Newborn Care – Skin

Pustular Melanosis

Pustular melanosis is a common skin rash that develops in newborns before they are born. Pustular melanosis is more common in African-American babies.

Signs and Symptoms

  • Small pimples on the skin filled with cloudy liquid
  • Dark circle or patch from burst pimples
  • Typically found behind ears, forehead, neck, back, and chin

Treatment

  • Does not require treatment

Rash usually disappears within 2 weeks

Erythema Toxicum Neonatorum

Erythema Toxicum affects nearly half of all newborns.

Signs and Symptoms

  • Red patches on skin with white or yellow pimples.
  • May develop anywhere on the body.
    • Most often on the trunk/waist and never on the soles of feet.
  • May start within a few hours after birth.
  • Do not pop pimples, as it increases the likelihood of infection.
  • Should disappear within 3 to 4 weeks.

Treatment

  • Does not require treatment.

Eczema

Eczema is a common skin condition that can cause dryness, itching and redness of the skin. It tends to run in families. 

Signs and Symptoms

  • Dry, rough, possibly crusty skin.
  • Newborns may scratch or rub the affected area.
  • Typically start within a few months of birth.
  • May develop anywhere on a newborn’s body.
  • In older children, rash most often appears on knees and elbows.
  • Normally lasts until your child reaches school age, but may continue into adulthood.

Treatment

  • Apply moisturizing cream when your baby’s skin is moist, such as after bathing.
    • Dab the skin to remove excess water before applying.
    • Use once to twice a day.

Ways to Reduce Eczema Triggers
If symptoms continue, speak with your pediatrician. Steroid creams may be prescribed, and your pediatrician may recommend ways to reduce triggers for eczema.
Photo source link (photo credit): http://www.odermatol.com/issue-in-html/2012-3-14-azs/

Heat Rash or “Prickly Heat”

Heat rashes most often develop in the diaper area, upper chest, or other areas where sweat is trapped under the skin. Heat rash typically goes away in 2 to 3 days.

Signs and Symptoms

  • Red patches with slightly rough or smooth texture.
  • May have small bumps or pimples on the skin.

Treatment

  • Does not require treatment.
  • Bathing or showering with cool water without soap can help, as well as the use of cool compresses to the area to relieve irritation.
    • 10 minutes, up to 4 times a day.
  • Use of hydrocortisone creams can help relieve itching.

If the rash does not go away after 3-4 days or begins to swell or ooze, contact your doctor.

Contact Dermatitis Rash

Contact rashes are allergic reactions caused by sensitivity to a substance that touched the skin.

Signs and Symptoms

  • Typically develops within a few hours.
  • Looks similar to Heat Rash or Eczema.
  • Red and possibly scaly or rough texture.
  • Typically do not cause discomfort, but may be itchy.

Treatment

  • Apply a moisturizer cream to the area.

If the rash does not improve, contact your pediatrician. They may prescribe a steroid cream to help treat the rash.

Preventing Contact RashFinding the cause of the contact rash is the best way to prevent future rashes. Common triggers include soaps, shampoos, detergents, and creams.

Yeast Infection

Yeast infections develop in areas of the body that are warm and moist, such as the groin, armpits, and around the neck.

Signs and Symptoms

  • Scattered tiny red dots or pink, moist, itchy areas.

Treatment

  • Speak with your pediatrician. Medicated creams may be prescribed.

Cradle Cap (seborrheic dermatitis) 

Cradle cap is a common skin condition found on your baby’s scalp. It is most common in newborns and usually clears up on its own within several months.

Signs and Symptoms

  • Thick, yellow, crusty or greasy patches on the scalp.

Treatment

  • Wash their hair with mild baby shampoo and loosen the scales with a small, soft-bristled brush.
  • For stubborn scales
    • Rub petroleum jelly or mineral oil onto the scales.
    • Wait a few minutes, then brush and shampoo their hair.

If Cradle cap persists, contact your pediatrician and ask about other options.

Milia

Milia is a common skin condition found in newborns. Most cases disappear on their own within a few weeks.

Signs and Symptoms

  • Tiny white bumps on the nose, chin, or cheeks.

Treatment

  • Wash your baby’s face once a day with a mild soap and water.

Baby Acne

Baby acne is a skin condition believed to be caused by exposure to maternal hormones during pregnancy.

Signs and Symptoms

  • Red or white bumps on the forehead or cheeks.
  • Develops within the first few months after birth.

Treatment

  • Wash your baby’s face once a day with a mild soap and water.

If the acne does not improve after several months, you may consult your pediatrician for other possible treatments.

Salmon Patch (Stork Bite)

A benign birthmark caused by blood vessels not forming properly.

Signs and Symptoms

  • A flat patch of pink or red skin.
  • Often small.
  • Typically found on the back (nape) of the neck (stork bite), on the forehead between the eyebrows (angel’s kiss), and on the eyelids.

Treatment

  • No treatment is necessary. The birthmark will usually fade within one year.

Dermal Melanocytosis

Dermal Melanocytosis is a common birthmark, more often found in Asian and Native American infants. They can be present at birth or develop in the first few weeks of life.

Signs and Symptoms

  • Flat, blue-grey, green-blue, or brown appearance
  • Can be one spot or multiple in close proximity to each other.
  • Can be very large.
  • Often found on buttocks and shoulders.

Treatment

  • Usually no treatment, as the birthmark is benign.
  • Usually disappear in childhood, but may never fade.

Blue Feet/Extremities (Acrocyanosis)

Acrocyanosis occurs when there is poor blood flow, normally to the hands or feet. It is usually due to infants being cold, and quickly resolves when they are warmed up.

Signs and Symptoms

  • Bluish-purple color of skin.
  • Often occurs in areas in extremities, especially the palms of the hands and soles of the feet.

Treatment

  • Normally quickly resolves after warming the infant.

If there is any bluish-purple color on centrally-located body parts (chest, stomach, face), this is not normal and may be serious. Please contact your doctor immediately.

Hives (Allergic reactions)

Hives are a skin condition marked by red, raised bumps. They are caused by an irritating item or allergic reaction. Hives will appear relatively quickly after the exposure, usually within a few minutes. Hives often resolve within a few hours or days, but keep a close eye for any other symptoms, as it may be part of a serious allergic reaction, requiring immediate medical attention.

Signs and Symptoms

  • Red bumps – oftenlook like mosquito bites but can appear blotchy
    • May form anywhere on the body
    • Usually form in clusters
  • Itching and irritation

Common Causes

  • Foods
  • Pollen or pet dander/hair
  • Insect bites
  • Exposure to sun or cold
  • Contact with chemicals such as soaps and laundry detergents

Treatment

  • Cool compresses – apply directly to affected area but do not rub
  • Loose-fitting clothes – loose cotton clothing is less likely to irritate hives further

If your baby is older than 6 months, medications may be given, but contact your doctor for proper guidance and dosage

Jaundice

Jaundice is relatively common in newborns. Jaundice is caused by an excess of an enzyme called Bilirubin. It is characterized by the skin and white part of eye (sclera) turning yellow.

Signs and Symptoms

  • Yellow color to skin and white portion of eye (sclera)
    • Often appears within a few days after birth
  • Pale-colored stool
  • Dark-colored urine

Treatment

  • Often resolves on its own within 7-10 days
  • Light therapy (phototherapy) – The newborn is placed under a special light that breaks down the excess bilirubin into a safe form that the body can expel.

Jaundice is often not life-threatening in newborns, but if it does not resolve within 2 weeks, treatment may be needed. If your baby’s skin appears yellow, contact your doctor, as they will most likely want to examine them.