Skin of a newborn: structure, disease, proper care

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

Features of the skin in a healthy child

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

Skin is a multifunctional organ of great importance, due to its function as the main barrier, the function of mechanical protection, thermoregulation, immune observation and prevention of fluid loss. Earlier it was believed that all the functions of the skin reach their maturity at about 34 weeks gestation. However, it must be said that the baby's skin after birth is immature, and it continues to develop up to 12 months. The skin of the newborn is subjected to a gradual process of adaptation to the ectopic environment, and during this period special care is required.

Physiological features of the skin of a newborn are characterized by sensitivity, subtlety and fragility. Moreover, compared to the skin of preterm infants, the skin of healthy newborns is even thinner with a thinner horny layer and less effective protective function of the skin. As a result, there is an increase in transsepidermal water loss, increased absorption of chemicals and slight trauma to the skin. This proves the need for gentle and careful skin care for a newborn baby.

The pH of a newborn baby is different from adults. Acidic pH of the skin surface, observed in adults and adolescents (pH <5), has a protective effect against microorganisms. In newborns, especially in premature babies, the pH of the skin surface is neutral, which significantly reduces the protection against excessive growth of microorganisms. This can also increase transsepidermal water loss, signaling a change in the function of the epidermal barrier.

Epidermal lipids play an important role in maintaining the protective function of the skin and the integrity of the skin. However, the lipid content in 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 in the future. Such a natural protective mechanism can not be substituted for a child, so maximum care is needed to not destroy this barrier. Destruction occurs mainly through the use of inappropriate chemical products during skin care.

The dermis of the newborn contains less mature collagen than in adults, and since it contains a high concentration of proteoglycans, it reaches a higher water content.

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

Since the epidermal barrier is immature in infants, skin permeability is very high, especially in the first two weeks of life. This causes a significant risk of toxicity from the absorption of drugs through the skin. In addition, this skin is easier to attack mechanically, since in the area of contact with diapers or with the use of napkins that cause repeated and localized removal of the cells of the stratum corneum and, therefore, increase the permeability of the skin.

The normal color of the skin of a newborn is different at different periods of life. Immediately after birth, the skin can have a bright red color, the so-called erythema. When a child begins to breathe air, the skin color changes to a lighter shade, and then becomes 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 characteristic of healthy children and are considered a physiological phenomenon. 

[1], [2], [3], [4], [5], [6], [7]

Diseases of the skin of newborns

Newborns often develop a rash or other skin problems. Some of them can really be dangerous for the life and health of the child, but most of these conditions will go away on their own in a few days or weeks.

Infectious diseases of the skin of newborns among all conditions occupy a small percentage. They develop when the microorganism hits the child's skin with the development of the inflammatory process. Given the baby's thin skin, infection can happen very simply. Purulent skin diseases in newborns develop with infection during labor or in the early postpartum period. Infectious agents can be streptococci, staphylococci, E. Coli, fungi. Staphylococcus on the skin of a newborn often causes common infections - vesiculopustulosis, staphyloderma. More dangerous when the microorganism gets on the already damaged skin of the baby, for example, with diaper rash. This leads to infection of deeper layers of the epidermis and the spread of infection.

Infants often have candida infection. This fungus can be in a small amount on mucous membranes, without causing any manifestations. When the candidate begins to multiply actively, it causes inflammation of the mucous membrane. Candidiasis of the skin in a newborn is found in weakened children with HIV infection or immunodeficiency, when the defenses are so violated that the microflora and skin balance are disturbed. This is manifested by a white coating on the mucous membranes and skin.

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

Pustules on the skin of the newborn are most often worried about the parents, which is unreasonable. They are more often localized on cheeks, on a nose and on a forehead. These are childhood acne, which can manifest itself during the first few weeks of life and usually go away on their own for several months. Such pustules in the newborn have nothing to do with whether your child will have problems with acne during adolescence. They develop because of the secretion in the cutaneous glands and the clogging of the glands, which looks like such pustules.

Non-infectious diseases of the skin of newborns also include toxic erythema. This is a feature of the reaction of newborns to physiological stimuli, which passes with small features. 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 vesicles are characteristic precisely for toxic erythema, and in the case of a benign character such erythema does not have a disruption to the general condition. Blisters on the skin of a newborn with toxic erythema disappear within a week without much effort and interventions.

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

Pale or white skin in a newborn can also periodically appear, as a rule, when there is a change in body temperature. During walks or at an unstable temperature outside, the newborn's body can not yet sufficiently regulate the temperature regime. Therefore, the temperature of his body can easily decline, which is manifested by vasospasm and pallor.

Marble skin in a newborn can appear with a decrease in body temperature, or in the case of disorders of the coordination of the nervous system. Such violations occur in children after hypoxic damage to the nervous system. In this case, when consulting a neurologist, one should speak about such episodes of marbling of the skin, which can be one of the manifestations of pathology.

Physiological jaundice is a condition in infants, when the level of bilirubin increases. Physiological jaundice does not appear until the second or third day after birth and disappears within 1-2 weeks. This compound has properties very quickly and easily penetrate the skin and mucous, causing yellow skin color. Yellow skin of the newborn can spread to the face, handles, trunk to the navel line. This is equivalent to the level of bilirubin, which is not dangerous for the life of the child. If you see that the yellow skin on the legs, on the handles, especially the feet and palms, this indicates a high figure of bilirubin and a risk to the health of the baby.

A newborn baby is born with a wrinkled skin and a protective coating called original grease. This coating on the skin exfoliates during the first week, which looks as if the skin of the newborn is obliterated.

Among pathological conditions that occur quite often, a hemorrhage in the skin of a newborn is considered to be common. This happens when the child is compressed during passage through the birth canal. Given that the skin of the newborns is very thin, and the vessels are fragile, there may be slight damage to them with the formation of small spotted hemorrhages. As a rule, such small petechiae on the skin quickly disappear. Sealing under the skin of a newborn can be with hematomas of considerable size, which can be located in the area of pliable places - the head, neck.

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

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

Parchment skin of a newborn can form on the background of pronounced dryness and peeling. This is more often observed in the transported children, but it can also be in healthy ones, whose parents suffer from atopic dermatitis. If you properly take care of such skin, then it does not bring discomfort to the child.

Aplasia of the scalp in newborns refers to congenital anomalies. This pathology is not so frequent as other congenital anomalies. It occurs when the formation of the skin is disturbed during the development of the child in the early stages. There is such a disease as the absence of a patch of epidermis and dermis on the scalp, which can be replaced with time scars. Children with this disease require careful care. 

[8], [9]

Proper skin care for a newborn

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

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

The very process of bathing a child has several important points. Until the age of one month you need to bathe your baby only in boiled water. The temperature of the water should be close to body temperature (37 - 37.5 ºC). The bath should be short, not more than 5 minutes, especially if soap is used. This will also help prevent skin maceration. The action of friction with a sponge or cloth contributes to a greater thermal loss, an increase in the loss of transsepidermal water reserves and a decrease in the hydration of the stratum corneum, therefore it is not recommended to use sponges. When bathing a newborn, you need to focus on areas that need more attention, such as face, neck, folds and diaper area. Handling of the folds of the skin of a newborn should be done more thoroughly using liquid preparations and further moistening.

Traditional soap has a good detergency, emulsifying ability and produces a sufficient foam, but it is irritating, and their alkaline pH can destroy the superficial lipid layer of the baby's skin. This can lead to excessive dryness of the skin and therefore should be avoided. Glycerin soaps due to excessive glycerin content, which is a powerful moisturizer, can absorb excess water from the skin, which can cause dryness and irritation.

Ideal cleansers for the newborn when bathing should be liquid, soft, without soap, odorless, with a neutral or slightly acidic pH. They should not irritate the skin or eyes of the child or change the protective acidic pH of the skin surface.

When using shampoos, the same aspects should be considered: they should be gentle, only slightly detergent, with a pH close to the body.

There are also some other precautions that should be taken to care for the child's skin. Diapers need to change frequently, and superabsorbent disposable diapers should be used because they have a greater ability to maintain dryness in the diaper area. Hygiene of the diaper area with warm water without soap is sufficient for daily urine purification. Daily use of local drugs to prevent dermatitis is not necessary for children with normal skin. Infant nails should be clean and short to avoid skin injuries.

When after skinny newborn skin is flaky, then such skin must be moistened. Moistening of 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. Than to smear a skin of the newborn? The advantage in use in newborns is emollients 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 it is applied immediately after bathing on damp skin. Aromatic softeners should be used very carefully because of the risk of irritation and sensitization. When the emollients are in the form of an ointment, they are occlusive and contribute to the lubricating effect. However, they can cause acne, folliculitis, and also aggravate the itching (especially in atopic patients) when used in extremely hot and humid areas. Moisturizers in the form of cream and lotion are easier to apply to the skin of a newborn baby, which leads to better adherence to treatment. They also contribute to the mitigating effect.

Oils for the skin of a newborn 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 as far as possible into the interior and do not create conditions for the formation of a "film effect". Olive oil for the skin of a newborn is considered the most universal, and it rarely causes allergic reactions.

Prophylaxis of skin diseases of a newborn is a daily bath and proper skin care. The main rule of prevention of any complications and rashes on the skin of a newborn is not to use detergents or cream, ointments on healthy skin. If the skin is dry, use only ointment or lotion on dry skin areas. Make sure that the child wears only soft clothes, preferably cotton. Most often, the diaper causes irritation in the area of its use. To prevent this, you need to regularly check diapers. Replace diapers immediately when they are wet or dirty. Rinse the area of the diaper with a mild cleanser without odor or clean water. With dry skin, you need to use special children's moisturizers.

The skin of a newborn child plays the role of not only a protective mechanism, but also the exchange of water and substances passes through the skin. Therefore, proper skin care for a newborn is the key to his health. Several harmless skin rashes and conditions can be present at birth or appear within the first few weeks, which does not require much anxiety. Preservation of the integrity of the skin, reducing the potential risk of atopic dermatitis (eczema) and parenting is a key priority of baby care.