Skin in a newborn baby: structure, diseases, proper care

The skin of a newborn has a number of features that every mother should know for better care of her baby. After all, many skin conditions of a newborn that seem dangerous to the mother are absolutely normal physiological features of the adaptation of the skin of newborns to the external environment. To prevent many pathologies, you need to know not only the features of the functioning of the skin, but also how to care for it.

Peculiarities of the skin of a healthy child

In order to understand which skin conditions are normal for a child and which are pathological, it is very important to know the basic functions and structural features of the baby's skin.

The skin is a multifunctional organ of great importance due to its function as a primary barrier, mechanical protection, thermoregulation, immune surveillance and prevention of fluid loss. It was previously believed that all skin functions reach maturity at about 34 weeks of pregnancy. However, it must be said that the baby's skin is immature after birth and continues to develop until 12 months. The skin of the newborn undergoes a gradual process of adaptation to the extrauterine environment, and special care is required during this period.

The physiological characteristics of newborn skin are sensitive, thin and fragile. Moreover, compared to the skin of premature babies, the skin of healthy newborns is even thinner with a thinner stratum corneum and a less effective protective function of the skin. As a result, there is an increase in transepidermal water loss, increased absorption of chemicals and easy traumatization of the skin. This proves the need for careful and thorough care of the skin of a newborn baby.

The pH of the newborn baby differs from that of adults. The acidic pH of the skin surface observed in adults and adolescents (pH < 5) has a protective effect against microorganisms. In newborns, especially premature infants, the skin surface pH is neutral, which significantly reduces the protection against microbial overgrowth. It may also contribute to increased transepidermal water loss, signaling a change in epidermal barrier function.

Epidermal lipids play an important role in maintaining the protective function of the skin and the integrity of the skin. However, the lipid content of the skin of infants is lower due to the low activity of the sebaceous glands. On the other hand, their skin has a high water content. Gradually, the amount of water decreases and is replaced by epidermal lipids, which act as a barrier later on. This natural protective mechanism cannot be replaced in any way for a child, so maximum care is required not to destroy this barrier. Destruction occurs mainly due to the use of inappropriate chemical products during skin care.

The dermis of newborns contains less mature collagen than that of adults, and because it contains a high concentration of proteoglycans, it achieves a higher water content.

Another feature of the newborn skin structure is a smaller thickness of the stratum corneum and an increased number of hair follicles. The smaller the child, the more sensitive he is to excessive glandular secretion (sweat and sebum), which can affect the development of such problems as prickly heat when the skin is occluded by a diaper.

Since the epidermal barrier is immature in infants, the permeability of the skin is very high, especially in the first two weeks of life. This causes a significant risk of toxicity from drug absorption through the skin. In addition, this skin is more easily attacked mechanically, as in the area of contact with diapers or by the use of wipes, which cause repeated and localized removal of cells of the stratum corneum and therefore increase the permeability of the skin.

The normal skin color of a newborn varies at different stages of life. Immediately after birth, the skin may be bright red, called erythema. When the baby begins to breathe air, the skin color changes to a lighter shade and then turns pink. This reddening of the skin usually begins to disappear on the first day. Then the skin becomes bright pink, which is considered normal. But there are a number of other skin color changes that are typical for healthy babies and are considered physiological.

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Skin diseases of newborns

Newborns very often develop rashes or other skin problems. Some of them can actually be life-threatening to the baby, but most of these conditions will go away on their own within a few days or weeks.

Infectious skin diseases of newborns account for a small percentage of all conditions. They develop when a microorganism gets on the baby's skin with the development of an inflammatory process. Considering the thin skin of a baby, infection can occur very easily. Purulent skin diseases in newborns develop when infected during childbirth or in the early postpartum period. The causative agents of infection can be streptococci, staphylococci, E. coli, fungi. Staphylococcus on the skin of a newborn often causes common infections - vesiculopustulosis, staphyloderma. It is more dangerous when a microorganism gets on the already damaged skin of the baby, for example, with diaper rash. This leads to infection of the deeper layers of the epidermis and the spread of the infection.

Newborns often have Candida infection. This fungus can be present in small quantities on the mucous membranes without causing any symptoms. When Candida begins to actively multiply, it causes inflammation of the mucous membrane. Skin candidiasis in newborns occurs in weakened children with HIV infection or immunodeficiency, when the immune system is so impaired that the microflora and balance of the skin are disrupted. This manifests itself as a white coating on the mucous membranes and skin.

A rash on the skin of a newborn can be a normal phenomenon, in which there are no pathogens. This concerns the physiological conditions of the child, which occur when the skin adapts to environmental conditions.

Pimples on the skin of a newborn are the most common concern for parents, which is unfounded. They are most often localized on the cheeks, nose and forehead. This is baby acne, which can appear during the first few weeks of life and usually goes away on its own within a few months. Such pimples in a newborn have nothing to do with whether your child will have problems with acne in adolescence. They develop due to the collection of secretions in the skin glands and the blockage of the glands, which has the appearance of such pimples.

Non-infectious skin diseases of newborns also include toxic erythema. This is a feature of the newborn's reaction to physiological irritants, which passes with minor peculiarities. Such rashes appear on the face or limbs and initially appear as red skin. Then the elements of the rash turn into a pustule with a "spotted" appearance. Such bubbles are characteristic of toxic erythema, and if it is benign, such erythema does not cause a violation of the general condition. Blisters on the skin of a newborn with toxic erythema disappear within a week without much effort and intervention.

There are many conditions that change the color of the skin of newborns. Physiological catarrh of the skin of newborns is redness in the first two days after birth. This is a normal phenomenon and does not require any action, because then the skin becomes pink and velvety. Blue skin in a newborn also occurs under normal conditions if such changes are localized on the fingers or around the mouth. Such a slight cyanosis can persist in healthy children as a result of low adaptation of the cardiovascular system. Of course, if cyanosis spreads to the entire skin or there are other symptoms, then such a change in skin color requires immediate consultation with a doctor.

Pale or white skin in a newborn can also appear periodically, usually when there is a change in body temperature. During walks or when the temperature outside is unstable, the newborn's body cannot yet regulate the temperature regime well enough. Therefore, its body temperature can easily decrease, which is manifested by vascular spasm and pallor.

Marbled skin in a newborn can appear when the body temperature drops, or in case of nervous system coordination disorders. Such disorders occur in children after hypoxic damage to the nervous system. In this case, when consulting a neurologist, you need to talk about such episodes of skin marbling, which can be one of the manifestations of pathology.

Physiological jaundice is a condition in infants when the bilirubin level increases. Physiological jaundice does not appear until the second or third day after birth and disappears within 1-2 weeks. This compound has the ability to very quickly and easily penetrate the skin and mucous membranes, causing the skin to turn yellow. Yellow skin in a newborn can spread to the face, arms, body up to the navel line. This is equivalent to a bilirubin level that is not life-threatening for the child. If you see yellow skin on the legs, arms, and especially the feet and palms, this indicates high bilirubin levels and a risk to the baby's health.

A newborn baby is born with wrinkled skin and a protective coating called vernix caseosa. This coating on the skin peels off during the first week, giving the appearance of peeling skin on a newborn.

Among the pathological conditions that occur quite often, a common one is hemorrhage in the skin of a newborn. This happens when the child is compressed during passage through the birth canal. Considering that the skin of newborns is very thin, and the vessels are fragile, they can be slightly damaged with the formation of small point hemorrhages. As a rule, such small petechiae on the skin quickly disappear. A compaction under the skin of a newborn can be with hematomas of significant size, which can be located in the area of pliable places - the head, neck.

Atopy of the skin in newborns is not so common, because during this period the intake of allergens into the baby's body is minimal. Most often, allergic reactions in a child can be to foods that the mother eats during breastfeeding. Therefore, food allergens can be considered the main cause.

One of the rare pathologies is considered to be ichthyosis of the skin in newborns. This disease is hereditary and is associated with the pathology of the gene that regulates the normal structure of the epidermis. This disease manifests itself in the first months of life. The child develops dry, rough skin, which is prone to severe hyperkeratosis. Such peeling of the skin occurs in layers with pronounced peeling and irritation of the deeper layers. Given the hereditary nature of the pathology, diagnosis is not difficult, because there must be episodes of such a disease in the family.

Parchment skin in a newborn can form against the background of pronounced dryness and peeling. This is more often observed in post-term babies, but can also occur in healthy children whose parents suffer from atopic dermatitis. If you properly care for such skin, it does not cause discomfort to the child.

Aplasia of the scalp in newborns is a congenital anomaly. This pathology is not as common as other congenital anomalies. It occurs when the formation of the skin is disrupted during the early stages of a child's development. The disease manifests itself as the absence of a section of the epidermis and dermis on the scalp, which can be replaced with scars over time. Children with this disease require careful care.

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Proper care of newborn skin

Due to the characteristics of the skin of newborns, infants and children, cosmetics intended for their hygiene and protection require special attention when used. One of the most important conditions is the exclusion of all ingredients that may be potentially aggressive to the skin of newborns. Percutaneous absorption of drugs and topical agents depends on the physical and chemical characteristics of the drug, as well as on the properties of the skin barrier. The higher the body surface area, the higher the risk of percutaneous toxicity. Other factors include immature drug metabolism systems, and in newborns, especially premature babies, the immaturity of the epidermal barrier. Unfortunately, many products intended for use by children contain potentially toxic substances that are harmful to the skin of newborns. Even labels containing phrases such as "dermatologically tested" or "pH balanced" or "natural or organic ingredients" do not guarantee the safety of the ingredients. Therefore, the treatment of the skin of a newborn must be done with a careful selection of special cosmetics.

Dry skin in a newborn is a common problem that parents of healthy children face at any time of the year. It often happens that the skin of a newborn peels because the top layer, which was exposed to the environment during childbirth, is removed. This is a completely normal phenomenon, but you need to properly bathe the baby and take care of the skin after bathing, since it is necessary to prevent the formation of cracks.

The process of bathing a baby has several important points. Up to the age of one month, you should bathe the baby only in boiled water. The water temperature should be close to body temperature (37 - 37.5 ºC). The bath should be short, no more than 5 minutes, especially if soap is used. This will also help prevent skin maceration. The action of rubbing with a sponge or cloth contributes to greater heat loss, increased loss of transepidermal water reserves and decreased hydration of the stratum corneum, so the use of sponges is not recommended. When bathing a newborn, you need to focus on areas that need more attention, such as the face, neck, folds and diaper area. Treatment of the folds of the newborn's skin should be carried out more thoroughly using liquid products and further moisturizing.

Traditional soaps have good cleaning power, emulsifying power and produce sufficient foam, but they are irritating and their alkaline pH can destroy the surface lipid layer of the baby's skin. This can lead to excessive dryness of the skin and should therefore be avoided. Glycerin soaps, due to the excessive content of glycerin, which is a powerful humectant, can absorb excess water from the skin, which can cause dryness and irritation.

Ideal cleansers for newborns during bathing should be liquid, mild, soap-free, fragrance-free, with a neutral or slightly acidic pH. They should not irritate the baby's skin or eyes or change the protective acidic pH of the skin's surface.

When using shampoos, the same aspects should be taken into account: they should be gentle, only slightly cleansing, with a pH close to the body.

There are also some other precautions that should be taken to care for the baby's skin. Diapers should be changed frequently and super absorbent disposable diapers should be used as they have a greater ability to keep the diaper area dry. Hygiene of the diaper area with warm water without soap is sufficient to clean urine daily. Daily use of topical preparations to prevent dermatitis is not necessary for babies with normal skin. Infants' nails should be kept clean and short to avoid injury to the skin.

When the skin of newborns peels after bathing, such skin must be moisturized. Moisturizing the skin of a newborn is recommended for daily care of dry skin, scaly dermatoses and in children with atopic dermatitis. In healthy newborns, the skin does not need daily moisturizing. What to smear on the skin of a newborn? The advantage in use for newborns is softening ointments or creams without perfumes, dyes and preservatives, which are the most effective, safe and often less expensive.

The effectiveness of any emollient is increased when applied immediately after bathing to damp skin. Scented emollients should be used with caution due to the risk of irritation and sensitization. When emollients are in the form of ointments, they are occlusive and promote a lubricating effect. However, they can cause acne, folliculitis, and also aggravate itching (especially in atopic patients) when used in extremely hot and humid areas. Moisturizers in the form of creams and lotions are easier to apply to the skin of a newborn baby, which leads to better compliance with treatment. They also promote a emollient effect.

Oils for newborn skin should not be used for inflammatory or exudative dermatoses. They can be used as a moisturizer for the skin of healthy children, then they penetrate deep and do not create conditions for the formation of a "film effect". Olive oil for newborn skin is considered the most universal, and it rarely causes allergic reactions.

Prevention of skin diseases in newborns is daily baths and proper skin care. The main rule for preventing any complications and rashes on the skin of a newborn is not to use detergents or creams, ointments on healthy skin. If the skin is dry, use only ointment or lotion on dry areas of the skin. Make sure that the child wears only soft clothes, preferably cotton. Most often, the diaper causes irritation in the area of use. To prevent this, you need to regularly check the diapers. Change diapers immediately when they are wet or dirty. Wash the diaper area with a mild, unscented cleanser or clean water. For dry skin, you need to use special baby moisturizers.

The skin of a newborn baby not only acts as a protective mechanism, but also exchanges water and substances through the skin. Therefore, proper skin care of a newborn is the key to its health. Several harmless skin rashes and conditions may be present at birth or appear during the first few weeks, which do not require special concern. Maintaining the integrity of the skin, reducing the potential risk of developing atopic dermatitis (eczema) and educating parents are key priorities in caring for the baby.