Dry skin in a 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. It performs many functions during this period, and any changes in the skin can signal problems with 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 dry skin in a newborn

A newborn's appearance, including skin, can change dramatically during the first few weeks of life. The skin is the body's largest organ, and its functions are critical to the health of other organ systems.

The 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 from ultraviolet radiation, prevents pathogen invasion, and regulates body temperature and sensory perception.

Functional and structural maturation of the skin is a dynamic process that begins at birth and ends in the first year of life. In full-term newborns, this process begins immediately after birth, and in premature newborns - 2-3 weeks after birth, when the skin has the same structure as a full-term baby. Skin cell proliferation 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 leads to the unique properties of infant skin. Regulatory mechanisms control the development of the epidermis and dermis, sweating, sebum secretion, skin surface acidity, transepidermal water loss, which develop during physiological maturation.

To understand why a newborn's skin may peel under normal conditions, and when this is a pathological condition, it is necessary to consider the main points of skin formation in a child.

Skin maturation begins during embryogenesis through intercellular and intracellular signals between the different tissue layers. Barrier development increases with gestational age, and epidermal maturation is complete by 34 weeks of age. The epidermis consists of four main layers. The physical barrier is primarily located in the stratum corneum, which includes lipid-rich cornified cells and epidermal germ cells.

If the baby is born prematurely, the thickness of the epidermis and stratum corneum is much smaller than that of full-term babies. Therefore, premature babies may be more prone to developing dryness and other skin problems. Thus, prematurity can be considered one of the risk factors.

Sebum levels are high in the first week of life due to strong androgen stimulation of sebum secretion before birth; such levels subsequently decrease. Infant skin contains less total lipid than adult skin. During the first 3 months of life, dryness and flaking of the skin increases, primarily on the face.

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

Neonatal skin has unique absorption characteristics, with high permeability to local agents. In the early neonatal period, there is significant absorption of the drug and high water loss in the skin due to incomplete development of the stratum corneum. Therefore, one of the causes of dry skin in a child may be the use of soap or other special products that disrupt skin respiration and lead to its dryness. Topically applied agents that are absorbed can cause toxic systemic effects, including dryness.

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 baby first comes into contact with the outside world after birth, it is exposed to air, which it was not before. If a baby is born after 40 weeks of pregnancy or more, it is in fluids for too long. This leads to the skin peeling immediately after birth, both from exposure to air and after a long intrauterine stay. And this is considered normal physiological peeling, which can be observed in any healthy baby.

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

In some cases, dry skin is caused by a condition called eczema or atopic dermatitis. Eczema can cause dry, red, itchy patches on your baby's skin. Atopic dermatitis is a chronic, usually inherited condition, and is more common in babies 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 comes into contact with an irritant, such as detergent or dust, or even a certain group of foods.

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

Based on the causes, the main risk factors for dry skin in infants can be identified: 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 dry skin in a newborn

Symptoms of dry skin in newborns may appear immediately after discharge from the maternity hospital. If this is physiological peeling of the skin, then dry skin in a newborn on the stomach will be observed most often, since the child lies almost all the time and is subject to friction. Later, the process can spread to other areas and dry skin of the arms and legs appears immediately after the same phenomenon on the stomach and back. Physiological features of skin maturation in infants are that the newborn's dry skin peels, which leads to the gradual maturation of new cells. This is considered a normal phenomenon and does not affect the general condition of the child.

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

When a newborn has dry skin on the face, especially on the cheeks, this is most often one of the symptoms of atopic dermatitis. In this case, spots of red, itchy, rough and dry skin appear on the skin. Usually, such areas are localized on the cheeks of the child and in the area of the extensor surfaces of the joints of the arms and legs. Very dry skin in a newborn over time causes hyperkeratosis and itching, which is accompanied by the formation of cracks. Such cracks can become infected and lead to the development of complications in the future. Dry skin in the neonatal period can be the only symptom of allergic dermatitis, and rashes on the skin or other manifestations can appear some time later. Therefore, always in the presence of severe dryness with the formation of cracks, it is necessary to potentially assess the child as an allergy sufferer.

Dry skin on the hands of a newborn and dry skin on the legs often form in the summer, when the child is too often exposed to sunlight. Such radiation is very harmful for newborn babies, since the number of melanocytes is insufficient. Therefore, the skin is not so protected. Any active solar radiation can cause a slight burn in a child, which can later be accompanied by dry skin in such exposed areas and peeling.

Dry scalp in newborns, also known as seborrheic dermatitis, usually appears in the first few weeks of a newborn baby's life and may recur up to 4-6 months.

Dry skin on a baby's head in the fontanelle area is caused by an overgrowth of normal fungus on the skin. This occurs due to stimulation from maternal hormones while the baby is still in the womb. However, in some babies, it may be an early sign of atopic dermatitis or eczema. This is an unsightly but harmless scalp condition that is common in newborns. It may appear as small patches of flaky, dry skin that looks like dandruff. In more severe cases, yellowish, thick, greasy, crusty patches may form. You may notice the same symptoms around your baby's ears or eyebrows, on his eyelids, or even in his armpits.

Dry scalp clears up on its own after a few months without causing any discomfort to the baby. However, if the skin becomes too dry, it can cause itching in the baby.

Complications and consequences

Consequences can appear within a few days after the first symptoms appear. Very dry skin in a newborn can crack, the child can scratch it, which leads to rapid damage. Such skin loses its barrier function, and microorganisms can quickly penetrate the inner layers. This leads to the development of staphylococcal skin infection, streptococcal rashes. Such complications often arise due to insufficient hygienic care. Among the rare complications of dry skin, there may be fungal infections of the skin, and then of the mucous membranes.

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Diagnostics dry skin in a newborn

Visually, you can always determine when dry skin in a newborn is a physiological phenomenon, and when it is an allergic manifestation. If there are dry areas on the skin with peeling in the form of small superficial scabs, then we are talking about simple peeling of the skin. If the skin looks rough, dry, with a tendency to crack, then this is a pathological condition, the cause of which must be sought.

If dry skin has symptoms characteristic of atopic dermatitis, then the child needs to be examined further. First, it is necessary to determine whether the rash is caused by an allergen or a simple irritant. Such an irritant can be soap, baby powder, powder, which cause dry skin in the area of their application.

For initial diagnosis of dry skin in a newborn and to confirm allergic etiology, simple tests should be performed - a general blood and urine test. With a pronounced allergic reaction, the child will have an increase in eosinophils, however, in newborns the results may not always be reliable.

The most accurate method of diagnosing and confirming allergic reactions is considered to be skin tests. The mother can only suspect the factors that cause such dry skin in the child, and confirmation can be a reaction to their superficial introduction using a prick test. But such methods are not used for diagnostics in newborns, so they can be taken into account in the future if the dry skin persists.

Instrumental diagnostics for this pathology is not performed.

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Differential diagnosis

The differential diagnosis for dry skin in newborns includes diaper rash, allergic dermatitis, contact dermatitis, drug and chemical reactions, exfoliative dermatitis, shingles, staph, and herpes. Diaper rash is an inflammation of a fold of skin caused by friction from clothing. Diaper rash may appear as a small red rash followed by dryness in the area. Diaper rash occurs in natural folds, such as the groin, buttocks, armpits, and between the toes, as opposed to simple flaking, which occurs on exposed skin. Contact dermatitis may occur if the baby is exposed to certain chemicals or environmental factors in the first few days of life. Exfoliative dermatitis also involves flaking, but the skin comes off in large sheets. This is a very serious disease, which is accompanied by severe intoxication syndrome, and the skin, which peels off, leaves deep wounds.

Heat rash is a type of rash that occurs in newborns because their sweat glands, which are not fully developed, are easily blocked. It is especially common in hot, humid climates. Instead of evaporating, the sweat remains under the skin, causing inflammation and a rash. Symptoms of heat rash are small red spots, usually on covered areas such as the back and buttocks. Dryness in these areas may develop over time, but it is always preceded by a rash.

Treatment dry skin in a newborn

Treatment of dry skin in a newborn should begin first and foremost with proper care. Some dryness of the skin after birth is normal as the baby's skin matures and forms its own protective barrier. However, there are some special features of caring for dry skin in a newborn:

1. Reduce bath time. Long baths can remove natural oils from your newborn's skin that protect it from dryness. If you give your newborn 20- or 30-minute baths, reduce the bath time to 5 or 10 minutes.
2. Use warm, not hot, water, and use only clean water without soap. Regular soap baths can dry out your skin.
3. Apply moisturizer. Apply a hypoallergenic moisturizer to your baby's skin twice a day, including after a bath. Applying cream to the skin immediately after a bath helps lock in moisture, which can prevent dryness and keep your baby's skin soft. Gently massaging your newborn's skin with moisturizer can help ease flaking. When it comes to moisturizers, the general rule is the thicker the better. If your baby's skin is still dry even with daily moisturizing, try switching from lotion to a thicker cream or ointment. Ointments are best at locking in moisture but can leave a greasy feeling, so just use a small amount and gently rub it into the skin. Creams rub in without leaving the skin greasy.
4. Protect your baby from cold air. Make sure your newborn's skin is not exposed to cold or wind outside. Wear socks in the summer to avoid the sun.
5. Avoid harsh chemicals. Because newborn skin is sensitive, it is also important to avoid harsh chemicals that may irritate your baby's skin. Do not apply perfume or scented products to your newborn's skin.
6. Instead of washing your newborn's clothes with regular laundry detergent, choose a detergent formulated specifically for baby's sensitive skin. You should also be careful to choose baby clothes made from natural fabrics without synthetics. If your baby's skin is very sensitive, avoid dressing him in clothes that are thick or rough. Also keep in mind that some fabrics, such as wool, can be especially 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 your newborn has dry scalp and crusts are forming. The best way to remove crusts is to wash your baby's hair daily with a gentle baby shampoo. Try massaging your baby's scalp with your fingers first. Before you apply shampoo, brush your baby's hair with a soft baby brush to remove loose flakes. After shampooing, gently brush your baby's scalp with a terry towel.

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

Medicines used in the treatment of dry skin can be used already in case of long-term dry skin, which causes discomfort, cracks and inflammation. In such cases, local antiseptics can already be used. If there is slight peeling of the skin, then hygienic measures and skin moisturizing may be enough in the treatment. Here are some medicines:

1. Tyrosur is a local antiseptic agent, the active substance of which is tyrothricin. This is a drug from the group of local antiseptics, which kills many microorganisms and prevents infection of dry skin. The method of application of the drug is 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 well known is that it can be added to milk to help with dry skin. Omega 3 Fish Oil has many anti-inflammatory properties and this will be especially helpful if your baby's dry skin is causing itching and irritability. Dosage of 500 mg once a day added to your baby's formula can really help. Side effects can include allergies or the baby refusing to drink the milk as it may have an unpleasant fishy smell.
3. Bepanten is a local remedy that can be used to treat dry skin in newborns. The active ingredient of the drug is dexpanthenol, which is converted into an active metabolite and is a vitamin for the skin. It restores damaged dry cells. The method of application of the drug is locally in the form of a cream, or in case of more severe damage and dryness in the form of an ointment. Side effects are allergic reactions, redness.

Vitamins can be used by the mother, which improves the child's condition. Physiotherapy is not used in the acute period.

Traditional methods of treating dry skin

Natural herbal remedies are gaining popularity due to several advantages such as fewer side effects, relatively less expensive remedies. 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 applied topically to extremely dry skin. It works well on flaky 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 rinse with warm water after about 20 minutes. Repeat the process once or twice a day, especially after bathing, or simply replace your regular moisturizer with aloe gel.
2. Honey tightens, softens and moisturizes dry skin. It increases blood circulation to the dry area and promotes deeper hydration. Honey should be applied to the affected areas at least once a day to help soothe dry newborn skin. Precautions – may cause an allergic reaction, so use with caution after a test.
3. Avocado is a nutritional powerhouse that provides numerous benefits for baby's dry skin. Not only does it nourish dry skin, but it also helps regenerate it. To prepare the remedy, blend half an avocado in a blender until it forms a paste, then apply it to your baby's dry skin. Leave it for 10 minutes and rinse off. You can also use avocado oil in the same way.
4. Birch tea is recommended for relieving dry skin. The tea can be made from fresh or dried birch leaves. To make the tea, steep four birch leaves in one cup of boiling water and let steep for five to ten minutes. For treatment, a breastfeeding mother can drink one cup of tea three to four times a day. To make a compress, dip a soft cloth in warm or cooled (not boiling) tea and apply to the skin.

Herbs for dry skin treatment can also be used as compresses or teas:

1. Dandelion leaf is used to treat dry skin for an herbal bath. A teaspoon of dried dandelion leaves or 1 handful of fresh dandelion leaves should be poured into a glass of hot water. The leaves contain volatile compounds, so the infusion should be left to stand for 30 minutes. Then add the tea to a warm (not hot) bath and you can bathe your baby.
2. Echinacea is used to treat dry skin. Forms for using Echinacea include juices and tea. To make tea, take the dry leaves of the plant and pour boiled warm water over them. Let it steep for three hours, then wipe the baby's dry skin three times a day.
3. Saffron is a natural plant derivative that acts as an antispasmodic, diaphoretic, antimicrobial and sedative. For a medicinal compress, you need to crush its leaves, squeeze out the juice, and then spread this gruel in a thin layer on dry areas of the skin.

Homeopathy for dry skin in newborns is rarely used, as the effect of treatment may be delayed. Therefore, preference is given to local remedies.

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Prevention

Prevention of dry skin in infants requires that all pregnant women be screened for infections during and immediately after pregnancy to prevent not only dry skin but also any related infections in the baby later on. After birth, mothers should be aware of the main rules of hygiene and baby care. It is very important that the baby is bathed correctly and that there are no factors that will aggravate dry skin.

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Forecast

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

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Dry skin in a newborn is a common manifestation that can make parents nervous. But most often, this is a normal reaction of the baby's skin and it is enough to simply bathe and moisturize the skin correctly. If there are other manifestations against the background of dryness - itching, redness, refusal to breastfeed - then you need to see a doctor.