Pill in the baby: how does it look, what to treat at home?

Among dermatological problems, sweating in children from the first days of birth up to two or three years old is one of the main places for parents' appeals to pediatricians.

Potnitz is referred to the diseases of the appendages of the skin - located throughout the body of small sweat (eccrine) glands. 

[1]

Epidemiology

The national clinical statistics of child's sweating is unknown. But, according to the American Academy of Family Physicians, this cutaneous pathology affects up to 40% of infants and usually appears during the first months of life. In 3-4.5% of cases, so-called crystalline sweating is diagnosed by pediatricians in newborns aged 7-10 days. It is this subtype or type of disease - the most common.

Also in some studies, it is noted that sweating in a newborn child most often occurs with a high birth weight, as well as in infants who are born prematurely or by cesarean section.

[2], [3], [4], [5],

Causes of the baby's sweating

The main causes of sweating in children are overheating - because of the hot weather and heat, and also because of mistakes in caring for children, in particular, when they are too warmly dressed or densely sang. This often causes skin problems such as sweating and diaper rash in children.

As a result, the production of sweat ekkrinnymi glands is increased, while its exit to the surface of the epidermis and natural evaporation are difficult. Thus, conditions for partial obstruction of excretory pores of sweat glands appear.

Often there is a sweating after the temperature in a child, when the hyperhidrosis is caused by a particular acute infection with fever.

This lesion of the skin is more often noted in the heat, but excessive warming and clothing created by the "greenhouse effect" lead to the fact that there may be a sweating in winter in the child.

[6]

Risk factors

Unconditional risk factors for the occurrence of sweating paediatricians see:

• in high temperature of air - indoors or outside in hot season, especially in combination with high humidity level;
• in clothes and bed-clothes of synthetic airtight fabrics that do not absorb sweat and block skin gas exchange;
• in excessive treatment of the skin in the warm season by non-permeable oils or creams on the fat basis, which leads to clogging of the sweat pores on its surface;
• in the extra weight of the child and a lot of deep skin folds, the skin in which constantly sweats without the timely evaporation of secreted sweat.

[7], [8], [9], [10]

Pathogenesis

To reduce body temperature when it overheats, small children, like adults, sweat. But why does sweat so often appear in early childhood?

To a large extent, the pathogenesis of child's sweating is conditioned not by the thermoregulatory system of the organism, which was formed and adapted to the conditions of the external environment, from birth to one and a half to two years. The role of the physiological features of their skin is also great: a dense horny layer of the dermis, the lack of a full hydrolyside (water-fat) and  acid mantle of the skin,  insufficient to protect the skin.

With the development of sweating, the eccrine sweat glands located in the skin throughout the body (which have the shape of tubules) and their incompletely developed excretory ducts opening in the superficial pores of the skin are blocked.

In the opinion of specialists, the conditionally pathogenic bacterium Staphylococcus epidermidis is involved in the development of child's sweating, especially the infusion of babies in the healthy skin (that is, being part of the cutaneous microbiota). It is believed that the substance forming the film produced by this microorganism covers the excretory pores. And the output of accumulating sweat directly through the glandular walls is manifested by rashes on the skin and its irritation.

By the way, another type of sweat glands - apocrine (lying deeper than eccrine and located under the armpits, in the perineum and groin, in the pubic region and navel) - in childhood they finish developing, but "turn on" with the onset of puberty. Their excretory ducts open, like the sebaceous glands, into the hair follicles.

[11], [12], [13], [14],

Symptoms of the baby's sweating

The first signs of sweating are skin rashes. And how it looks like a child's sweating depends on its variety.

Crystalline sweating is manifested by vesicles - small transparent bubbles filled with liquid; while the skin does not turn red, and the rash does not cause itching and other unpleasant sensations. Each vesicle develops to a spontaneous perforation, followed by drying and desquamation. How long does the sweating take place in children? Crystalline sweating is usually resolved by itself (scales peel off for several days), but - when the effect of causative factors continues - the rash may appear again.

If the sweating on the head and on the forehead of a child is localized, it appears on the neck (in folds, behind the ears, along the hair growth line) or on the body - on the back, on the abdomen, and also poured out on the hands (in the folds of the elbow joints and in the forearm area ) and on the legs (in the folds of the knee joints), in 85-92% of cases this is a crystalline type of pathology. See also -  Infant of the newborn on the face and neck

With red sweats, the baby's skin first becomes covered with itchy red and pink spots, where reddish nodules form in a few hours. They last for several days, often transforming into pustules, causing a parallel name in dermatology - "pustular sweats". The places of her rashes: the folds of the limbs, the scalp and neck; often such a sweating in children under the armpits.

There may also appear a red sweating on the soles of the feet (between the toes and the arch of the feet), in the groin and on the buttocks, that is, on the pope. The area of rashes can be quite extensive, often occurs maceration of the epidermis; itching of the skin irritates the child, which affects his behavior, sleep and feeding.

If a deep sweating occurs, a rash in the form of pink or red spots and bright papules of different sizes spreads throughout the body, but is more concentrated in the neck and back; fever, general malaise, itching and irritation of the skin.

[15], [16]

Forms

Dermatologically different types of sweating:

• crystalline (miliaria crystallina) - superficial, most often diagnosed;
• red (miliaria rubra) - deeper, more often in newborns, usually developing between the first and third weeks of life of the baby;
• The deep (miliaria profunda) is the rarest, since it affects, mainly, those living in the tropical climate of adults. Moreover, it is the most serious, as it is caused by complete obstruction of the apical sections of the tubules of the eccrine glands; is often a complication of repeatedly recurring red sweats.

[17]

Complications and consequences

If caring for the skin with the chuff is not high enough, or the child combs the itchy places, the consequences and complications - in the form of bacterial or fungal infection of the damaged skin - will not keep you waiting. First of all, the epidermal staphylococcus aureus is activated, malovirulent in favorable conditions and quite aggressive in any damage to the surface layers of the skin.

Most often, sweating is complicated by staphylococcal or streptococcal pyoderma - pustular inflammation, as well as periporitis - an inflammatory process directly in the pores of the eccrine sweat glands.

Deep perspiration after prolonged overheating, which caused the child to sweat, can lead to a thermal shock: with fever, hyperemia and dry skin, vomiting, weakness, rapid breathing and even loss of consciousness. But this can happen only as a last resort.

[18], [19], [20], [21]

Diagnostics of the baby's sweating

At first glance, the diagnosis of sweating in the child does not cause any particular complications, and usually it is done by the district pediatrician, attentively examining the child, fixing and analyzing the nature and localization of the rashes on the skin.

But there are a lot of diseases with similar symptoms, and there may be a rash in the child that looks like a chicken with chickenpox, rubella or measles.

[22], [23], [24], [25]

Differential diagnosis

Therefore, differential diagnosis should accurately determine what problem with the skin actually arose: neonatal pemphigus, atopic dermatitis, diarrhea erythema, allergy or sweating in the child.

Treatment of the baby's sweating

The treatment of sweating in children at home is conducted, and the key therapeutic method is the elimination of the effect of heat on the baby's skin (reducing the intensity of sweat secretion) and proper skin care. As a rule, there is no need for drug treatment.

However, parents often ask the same question: how to smear a child's sweatshirt? Doctors strongly recommend that you do not smear rashes at once! First of all, the treatment of sweating in children includes bathing the child in water with the addition of a weak (pale pink) solution of potassium permanganate and subsequent careful drying of the skin (moisture should not be wiped and gently blotted out). To achieve the absolute dryness of the skin, necessary for getting rid of the perspiration, the air baths will help: for a few minutes the child should be without clothes.

Skin folds, redness and rashes powder powdered baby powder; also permissible antiseptic agents for sweating in children: 0.5-1% ethyl boric acid solution (boric alcohol), 1% salicylic acid solution (salicylic alcohol), furacilin solution.

Any ointment or cream from perspiration in children is important to use with caution: funds on fat basis (most often it's Vaseline) clog the pores and only aggravate the situation.

To remove redness of the skin (if there is no maceration),  D-Panthenol  and Bepanten (with D-panthenol) creams or Pantestine gel (which also contains myramistin) can be used.

When the sweating is scratched in a child older than one month, exclusively for the doctor's prescription, the antihistamine Dymetinden (Fenistil) used in allergic dermatitis and hives can be used in the form of a gel that is applied two or three times a day to the problem area.

If the symptoms persist for more than a few days and the skin becomes wet, then an antiseptic and drying suspension with zinc oxide-Tsindol can be applied (applied to the affected areas). This is a better remedy than the usual (on a vaseline-based) zinc ointment. It is more expedient to use zinc ointment with white paraffin (it is available in tubes, but not in cans).

Judging by the presence of the item "rashes of different etiologies" in the list of indications for use, lotion Kalamin can be used - to remove the itching and irritation of the skin, disinfect and dry the rashes. In addition to zinc oxide and zinc-containing mineral calamite, this compound (claimed as a baby lotion that soothes the skin) has a strong bactericidal substance - phenol, used to treat purulent skin diseases, penetrating through the skin to the blood and ... Contraindicated to children.

Antibacterial agents for external use - Levomekol or Kortomycetin, as well as the liniment of synthomycin with antibiotic levomitsetinom - the doctor appoints when there is no sweating in the child due to inflammation of the skin that occurs when it is infected.

If the situation is further complicated, then the case can reach the topical corticosteroids - for the removal of inflammation and itching. However, the serious side effects of most of these drugs are well known to many. And if someone recommended the cream  Advantan, then you need to keep in mind the following: according to the instruction, this drug with methylprednisolone aceponate (synthetic analogue of prednisolone) is allowed to use for dermatitis, neurodermatitis, eczema, psoriasis, etc. From 4 months of age (and for the drug in the form of an emulsion, age limits are not specified at all). But methylprednisolone is contraindicated in children under 12 years of age.

Glucocorticosteroids are absorbed by the skin of the child and enter the blood, increasing the undesirable systemic effect of the synthetic hormones of the adrenal cortex. In addition, the use of such drugs for children without extreme need causes dermatosis and atrophy of the epidermis.

Alternative treatment

For a long time the classic treatment of sweets has become a classic, this is the treatment with herbs, that is, bathing the child in water, adding to it the broths of medicinal plants: flowers of chamomile and calendula officinalis, leaves of plantain large, herb threefold, coriander seed.

Its anti-inflammatory and astringent effect will help rinsing the skin or slightly warm lotions with decoction from the oak bark, roots of elecampane, grass horsetail or swine swine.

For the same purpose, you can use natural apple cider vinegar, diluted with boiled water (1: 1) - spraying the resulting solution onto the skin and letting the moisture completely dry.

And to remove itching and prevent inflammation, it is recommended to treat the area of sweets with a soda solution (one teaspoon per glass of warm water) or diluted with fresh water with fresh aloe juice.

[26], [27], [28]

Prevention

It is clear that the prevention of sweating in children consists of two points: do not overheat the child either in summer or in winter (that is, do not wrap it so that it sweat later) and observe the rules of hygiene and the principles of skin care for infants.

[29], [30]

Forecast

The prognosis of blockage of small sweat glands, leading to the development of sweating, is favorable: the problem can be solved quickly if the child is properly dressed and cleaned.

[31]