne, is localized on the cheeks. Both pathologies have reddening of the skin, but the elements of the rash differ. Acne has the appearance of elevations against the background of hyperemic skin, which in the center have a white dot. An allergic rash is also on the background of red skin, but the elements themselves are red and have an irregular shape or in the form of a point without changes in the center. The rash is usually symmetrical with allergies and can spread to the extremities, and acne has a one-sided localization - at the wings of the nose, or on the cheek, or forehead, without the tendency to wide distribution.

[18], [19], [20], [21], [22], [23], [24]

Differential diagnosis

Differentiation is also necessary with inflammatory acne, in which treatment is necessary. Such acne also has a white point in the center, but it increases with time and it becomes clear that pus is formed in the center. This causes painful sensations in the baby and he is capricious, does not allow to touch the affected areas of the skin. This is the main differential sign for mom in the first place, which requires attention.

Treatment of the eels in newborns

Treatment of acne physiological etiology, that is, milia, does not imply special remedies or medicines - it is important to remember every mother. First of all, you need to organize the proper skin care. To bathe a kid with acne should be at home, in a warm and clean boiled water. No herbs can not be added to water, as this can cause additional sensibilization and an allergic reaction. It is very important to use only baby soap and shampoo without special additives and antiseptics, because it additionally dries the skin. That is, skin care should be like the skin of a healthy newborn baby. Do not squeeze or comb acne - this significantly increases the risk of complications and additional injuries. The use of antiseptics, ointments and medicinal creams is not justified, since all means create a layer of impermeable film that covers the skin of the baby and does not allow it to breathe. Therefore, with the formation of physiological acne, there is no need for special treatment of them - after two weeks from the beginning they will pass by themselves. If there is at least the slightest risk of infection or there are clinical signs of this, then it is necessary to apply the medication as early as possible to avoid complications. For the purpose of treatment, local therapy is used, and then systemic remedies.

1. Eplan is an ointment that can be used as a local remedy to treat infection and prevent complications of acne in newborns. The composition of the drug includes glycerol, triethylene glycol, carbitol. Due to this composition, the preparation has a pronounced softening, anti-inflammatory, bacteriostatic, regenerating effect. How to apply the ointment - you need to lubricate the affected skin twice a day. Dosage is small - a small grain of ointment should be squeezed out and this lubricate all affected areas with a thin layer, avoiding the area around the eyes. Side effects - there may be allergic reactions of a local nature, no systemic reactions were noted, since the drug does not enter the systemic blood flow very much.
2. Sudokrem is a means for local skin care that can be used to treat acne at the risk of their inflammation. The composition of the drug paraffin, zinc oxide, oils and acids. Such a composition promotes the healing of acne during their maceration, dries the skin and forms a waterproof film that protects all layers of the skin from further damage. The way of using the drug - it is necessary to apply a thin layer, so that the film does not contribute to a strong overdrying of the skin. Dosage - recommended in the morning once a day. Precautions - Avoid contact with mucous membranes.
3. Bepanten - plus - a cream, which includes panthenol and chlorhexedine. This formulation has not only healing effect, but also antibacterial. Chlorghexidine is an active antiseptic that has efficacy against staphylococci. These bacteria are the most frequent causative agent of cutaneous infectious inflammation of the newborn, so the use of the drug is very justified in this case. Panthenol when exposed to the skin releases pantothenic acid, which, when activated, acts as a vitamin and restores the structure of damaged skin cells. The method of application only externally on skin areas with a thin layer. Dosage should not exceed five grams per day. Side effects can be in the form of blistering or with a larger area of use - respiratory or cardiovascular disorders.
4. Regecin is a gel that is used to treat acne and prevent the spread of bacteria. The gel contains zinc chloride, sodium hydroxide, which have an antiseptic and drying effect. Due to this, the drug can be used in case of severe irritation and the formation of wet skin changes. Method of application of the drug - twice a day. Dosage should not be more than three grams. Apply by lubricating a thin layer of skin. Side effects can be local with an allergic reaction to the components of the drug.
5. Skin-cap is a remedy for external application in the form of a gel and external aerosol. The preparation has in the zinc and other active substances, which have a pronounced antiseptic effect. The method of application of the drug is external, but you can not use a large amount because of the risk of burns. Before applying the drug, it is recommended to carry out a test on uninfected areas of the skin. Side effects except for allergies can be manifested by minor burns.
6. Systemic treatment of acne with their infection and the threat of streptoderma and skin staphyloderma is mandatory. Therefore, the use of antibiotics of systemic action is an indispensable condition for the treatment of inflammatory acne lesions in the newly born. Given the spectrum of possible pathogens, antibiotics from the macrolide group are used, whose efficacy in neonates is weight-bearing with safety.

Clarithromycin is an antibacterial agent from the macrolide group. Among the known drugs has the maximum activity against intracellular parasites and microorganisms of the group of staphylo- and streptococci, that is, it acts on possible pathogens of cutaneous inflammatory infections, thus interrupting the persistence of the pathogen. Clarithromycin has a long half-life. The method of application depends on the age and can be in the form of suspension or tablets, but the initial stages are better to start the reception intramuscularly in parallel with another antibiotic. It is prescribed for children older than 3 years and the dosage is 10 mg / kg / day on the first day, from 2 to 7-10 days - 5 mg / kg / day 1 time per day. A mandatory condition is eating two hours after a meal or an hour before it. The course of treatment is 5-7-10 days. Side effects of azithromycin - paresthesia, violations of skin sensitivity, numbness of the hands and feet, tremor, violation of the outflow of bile, as well as dyspepsia. Precautions - do not use for cholestasis or cholelithiasis.

Vitamins can be used by the mother while breastfeeding the baby, but a direct positive effect on the reverse development of acne is not proven. The best source of vitamins and the greatest benefit for a newborn baby with acne is rational nutrition with enough vitamins in food.

Such drugs, both local and systemic, can be used only in the presence of indications in the form of inflammatory complications, and self-medication and routine unreasonable use of ointments, creams, antibiotics can lead to unforeseen consequences.

Alternative treatment of acne in a newborn

Speaking about the alternative treatment of acne in newborns, you need to remember that you can use all means only after consulting a doctor. It is important to treat not only the baby itself and changes in the skin, but especially the mother - her hormonal background during breastfeeding plays a very important role in the recovery and resolution of all problems.

1. The most active vitamin for the skin is vitamin A and E. They contribute to the active healing and recovery of epidermal cells. But the use of vitamins in high therapeutic concentration can be harmful for the baby, so use alternative means that allow replenishing the supplies of vitamins. To this end, it is recommended to introduce fruit juice into the ration of the nursing mother. To do this, take an equal amount of freshly prepared apple juice, carrot and pumpkin and mix. Take it in the morning once a day for forty grams. It should be borne in mind that the child's body can take this for an allergen, so you need to start cautiously with a half dose.
2. Bathing healthy babies in herbs is not recommended to date, as this increases the risk of allergies. But to wipe the face of a child with warm boiled water with herbs for acne is very useful. This does not allow you to inhale the vapors of these herbs, and the action on the skin of the face while maximizing the effective. To do this, use the grass of the string and calendula - you must first start with one grass, and then add another one by one. Wipe the baby's face carefully, so as not to rub and do not cause irritation. Do it better two or three times a day.
3. When bathing a good effect gives the addition of potassium permanganate in water. It has antiseptic effect and prevents reproduction of pathogenic flora. For a weak solution per liter of water, take one gram of the powder and dilute, then add this solution to the bathing water. The vodka should have a slightly noticeable pink tinge. It must be remembered that such water should not fall on the mucous membranes and in the eyes.

Herbal treatment can be used only by "transferring" from the mother, since the use of herbs in a child is dangerous and unpredictable.

1. Mom can drink tea from medicinal herbs - daisy needs to be soaked in water and drink warmly at least twice a day. It should be remembered that it is better to add a little sugar and a little lemon juice, avoiding honey.
2. Tea from the turn and viburnum also helps to cleanse the skin, since it has many useful flavonoids. To make tea, you need to take thirty grams of each herb and pour a liter of water. You need to take one hundred grams three times a day.
3. Aloe has a lot of cleansing and antiseptic substances that normalize the water balance of the skin and eliminate the obstruction of the duct more effectively than any cosmetic ointment. The use of aloe or calanchoe in newborn infants is not recommended. However, given the properties of such a drug, you can apply it to your mother. To do this, wash the aloe leaf and squeeze out the fresh juice from it. Adding a few drops of lemon juice you need to take 10 grams of aloe juice once a day.

Homeopathy in treating acne in toddlers can also be used, which prevents the risk of complications and other dangerous skin conditions. Especially recommended is the prophylactic reception of homeopathic remedies even before birth to mothers at risk or having problems with their own skin.

1. Pulsatilla is an organic homeopathic preparation, which includes herbs. Used to treat acne in children whose mothers have blonde hair and soft facial features. Method of oral administration in the form of grains for mum. Dosage - one pellet five times a day. Dilution is recommended to apply no more than one to six. Side effects are possible in the form of increased salivation and nausea.
2. Gepar Sulfur is a preparation of homeopathic origin from the group of inorganic preparations. Used to treat acne, which has a tendency to complications against the background of active observation for a long time. The method of application of the preparation in the form of drops of a certain dilution. Dosage in case of taking drops - one drop once a day for the mother. Side effects are not frequent.
3. Kutis-compositum is a homeopathic remedy of natural plant origin based on herbs. The drug can be used to treat acne, which is prolonged, but uncomplicated. The method of using the drug is the use of a homeopathic solution in ampoules, dissolving them in pure water. Dosage - five drops per glass of water for the mother, and for the baby one drop should be dissolved in a glass of warm boiled water, then you need to wipe the face and areas with the localization of acne. Side effects can be in the form of insomnia in the mother or a disorder of stool with diarrhea in the child
4. Hormel is a homeopathic remedy of natural plant origin, which is recommended for use only for newborns born to mothers with hormonal disorders. This plant is mainly a systemic tool for normalizing the hormonal background and restoring it not only in the baby, but also in the mother in the postpartum period. The way of using the drug is for the mother in the form of drops, dissolving them in pure water. Dosage - three drops per fifty grams of water. Side effects can be in the form of increased pressure, tachycardia, insomnia. Often there are disorders of stool in the form of diarrhea. Precautions - should not be used if there is an allergy in the family to conifers.

[25], [26]

Prevention

Preventive maintenance of complications is very simple and consists in correct hygiene of a skin, minimization of interventions. It is important to consult a doctor when such changes occur, and in the future an experienced specialist will determine the correct state of the child and the need for intervention. The most important thing is not to squeeze out blackheads and not to lubricate anything if there is no evidence for this.

[27], [28], [29]

Forecast

The prognosis for resolving the situation is favorable, since this is a transient state of the newborn, which passes without treatment after two or three weeks.

Acne of newborns is physiological changes in the skin caused by a violation of outflow of secret from the sebaceous glands of the child. This condition is very frequent, and does not require any additional intervention. If there are no complications, then there is no need to treat such a condition. The main thing is the proper care of the child, the nutrition of the mother and the attention of the father.