Dry skin in newborn

Dry skin in a newborn can become not only a cosmetic problem, but also a serious medical problem, since the skin plays an important role in the life of the baby. She performs a lot of functions during this period, and any changes on the skin can signal violations of the internal organs.

Epidemiology

Statistics show that more than 70% of all newborns have dry skin and physiological peeling after birth. About 80% of such children have a gestational age of more than 40 weeks. Only 12% of cases of dry skin in newborns are associated with the development of atopic dermatitis in the child in the future.

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Causes of the dry skin in a newborn

The appearance of the newborn, including the skin, can vary greatly during the first few weeks of life. Skin is the largest organ of the body, and its functions are very important for the health of other organ systems.

Skin is a dynamic complex organ that performs several vital functions; in particular, it creates a physical barrier between the body and the environment. It provides protection against ultraviolet radiation, prevents the invasion of pathogens and regulates body temperature and sensory perception.

Functional and structural maturation of the skin is a dynamic process that begins at the moment of the birth of the child and ends in the first year of life. In newborns with a full gestational period, this process begins immediately after birth, and in preterm infants - 2-3 weeks after birth, when the skin has the same structure as the full-term baby. Reproduction of skin cells in infants is higher than in adults, and is characterized by a higher ability to restore itself as a barrier. This adaptive flexibility of skin maturation results in unique properties of the infant's skin. Regulatory mechanisms control the development of the epidermis and dermis, sweating, sebum secretion, acidity of the skin surface, transsepidermal water loss, which develop during physiological maturation.

To understand why the skin of a newborn can peel in normal conditions, and when this is a pathological condition, you need to consider the main points of skin formation in a child.

Maturation of the skin begins during embryogenesis through intercellular and intracellular signals between different tissue layers. The development of the barrier increases with the age of gestation, and the maturation of the epidermis terminates at the age of 34 weeks. The epidermis consists of four main layers. The physical barrier is mainly localized in the stratum corneum, which includes keratinized cells enriched with lipids, and germinal epidermal cells.

If the child was born prematurely, then the thickness of the epidermis and stratum corneum compared to those of full-term, much less. Therefore, premature babies may be more prone to developing dryness and other skin problems. Thus, prematurity can be attributed to one of the risk factors.

The levels of sebum in the first week of life are high because of the strong androgen stimulation of sebum secretion before birth; such levels are subsequently reduced. Infant skin contains less total lipids compared to adults. During the first 3 months of life, dryness and peeling of the skin increases, especially on the face.

Infant skin functionally still develops, and the impaired barrier function of the newborn skin makes it more susceptible to chemical irritation and local or systemic infections compared to adults. Therefore, the pathogenesis of skin dryness in infants is precisely in its immaturity.

Neonatal skin possesses peculiar characteristics of absorption, with high permeability to local agents. In the early neonatal period, there is a marked absorption of the drug and a high loss of water on the skin due to incomplete development of the stratum corneum. Therefore, one of the reasons for the dryness of the skin in a child can be the use of soap or other special means that break the breath of the skin and lead to its dryness. Locally used agents that are absorbed can cause toxic systemic effects and dryness including.

Dry skin can be normal in some cases. Newborns are born in various fluids. This includes amniotic fluid, blood and vernix. Vernix is a thick coating that protects the baby's skin from the amniotic fluid. When a child comes into contact with the external environment for the first time after birth, it can be influenced by air, which was not the case before. If a child is born after 40 weeks of pregnancy or more, then he is in fluids too much time. This leads to the fact that immediately after birth, the skin can peel, both under the influence of air, and after a long intrauterine stay. And this is considered normal physiological peeling, which can be observed in any healthy child.

The causes of dry skin in a newborn are not limited to physiological phenomena, but there are a number of diseases that manifest themselves so.

In some cases, dry skin is caused by a condition called eczema or atopic dermatitis. Eczema can cause dry, red, itchy spots on your baby's skin. Atopic dermatitis is usually an inherited chronic disease, more common in infants with a family history of allergies, eczema and asthma.

Another cause of dry skin in a newborn is contact dermatitis: a reaction when the skin contacts an irritant such as a detergent or dust or even a certain group of foods.

Excessive dryness of the skin in newborns can also be caused by a genetic condition called ichthyosis. This skin condition causes the formation of scaly, itchy dry skin.

Based on the reasons, we can identify the main risk factors for dry skin in infants: allergic diseases in parents, prematurity, genetically dry skin in the mother, as well as the presence of animals and other factors that are potential strong allergens.

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Symptoms of the dry skin in a newborn

Symptoms of dry skin in newborns can appear immediately after discharge from the hospital. If this is a physiological peeling of the skin, then the dry skin of the newborn on the abdomen will be observed most often, since the child practically all the time lies and is susceptible to the action of friction. In the future, the process can spread to other areas and dry skin of the hands and feet appears immediately after the same phenomenon on the abdomen and back. Physiological features of maturation of the skin in infants is precisely the fact that the newborn skin dry skin, which leads to the gradual maturation of new cells. This is considered normal and does not affect the overall condition of the child.

The first signs of pathology, in particular atopic dermatitis, can appear in infancy. Atopic dermatitis is the most common condition of the skin that affects children. This disease is an immune response and has a genetic basis. Concomitant factors that may act as triggers or worsen the condition include: environmental factors such as high temperatures, house dust mites, viral infections, vaccination.

When a newborn has dry skin on the face, especially on the cheeks, this is often one of the symptoms of atopic dermatitis. At the same time on the skin there are spots of red, itchy, rough and dry skin. Usually such sites are localized on the cheeks of the child and in the area of the extensor surfaces of the joints of the hands and feet. Very dry skin in a newborn with time causes hyperkeratosis and itching, which is accompanied by the formation of cracks. Such cracks can become infected and lead to further development of complications. Dry skin in the period of newborns may be the only symptom of allergic dermatitis, and rashes on the skin or other manifestations may appear after a while. Therefore, always in the presence of severe dryness with the formation of cracks, it is necessary to evaluate the child as an allergy sufferer.

The dry skin of the hands of the newborn and dry skin on the legs are often formed in the summer season, when the child is excessively often exposed to sunlight. Such radiation is very harmful for newborn babies, since the amount of melanocytes they lack. Therefore, the skin is not so protected. Any active solar radiation can cause a child to burn lightly, which in the future can be accompanied by dry skin of such open areas and peeling.

Dry head skin in a newborn, also known as seborrheic dermatitis, usually manifests itself in the first few weeks of a newborn baby's life and can be repeated up to 4-6 months.

Dry skin on the head of the child in the fontanel area arises from the growth of normal skin fungus. This is due to stimulation with maternal hormones, while the baby is still in utero. However, in some children this may be an early sign of atopic dermatitis or eczema. This phenomenon has an ugly appearance, but in fact - this is a harmless condition of the scalp, common in newborns. It can look like small patches of scaly dry skin that looks like dandruff. In more severe cases, yellowish, thick, fat cortical spots may form. You may notice the same symptoms around your child's ears or eyebrows, on his eyelids or even under the armpits.

 The dryness of the skin on the head is cleared by itself in a few months, without bringing any unpleasant sensations to the child. However, if the skin becomes too dry, it can cause itching in the baby.

Complications and consequences

Consequences can be already in some days after display of the first signs. Very dry skin in a newborn can crack, a child can scratch it, which leads to rapid damage. Such skin loses its barrier function, and microorganisms can quickly fall into the inner layers. This leads to the development of staphylococcal skin infection, streptococcal rashes. Such complications often arise against insufficient hygienic care. Among infrequent complications of dry skin can be fungal infections of the skin, and then of the mucous membranes.

[5], [6], [7]

Diagnostics of the dry skin in a newborn

Visually, you can always determine when the dry skin of a newborn is a physiological phenomenon, and when it is an allergic manifestation. If the skin has dry areas with peeling in the form of shallow superficial losochek, then it is a question of a simple peeling of the skin. If the skin looks coarse, dry, with a tendency to crack, then this is a pathological condition, the cause of which must be sought.

If dry skin has symptoms that are characteristic of atopic dermatitis, then you need to further examine the child. First, you need to determine whether the rash is caused by an allergen or a mild irritant. Such an irritant can be soap, baby powder, powder, which cause dry skin in the field of their application.

For the initial diagnosis of dry skin in a newborn and to confirm the allergic etiology it is necessary to conduct simple tests - a general analysis of blood and urine. With severe allergic reaction, the child will have an increase in eosinophils, however, in neonates the results may not always be reliable.

The most accurate method of diagnosis and confirmation of allergic reactions are skin tests. Mom can only suspect those factors that the child causes such dryness of the skin, and the confirmation can be a reaction to their superficial introduction using prik-test. But in newborns, these methods are not used for diagnosis, so they can be taken into account in the future if the dryness of the skin will persist.

Instrumental diagnostics in this pathology is not carried out.

[8], [9], [10], [11], [12], [13]

Differential diagnosis

Differential diagnosis for dry skin in newborns includes diaper rash, allergic dermatitis, contact dermatitis, reaction to medications and chemicals, exfoliative dermatitis, shingles, staphylococcal and herpetic infection. Fatigue is an inflammation of the skin fold caused by friction of clothing. Fracture may look like a small red rash, and then dryness appears in this area. Fractures are localized in the natural folds, in the groin, on the buttocks, under the arms and between the fingers, unlike simple peeling, which happens in the open areas of the skin. Contact dermatitis can occur if a child is exposed to certain chemicals or natural factors in the first few days of life. Exfoliative dermatitis is also characterized by skin peeling, but in this case the skin departs in the form of large layers. This is a very serious disease, which is accompanied by a severe intoxication syndrome, and the skin, which lends itself to peeling, leaves deep wounds.

Sweating is the type of rash that occurs in newborns, because their sweat glands, not fully developed, are easily blocked. This is especially common in hot, humid climates. Instead of evaporation sweat remains under the skin, causing inflammation and a rash. Symptoms of sweating are small red spots, usually on covered areas, such as back and buttocks. Over time, dryness may appear in these areas, but it must precede rashes.

Treatment of the dry skin in a newborn

Treatment of dry skin in a newborn should begin in the first place with proper care. Certain dryness of the skin after birth is normal, when the skin of a child ripens and forms its own protective barrier. However, there are some features of caring for dry skin of a newborn baby:

1. Reduce the time of bathing. Long baths can remove natural oils from the skin of your newborn baby, which protect it from dryness. If you give your newborn a 20- or 30-minute bath, shorten the bath time to 5 or 10 minutes.
2. Use warm, not hot water, and use only clean water without soap. Regular soapy baths can overdry the skin.
3. Apply a moisturizer. Apply hypoallergenic moisturizing cream to your baby's skin twice a day, including after a bath. Applying cream on the skin right after the bath helps to keep moisture, and this can prevent dryness and keep your baby's skin soft. Gently massaging the skin of your newborn with a moisturizer, you can loosen skin peeling. As for moisturizing creams, the general rule is that the thicker, the better. If your baby's skin is still dry even with daily moisturizing, try switching from a lotion to a thicker cream or ointment. The ointment best retains moisture in the skin, but can leave a greasy feeling, so just use a small amount and gently rub it into the skin. Creams are rubbed, leaving no oily skin.
4. Protect your child from cold air. Make sure that your newborn's skin is not exposed to cold or wind outside. Put on your socks in the summer to avoid the sun.
5. Avoid aggressive chemicals. Because the newborn's skin is sensitive, it is also important to avoid aggressive chemicals that can irritate your baby's skin. Do not apply to the skin of a newborn perfume or fragrant products.
6. Instead of washing your newborn's clothes with a usual detergent for washing, select a detergent designed specifically for sensitive baby skin. You also need to carefully choose children's things from natural fabrics without synthetics. If your baby's skin is very sensitive, do not put it on clothes that are dense or rough. Also keep in mind that some fabrics, such as wool, can be particularly irritating to dry skin.
7. Use a humidifier. If the air in your home is too dry, use a cooled humidifier to increase the humidity level in your home.

What to do if the dry skin of the newborn on the head, and crusts are formed. The best way to remove such crusts is to wash your child's hair daily with a gentle baby shampoo. Try first to massage your baby's head with your fingers. Before you apply the shampoo, brush your baby's hair with a soft baby brush to remove loose scales. After washing with shampoo, gently clean the baby's scalp with a towel made of terry cloth.

You can also use oils. First, apply a few drops of pure natural oil, such as almond or olive, to your fingertips, and then massage your baby's scalp gently. Using gentle pressure, make small circular movements with your fingertips. Leave it for about 15 minutes. Gently clean the scales with a thin comb or clean them with a soft brush. Wash the skin of your baby's head with a mild baby shampoo.

Medications that are used in the treatment of dry skin can be used even with prolonged dryness of the skin, which causes discomfort, the formation of cracks and inflammation. In such cases, local antiseptic agents can already be used. If there is an easy peeling of the skin, then hygienic measures and moisturizing the skin can be enough in the treatment. Here are some medicines:

1. Tyrosurum is a local antiseptic, the active ingredient of which is tyrotricin. It is a drug from a group of local antiseptics that kills many microorganisms and prevents the infection of dry skin. The method of application of the drug - in the form of powder on the affected areas. Side effects can be in the form of allergic reactions.
2. Most people know that fish oil is one of the so-called essential nutrients. Less is known that it can be added to milk to help with dry skin. Omega-3 Fish oil has many anti-inflammatory properties, and it will be especially useful if your child's dry skin leads to itching and irritability. Dosage - 500 mg once a day to your baby's formula can really help. Side effects can be in the form of an allergy or a child's refusal of milk, as it can have an unpleasant fish-smell.
3. Bepanten is a local remedy that can be used in the treatment of dry skin in newborns. The active substance of the drug is dexpanthenol, which turns into an active metabolite and is a vitamin for the skin. It restores damaged dry cells. The method of application of the drug - topically in the form of a cream, or with more severe injuries and dryness in the form of an ointment. Side effects are allergic reactions, redness.

Vitamins can be used by the mother, which improves the condition of the child. Physiotherapeutic treatment in acute period is not used.

Alternative therapies for dry skin

Natural medicines from plants are gaining popularity due to several advantages, such as fewer side effects, relatively less expensive means. For these reasons, several plants can be used to treat dry skin in newborns. 

1. Aloe vera gel has soothing, healing and moisturizing properties when used locally on extremely dry skin. It works well on peeling skin, as it gently removes the top layer of dead skin cells. Apply a thin layer of 100% pure aloe vera gel to the affected areas and after about 20 minutes rinse with warm water. Repeat the process once or twice a day, especially after bathing, or simply replace the usual moisturizing cream with aloe gel.
2. Honey tightens, softens and moisturizes dry skin. It increases blood circulation in the area of dryness and promotes deeper moistening. It is necessary to apply honey to the affected areas, at least once a day, to help soothe the dry skin of the newborn. Precautions - may cause an allergic reaction, so use caution after the sample.
3. Avocados are a nutritious source that provides numerous benefits for the baby's dry skin. It not only nourishes dry skin, but also promotes its regeneration. To prepare the medicine, you need to beat half of the avocado in the blender before the formation of gruel, and then apply to the dry skin of your child. Leave for 10 minutes and rinse. In the same way, you can use avocado oil.
4. Birch tea is recommended for the relief of dry skin. Tea can be made from fresh or dried birch leaves. To make tea, pour four birch leaves with one cup of boiling water and insist from five to ten minutes. For treatment, a mother breastfeeding can drink one cup of tea three to four times a day. To make a compress, dip a soft cloth in warm or chilled (not boiling) tea and apply to the skin.

Herbs in the treatment of dry skin can also be used as compresses or teas:

1. A dandelion leaf is used in the treatment of dry skin for a herbal bath. A teaspoon of dried dandelion leaves or 1 handful of fresh dandelion leaves should be poured with a glass of hot water. The leaves contain volatile compounds, so infusion should be allowed to stand for 30 minutes. Then add the tea in a warm (not hot) bath and you can bathe the baby.
2. Echinacea is used to treat dry skin. Forms for the use of Echinacea include juices and tea. To make tea, take the dry leaves of the plant and pour boiled warm water. Infuse it for three hours, and then wipe the baby's dry skin three times a day.
3. Saffron is a product derived from natural plants, which acts as a spasmolytic, diaphoretic, antimicrobial and sedative. For a medical compress, you need to crush its leaves, squeeze out the juice from them, and then spread this slurry on dry parts of the skin.

Homeopathy with dry skin in newborns is rarely used, as the effect of treatment may be delayed. Therefore, the advantages are given to local funds.

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Prevention

The prevention of skin dryness in infants requires that all pregnant women be screened for infections during and immediately after pregnancy in order to prevent not only the dryness of the skin, but also the associated infection of the baby in the future. After delivery, mothers should be aware of the main rules of hygiene and the rules of childcare. It is very important that the baby is properly bathed, and there are no factors that will exacerbate the dryness of the skin.  

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Forecast

The prognosis for dry skin is always favorable, sometimes enough correct bathing and care. Complications do not develop often, mostly in families with unfavorable conditions.

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Dry skin in a newborn is a frequent manifestation, which can cause parents to be nervous. But most often this is a normal reaction of the baby's skin and it is enough just to bathe and moisturize the skin. If there are other manifestations on the background of dryness - itching, redness, rejection of the breast - then you need to see a doctor.