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NEW YORK (October 18, 2006)
* Almost right from the beginning of a child's life, parents encourage their
children to be healthy eaters while being active and fit. This also is an
important time to promote healthy skin care. Whether washing the delicate skin
of an infant or providing effective treatment for toddlers with eczema, there
are numerous ways parents and dermatologists can work together to keep
children's skin clean, healthy and nourished.
Speaking today at the American Academy of Dermatology's (Academy) Academy,
dermatologist Sandra M. Johnson, MD, FAAD, clinical assistant professor of
dermatology at the University of Arkansas for Medical Sciences in Little Rock,
Ark., discussed daily skin care for children and the treatment of common
pediatric skin care conditions.
"Teaching your child healthy skin care habits and modeling these behaviors for
them can be tremendously helpful in preventing and treating various skin
conditions," said Dr. Johnson. "A dermatologist is an important member of your
child's healthcare team and if parents have concerns about their child's skin,
hair or nails, I recommend that they establish a relationship with a
dermatologist so that as their child grows, their skin and body care can
continue to progress on a healthy note."
Daily Skin Care for Children
The skin of toddlers is sensitive and can experience numerous changes in the
first few years of life. Parents may be concerned by their child's
less-than-perfect skin, but a dermatologist can evaluate and determine which
conditions will resolve themselves and which may need additional treatment.
When cleaning a toddler's skin or when it's time for toddlers to learn how to
wash their own skin, the use of gentle cleansers and soaps is important, stated
Dr. Johnson. Fragrance-free products or those with natural ingredients work
well and will not irritate sensitive skin. Emollients which will hold moisture
in the skin and prevent dry skin conditions and rashes should be applied
Most important of all, recommends Dr. Johnson, is to start children with a
strong foundation in sun safety. The regular use of sunscreen is one of the
best "sun-smart" tips to share with children. Dermatologists strongly recommend
using a sunscreen with broad-spectrum protection from both ultraviolet A (UVA)
and ultraviolet B (UVB) rays and that offers a Sun Protection Factor (SPF) of 15
If your child is prone to skin irritation or allergic reactions, choose a
physical or chemical-free sunscreen made with zinc oxide or titanium dioxide
because the ingredients sit on top of the skin, forming a barrier against the
sun's rays. If you do use a chemical-based sunscreen, do a patch test first to
make sure your child won't have a reaction to it. Apply a small amount to the
inside of the upper arm. If he or she develops a rash or redness at the site by
the next day, choose another formula instead.
"Early initiation of sun protection behaviors by parents and consistent use
throughout life can help decrease a child's lifetime risk of developing skin
cancer," stated Dr. Johnson. "Modeling the use of sunscreen and other
sun-protection habits, such as the wearing sun-protective clothing, hats and
sunglasses, and seeking shade whenever possible, is an important way to teach
your children these skills."
Pediatric Skin Infections
Warts are non-cancerous skin growths caused by a viral infection in the top
layer of the skin. Warts occur more easily if the skin has been damaged in some
way, which explains the high frequency of warts in children who are prone to
cuts and scrapes, and who bite their nails or pick at hangnails. In children,
warts can disappear without treatment over a period of several months to years.
However, warts that are bothersome, painful, or rapidly multiplying should be
treated by a dermatologist. There are many treatments for warts, including
topical treatments that are applied directly to the wart such as salicylic acid,
liquid nitrogen or cantharidin.
Less common, but still of concern for children, is the "superbug" or Community
Acquired Methicillin Resistant Staphylococcus Aureaus (CA-MRSA) infection. CA-MRSA
is commonly spread within families and among children in daycare centers or at
local community centers. This condition presents itself as skin and soft tissue
infections, such as cellulitis and abscesses or open sores. Treatment for this
infection includes oral antibiotics such as clindamycin and some tetracyclines.
To prevent CA-MRSA, Dr. Johnson recommends that children wash their hands often,
that cuts and scrapes are quickly cleaned, treated and bandaged, and that
children do not touch other people's wounds or bandages.
As summer peaks, so do the inevitable bug bites. However, Dr. Johnson advises
that parents and children can enjoy a relatively biteproof summer by following a
few practical suggestions aimed at reducing the risk for bug bites.
The most common bug bites are those from fleas, mosquitoes, wasps or bees.
While these bug bites can be annoying and seem fairly harmless, it is possible
to have a bad reaction to a sting. Dr. Johnson recommends having an emergency
allergy kit available, which can be purchased through your doctor.
Some bug bites can cause bacterial infections, such as impetigo, a superficial
infection of the skin characterized by yellow, crusted, well-defined lesions.
Treatment includes topical or oral antibiotics, and infected areas and lesions
should be bandaged until treatment has been determined effective. "Impetigo is
highly contagious and can spread rapidly among children," said Dr. Johnson. "In
many states, a physician's note is required before children can return to
daycare or school."
Before going outdoors, it is important to use insect repellents on the skin and
clothing to be completely protected against bug bites. The active ingredient in
most commercial repellents is either the insecticide permethrin or the chemical
DEET. Repellents containing permethrin should be applied only to clothing,
where the agent has a residual effect through several wash cycles, providing
lasting protection against bugs. In contrast, an insect repellent containing
the chemical DEET should be applied directly onto the skin to ward off
mosquitoes, ticks and other insects.
"While I recommend using an insect repellent with a 10 percent or lower DEET
concentration for children, I do not recommend using a combination sunscreen and
insect repellent because the reapplication of the product will increase the
percentage of DEET on the skin," said Dr. Johnson. "It also is important to
note that insect repellents with DEET should never be used on a baby less than
two months old, as their skin is very sensitive. To avoid irritation, I advise
everyone to wash off the repellent with soap and water once they come inside."
Pediatric Skin Inflammations
Atopic dermatitis or eczema is a common condition found in newborns and young
children. This itchy, oozing, crusting rash occurs mainly on the face and
scalp, but patches can appear anywhere. It is estimated that this condition
affects 10 percent of the U.S. infant population. However, in nearly half of
these children, the disease will improve greatly by the time they are between
five and 15 years of age. Others will have some form of the disease throughout
"Children with eczema are unique patients because it may be difficult for them
to resist scratching, thereby making the condition worse," said Dr. Johnson.
"Fortunately, for mild to moderate cases, the application of moisturizer on a
regular basis can be very helpful. In the meantime, avoid as many eczema
triggers as possible, such as dust, pet dander and mold."
It also may be helpful to use mild soaps, both on your child's skin and on their
clothing, avoid sudden temperature changes, keep your child's bedroom and play
areas free of dust, and dress your child in breathable, preferably cotton,
"Caring for a toddlers skin can be challenging at times, but a soft touch,
common sense and working with a dermatologist can put parents at ease about any
skin conditions that arise," said Dr. Johnson.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations. With a membership of more than
15,000 dermatologists worldwide, the Academy is committed to: advancing the
diagnosis and medical, surgical and cosmetic treatment of the skin, hair and
nails; advocating high standards in clinical practice, education, and research
in dermatology; and supporting and enhancing patient care for a lifetime of
healthier skin, hair and nails. For more information, contact the Academy at
1-888-462-DERM (3376) or www.aad.org
Knowledge is Power.
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